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DEJA REVIEW
USMLE Step 2 CK
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DEJA REVIEW
USMLE Step 2 CK
Second Edition
John H. Naheedy, MD
Fellow, Pediatric Radiology Department of Radiology
Children’s Hospital Boston
Harvard Medical School
Boston, Massachusetts
Daniel A. Orringer, MD
Chief Resident
Department of Neurosurgery
University of Michigan Medical School
Ann Arbor, Michigan
Khashayar Mohebali, MD
Chief Resident, Clinical Instructor
Division of Plastic and Reconstructive Surgery
Department of Surgery
University of California, San Francisco San Francisco, California
Peter F. Aziz, MD
Fellow-Pediatric Cardiology
Department of Pediatrics
Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Susie Lim, MD
Clinical Instructor
Obstetrics and Gynecology
Kaiser Permanente Northwest
Portland, Oregon
Copyright © 2010, 2006 by John H. Naheedy, Daniel A. Orringer, Khashayar Mohebali, Peter F. Aziz, and Susie Lim. All
rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be
reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written
permission of the publisher.
ISBN: 978-0-07-163941-5
MHID: 0-07-163941-1
The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-162716-0, MHID: 0-07-162716-2.
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To my family and friends, for their love and encouragement; and to my parents, for being an example of everything I
want to be.
—John
To Megan, the true author in the family.
—Dan
To my parents for dedicating and sacrificing their lives to make mine better and to my friends for their invaluable
loyalty.
—Khashi
To my family, for teaching me that the love of medicine can be genetically inherited; and to the bunker, the sand trap of
my closest friends, thanks for the inspiration.
—Pete
To Michael, Oliver and Soë
—Susie
Contents
Contributors
Reviewers
Preface
Acknowledgments
Chapter 1 INTERNAL MEDICINE
Cardiology
Pulmonary
Infectious Diseases
Gastroenterology
Renal/Genitourinary
Endocrine
Hematology/Oncology
Rheumatology/Musculoskeletal
Dermatology
Preventative Medicine, Ethics, and Biostatistics
Chapter 2 SURGERY
Trauma
General Surgery
Vascular Surgery
Orthopedics
Abdominal Pain
Make the Diagnosis
Chapter 3 NEUROLOGY
Headache
Seizures
Cerebral Vasculature
Intracranial Hemorrhage
Brain Tumors
CNS Infections
Cognitive Disorders
Movement Disorders
Amyotrophic Lateral Sclerosis, Multiple Sclerosis, and other Demyelinating Diseases
Vertigo
Neuromuscular Disease
Ophthalmology
Syncope
Peripheral Neuropathy
Localize the Lesion
Make the Diagnosis
CHAPTER 4 PSYCHIATRY
Mood Disorders
Suicide and Violence
Psychotic Disorders
Anxiety Disorders
Somatoform Disorders
Eating Disorders
Substance Abuse
Childhood Disorders
Personality Disorders
Miscellaneous Psychiatric Disorders
Psychopharmacology
Make the Diagnosis
Chapter 5 OBSTETRICS AND GYNECOLOGY
Obstetrics
Antepartum
Intrapartum
Postpartum
Gynecology
Gynecology Oncology
Reproductive Endocrinology
Urogynecology
Make the Diagnosis
Chapter 6 PEDIATRICS
Genetic Defects
Congenital Heart Disease
Development
Immunodefiency Syndromes
Child Abuse
Neonatology
Infectious Disease
Nephrology
Gastroenterology
Endocrinology
Hematology
Pulmonology
Oncology
Rheumatology
Neurology
Miscellaneous
Make the Diagnosis
Chapter 7 EMERGENCY MEDICINE
Trauma
Toxicology
Environmental Emergencies
Make the Diagnosis
Appendix ABBREVIATIONS
Index
Contributors
Karla Fredricks, MD
Resident
Department of Pediatrics
Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania
Chapter: Pediatrics
Emily Y. Fukuchi, MD
Resident
Department of Obstetrics and Gynecology
University of California, San Francisco
San Francisco, California
Chapters: Internal Medicine, Surgery
Karen A. Kinnaman, MD
University of Michigan Medical School
Ann Arbor, Michigan
Class of 2009
Chapter: Emergency Medicine
Vijay Pottathil, MD
Resident
Department of Internal Medicine
University of Iowa
Iowa City, Iowa
Chapter: Internal Medicine
Jayson Sack, MD
Resident
Department of Neurosurgery
University of South Florida
Tampa, Florida
Chapters: Neurology, Psychiatry
Miguel Trujillo, MD
Resident
Department of Obstetrics and Gynecology
Oregon Health and Science University
Portland, Oregon
Chapter: Obstetrics and Gynecology
Reviewers
Jessica Bury, MPH
Medical Student
Mayo Clinical College of Medicine
Class of 2010
Tina Nguyen, MD
Resident, Emergency Medicine
Harbor UCLA Medical Center
University of California Los Angeles
SUNY Upstate Medical University
Class of 2008
Preface
Déjà Review™ USMLE Step 2 CK has been scrutinized and edited to produce a second edition that is even higher yield and
easier to use than the first. Outstanding medical students, who have recently taken Step 2, revised the original text to ensure
the material covered herein is complete and current. The authors, now with a combined 30 years of experience in the
medical field, have also edited the manuscript to emphasize the clinical relevance of the core concepts covered in Step 2.
We are confident that our efforts have produced one of the most useful guides for Step 2 review available today.
Step 2 of the United States Medical Licensing Examination (USMLE) tests the senior medical student’s ability to apply the
basic principles of clinical medicine. However, before you can apply those principles, you must be able to rapidly recall a
core body of essential facts. This is why the Déjà Review series is the most efficient, well-organized, portable, and above
all, high-yield resource to prepare students for the USMLE. As recent graduates who have taken Step 2, we are confident
that we have compiled a novel review guide that promotes rapid recall of all of the essential facts necessary for success on
this examination. We also realize that a solid foundation in these principles will allow you to make a smooth transition into
your residency.
ORGANIZATION
All concepts are presented in a question and answer format that covers the key facts on hundreds of common and
uncommon diseases. The material is divided into chapters covering the six major divisions of clinical medicine: internal
medicine, surgery, neuroscience, psychiatry, OB/GYN, and pediatrics. We have also included a brief emergency medicine
chapter that addresses topics not covered under emergent conditions in each of the other chapters.
This question and answer format has several important advantages:
• It provides a rapid, straightforward way for you to assess your strengths and weaknesses.
• It allows you to efficiently review and commit to memory a large body of information.
• It will prepare you for getting “pimped” by residents and attendings on the wards.
• It offers you a break from tedious, convoluted multiple-choice questions.
• The clinical vignettes will expose you to the prototypic presentation of diseases classically tested on the USMLE
Step 2.
• It serves as a quick, last-minute review of high-yield facts.
The compact, condensed design of the book is conducive to studying on the go, especially during any downtime on the
wards.
HOW TO USE THIS BOOK
Remember, this text is not intended to replace textbooks, course packs, or lectures. It is, however, intended to serve as a
supplement to your studies during the third and fourth years of medical school. This text has been sampled and refined by a
number of medical students who found it to be an essential part of their preparation for the USMLE shelf examinations, in
addition to Step 2 itself. We recommend having the text spiral bound to make it more portable and easier to use. Begin
using this book early in your third year by carrying it with you during your clinical clerkships. You may cover up the
