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Master the Boards USMLE Step 2 CK, 6th Edition (2021)

With Master the Boards USMLE Step 2 CK, 6th Edition (2021), you�ll gain valuable insights into exam trends and question difficulty levels.

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    Master the Boards USMLE ® Step 2 CK Sixth Edition Conrad Fischer, MD

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    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

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    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. This publication is designed to provide accurate information in regard to the subject matter covered as of its publication date, with the understanding that knowledge and best practice constantly evolve. The publisher is not engaged in rendering medical, legal, accounting, or other professional service. If medical or legal advice or other expert assistance is required, the services of a competent professional should be sought. This publication is not intended for use in clinical practice or the delivery of medical care. To the fullest extent of the law, neither the publisher nor the editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. © 2021, 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: 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: 978-1-5062-5459-3 Kaplan Publishing print books are available at special quantity discounts to use for sales promotions, employee premiums, or educational purposes. For more information or to purchase books, please call the Simon & Schuster special sales department at 866-506-1949. 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, Mena Mirhom, MD, and Niket Sonpal, 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

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    Table of Contents

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    Title Page Other Titles Copyright Page Table of Contents About the Authors Acknowledgments Introduction PART 1: Internal Medicine Chapter 1: Gastroenterology Chapter 2: Endocrinology Chapter 3: Cardiology Chapter 4: Pulmonology Chapter 5: Infectious Diseases Chapter 6: Fungal, Tropical, and Animal-Borne Diseases Chapter 7: Allergy and Immunology Chapter 8: Rheumatology Chapter 9: Hematology Chapter 10: Neurology Chapter 11: Nephrology Chapter 12: Oncology PART 2: Preventive Medicine PART 3: Dermatology PART 4: Surgery PART 5: Sports Medicine PART 6: Ear, Nose, and Throat (ENT) PART 7: Pediatrics PART 8: Obstetrics PART 9: Gynecology PART 10: Radiology PART 11: Ophthalmology PART 12: Psychiatry PART 13: Emergency Medicine PART 14: Ethics PART 15: Biostatistics and Epidemiology PART 16: Patient Safety

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    For Test Changes or Late-Breaking Developments kaptest.com/retail-book-corrections-and-updates 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 aer 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/retail-book-corrections-and-updates.

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    Additional resources available at https://www.kaptest.com/usmle-step-2ck/free/mtb-step-2ck-qbank- free-trial

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    About the Authors Conrad Fischer, MD, is program director of the Internal Medicine residency program at Brookdale University Hospital and Medical Center, as well as professor of 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.

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    SECTION AUTHORS Niket Sonpal, MD, is assistant professor at Touro College of Osteopathic Medicine in New York City and a fellow of the American College of Physicians. He is 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. 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 Elizabeth August, MD, Alina Gonzalez-Mayo, MD, and Mena Mirhom, MD.

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    Peer Reviewers/Section Editors Pharmacology (throughout the book): Ed El Sayed Cardiology : Yury Malyshev, Hal Chadow Dermatology : Niket Sonpal Emergency Medicine : Sandra Scott Endocrinology : Chris Paras Fungal, Tropical, and Animal-Borne Diseases : Richard Cofsky Gastroenterology : Niket Sonpal Hematology : Hamza Minhas Infectious Diseases : Richard Cofsky Nephrology : Muhammad Bakhtyar Khan Neurology : Alexander Andreev Obstetrics/Gynecolog : Victoria Hastings Oncology : Hamza Minhas Pediatrics : Conrad Fischer Preventive Medicine : Herman Lebovitch Psychiatry : Mena Mirhom, Peter You Pulmonology : Seth Wenig, Sonu Shani Radiology : Niket Sonpal Rheumatology : Chris Paras Sports Medicine : Philip Koehler Surgery : Conrad Fischer

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    Acknowledgments The authors wish to acknowledge the expert attention to detail of Dr. Ana Franceschi and Dr. Gabriel Vílchez Molina. 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. Victoria Hastings wishes to acknowledge her husband, who lis me up and pushes me to achieve great things.

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    Introduction About the USMLE Step 2 CK Examination The USMLE Step 2 CK (Clinical Knowledge) is typically taken as the second test in a series of 3 certifying examinations that are necessary to obtain a license to practice medicine in the United States. Step 2 CK is usually taken in medical school between the end of years 3 and 4. The most common mistake in preparation is doing the same single question bank over and over! Do as many different questions as you can. Step 2 CK is more clinically based than Step 1. Although there is no requirement to take Step 1 before Step 2 CK, that 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. Step 2 CS (Clinical Skills) is the second part of the USMLE Step 2 exam; it uses model patients to test the ability to perform in a real clinical setting.

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    Step 2 CK Examination Structure USMLE Step 2 CK is a computer-based test that will not exceed 318 questions taken over a 9-hour period. USMLE Step 2 CK uses 2 types of questions: single best answer (most common type) and sequential. USMLE Step 2 CK questions have to be unequivocally clear. If an area is controversial, USMLE will avoid it, and ask only what is clear. The exam will not trick you. SINGLE BEST ANSWER The majority of Step 2 CK questions are multiple-choice questions that follow a clinical vignette. The basic structure is: Eight blocks, each one 60 minutes Once you have completed a block or 60 minutes has run out, you will not be able to go back to any questions in that block. The total break time throughout the day will be 45 minutes. The computer will keep track of your break time. Be sure not to exceed the 45 minutes or you will be penalized by having time deducted from your last block of the test.

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    There are 5 basic question types (and consequently, the very structure around which this book is created): When the question reads: “ What is the most appropriate next step in management? ” this can refer to a test or a treatment. The phrase “most appropriate next step” can also be referred to as action, management, or simply what should you do next? The phrase “most appropriate” can be very difficult to interpret. It is not always clear whether it means “first,” “best,” or “most accurate.” The most frequently asked question on Step 2 CK is “ What is the most likely diagnosis? ” As a result, many of the chapters in this book have a specific section labeled “What is the most likely diagnosis?” One of the many unique attributes of the Master the Boards format is that the History of present illness Physical examination Possibly laboratory and radiologic tests What is the most likely diagnosis ? What is the best initial diagnostic test ? What is the most accurate diagnostic test ? What physical finding is most likely to be associated with this patient? What is the best initial therapy ?

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