USMLE STEP 2 CS Q&A
This publication is for scientific scholars getting ready to the USMLE Step 2 medical talents examination. this can be a mix of a number of selection questions and common assessment and is designed to get you to consider definite facets of the sufferer workup equivalent to differential analysis, workup, and therapy, and different crucial components of the exam.
Please ship requests for development, alterations, and additions to firstname.lastname@example.org. Submissions of a number of selection questions is usually despatched to the e-mail deal with above.
Last replace: 8/2/12.
TABLE OF CONTENTS
- stomach pain
- Acid reflux
- Chest Pain
- Epigastric pain
- Gastrointestinal bleeding
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Oral vancomycin is a second-line agent utilized in sufferers allergic to metronidazole or in sufferers with recurrent illness. - extra critical diarrhea linked to dehydration and/or fever and belly soreness is healthier handled with bowel relaxation, IV hydration, and oral metronidazole or vancomycin. - Proctosigmoiditis may perhaps reply to vancomycin enemas. - Recurrent colitis happens in as much as 20% of sufferers and will be taken care of with an extended process oral metronidazole or vancomycin (up to at least one month). - Reintroduction of ordinary plant life by way of ingestion of probiotics has been recommended as a potential therapy for recurrent or refractory affliction. - Fulminant colitis, characterised via septicemia and/or proof of perforation, calls for emergent laparotomy. - a complete stomach colectomy with ened ileostomy might be lifesaving. . . . . . SYMPTOM: EPIGASTRIC ache A 50 12 months previous guy with epigastric discomfort unrelieved with proton pump inhibitors. You practice an top endoscopy and a mass is located within the belly. You biopsy it and it comes again as a malignant stromal tumor (gastro-intestinal stromal tumor-GIST). The sufferer undergoes resection yet post-op pathology indicates metastases within the liver. the following acceptable remedy is: . a. radiation treatment b. five fluorouracil and cisplatin c. Gleevec d. Do not anything . . . . . solution - the answer's c - Gleevec, a tyrosine kinase inhibitor, has been came across to be tremendous powerful for metastatic gastro-intestinal stromal tumors. . . . A 50 yr outdated guy provides with epigastric discomfort unrelieved with proton pump inhibitors. You practice an higher endoscopy and a mass is located within the belly. You biopsy it and it comes again lymphoma. belly CT experiment exhibits that the mass is complete thickness and 3/4 of the tummy is concerned. the main acceptable treatment during this sufferer is: . a. overall gastrectomy b. Partial gastrectomy c. Chemo-XRT d. Triple remedy for H. pylori . . . . . solution: the answer's C. - therapy or gastric lymphoma is chemo-XRT - surgical procedure is indicated just for issues of the ailment (bleeding, perforation, obstruction) or in all likelihood for degree I ailment constrained to the mucosa. SYMPTOM: FEVERS a three yr outdated undergoes splenectomy for hereditary spherocytosis. Six weeks later, the kid returns to the emergency room with a fever of 104, chills, rigors, and a systolic blood strain of 60. The kid's white blood cellphone count number is 20. the entire following are precise of the kid's probably situation other than: . a. The is extra universal in sufferers who endure splenectomy for malignancy or hematologic illness in comparison to trauma b. the most typical organism concerned is N. meningitides c. young children much less then five years of age present process splenectomy are at better danger d. The is because of a selected loss of immunity to capsulated organisms . . . . . - the answer's b. - publish splenectomy sepsis syndrome is particularly infrequent after splenectomy. - It happens as a rule in sufferers present process splenectomy for non-traumatic symptoms. - the most typical organism excited by PSSS is step pneumoniae.