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Neurology · USMLE Step 2 CK

USMLE Step 2 CK Neurology

Clinical neurology presentations and management decisions tested on USMLE Step 2 CK, distinct from the Step 1 tract-and-lesion focus of USMLE Neuro.

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What is the time window for IV tPA administration in acute ischemic stroke from symptom onset?
4.5 hours
What is the first imaging study obtained in a patient with suspected acute ischemic stroke?
Noncontrast CT scan of the head
Name one absolute contraindication to giving IV tPA in acute ischemic stroke.
Active internal bleeding (or a recent intracranial hemorrhage)
Mechanical thrombectomy for large vessel occlusion stroke can be performed up to ____ hours after last known well in carefully selected patients.
24
What clinical scoring system estimates short-term stroke risk after a TIA?
ABCD2 score
What is the first-line drug class for terminating status epilepticus?
Benzodiazepines (e.g., IV lorazepam)
If benzodiazepines fail to stop status epilepticus, what class of agent is given next?
An antiepileptic load such as IV fosphenytoin
What is the first-line treatment for Bell's palsy started within 72 hours of symptom onset?
Oral corticosteroids
A facial droop that spares the forehead (patient can still wrinkle it) suggests a lesion where?
Central, an upper motor neuron lesion such as stroke
What antibody test is most specific for diagnosing myasthenia gravis?
Acetylcholine receptor (AChR) antibody
What bedside test transiently improves ptosis in myasthenia gravis?
Ice pack test
What pulmonary function measurement guides the decision to intubate in a myasthenic crisis?
Forced vital capacity (FVC)
What are the two first-line treatments for Guillain-Barre syndrome?
IVIG or plasmapheresis
Why is respiratory function closely monitored in Guillain-Barre syndrome?
Ascending paralysis can progress to respiratory failure needing mechanical ventilation
What MRI finding pattern is required to diagnose multiple sclerosis?
Lesions disseminated in time and space

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