First Aid USMLE Step 2 CK Cases

577 Pages·2010·5.16 MB·English

by  Tao Le

FIRST AID
™
CASES
FOR THE
USM LE
STEP 2 CK
Second Edition
TAO LE, MD, MHS
Assistant Clinical Professor of Pediatrics and Medicine
Division of Allergy and Clinical Immunology
Department of Pediatrics
University of Louisville
ELIZABETH EBY HALVORSON, MD
Vanderbilt School of Medicine
Class of 2009
Resident
Department of Pediatrics
Wake Forest University Baptist Medical Center
New York / Chicago / San Francisco / Lisbon / London / Madrid / Mexico City
Milan / New Delhi / San Juan / Seoul / Singapore / Sydney / Toronto
Copyright © 2010, 2007 by Tao Le. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be repro-
duced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.
ISBN: 978-0-07-162926-3
MHID: 0-07-162926-2
The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-162570-8, MHID: 0-07-162570-4.
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DEDICATION
To the contributors to this and future editions, who took time to share their
knowledge, insight, and humor for the benefi t of all those who yearn to pass
their boards.
and
To our families, friends, and loved ones, who encouraged and assisted us in
the task of assembling this guide.
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CONTENTS
Contributing Authors xv
Senior Reviewers xvii
Preface xix
Acknowledgments xxi
How to Contribute xxiii
Cardiology 1
Case 1: Abdominal Aortic Aneurysm 2
Case 2: Acute Cardiogenic Pulmonary Edema 3
Case 3: Acute Coronary Syndrome 4
Case 4: Aortic Dissection 6
Case 5: Acute Myocardial Infarction—Long-Term Management 8
Case 6: Aortic Regurgitation 9
Case 7: Atrial Fibrillation 10
Case 8: Cardiac Tamponade 12
Case 9: Congestive Heart Failure 14
Case 10: Deep Venous Thrombosis 16
Case 11: Dilated Cardiomyopathy (Alcoholic) 18
Case 12: Diastolic Heart Failure 20
Case 13: Aortic Stenosis 21
Case 14: Hypercholesterolemia 22
Case 15: Hypertension—Essential 23
Case 16: Hypertension—Renal Artery Stenosis 24
Case 17: Hypertrophic Obstructive Cardiomyopathy 26
Case 18: Infective Endocarditis 28
Case 19: Myocardial Infarction 30
Case 20: Papillary Muscle Rupture 32
Case 21: Pericarditis 34
Case 22: Peripheral Vascular Disease 36
Case 23: Mitral Regurgitation 37
Case 24: Second-Degree Heart Block 38
Case 25: Wolff-Parkinson-White Syndrome 40
Dermatology 43
Case 1: Acanthosis Nigricans 44
Case 2: Acne Vulgaris 46
Case 3: Atopic Dermatitis 47
v
Case 4: Basal Cell Carcinoma 48
Case 5: Bullous Pemphigoid 50
Case 6: Herpes Simplex 51
Case 7: Hidradenitis Suppurativa 52
Case 8: Kaposi Sarcoma 53
Case 9: Lichen Planus 54
Case 10: Molluscum Contagiosum 56
Case 11: Pemphigus 58
Case 12: Pityriasis Rosea 60
Case 13: Psoriasis 62
Case 14: Stevens-Johnson Syndrome 64
Case 15: Varicella-Zoster Virus 66
Case 16: Tuberous Sclerosis 68
Case 17: Onychomycosis 69
Case 18: Melanoma 70
Endocrinology 71
Case 1: Acromegaly 72
Case 2: Cushing’s Syndrome 74
Case 3: Adrenal Insuffi ciency (Addison’s Disease) 76
Case 4: Diabetes Insipidus 77
Case 5: Diabetes Mellitus, Type 1 78
Case 6: Diabetic Ketoacidosis 79
Case 7: Hyperthyroidism (Graves’ Disease) 80
Case 8: Hypokalemia (Hyperaldosteronism) 82
Case 9: Hyperparathyroidism 84
Case 10: Hypothyroidism (Hashimoto’s Thyroiditis) 85
Case 11: Multiple Endocrine Neoplasia, Type I 86
Case 12: Metabolic Syndrome 88
Case 13: Multiple Endocrine Neoplasia, Type II 89
Case 14: Osteoporosis 90
Case 15: Paget’s Disease of Bone 92
Case 16: Pheochromocytoma 94
Case 17: Syndrome of Inappropriate Antidiuretic Hormone Secretion 96
Case 18: Thyroid Nodule 98
Case 19: Subacute Granulomatous Thyroiditis (de Quervain’s Thyroiditis) 100
Epidemiology and Preventive Medicine 101
Case 1: Bias and Confounding 102
Case 2: Bioterrorism 104
Case 3: Breast Cancer Screening 106
Case 4: Cohort Studies 108
Case 5: Health Care Screening 109
Case 6: Incidence and Prevalence 110
Case 7: Infl uenza Vaccine 112
vi
Case 8: Obesity Effects on Health 114
Case 9: Randomized Clinical Trial 116
Case 10: Sensitivity and Specifi city 118
Case 11: Reliability and Validity 120
Case 12: Positive Predictive Value, and Negative Predictive Value 121
Ethics and Legal Issues 123
Case 1: Confi dentially and Disclosure 124
Case 2: End-of-Life Issues (Advance Directives and Withdrawal of Care) 125
Case 3: Informed Consent 126
Case 4: Minors 127
Gastrointestinal 129
Case 1: Acute Cholecystitis 130
Case 2: Acute Pancreatitis 132
Case 3: Achalasia 134
Case 4: Carcinoid 135
Case 5: Colorectal Cancer 136
Case 6: Celiac Disease 138
Case 7: Diverticulitis 139
Case 8: Esophageal Carcinoma 140
Case 9: Gastroesophageal Refl ux Disease 141
Case 10: Hemochromatosis 142
Case 11: Hiatal Hernia 144
Case 12: Infl ammatory Bowel Disease 146
Case 13: Liver Cirrhosis 148
Case 14: Irritable Bowel Syndrome 150
Case 15: Peptic Ulcer Disease 151
Case 16: Primary Sclerosing Cholangitis 152
Case 17: Pseudomembranous Colitis 153
Case 18: Small Bowel Obstruction 154
Case 19: Spontaneous Bacterial Peritonitis 156
Case 20: Viral Hepatitis 157
Case 21: Wilson’s Disease 160
Case 22: Zollinger-Ellison Syndrome 162
Hematology/Oncology 163
Case 1: Acute Myelogenous Leukemia 164
Case 2: Acute Lymphoblastic Leukemia 166
Case 3: Amyloidosis 167
Case 4: Chronic Lymphocytic Leukemia 168
Case 5: Factor V Leiden 170
Case 6: Fanconi’s Anemia 171
Case 7: Glucose-6-Phosphate Dehydrogenase Defi ciency 172
Case 8: Hairy Cell Leukemia 174
vii
Case 9: Hemophilia 175
Case 10: Hodgkin’s Lymphoma 176
Case 11: Microcytic Anemia 178
Case 12: Multiple Myeloma 180
Case 13: Idiopathic Thrombocytopenic Purpura 182
Case 14: Neutropenia 183
Case 15: Polycythemia 184
Case 16: Sickle Cell Anemia 186
Case 17: α-Thalassemia 188
Case 18: Hemorrhage, Drug-Induced 190
Case 19: Thrombotic Thrombocytopenic Purpura with Hemolytic Uremic Syndrome 191
Case 20: Porphyria 192
Case 21: Transplant Rejection 193
Case 22: von Willebrand’s Disease 194
Infectious Disease 195
Case 1: AZT-Induced Anemia 196
Case 2: Chlamydia 197
Case 3: Gonococcal Infection 198
Case 4: Histoplasmosis 200
Case 5: Infectious Mononucleosis 201
Case 6: Lyme Disease 202
Case 7: Malaria 204
Case 8: Methicillin-Resistant Staphylococcus aureus 206
Case 9: Necrotizing Fasciitis 208
Case 10: Neutropenic Fever 209
Case 11: Osteomyelitis 210
Case 12: Pneumocystosis 212
Case 13: Endocarditis 214
Case 14: Rocky Mountain Spotted Fever 215
Case 15: Septic Arthritis 216
Case 16: Thrombophlebitis 217
Case 17: Urinary Tract Infection 218
Musculoskeletal and Connective Tissue 219
Case 1: Ankylosing Spondylitis 220
Case 2: Carpal Tunnel Syndrome 222
Case 3: Compartment Syndrome 223
Case 4: Dermatomyositis 224
Case 5: Duchenne Muscular Dystrophy 225
Case 6: Herniated Lumbar Disk 226
Case 7: Gout 228
Case 8: Fibromyalgia 229
Case 9: Juvenile Rheumatic Arthritis 230
Case 10: Legg-Calvé-Perthes Disease 231
viii
Case 11: Osteosarcoma 232
Case 12: Rheumatoid Arthritis 234
Case 13: Scleroderma 236
Case 14: Spinal Stenosis 238
Case 15: Systemic Lupus Erythematosus 240
Case 16: Slipped Capital Femoral Epiphysis 242
Case 17: Osteoarthritis 244
Case 18: Takayasu Arteritis 245
Case 19: Temporal Arteritis 246
Case 20: Polymyalgia Rheumatica 247
Neurology 249
Case 1: Amyotrophic Lateral Sclerosis 250
Case 2: Dementia 252
Case 3: Epidural Abscess 254
Case 4: Epidural Hematoma 256
Case 5: Glaucoma 258
Case 6: Glioblastoma Multiforme 260
Case 7: Guillain-Barré Syndrome 262
Case 8: Headache 264
Case 9: Huntington’s Disease 266
Case 10: Infantile Spasms 267
Case 11: Internuclear Ophthalmoplegia 268
Case 12: Benign Positional Paroxysmal Vertigo 269
Case 13: Meningitis 270
Case 14: Multiple Sclerosis 272
Case 15: Myasthenia Gravis 275
Case 16: Partial Complex Seizures 276
Case 17: Stroke 278
Case 18: Parkinson’s Disease 281
Case 19: Subacute Combined Degeneration 282
Case 20: Subarachnoid Hemorrhage 284
Case 21: Subdural Hematoma 286
Case 22: Tonic-Clonic Seizures 288
Case 23: Tabes Dorsalis 290
Obstetrics 291
Case 1: Abortion 292
Case 2: Contraception 293
Case 3: Deep Venous Thrombosis 294
Case 4: Disseminated Intravascular Coagulation 295
Case 5: Ectopic Pregnancy 296
Case 6: Fetal Monitoring 298
Case 7: Gestational Diabetes 300
Case 8: Hydatidiform Mole 302
ix