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Repeated USMLE Questions Step 2 CK- Review- 4

Q- A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size.

Which one of the following nerves is affected in this patient?

A- Left oculomotor nerve

B- Left optic nerve

C- Right oculomotor nerve

D- Right optic nerve

B-Left optic nerve- Consensual light reflex differentiates between optic nerve injury vs oculomotor nerve injury. It is lost in optic nerve injury while it is intact in oculomotor nerve injury.



Q- A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray?

A- Boot-shaped heart

B- Enlarged cardiac shadow in both directions

C- Left ventricular hypertrophy

D- Right ventricular hypertrophy

C-Left ventricular hypertrophy- This is a case of aortic stenosis. Left ventricular hypertrophy occurs in most cases followed by other features. Boot-shaped heart characterizes tetralogy of Fallot. Right ventricular hypertrophy may occur later in the process while B is seen in cardiac tamponade.



Q- A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management?

A-Broad spectrum antibiotics to avoid meningitis

B-Manual compression of the lesion

C-Immediate lumber puncture

D-Urgent surgical interference

D-Urgent surgical interference- This is a severe form of spina bifida called myelomeningocele. It is an emergency as it may affect respiration and vital organs.



Other Repeated USMLE Questions Step 2 CK

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