Master the boards step 2 CK

1150 Pages·2019·7.91 MB·English

by  Conrad Fischer MD

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Master the Boards
USMLE®

Step 2 CK

Fifth Edition

Other Titles by Conrad Fischer

Master the Boards USMLE® Step 3

Other Titles from Kaplan Medical

USMLE Step 2 CK Lecture Notes

Dr. Pestana’s Surgery Notes

Master the Boards
USMLE®

Step 2 CK

Fifth Edition

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of
Medical Examiners (NBME), which neither sponsor nor endorse this product.

All rights reserved under International and Pan-American Copyright Conventions. By payment of the
required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of
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engineered, or stored in or introduced into any information storage and retrieval system, in any form or by
any means, whether electronic or mechanical, now known or hereinafter invented, without the express
written permission of the publisher.

© 2019, 2017, 2015, 2013, 2011 by Conrad Fischer, MD

The authors of the following sections have granted Conrad Fischer, MD, and Kaplan Publishing exclusive
use of their work:

Victoria Hastings, DO, MPH, MS: Part 8, Obstetrics, and Part 9, Gynecology
Niket Sonpal, MD: Part 4, Surgery; Part 7, Pediatrics; and Part 16, Patient Safety

Alina Gonzales-Mayo, MD, and Mena Mirhom, MD: Part 12, Psychiatry
Philip J. Koehler III, DO, MS: Part 5, Sports Medicine

Published by Kaplan Publishing, a division of Kaplan, Inc.
750 Third Avenue
New York, NY 10017

All rights reserved. The text and illustrations of this publication, or any part thereof, may not be reproduced
in any manner whatsoever without written permission from the publisher.

10 9 8 7 6 5 4 3 2 1

ISBN-13: 978-1-5062-3595-0

PART 1:

Chapter 1:

Chapter 2:

Chapter 3:

Chapter 4:

Chapter 5:

Chapter 6:

Chapter 7:

Chapter 8:

Chapter 9:

Chapter 10:

Chapter 11:

Chapter 12:

PART 2:

Table of Contents

About the Authors

Acknowledgments

Introduction

Author’s Note

Internal Medicine

Gastroenterology

Endocrinology

Cardiology

Pulmonology

Infectious Diseases

Fungal, Tropical, and Animal-Borne Diseases

Allergy and Immunology

Rheumatology

Hematology

Neurology

Nephrology

Oncology

Preventive Medicine

PART 3:

PART 4:
PART 5:

PART 6:
PART 7:

PART 8:

PART 9:
PART 10:

PART 11:

PART 12:

PART 13:
PART 14:

PART 15:

PART 16:

Dermatology

Surgery
Sports Medicine

Ear, Nose, and Throat (ENT)
Pediatrics

Obstetrics

Gynecology
Radiology

Ophthalmology

Psychiatry

Emergency Medicine
Ethics

Biostatistics and Epidemiology

Patient Safety

Index

For Test Changes or Late-Breaking Developments

kaptest.com/publishing

The material in this book is up-to-date at the time of publication. However, the
Federation of State Medical Boards (FSMB) and the National Board of Medical
Examiners (NBME) may have instituted changes in the test after this book was
published. Be sure to carefully read the materials you receive when you register
for the test. If there are any important late-breaking developments—or any
changes or corrections to the Kaplan test preparation materials in this book—we
will post that information online at kaptest.com/publishing.

About the Authors

Conrad Fischer, MD, is director of the Internal Medicine residency program
at Brookdale University Hospital and Medical Center in New York City and
associate professor of physiology, pharmacology, and medicine at Touro College
of Osteopathic Medicine in New York City. He teaches USMLE Steps 1, 2, and
3; Internal Medicine Board Review and Attending Recertification; and USMLE
Step 1 Physiology.

Section Authors

Niket Sonpal, MD, is assistant program director of internal medicine
residency at Brookdale Hospital Medical Center in Brooklyn and associate
professor at Touro College of Osteopathic Medicine in New York City. He is a
fellow of the American College of Physicians, a practicing gastroenterologist
and hepatologist focusing on men’s health and women’s health, and co-author of
the best-selling books Master the Boards: USMLE Step 2 CK and Master the
Boards: USMLE Step 3. Dr. Sonpal teaches USMLE, COMLEX, and American
Board of Internal Medicine review.

Victoria Hastings, DO, MPH, MS, is a resident physician in obstetrics and
gynecology at New York Presbyterian Brooklyn Methodist Hospital. She
received her master of public health degree in biostatistics and epidemiology
from Saint Louis University and her doctorate in osteopathic medicine with a
master of science from NYIT College of Medicine. She is section editor of the
obstetrics and gynecology chapters in Master the Boards: USMLE Step 3. She
teaches obstetrics, gynecology, and biostatistics for USMLE Steps 1, 2, and 3.

Mena Mirhom, MD, teaches live lectures in psychiatry for Kaplan Medical.
He is an adjunct professor at several medical schools and is in training at the
Icahn School of Medicine at Mount Sinai’s clinical affiliate in New York City.

Philip J. Koehler III, DO, MS, is a resident in physical medicine and
rehabilitation. He completed an Osteopathic Manipulative Medicine (OMM)
teaching fellowship at the Philadelphia College of Osteopathic Medicine.

Previous contributions by Alina Gonzalez-Mayo, MD, and Elizabeth August,
MD.

Additional resources available at

www.kaptest.com/usmlebookresources

Acknowledgments

Niket Sonpal wishes to acknowledge Mr. Navin Sonpal, Mahendra Patel, Raj
Patel, and Dr. Mukul Arya for their unwavering support, hope, and stance by me
through thick and thin. Without them my path to becoming a physician would
not have been possible.

The authors wish to acknowledge the expert attention to detail of Dr. Ana
Franceschi and Dr. Gabriel Vílchez Molina.

Elizabeth August wishes to acknowledge Professor Edward C. August, Mrs.
Donna M. August, and Eric D. August for their love, generosity, and unwavering
support. Without them, my dreams would not be a reality.

Peer Reviewers/Section Editors

The authors also wish to recognize the contributions of the following peer
reviewers:

GASTROENTEROLOGY: Niket Sonpal

ENDOCRINOLOGY: Chris Paras

CARDIOLOGY: Yury Malyshev

PULMONOLOGY: Chris Paras, Ehizode Udevbulu

INFECTIOUS DISEASES: Richard Cofsky

FUNGAL, TROPICAL, AND ANIMAL BORNE-DISEASES: Richard Cofsky

RHEUMATOLOGY: Nanette Thomas

HEMATOLOGY: Hamza Minhas

NEPHROLOGY: Muhammad Bakhtyar Khan

ONCOLOGY: Hamza Minhas

PREVENTIVE MEDICINE: Herman Lebovitch

DERMATOLOGY: Niket Sonpal

SURGERY: Ravi Kothuru

SPORTS MEDICINE: Philip Koehler

PEDIATRICS: Fernanda Kupferman

OBSTETRICS: Victoria Hastings

GYNECOLOGY: Victoria Hastings

RADIOLOGY: Niket Sonpal

PSYCHIATRY: Mena Mirhom

EMERGENCY MEDICINE: Sandra Scott

•
•
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Introduction

Congratulations! By studying for your Step 2 CK exam, you are well on your
way to becoming a doctor. This book contains information to help you perform
well on the test and target areas of study. Master the Boards USMLE Step 2 CK
offers a complete outline for Step 2 CK preparation in a convenient, colorful
format. For many medical students, this book may be all the review you need,
since your concurrent medical training offers hands-on learning opportunities to
reinforce the medical principles and best practices tested on the USMLE.

Depending on how well you recall the topics in any given section of this book,
you will be able to customize your study appropriately. For example, if you find
yourself not recalling some major topics in the cardiology section, go back and
review your primary texts, and consider supplementing with question banks and
practice questions. Some students like to use a Master the Boards book before
taking an in-depth live course, or to recap the content after the course concludes.

This book contains exam-style questions and it offers the opportunity to test your
knowledge as you review. The answer explanations are another way to reinforce
knowledge. Therefore, this book can be used in tandem with question banks or
any other case studies program.

The Master the Boards series is arranged by medical specialty. Each section
contains:

Tips for recognizing incorrect answers
Mini cases with detailed answer explanations to reinforce learning
Full-color images of relevant items from the text

About the USMLE Step 2 CK

The USMLE Step 2 CK (Clinical Knowledge) is typically taken as the second
test in a series of three national certifying examinations that are necessary to
obtain a license to practice medicine in the United States. Step 2 CK is usually
taken between the end of the third year of medical school and the end of the
fourth year. How is Step 2 CK different from Step 1? Generally speaking, Step
2 CK is more clinically based than Step 1. Although there is no requirement to
take Step 1 before Step 2 CK, this is the typical sequence for U.S. graduates.
According to the test maker, the questions on Step 2 CK measure the ability to
apply medical knowledge, skills, and understanding of clinical science as they
pertain to patient care (under supervision), with emphasis on health promotion
and disease prevention. Clinical Knowledge is one of two components of Step 2;
the other, Clinical Skills (CS), uses model patients to test the ability to perform
in a real clinical setting. Step 2 CK provides the foundation for the safe and
effective practice of medicine by future medical doctors.

Results of the USMLE are reported to medical licensing authorities in the United
States and its territories for use in granting the initial license to practice
medicine. The sponsors of the USMLE are the Federation of State Medical
Boards (FSMB) and the National Board of Medical Examiners (NBME).

About the USMLE Step 2 CK: Exam Blueprint

USMLE Step 2 CK is a computer-based test that will not exceed questions taken
over a 9-hour period. The test is divided into 8 blocks, each of which lasts 60
minutes. Once you have completed a block or your 60 minutes has run out, you
will not be able to go back and review or change any of your work on that block.
You will have 45 minutes of break time, which is used to transition between
blocks and for longer breaks that require you to leave your seat (i.e., authorized
breaks). The computer keeps track of your break time. You must be sure not to
exceed the 45 minutes or you will be penalized by having any overage break
time taken from the 60 minutes allotted for the last block of the test.

Structure of Step 2 CK Questions

The majority of Step 2 CK questions are single best answer (multiple-choice)