Brochert's Crush Step 2: The Ultimate USMLE Step 2 Review, 4e

444 Pages·2012·11.73 MB·English

BROCHERT’S
2
CRUSH
STEP
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BROCHERT’S
2
CRUSH
STEP
THE ULTIMATE USMLE
STEP 2 REVIEW
FOURTH EDITION
Theodore X. O'Connell, MD
Program Director, Family Medicine Residency Program
Kaiser Permanente Woodland Hills, California
Assistant Clinical Professor, Department of Family Medicine
David Geffen School of Medicine at UCLA, Los Angeles, California
Partner Physician, Southern California Permanente Medical Group
Woodland Hills, California
Mayur K. Movalia, MD
Hematopathologist
Dahl-Chase Pathology Associates
Bangor, Maine
www.cambodiamed.blogspot.com | Best Medical Books | Chy Yong
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Philadelphia, PA 19103-2899
Brochert's Crush Step 2: The Ultimate USMLE Step 2 Review ISBN: 9781455703111
Copyright © 2013 Saunders, an imprint of Elsevier Inc. All rights reserved.
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than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
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With respect to any drug or pharmaceutical products identified, readers are advised to check the most
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To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume
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Previous editions copyrighted 2007, 2003
Library of Congress Cataloging-in-Publication Data
O'Connell, Theodore X.
Brochert's crush step 2 : the ultimate USMLE step 2 review / Theodore
X. O'Connell, Mayur Movalia. – Ed. 4.
p. ; cm.
Brochert's crush step two
Crush step 2
Rev. ed. of: Crush step 2 / Adam Brochert. 3rd ed. c2007.
Includes bibliographical references and index.
ISBN 978-1-4557-0311-1 (pbk. : alk. paper)
I. Movalia, Mayur. II. Brochert, Adam, 1971- Crush step 2. III. Title.
IV. Title: Brochert's crush step two. V. Title: Crush step 2.
[DNLM: 1. Clinical Medicine–Examination Questions. WB 18.2]
616.0076–dc23
2011043807
Acquisitions Editor: James Merritt
Developmental Editor: Christine Abshire
Publishing Services Manager: Peggy Fagen
Project Manager: Deepthi Unni
Design Direction: Steven Stave
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
STUDENT REVIEW
BOARD
Each of the following student reviewers scored within the 99th percentile on the USMLE Step 2. The
authors and publisher express sincere thanks to these students who provided many useful c omments
and helpful suggestions for improving the text and questions that appear in this product.
Keila Ching, MD Lobna Shahatto, MD
Class of 2010 Class of 2010
David Geffen School of Medicine at UCLA David Geffen School of Medicine at UCLA
Los Angeles, California Los Angeles, California
Resident Resident
Internal Medicine Internal Medicine
University of Hawaii Loma Linda University
Honolulu, Hawaii Loma Linda, California
Nzinga Graham, MD Dina Wallin, MD
Resident Physician Resident
Family Medicine Department of Emergency Medicine
Kaiser Permanente UCSF/SFGH
Woodland Hills, California San Francisco, California
Casey Grover, MD Christine J. Yoon, MD
Resident Physician Class of 2010
Stanford/Kaiser Emergency Medicine David Geffen School of Medicine at UCLA
Residency Los Angeles, California
Stanford, California Resident
Emergency Medicine
Christopher Dinh Nguyen, MD Harbor-UCLA Medical Center
Resident Physician, PGY1 Torrance, California
Internal Medicine
UCLA School of Medicine
Los Angeles, California
Joy Sarkar, MD
Resident
Department of General Surgery
Tripler Army Medical Center
Honolulu, Hawaii
v
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CONTENTS
Introduction ix
Using the QR Codes xi
1 Cardiovascular Medicine 1
2 Dermatology 12
3 Ear, Nose, and Throat 24
4 Emergency Medicine 30
5 Endocrinology 34
6 Ethics and Patient Encounters 41
7 Gastroenterology 44
8 General Surgery 57
9 Genetics 71
10 Geriatrics 76
11 Gynecology 78
12 Hematology 89
13 Immunology 98
14 Infectious Disease 103
15 Internal Medicine 114
16 Laboratory Medicine 136
17 Nephrology 138
18 Neurology 143
19 Neurosurgery 156
20 Obstetrics 163
21 Oncology 182
22 Ophthalmology 197
23 Orthopedic Surgery 205
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viii Contents
24 Pediatrics 211
25 Pharmacology 231
26 Preventive Medicine, Epidemiology, and Biostatistics 236
27 Psychiatry 244
28 Pulmonology 255
29 Radiology 261
30 Rheumatology 264
31 Urology 271
32 Vascular Surgery 278
33 Photos, Images, and Multimedia 283
34 Signs, Symptoms, and Syndromes 312
Appendix: Abbreviations 315
Answers 321
INTRODUCTION
This fourth edition of Crush Step 2 attempts to incorporate the many changes that have occurred in
medicine and the exam since 2007, as well as suggestions from readers based on material they encoun-
tered on their exams. For this edition, we have created a student review board composed of recent
students who each scored in the 99th percentile on Step 2. Their input and suggestions have been
invaluable in helping this book reflect the content and structure of the recent USMLE Step 2 exams.
Though the format of the exam is constantly changing, many of the basic concepts you need to know to
be a successful house officer have not changed in decades. If you understand the concepts in this book,
you should do much better than pass: you should Crush Step 2!
Though Step 2 is the same level of difficulty as Step 1, the focus is more clinical and the questions
are more relevant to the everyday practice of medicine. Knowing how to recognize, diagnose, manage,
and treat common conditions is stressed. The exam tests not just theory but practice—in other words,
what you should do next. Treatable emergency conditions are also tested, because you will soon be asked
to take care of patients in the middle of the night, some of whom may require heroic measures if they
are to survive until morning rounds.
Some information from Step 1 is still relevant and high yield for Step 2. Epidemiology and
biostatistics, pharmacology, and microbiology are all tested with a slightly more clinical slant.
Cardiac physiology and pathophysiology and behavioral science are also retested and are high
yield. Overall, though, Step 2 has a different focus, and that focus is clinical. If a patient presented
with chest pain, what would you do? What kinds of questions would you ask him or her? Which
tests would you order? How would you select medications or treatments?
Here are some general tips to keep you focused while studying for and taking the test:
1. Always get more history when it is an option, unless the patient is unstable and you think imme-
diate action is needed.
2. Know the cutoff values for the treatment of common conditions (e.g., at what numbers do you treat
hypertension, diabetes, and hypercholesterolemia; below what CD4 count should you institute
chemoprophylaxis in HIV patients).
3. A presentation might be normal, especially in psychiatry and pediatrics, and require no treatment!
4. Don't forget to study your subspecialties. Just because you never took an ophthalmology or derma-
tology rotation doesn't mean there won't be any basic questions on these topics. You don't have to be
an expert, but knowing common and life-threatening diseases in the subspecialties can significantly
increase your score.
5. Time management during the exam is critical. Make sure you are prepared to answer all of the
questions in the allotted time.
Residency programs generally only see those magic two- and three-digit scores, not the breakdown.
Don't skip studying a subject because you know you aren't going into it—you might miss out on easy
points.
Studying for Step 2 can seem like an overwhelming task. Given the time constraints of medical stu-
dents in their clinical years, most need a concise, high-yield review of the tested topics. It is our hope
that Crush Step 2, fourth edition, will meet your needs in this regard.
Theodore X. O'Connell, MD
Mayur K. Movalia, MD
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