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Repeated USMLE Questions Step 2 CK- Review- 6

Q- A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition?

A- Ethosuximide

B- Felbamate

C- Phenytoin

D- Topiramate

C-Phenytoin- This is a typical case of tonic-clonic seizure (grand mal epilepsy) and phenytoin is the initial drug of choice. It prevents further attacks in the future.

 

Q- In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient?

A- Hepatojugular reflux

B- Kussmaul sign

C- Raynaud’s phenomenon

D- S3 gallop

B-Kussmaul sign- It is positive when venous pressure increases with inspiration.

 

Q- A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg.

Which of the following is the immediate treatment of this case?

A- Fasciotomy and tissue perfusion

B- Intravenous broad-spectrum antibiotics

C- Referral to orthopedics

D- Send home and observation

A-Fasciotomy and tissue perfusion- This is a typical case of compartment syndrome with the 6 Ps. Immediate fasciotomy to decrease pressure and increase tissue prefusion is life saving emergency.



More Repeated USMLE Questions Step 2 CK

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