USMLE Step 2 CK Cheat Sheet

Social Sciences and Patient Safety

10-15% of exam
Consent, Capacity, Confidentiality Patient Safety and Quality Ethics Next Step RCA vs FMEA Capacity Four Elements

Renal, Urinary and Reproductive

7-13% of exam
Electrolytes and Acid-Base Urology and Gynecology Rules Hyponatremia Workup Anion Gap Causes

Cardiovascular System

6-12% of exam
BP Stages and Targets ACS and Arrhythmia Timing Heart Failure and Murmurs Chest Pain Next Step CHA2DS2-VASc Stroke Risk

Musculoskeletal, Skin and Subcutaneous

6-12% of exam
Skin and Joint Emergencies Ortho Decision Rules SJS vs SSSS ABCDE Melanoma Check

Behavioral Health

5-10% of exam
Psychiatry First-Line Choices Serotonin Syndrome vs NMS SIG E CAPS Depression Lithium Level Range

Blood, Lymphoreticular and Immune

5-10% of exam
Transfusion and Coagulation Hypersensitivity and Immunodeficiency TTP vs DIC Hemoglobin 7 Threshold

Gastrointestinal System

5-10% of exam
GI and Liver Cutoffs Crohn vs Ulcerative Colitis Lipase Three Times Normal Ascites Neutrophils 250

Nervous System and Special Senses

5-10% of exam
Neurologic Time Windows Altered Mental Status Picker Delirium vs Dementia Thrombolysis 4.5 Hours

Respiratory System

5-10% of exam
Pulmonary Scores and Cutoffs Acute Dyspnea Picker Transudate vs Exudate CURB-65 Admission Score

Multisystem Processes and Disorders

4-8% of exam
Sepsis and Infection Bundles Toxicology Antidotes First Imaging Picker Sepsis Hour-1 Bundle

Endocrine System

3-7% of exam
Diabetes and Thyroid Numbers DKA vs HHS A1C 6.5 Percent Cutoff Metformin First Line

Pregnancy, Childbirth and Puerperium

3-7% of exam
Prenatal Care Timeline Obstetric Emergencies Bleeding in Pregnancy Previa vs Abruption Prenatal Timing Anchors

Biostatistics and Epidemiology

3-5% of exam
Biostatistics Formulas Study Design and Bias Sensitivity vs Specificity Lead-Time vs Length-Time

Human Development and Well Care

2-4% of exam
USPSTF Screening Ages Adult Immunization Triggers Pediatric Milestones Preventive Visit Picker

Nutrition (Double-Coded Discipline)

15-20% of exam
Nutrition and Deficiency Clues Refeeding Syndrome Thiamine Before Glucose Double-Coded Discipline

Quick Facts

Exam USMLE Step 2 CK
Body NBME and FSMB
Format 16 blocks x 30 min
Items 316 (max 318)
Per block Up to 20 items
Session One 9-hour day
Break 55 minutes minimum
Tutorial 5-minute optional
Pass score 218 three-digit scale
Fee $695 (+$235 abroad)
Attempts 4 lifetime, 3 yearly
Pass rate 98% US MD first-takers
New format Effective May 7, 2026
Provider Prometric test centers

Capacity Four Elements SO

Understand, appreciate, reason, communicate a choice
Capacity is decision-specific Competence is a legal finding Physicians assess capacity

RCA vs FMEA SO

Root cause analysis

After an event
Finds the cause
Retrospective

Failure modes analysis

Before an event
Predicts failure modes
Prospective
Looks back vs forward

Ethics Next Step SO

Adult refuses life-saving care → Assess capacity, then honor
Minor requests contraception → Provide confidentially ( State laws vary )
Unconscious, no surrogate → Treat under implied consent
Family hides the diagnosis → Ask patient preference first
Suspected child abuse → Report to authorities ( Mandatory )
Colleague appears impaired → Report to supervisor
Threat to identified person → Warn and protect
Language barrier at visit → Use trained interpreter ( Not family )

Physician Task Weights SO

Diagnosis 16-20 percent Largest task
Lab/diagnostic studies 13-17 percent
Mixed management 12-16 percent
Pharmacotherapy 8-12 percent
Clinical interventions 6-10 percent
Health maintenance 5-10 percent
Prognosis/outcome 5-9 percent
Systems-based practice 5-7 percent
Professionalism 5-7 percent
Practice-based learning 3-5 percent

Clinical Science Weights SO

Medicine 55-65 percent Overlapping
Pediatrics 17-27 percent
Obstetrics and gynecology 10-20 percent
Psychiatry 10-15 percent
Surgery 5-15 percent
Why totals exceed 100 Items coded to several sciences

Consent, Capacity, Confidentiality SO

Capacity elements Understand, appreciate, reason, communicate
Emancipated minor Married, military, or parent
Minor consent exceptions Contraception, pregnancy, infection, substances
Adult refusing treatment Honor when capacity intact
Surrogate order Agent, spouse, adult child
Advance directive conflict Written directive usually controls
Emergency consent Implied when life threatened
Confidentiality exception Serious harm to others
Mandatory reporting Abuse and certain infections
Impaired colleague Report to supervisor first
Language barrier Use trained medical interpreter

Patient Safety and Quality SO

Root cause analysis Retrospective, after an event
Failure modes analysis Prospective, before an event
Swiss cheese model Aligned system holes
Never event Wrong-site surgery example
Sentinel event Serious unexpected harm
Error disclosure Disclose promptly and honestly
PDSA cycle Plan, do, study, act
Active error Frontline person, immediate effect
Latent error System or design flaw
Surgical time-out Verify patient, site, procedure
Handoff tool SBAR structured communication

Anion Gap Causes RE

MUDPILES for high anion gap acidosis
M: methanol U: uremia D: diabetic ketoacidosis P: propylene glycol I: isoniazid L: lactate E: ethylene glycol S: salicylates

Hyponatremia Workup RE

Any low sodium → Check serum osmolality
Normal serum osmolality → Consider pseudohyponatremia
High serum osmolality → Look for hyperglycemia
Low osmolality, hypovolemic → Isotonic saline
Low osmolality, euvolemic → Treat as SIADH ( Fluid restriction )
Seizure or coma → Hypertonic saline now

Electrolytes and Acid-Base RE

Sodium correction cap 8 mEq/L per 24 hours
Overcorrection risk Osmotic demyelination syndrome
Severe hyperkalemia Calcium gluconate first
Hyperkalemia ECG Peaked T waves
Anion gap Sodium minus chloride minus bicarbonate
Winter formula Expected PaCO2 in acidosis
Symptomatic hypercalcemia Saline, then bisphosphonate
Prerenal azotemia BUN/creatinine over 20
Acute tubular necrosis Muddy brown granular casts
Contrast nephropathy Prevent with isotonic saline

Urology and Gynecology Rules RE

Suspected kidney stone Noncontrast CT abdomen pelvis
Stone under 5 mm Likely passes, add tamsulosin
Testicular torsion Doppler ultrasound, urgent exploration
Pyelonephritis Culture, then empiric antibiotics
Abnormal uterine bleeding Exclude pregnancy first
Postmenopausal bleeding Endometrial biopsy required
Polycystic ovary syndrome Rotterdam, two of three
Ectopic pregnancy Abnormal hCG rise, empty uterus
Emergency contraception Copper IUD most effective

CHA2DS2-VASc Stroke Risk CA

Score 2 or more, anticoagulate
C: heart failure H: hypertension A2: age 75 plus D: diabetes S2: prior stroke V: vascular disease A: age 65-74 Sc: female sex

Chest Pain Next Step CA

ST elevation on ECG → Activate catheterization lab ( Under 90 minutes )
Rising troponin, no elevation → NSTEMI pathway ( Antithrombotics )
Tearing pain to back → CT angiography aorta ( Control blood pressure )
Pleuritic pain with hypoxia → CT pulmonary angiography ( Score risk first )
Absent breath sounds, hypotension → Needle decompression ( Do not image )
Burning, worse lying flat → Trial of PPI ( Reflux )
Reproducible wall tenderness → NSAIDs ( Costochondritis )
Diffuse elevation, PR depression → NSAID plus colchicine ( Pericarditis )

BP Stages and Targets CA

Normal Under 120/80 2025 guideline
Elevated Systolic 120-129, diastolic normal
Stage 1 130-139 or 80-89
Stage 2 140/90 or higher
Universal target Under 130/80
Drug trigger PREVENT risk 7.5 percent
First-line agents Thiazide, ACE inhibitor, CCB
Hypertensive emergency High BP plus organ damage
Emergency lowering rate About 25 percent, first hour

ACS and Arrhythmia Timing CA

STEMI at PCI center Balloon within 90 minutes
STEMI needing transfer Balloon within 120 minutes
No PCI available Fibrinolysis within 30 minutes
First ACS drugs Chewed aspirin, nitrates, heparin
NSTEMI marker Rising troponin, no elevation
Unstable tachycardia Synchronized cardioversion now
Stable narrow SVT Vagal, then adenosine
Pulseless VT or VF Defibrillate immediately
Torsades de pointes Intravenous magnesium sulfate
Atrial fibrillation stroke risk CHA2DS2-VASc 2 or more

Heart Failure and Murmurs CA

HFrEF pillars ARNI, beta-blocker, MRA, SGLT2
BNP use Rules out acute dyspnea
Acute pulmonary edema Oxygen, upright, intravenous furosemide
Aortic stenosis Crescendo-decrescendo, radiates carotids
Mitral regurgitation Holosystolic, radiates axilla
Hypertrophic cardiomyopathy Louder with Valsalva
Aortic regurgitation Decrescendo, wide pulse pressure
Mitral stenosis Opening snap, diastolic rumble
Cardiac tamponade Beck triad, pulsus paradoxus

ABCDE Melanoma Check MS

Asymmetry, Border, Color, Diameter, Evolving
Diameter over 6 mm Evolving matters most Excisional biopsy preferred

SJS vs SSSS MS

Stevens-Johnson

Mucosal erosions present
Drug trigger typical
Full-thickness necrosis

Staph scalded skin

Mucosa spared
Staph toxin mediated
Superficial split
Mucosa involved vs spared

Skin and Joint Emergencies MS

Septic arthritis fluid White cells over 50,000
Gout crystals Negatively birefringent needles
Pseudogout crystals Positively birefringent rhomboids
Stevens-Johnson syndrome Under 10 percent skin
Toxic epidermal necrolysis Over 30 percent skin
Necrotizing infection clue Pain beyond skin findings
Simple cellulitis Cephalexin unless MRSA suspected
Melanoma workup ABCDE, then excisional biopsy
Pemphigus vulgaris Positive Nikolsky, oral erosions
Toxic shock syndrome Fever, rash, later desquamation

Ortho Decision Rules MS

Ottawa ankle rules Tenderness or cannot bear weight
Compartment syndrome Pain with passive stretch
Scaphoid tenderness Splint despite normal x-ray
Open fracture Antibiotics and urgent washout
Elderly hip fracture Surgery within 48 hours
Cauda equina syndrome Urgent MRI, then decompression
Anterior shoulder dislocation Check axillary nerve sensation

SIG E CAPS Depression BE

Five symptoms, two weeks, plus core mood
Sleep, interest, guilt Energy, concentration Appetite, psychomotor, suicidality Need low mood or anhedonia

Serotonin Syndrome vs NMS BE

Serotonin syndrome

Onset within hours
Hyperreflexia and clonus
Cyproheptadine

Neuroleptic malignant

Onset over days
Lead-pipe rigidity
Dantrolene or bromocriptine
Clonus vs rigidity

Psychiatry First-Line Choices BE

Major depression SSRI plus psychotherapy
Antidepressant trial length 4 to 6 weeks
Bipolar mania Lithium or valproate
Lithium therapeutic level 0.6 to 1.2 mEq/L
Schizophrenia Second-generation antipsychotic
Treatment-resistant schizophrenia Clozapine, monitor neutrophils
Alcohol withdrawal Benzodiazepines, symptom-triggered
Opioid use disorder Buprenorphine or methadone
Panic disorder SSRI plus cognitive therapy
Active suicidal intent Ensure safety, hospitalize

TTP vs DIC HE

TTP

Normal PT and PTT
ADAMTS13 deficiency
Plasma exchange

DIC

Prolonged PT and PTT
Low fibrinogen
Treat underlying cause
Clotting times normal vs prolonged

Transfusion and Coagulation HE

Stable transfusion threshold Hemoglobin under 7 g/dL
Prophylactic platelets Count under 10,000
Febrile nonhemolytic reaction Fever, chills, no hemolysis
Acute hemolytic reaction ABO mismatch, stop transfusion
TRALI Hypoxia within 6 hours
Microcytic anemia Check iron studies first
Warfarin reversal Four-factor PCC, vitamin K
Heparin reversal Protamine sulfate
Suspected HIT Stop heparin, start argatroban
Suspected DVT Compression ultrasound of leg

Hypersensitivity and Immunodeficiency HE

Type I IgE, immediate anaphylaxis
Type II Antibody against cell surface
Type III Immune complex deposition
Type IV T cell, delayed onset
Anaphylaxis first drug Intramuscular epinephrine, lateral thigh
Recurrent sinopulmonary infection Check immunoglobulin levels
Asplenia risk Encapsulated organism sepsis

Crohn vs Ulcerative Colitis GI

Crohn disease

Mouth to anus
Skip lesions
Transmural, fistulas

Ulcerative colitis

Rectum extending proximally
Continuous involvement
Mucosa only
Skip lesions vs continuous

GI and Liver Cutoffs GI

Upper GI bleed Endoscopy within 24 hours
Variceal bleed Octreotide plus ceftriaxone
Acute pancreatitis Lipase three times normal
Right upper quadrant pain Ultrasound is first test
Ascending cholangitis Charcot triad, urgent ERCP
Spontaneous bacterial peritonitis Ascites neutrophils over 250
Hepatic encephalopathy Lactulose, then rifaximin
Adult appendicitis CT with contrast
C. difficile colitis Oral vancomycin or fidaxomicin
Celiac testing Tissue transglutaminase IgA

Delirium vs Dementia NE

Delirium

Acute onset
Attention impaired
Often reversible

Dementia

Months to years
Memory affected first
Progressive course
Attention vs memory

Altered Mental Status Picker NE

Any altered patient → Check glucose first
Pinpoint pupils, slow breathing → Give naloxone
Fever with neck stiffness → Cultures, then antibiotics ( Do not delay )
Sudden focal deficit → Noncontrast head CT ( Stroke pathway )
Alcohol use with confusion → Thiamine before glucose
Fluctuating attention, acute onset → Treat delirium cause
Seizure with low sodium → Hypertonic saline bolus

Neurologic Time Windows NE

Intravenous thrombolysis Within 4.5 hours onset
Thrombectomy Up to 24 hours, selected
First stroke test Noncontrast head CT
Thunderclap headache CT, then lumbar puncture
Status epilepticus Intravenous lorazepam first
Bacterial meningitis Antibiotics before delayed imaging
Giant cell arteritis Steroids before biopsy
Myasthenic crisis Follow vital capacity
Normal pressure hydrocephalus Gait, incontinence, dementia
Wernicke encephalopathy Confusion, ataxia, eye findings

CURB-65 Admission Score RE

Confusion, Urea, Respirations, BP, age 65
Urea above 19 Respirations 30 or more Systolic under 90 Score 2, consider admission

Transudate vs Exudate RE

Transudate

Pressure problem
Heart failure, cirrhosis
Low protein

Exudate

Inflammation or infection
Meets Light criteria
High LDH
Pressure vs inflammation

Acute Dyspnea Picker RE

Wheeze with known asthma → Albuterol and steroids
Fever with purulent sputum → Treat pneumonia ( CURB-65 triage )
Crackles with high BNP → Intravenous diuresis ( Heart failure )
Pleuritic, tachycardic, hypoxic → Evaluate for embolism
Stridor and drooling → Secure the airway ( Do not examine throat )
Hypoxia after transfusion → Stop transfusion ( Consider TRALI )
Hyperresonance with hypotension → Needle decompression

Pulmonary Scores and Cutoffs RE

CURB-65 of 2 Consider hospital admission
Low PE probability Apply PERC rule
D-dimer role Rules out low-probability embolism
PE confirmation CT pulmonary angiography
Asthma exacerbation Albuterol, ipratropium, systemic steroids
COPD exacerbation Bronchodilators, steroids, antibiotics
COPD diagnosis Post-bronchodilator FEV1/FVC under 0.70
Light criteria Protein or LDH ratio
ARDS oxygenation PaO2/FiO2 under 300
Tension pneumothorax Decompress before imaging

Sepsis Hour-1 Bundle MU

Lactate, cultures, antibiotics, fluids, pressors
Cultures before antibiotics 30 mL/kg crystalloid Norepinephrine first Remeasure the lactate

First Imaging Picker MU

Right upper quadrant pain → Abdominal ultrasound ( Gallstones )
Suspected appendicitis, adult → CT with contrast
Suspected appendicitis, child → Ultrasound first ( Limit radiation )
Flank pain with hematuria → Noncontrast CT ( Stones )
Head trauma, red flags → Noncontrast head CT
Thunderclap headache → Noncontrast head CT ( Then lumbar puncture )
Unstable blunt abdominal trauma → Bedside FAST ultrasound
Stable suspected dissection → CT angiography
Acute testicular pain → Doppler ultrasound ( Torsion )
Suspected pulmonary embolism → CT pulmonary angiography

Sepsis and Infection Bundles MU

Sepsis definition Infection plus organ dysfunction
Antibiotics in shock Within 1 hour
Initial fluid 30 mL/kg crystalloid, 3 hours
MAP target 65 mmHg or higher
First vasopressor Norepinephrine
Lactate Remeasure when above 2
Adult meningitis empiric Vancomycin plus ceftriaxone
Add ampicillin Age over 50, listeria
Necrotizing fasciitis Surgical debridement, not imaging

Toxicology Antidotes MU

Acetaminophen N-acetylcysteine
Opioid Naloxone
Benzodiazepine Flumazenil, seizure risk
Organophosphate Atropine plus pralidoxime
Beta-blocker overdose Glucagon, then calcium
Calcium channel blocker High-dose insulin, calcium
Methanol or ethylene glycol Fomepizole plus dialysis
Carbon monoxide 100 percent oxygen
Iron Deferoxamine
Digoxin Digoxin-specific antibody fragments
Salicylate Bicarbonate, then dialysis

DKA vs HHS EN

DKA

Glucose often over 250
Anion gap acidosis
Ketones strongly positive

HHS

Glucose often over 600
Osmolality over 320
Minimal ketones
Acidosis vs osmolality

Diabetes and Thyroid Numbers EN

Diabetes A1C 6.5 percent or higher
Fasting glucose 126 mg/dL or higher
Two-hour OGTT 200 mg/dL or higher
Prediabetes A1C 5.7 to 6.4 percent
Usual adult A1C goal Under 7 percent
Type 2 first line Metformin plus lifestyle
Heart or kidney disease Add SGLT2 or GLP-1
DKA hallmark Anion gap plus ketones
Primary hypothyroidism High TSH, low T4
Thyroid nodule workup TSH, then ultrasound

Prenatal Timing Anchors PR

Anatomy 20, glucose 26, strep 36
Anatomy scan 18-22 weeks Glucose challenge 24-28 weeks Group B strep 36-37 weeks Tdap 27-36 weeks

Previa vs Abruption PR

Placenta previa

Painless bleeding
Ultrasound before exam
No digital exam

Abruption

Painful bleeding
Rigid tender uterus
Largely clinical diagnosis
Painless vs painful

Bleeding in Pregnancy PR

First trimester bleeding → Ultrasound and hCG
Empty uterus, elevated hCG → Treat as ectopic
Painless third-trimester bleeding → Ultrasound before exam ( Previa )
Painful bleeding, rigid uterus → Prepare for delivery ( Abruption )
Postpartum bleeding, boggy uterus → Massage plus oxytocin
Rh-negative mother bleeding → Give anti-D globulin
Membrane rupture with bleeding → Emergency cesarean ( Vasa previa )

Prenatal Care Timeline PR

Dating ultrasound First trimester most accurate
Cell-free fetal DNA From 10 weeks
Nuchal translucency 11-14 weeks
Quad screen 15-22 weeks
Anatomy ultrasound 18-22 weeks
Glucose challenge 24-28 weeks, 50 grams
Anti-D immune globulin 28 weeks and postpartum
Tdap dose 27-36 weeks each pregnancy
Group B strep culture 36w0d to 37w6d
Antibody screen First visit, repeat 28 weeks

Obstetric Emergencies PR

Preeclampsia BP 140/90 twice, 4 hours apart
Severe-range BP 160/110 or higher
Severe-feature labs Platelets under 100,000
Eclampsia treatment Magnesium sulfate, then delivery
Aspirin prophylaxis 81 mg from 12 weeks
Magnesium toxicity Lost reflexes, give calcium
Postpartum hemorrhage Uterine atony most common
Shoulder dystocia McRoberts, suprapubic pressure
Chorioamnionitis Antibiotics and deliver

Sensitivity vs Specificity BI

Sensitivity

Detects disease
Negative rules out
Good for screening

Specificity

Confirms disease
Positive rules in
Good for confirmation
Rule out vs rule in

Biostatistics Formulas BI

Sensitivity True positives among diseased
Specificity True negatives among well
Positive predictive value Rises with prevalence
Negative predictive value Falls as prevalence rises
Relative risk Cohort and trial designs
Odds ratio Case-control designs
Absolute risk reduction Control risk minus treated
Number needed to treat One over absolute reduction
Incidence New cases over time
Prevalence All existing cases now
Positive likelihood ratio Higher value, stronger test
Type I error False positive, alpha
Type II error False negative, beta
Power One minus beta

Study Design and Bias BI

Randomized trial Strongest causal evidence
Cohort study Exposure first, follow forward
Case-control study Outcome first, look backward
Cross-sectional study Snapshot, yields prevalence
Lead-time bias Earlier diagnosis, unchanged death
Length-time bias Screening favors slow tumors
Confounding Third variable distorts association
Recall bias Case-control interview error
Berkson bias Hospital-based selection problem
Intention to treat Analyze as randomized

Preventive Visit Picker HU

Woman turning 40 → Offer biennial mammography
Adult turning 45 → Start colorectal screening
Smoker aged 50 to 80 → Annual low-dose CT ( 20 pack-years )
Man 65-75 who smoked → One-time aortic ultrasound
Woman turning 65 → Order DXA scan
Adult 35-70 with obesity → Screen for diabetes

USPSTF Screening Ages HU

Mammography Biennial, ages 40-74 2024
Colorectal screening Ages 45 through 75 2021
Cervical cytology Every 3 years, 21-29
Cervical age 30-65 hrHPV every 5 years
Lung low-dose CT Annual, ages 50-80 20 pack-years
Lung quit rule Quit within 15 years
Aortic aneurysm Men 65-75 who smoked One-time
Osteoporosis DXA Women 65 and older 2025
Diabetes screening Ages 35-70 with overweight
HIV screening Once, ages 15-65
Hepatitis C Once, ages 18-79
Statin primary prevention 40-75, risk 10 percent
Depression and anxiety Screen all adults
Prostate PSA Shared decision, ages 55-69

Adult Immunization Triggers HU

Tdap in pregnancy Every pregnancy, 27-36 weeks
Influenza Annual from 6 months
Recombinant zoster Two doses, age 50
Pneumococcal conjugate All adults 50 and older
HPV series Routine 11-12, catch-up 26
Td booster Every 10 years
RSV vaccine Single dose, age 75
Hepatitis B All adults 19-59

Pediatric Milestones HU

2 months Social smile
6 months Sits supported, babbles
9 months Pulls to stand, stranger anxiety
12 months First words, walks alone
18 months Runs, several single words
2 years Two-word phrases, climbs stairs
3 years Tricycle, copies circle
4 years Hops, copies cross
5 years Skips, copies triangle

Nutrition and Deficiency Clues NU

Nutrition weighting 15-20 percent, double-coded Overlaps systems
Refeeding syndrome Low phosphate, magnesium, potassium
Thiamine before glucose Prevents Wernicke encephalopathy
Vitamin B12 deficiency Macrocytic with neurologic signs
Folate deficiency Macrocytic, nerves spared
Vitamin D deficiency Low calcium, high PTH
Vitamin K deficiency Prolonged PT and INR
Zinc deficiency Poor healing, perioral rash
Vitamin A deficiency Night blindness, dry eyes

Common Traps

Capacity vs competence

Physicians assess capacity ≠ Courts decide competence

Screening vs diagnosis

Screening finds risk ≠ Diagnosis confirms disease

Sensitivity vs predictive value

Sensitivity ignores prevalence ≠ PPV depends on prevalence

Retrospective vs prospective analysis

RCA looks backward ≠ FMEA looks forward

DKA vs HHS

DKA has acidosis ≠ HHS has extreme osmolality

Previa vs abruption

Previa bleeding is painless ≠ Abruption bleeding is painful

Lead-time vs length-time bias

Lead-time shifts diagnosis earlier ≠ Length-time favors slow tumors

Delirium vs dementia

Delirium impairs attention ≠ Dementia impairs memory

Folate vs B12 deficiency

Both cause macrocytosis ≠ Only B12 harms nerves

Gout vs pseudogout crystals

Gout has negative birefringence ≠ Pseudogout has positive birefringence

Nutrition weighting confusion

Nutrition is double-coded ≠ Systems already total 100

Block count vs item count

Sixteen 30-minute blocks now ≠ Item total is unchanged

Last Minute

1. Sixteen 30-minute blocks, 9-hour day
2. Up to 20 items per block
3. 55 minutes break, 5-minute tutorial
4. Passing score is 218
5. Fee $695; $235 outside US/Canada
6. Three attempts yearly, four lifetime
7. Report 30 minutes before start
8. Bring unexpired photo-signature ID
9. Social sciences is largest system
10. Diagnosis tasks are 16-20 percent
11. Mammography 40-74; colon from 45
12. Lung CT 50-80, 20 pack-years
13. Blood pressure target under 130/80
14. Stroke thrombolysis within 4.5 hours
15. Septic shock antibiotics within 1 hour
16. Raise sodium under 8 daily
17. Transfuse when hemoglobin under 7
18. Check glucose in every confusion
19. Group B strep culture 36-37 weeks
20. Capacity is decision-specific, not global

USMLE Step 2 CK

Practice Questions 260 questions Study Guide 55 topics Cheat Sheet 272 facts Flashcards 50 cards Videos 1 video Blogs 1 blog 1 Job Wiki Free CE Podcast