Repeated USMLE Questions Step 2 CK- Review- 24

Q- Which of the following is the most common cause of sudden death from congestive heart failure?

A- Arrhythmias

B- Emboli

C- Myocardial infarction

D- Pulmonary edema

A- Arrhythmias- Ventricular arrhythmias are provoked by ischemia leading to sudden death. Beta blockers could prevent it. Meanwhile, beta blockers cannot be given in the acute treatment of congestive heart failure.

Q- A patient presents with fever, neck stiffness, severe headache and photophobia. On examination, there is weakness of the left extremities. Which of the following is the first step of action?

A- Administer ceftriaxone

B- Head CT scan

C- Lumber puncture

D- Neurology consultation

B- Head CT scan- We have to exclude brain abscess before we proceed to treat as a case of meningitis. 

Q- Which one of the following laboratory tests is the most accurate test for diagnosis of polymyalgia rheumatica?

A- Biopsy of the temporal artery

B- C-reactive protein

C- Erythrocyte sedimentation rate

D- Rheumatic factor

A- Biopsy of the temporal artery- All the test on the list can be elevated in a case of polymyalgia rheumatica but the biopsy of the affected artery is the most accurate test.

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2 thoughts on “Repeated USMLE Questions Step 2 CK- Review- 24”

  1. You are right Dr. Cedric. I changed the answer to CT scan of the head. Thank you so much.

  2. Hello Dr !!

    Please I don’t understand the answer on the second question.

    The patient presents with fever,neck stiffness, photophobia which are signs of meningitis but associated with left body weakness which the Bergman syndrome suggesting a cerebral abces. In this situation lumbar puncture is contra-indicated as first intention. The head CT scan should be done first to exclude the mass occupying lesion(cerebral abces) before doing the LP. If the cerebral abces is confirmed LP is contraindicated.

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