Nick USMLE step 2CK/3 Part4 Quiz - Gradiuz

Nick USMLE step 2CK/3 Part4 Quiz

Quiz generated from Nick USMLE step 2CK/3 Part4

Want to study this quiz?

Copy it to your free Gradiuz library and make it your own.

Make your own from a PDF
Question 1

What is pulsus paradoxus?

  • A decrease in systolic blood pressure >10 mmHg during inspiration
  • An increase in systolic blood pressure >10 mmHg during inspiration
  • A decrease in systolic blood pressure >10 mmHg during expiration
  • An increase in pulse pressure during inspiration
Question 2

A 22-year-old student has studied for 2 days without sleep. She is restless, diaphoretic, tachycardic, has BP 150/90 mmHg, and is behaving bizarrely. What is the most likely diagnosis?

  • Stimulant intoxication
  • Alcohol withdrawal
  • Opioid intoxication
  • Panic attack
Question 3

Ad hoc interpretation by untrained bilingual family members should be avoided in non-emergency medical encounters because it may cause error and bias.

  • True
  • False
Question 4

Which medication is first-line for trigeminal neuralgia?

  • Carbamazepine or oxcarbazepine
  • Phenytoin
  • Gabapentin
  • Amitriptyline
Question 5

Which finding best indicates pyelonephritis rather than cystitis?

  • White blood cell casts
  • Nitrites
  • Hematuria
  • Proteinuria
Question 6

Cri-du-chat syndrome, a chromosomal deletion syndrome, is associated with increased maternal age.

  • False
  • True
Question 7

A pregnant woman has a positive IGRA but no TB symptoms. What is the next best step?

  • Chest x-ray with appropriate shielding
  • Start treatment for latent TB immediately
  • Obtain sputum cultures first
  • Amniocentesis
Question 8

In DKA, the best indicator of treatment response is the serum ___ gap.

Fill in the blank

Question 9

Which infection is the most common cause of a heterophile antibody-negative mononucleosis-like syndrome?

  • Cytomegalovirus
  • Epstein-Barr virus
  • HHV-6
  • Toxoplasmosis
Question 10

A pregnant woman is a known carrier of an autosomal recessive disease. What is the first next step to assess the fetus's risk?

  • Test the father for the same disorder
  • Chorionic villus sampling
  • Amniocentesis
  • Fetal DNA sequencing
Question 11

Screening asymptomatic patients with a smoking or family history for bladder cancer has been shown to improve survival and is recommended.

  • False
  • True
Question 12

Which opioid is preferred in chronic kidney disease because its liver metabolite is inactive?

  • Fentanyl
  • Morphine
  • Codeine
  • Meperidine
Question 13

A patient reports epigastric burning that is provoked by exertion and disappears with rest. What is the most appropriate next test?

  • Exercise ECG
  • Upper endoscopy
  • Cardiac catheterization
  • Reassurance only
Question 14

A 27-year-old man had an episode of syncope without prodrome or positional change, lasting 2 minutes with a few seconds of jerking and no confusion afterward. Which cause is most likely?

  • Cardiac arrhythmia
  • Vasovagal syncope
  • Seizure
  • Orthostatic hypotension
Question 15

A head CT is necessary in this patient because he had a syncopal episode with brief jerking 2 days ago.

  • False
  • True
Question 16

The most common cause of death in end-stage renal disease is ___.

Fill in the blank

Question 17

In end-stage renal disease, the second most common cause of death is infection.

  • True
  • False
Question 18

Arterial thrombosis causing acute limb ischemia occurs most often in patients without preexisting peripheral artery disease.

  • False
  • True
Question 19

A patient with peripheral artery disease faces a greater risk of myocardial infarction than of limb amputation.

  • True
  • False
Question 20

A patient with diabetes plans 30 minutes of aerobic exercise. Which adjustment best reduces the risk of exercise-induced hypoglycemia?

  • Reduce the dose of short-acting insulin given with the preceding meal
  • Reduce both basal and premeal insulin and increase carbohydrate intake
  • Hold the basal insulin dose completely
  • Take extra insulin before exercise
Question 21

For exercise lasting longer than 1 hour in a patient with diabetes, hypoglycemia risk may be reduced by decreasing both basal and premeal insulin and increasing carbohydrate intake, without completely stopping basal insulin.

  • True
  • False
Question 22

A patient asks for a diagnostic test that the physician does not believe is indicated. What is the best initial response?

  • Explore the patient's concerns and motivations
  • Order the test to preserve patient satisfaction
  • Refuse without further discussion
  • Tell the patient the request is unreasonable
Question 23

A study reports a bivariate OR of 3.0 and a multivariate OR of 1.5 for the same exposure. Which OR should guide conclusions?

  • Multivariate (adjusted) OR
  • Bivariate (unadjusted) OR
  • The larger OR
  • The OR closest to 1.0
Question 24

Which medication is a first-line antihypertensive in pregnancy?

  • Labetalol
  • Lisinopril
  • Spironolactone
  • Hydrochlorothiazide

Made with Gradiuz

Turn any PDF into quizzes, flashcards and summaries - free.

Try it yourself