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USMLE step 2 CK (latest 2021-2022)

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pregnant with active HBV - tx newborn with HBIG and HBV vaccine Beck's triad for tamponade - hypotension, JVD, muffled heart sounds (also pulsus paradoxus). Electrical alternans subarachnoid hemorrhage - increased ADH and BNP --> hyponatremia. Tx - water restriction coccidioidomycosis - SW US, central/south America. Pulm infection - dry cough, weight loss, pleuritic chest pain, erythema multiforme/nodosum, arthralgias histoplasmosis - SE US, mid Atlantic, central US, caves. Acute PNA, but usually asymptomatic. HIV disseminated infection- hilar LAD, pneumonitis, pancytopenia, hepatosplenomegaly, palatal ulcers. tx- IV amphotericin B followed by lifelong itraconazole. Blastomycosis - central US (most in Wisconsin). Often asymptomatic or flu-like Sx. Systemic disease- lytic bone lesions, pulmonary infection, skin lesions. Dx- broad-based budding yeast. Txitraconazole, amphotericin B aspergillosis - invasive in IMCD. CXR - cavitary lesions. CT - pulm nodules, halo sign, air crescent sporotrichosis - subcutaneous infection. Gardeners. Travel up lymphatics for nodules on forearms cryptococcus - pulm infection often asymptomatic. Usually meningoencephalitis in HIV with CD4<200 hemochromatosis infections - Listeria monocytogenes, Yersinia enterocolitica, septicemia - Vibrio vulnificusNarcolepsy treatment - methyldphenidate, modafinil, antidepressants (for cataplexy) galactorrhea - test B-HCG, prolactin, TSH septic abortion - cervical/blood cultures, antibiotics, gentle suction currettage Lesch-Nyhan - x-linked recessive, HPRT deficiency, increased uric acid. Sx - self mutilation, dystonia, spacticity, gout. Presents at 6 months. minimal change disease - tx - prednisone, cyclophosphamide for resistant cases/frequent relapse Sturge-Weber - seizures, retardation, trigeminal port-wine stain, hemi neuro findings, tramline intracranial calcifications tuberous sclerosis - seizures, retardation, intracranial calcifications (tubers), ashleaf spots, adenoma sebaceum (red papules on face) osteogenesis imperfecta - autosomal dominant. Type 1 collagen problem. Type 2 most severe with perinatal fractures and often intrauterine death. Blue sclera, fractures, hypotonia, hearing loss, joint hypermobility, dentinogenesis imperfecta polymyalgia rheumatica - neck/shoulder/hip pain/stiffness. >50 years old, high ESR. Tx- low dose prednisone, high dose for temporal arteritis massive blood transfusion - citrate anticoagulant --> chelates Ca and Mg --> low Ca --> paresthesias, hyperactive reflexes nephrotic syndrome - dyslipidemia, accelerated atherosclerosis, hypercoagulable, risk for MI/stroke, higher infxn susceptibility. Can have renal vein thrombosis, usually with membranous GN

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