Bonus
First Aid Microbiology Tables
These Tables were cut from the 2010 First Aid Edition and are provided here:
Step 1 First Aid Casebook
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- A woman rushes her 65-year-old husband into the emergency department after he said he felt crushing chest pain while eating a steak. Blood work is ordered and the physician finds that the man’s cholesterol is very high and that the man most likely had an acute myocardial infarction because of the finding of elevated enzymes. - A 4-year-old boy is brought to the emergency department after being seen shaking on the floor. He had been playing with a video game when the episode began. He has no prior history of seizures or neurologic disorders. The episode resolved after 2 minutes. What is the most likely diagnosis for this patient? Most likely, - A newborn boy is found to have an increased head circumference, macroglossia, an umbilical hernia, lethargy, and a hoarse cry. The mother has no significant past medical history, takes no medications, and received adequate prenatal care. His serum thyroxine (T4) concentration is ~50% that of normal infants. What is the most likely diagnosis? Congenital hypothyroidism - A 56-year-old homeless man with a history of alcohol abuse is found unconscious on a street corner. He is brought into the emergency department for monitoring. He is found to have a temperature of 38.9°C (102°F). X-ray of the chest is significant for pleural effusion, empyema, and cavitation of his right upper lobe. As he - A third-year clerk on medical rounds notices that a large majority of his patients have either hypertension or congestive heart failure. He realizes that in treating both of these conditions, one class of drugs is commonly used. What class of drugs is commonly used for these two conditions? List examples of drugs within this class? - A 47-year-old man presents to his physician for his annual check-up. He reports that he does not smoke, consumes a reasonable diet, exercises regularly, and drinks less than one drink per week. He does not take any medications or supplements. Family history is notable for the death of his father at age 55 years from - A 70-year-old man with type 2 diabetes mellitus (DM) and benign prostatic hyperplasia (BPH) is rushed to the emergency department after being found by his weekly visiting nurse to be lethargic, disoriented, and barely conscious. She found that his pill box was full of last week’s diabetes and BPH medications. On physical examination, the patient - A 35-year-old nurse presents to the emergency department complaining of heart palpitations. She has also been jittery, hot, and sweaty for several hours. She has lost 15 lb (6.8 kg) in the past 2 months, missed her period in the last month, and has had frequent bouts of diarrhea ever since her fiancé cheated on - A 42-year-old man suffers a high-speed motor vehicle collision with a tree and police quickly respond to the scene to find the man with an extremely faint pulse. The man is rushed to the emergency department. The patient is slipping in and out of consciousness, and the attending physician quickly gives the man hexamethonium because - A 56-year-old man presents to the emergency department with fevers, chills, and a feeling of malaise. He states that the onset of symptoms was gradual. His past medical history is significant for replacement of his aortic valve 6 months ago. On physical examination, there is a 2/6 systolic ejection murmur that was not noted previously.
Step 1 USMLERx Questions
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- A 45-year-old man who is of Scandinavian descent presents to the physician with hematuria, left-sided flank pain, and a palpable mass in his left flank. He undergoes a kidney biopsy and is diagnosed with renal cell carcinoma. Radiographic findings suggest metastatic disease to his lung. He is initiated on a chemotherapy regimen that includes an - A 56-year-old obese man comes to the emergency department because of crushing chest pain that has been present for 3 hours. The pain radiates to his left arm and neck. He also complains of nausea. On physical examination, the patient is found to be sweating and his blood pressure is 164/122 mm Hg. Laboratory analysis - A 67-year-old man presents to the emergency department because of acute chest pain that began more than 6 hours ago. ECG shows elevated ST-segments in three consecutive leads. If a biopsy of the affected tissue were taken at this point, bands would be visible under the microscope. What is the best explanation for the presence - A 25-year-old man comes to the physician with constipation, polyuria, polydipsia, hyporeflexia, and lethargy. Laboratory studies confirm an abnormality in calcium handling. Which of the following drugs would most likely alleviate these symptoms? A. Acetazolamide B. Furosemide C. Hydrochlorothiazide D. Mannitol E. Parathyroid hormone The correct answer is B. This patient displays the signs and - A 42-year-old man presented to his primary care physician several months ago with complaints of fatigue, loss of appetite, difficulty concentrating, decreased sleep, and feelings of worthlessness. He has been receiving pharmacologic treatment for these symptoms and has now begun to develop symptoms of urinary retention, blurred vision, constipation, and aggravation of his glaucoma. Which - An infant is born prematurely at 34 weeks’ gestation. At birth he exhibits a grimace and has a pink trunk with blue extremities, a pulse of 85/min, some muscle tone, and a respiratory rate of 25/min. What is the infant’s Apgar score? A. 5 B. 6 C. 7 D. 8 E. 9 The correct answer
Step 2CK Casebook
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- Case 20 – A 1-month-old girl with failure to thrive A 1-month-old white girl is sent to the emergency room by her pediatrician for failure to thrive. She was born at full term, weighing 2.72 kg (6 lb), via spontaneous vaginal delivery with no complications. She was discharged to home with her mother and has - Case 19 – A 27-year-old woman with fever and cough A 27-year-old woman presents to her physician because of 5 days of fever and cough. She has no significant past medical history but has been “fighting colds” for the past 3 months, which she attributed to the winter season. She began having low-grade fevers as - Case 18 – A 60-year-old man with significant bleeding A 60-year-old man presents to the emergency department complaining of a persistent nosebleed. His nose began bleeding spontaneously about 3 hours ago, and he has not been able to get it to stop despite direct pressure and ice packs. He denies trauma, blood disorders, cancer, or - Case 17 – A 29-year-old woman with substance dependence A 26-year-old G7P3 woman at 34 weeks’ gestation presents to the emergency department because she feels she is beginning to experience contractions and does not have an obstetrician to consult. On examination her pupils are dilated and she appears agitated and nervous. She then changes her - Case 16 – A 19-year-old man with substance abuse A 19-year-old student is being evaluated at his student health center. The physician notes the young man is tachycardic at 101/min with a blood pressure of 145/93 mm Hg. His pupils are constricted and there is a fine tremor in his hands. The patient appears agitated - Case 15 – A 25-year-old man after a motor vehicle accident A 25-year-old man is brought to the emergency department by ambulance after a motor vehicle accident. The paramedics report that his vehicle, which was not equipped with airbags, hit a telephone pole at a speed of approximately 35 mph. His temperature is 37.0°C (98.6°F), - Case 14 – A 68-year-old man with lower abdominal pain A 68-year-old man presents to the emergency department with severe lower abdominal pain. He has a constant desire to urinate but can only produce a small amount of urine. His past medical history is unremarkable, but he says he has experienced hesitancy before the onset - Case 13 – A 70-year-old man with narcotic overdose A 70-year-old man with a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), myasthenia gravis, and chronic back pain is recovering after a motor vehicle accident. The patient fractured both tibiae and multiple ribs, but remains without serious internal organ injury. His problem - Case 12 – A 35-year-old man with opioid withdrawal A 35-year-old homeless man is admitted to the medical ward for treatment of an acute asthma exacerbation. He has a medical history significant for chronic severe asthma with multiple hospital admissions as well as tobacco use, heroin abuse, hypertension, and chronic, untreated tinea corporis infection. He - Case 11 – A 45-year-old woman with disseminated disease A 45-year-old woman from Cincinnati presents to her physician complaining of cough, dyspnea, fevers, and weight loss. She has been HIV positive for 20 years and has been using highly active antiretroviral therapy for the past decade. Although she continues to take her medications, this past
Step 2CK USMLERx Questions
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- A 2-year-old boy is brought to the clinic for evaluation after 2 days of low-grade tactile fever, irritability, and decreased activity. His mother reports that on waking him this morning, his pillow was stained with a small amount of yellow fluid. His heart rate is 92/min, blood pressure is 104/70 mm Hg, respiratory rate is - A 53-year-old woman with a history of polycystic kidney disease undergoes a renal transplant from a cadaveric donor. She experiences several bouts of acute rejection that are controlled by appropriate increases in immunosuppression during the first year posttransplant. During her fourth posttransplant year her creatinine is rising gradually. Transcutaneous biopsy reveals architectural distortion and sclerosis - A 30-year-old woman presents to a primary care physician for a new patient visit. She reports recurrent episodes of pneumonia, bronchitis, and otitis over the past 4 years. Although her vaccinations were up to date, she developed tetanus following a foot laceration last year. Her lymph nodes and tonsils are enlarged. Laboratory testing reveals low - A 30-year-old man has episodes of wheezing and shortness of breath two to three times per week. Approximately every 2 weeks he awakens at night due to cough and difficulties breathing. He reports having similar symptoms since he was a child, but believes that they are worsening somewhat now. His symptoms are worsened by cold - A 26-year-old woman who is 32 weeks’ pregnant with her first child presents to her obstetrician for a routine visit. Her pregnancy has been uneventful and she has been feeling well, although somewhat anxious over the arrival of her first child. She has blood drawn for glucose levels following a 1-hour glucose tolerance test, but - A 31-year-old woman is brought to the emergency department after a motor vehicle crash. According to the paramedics, her left arm was pinned between the steering wheel and the door, so extrication was prolonged. The patient is fully oriented and complaining of severe pain in her upper arm. She is holding her arm in a - A 63-year-old postmenopausal woman is referred to the gynecologic clinic by her primary care physician for evaluation of genital pruritus of 1 months’ duration. She has a remote history of human papillomavirus infection. She denies changes in vaginal discharge or vaginal bleeding. She also denies constitutional symptoms or weight loss. On examination she is in - Hi, I’m a fourth-year medical student who recently took the Step 2 CK exam. I waited until the very end of the year to take it, which kind of ruined the holidays for me. So my advice is to take the exam a little earlier rather than later, although we know that isn’t always possible.
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