Best next diagnostic or management step for adult GI, hepatic, and renal presentations tested on USMLE Step 2 CK.
About this set
39 basic cards for USMLE Step 2 CK Internal Medicine. Set 4 of 7 in USMLE Step 2 CK Internal Medicine. It opens with "A patient has typical GERD symptoms (heartburn, regurgitation) with no alarm" and "A patient with dysphagia also has weight loss and is over 50 years old. What is". Study it alongside the other USMLE Step 2 CK sets below.
39 cards · basic cards · AI-written, checked twice. Edit anything.
- A patient has typical GERD symptoms (heartburn, regurgitation) with no alarm features. What is the best initial management step?
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Empiric trial of a proton pump inhibitor- A patient with dysphagia also has weight loss and is over 50 years old. What is the next diagnostic step?
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Upper endoscopy (EGD)- A barium esophagram shows a dilated esophagus with distal tapering ('bird's beak'). What diagnosis does this suggest?
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Achalasia- After a barium esophagram suggests achalasia, what test confirms the diagnosis?
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Esophageal manometry- Which single lab test is most useful for diagnosing acute pancreatitis?
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Serum lipase- Diagnosing acute pancreatitis requires meeting 2 of which 3 criteria?
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Characteristic abdominal pain, lipase or amylase over 3 times the upper limit of normal, and characteristic imaging findings- What is the best initial imaging study for suspected acute cholecystitis?
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Right upper quadrant ultrasound- RUQ ultrasound is equivocal for acute cholecystitis. What is the next best test?
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HIDA scan (cholescintigraphy)- A patient has a dilated common bile duct and rising liver enzymes suggesting choledocholithiasis. What is the best next imaging step?
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MRCP (magnetic resonance cholangiopancreatography)- A hemodynamically stable patient presents with an acute upper GI bleed. Within what timeframe should endoscopy be performed after resuscitation?
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Within 24 hours- A cirrhotic patient presents with suspected variceal hemorrhage. What medication should be started before endoscopy?
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Octreotide- A hospitalized patient develops new watery diarrhea after antibiotic use. What is the best initial diagnostic test?
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Stool PCR or toxin assay for Clostridioides difficile- What is the best initial screening test for celiac disease?
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Tissue transglutaminase IgA antibody (tTG-IgA)- A patient has a positive tTG-IgA antibody test. What confirms the diagnosis of celiac disease?
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Duodenal biopsy showing villous atrophy- A patient with suspected peptic ulcer disease needs testing for H. pylori without endoscopy. Which noninvasive tests are used?
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Urea breath test or stool antigen test
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