Common adult inpatient and outpatient presentations with the best next diagnostic or management step, as tested on USMLE Step 2 CK.
49 cards · basic cards · AI-written, checked twice. Edit anything.
- What is the next step in management for a patient with ST-elevation on ECG and ongoing chest pain?
- Emergent reperfusion with percutaneous coronary intervention (PCI)
- Best initial imaging test for a hemodynamically stable patient with suspected pulmonary embolism?
- CT pulmonary angiography
- Preferred imaging for suspected PE when a patient has severe renal impairment or contrast allergy?
- Ventilation-perfusion (V/Q) scan
- First-line outpatient antibiotic for a healthy adult with community-acquired pneumonia and no comorbidities?
- Amoxicillin (or a macrolide)
- Empiric antibiotic regimen for a hospitalized non-ICU patient with community-acquired pneumonia?
- A beta-lactam plus a macrolide
- Acute pancreatitis is diagnosed when at least ____ criteria are met: characteristic abdominal pain, lipase/amylase over 3 times normal, or imaging findings of pancreatitis.
- 2 of 3
- Most useful initial lab test when acute pancreatitis is suspected?
- Serum lipase
- First-line imaging study for suspected acute cholecystitis?
- Right upper quadrant ultrasound
- Best next step when choledocholithiasis is suspected after ultrasound shows a dilated common bile duct but no clear stone?
- MRCP (magnetic resonance cholangiopancreatography)
- Within what time frame should upper endoscopy be performed in a hemodynamically stable patient with an upper GI bleed?
- Within 24 hours
- What drug class is used for primary prophylaxis against variceal hemorrhage in cirrhotic patients with medium or large varices?
- Nonselective beta blockers
- Preferred test to diagnose Clostridioides difficile infection in a symptomatic patient?
- Stool PCR or toxin assay for C. difficile
- First-line treatment for an initial episode of C. difficile colitis?
- Oral vancomycin or fidaxomicin
- Initial management for a hemodynamically stable patient with new-onset atrial fibrillation and rapid ventricular rate?
- Rate control with a beta blocker or nondihydropyridine calcium channel blocker
- Management of atrial fibrillation in a patient who is hemodynamically unstable?
- Immediate synchronized electrical cardioversion