Repeated USMLE Questions Step 2 CK- Review- 8

Q- Which one of the following types of anemia is associated with absent thumbs, café au lait spots, microcephaly and pancytopenia?

A- Aplastic anemia due to parvovirus B19

B- Diamond-Blackfan anemia

C- Fanconi anemia

D- Iron-deficiency anemia

C- Fanconi anemia- It is also associated with absent radii and hyperpigmentation. It is a rare genetic disease characterized by bone marrow failure and developmental abnormalities.

Q- Which one of the following tests is the most reliable to differentiate between fat necrosis of the breast and breast cancer?

A- Core needle biopsy

B- Fine needle biopsy

C- Mammogram

D- Ultrasonography

A- Core needle biopsy- It is more reliable than other listed tests. It involves a larger sample than fine needle biopsy to confirm or exclude the diagnosis of breast cancer.

Q- Which one of the following differentiates left sided congestive heart failure from right sided congestive heart failure?

A- Fluid retention predominates

B- Hepatojugular reflux

C- Peripheral edema

D- Pleural effusion

D- Pleural effusion- In left sided heart failure, dyspnea predominates as it causes pulmonary edema and plural effusion. Common presentations are orthopnea and paroxysmal nocturnal dyspnea. In right sided heart failure, fluid retention predominates, JVD, peripheral edema, hepatomegaly and ascites

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