Repeated USMLE Questions Step 2 CK- Review- 2

Q- Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient?

A- Cullen’s sign

B- Grey Tunner sign

C- Murphy’s sign

D- Nikolsky’s sign


The correct answer is A- Cullen’s sign- It is positive if periumbilical discoloration is found in abdominal examination. B- Flank discoloration is also seen in acute pancreatitis. C- It is positive in acute cholecystitis. D- It is positive in pemphigus vulgaris.


Q- A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles.

Which of the following is the most likely initial diagnosis?

A- Crohn’s disease

B- Irritable bowel syndrome

C- Polycystic kidney disease

D- Ulcerative colitis


The correct answer is A- Crohn’s disease- It is characterized by the formation of fistula between different abdominal organs. In this patient there is a fistula between GIT and urinary system.


Q- An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment?

A- Broad spectrum antibiotics

B- Intravenous thiamine

C- Oral lactulose

D- Oral lorazepam


The correct answer is C- Oral lactulose- It helps to trap the ammonia in the colon by binding to it and prevent absorption of ammonia which is the main cause of hepatic encephalopathy.

Repeated USMLE Questions Step 2 CK- Review 1

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