Surgery · USMLE Step 2 CK

USMLE Step 2 CK Surgery

Acute abdomen, trauma triage, and perioperative management scenarios tested on USMLE Step 2 CK.

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Where is McBurney's point located?
Two-thirds of the way from the umbilicus to the anterior superior iliac spine
What is Rovsing's sign?
Palpation of the left lower quadrant causes pain in the right lower quadrant
What does a positive psoas sign indicate?
Pain on hip extension, suggesting retrocecal appendicitis
What does a positive obturator sign suggest?
Pain on internal rotation of the flexed hip, suggesting a pelvic appendix
What is Murphy's sign?
Inspiratory arrest on palpation of the right upper quadrant
Charcot's triad for ascending cholangitis consists of ____.
fever, jaundice, and right upper quadrant pain
What two additional findings turn Charcot's triad into Reynolds' pentad?
Hypotension and altered mental status
What causes Boerhaave syndrome?
Full-thickness esophageal rupture, usually from forceful vomiting
How does a Mallory-Weiss tear differ from Boerhaave syndrome in depth of injury?
Mallory-Weiss is a mucosal tear only; Boerhaave is a full-thickness rupture
What does free air under the diaphragm on an upright chest x-ray indicate?
Perforation of a hollow viscus
A Sister Mary Joseph nodule (periumbilical nodule) suggests what?
Metastatic intra-abdominal malignancy
What does Cullen's sign (periumbilical ecchymosis) indicate?
Retroperitoneal hemorrhage, classically from hemorrhagic pancreatitis
What does Grey Turner's sign (flank ecchymosis) indicate?
Retroperitoneal hemorrhage, classically from hemorrhagic pancreatitis
What is the purpose of Ranson's criteria?
To estimate the severity and mortality risk of acute pancreatitis
What is the first-line imaging study for suspected appendicitis in a pregnant patient?
Ultrasound

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