USMLE Step 2 CK case studies

USMLE Step 2 CK · Put your knowledge to work in context.

USMLE Step 2 CK (Clinical Knowledge) is the middle exam of the three-step United States Medical Licensing Examination program, which is owned jointly by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Step 2 CK assesses an examinee's ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, and it includes emphasis on health promotion and disease prevention - so preventive care is part of the exam's stated purpose, not an afterthought. The USMLE Step 2 CK case studies are 5 cases and about 3,987 words.

Atrial Fibrillation, Falls, and a Prior GI Bleed: Choosing Anticoagulation

A 78-year-old woman with hypertension, type 2 diabetes, and a prior TIA is seen 3 months after atrial fibrillation was diagnosed. She has had two mechanical falls in the past year, neither causing injury, and a lower-GI bleed 2 years ago from angiodysplasia that was treated endoscopically with no recurrence.

794 words, about 4 min 2

Day-4 Acute Cholecystitis with Dilated Common Bile Duct: Timing, Imaging, and Antibiotics

A 64-year-old man presents on day 4 of right-upper-quadrant pain, fever to 38.8 °C, and vomiting. Heart rate 114/min, BP 104/66 mmHg, BMI 36, and he is alert and oriented.

824 words, about 4 min 3

New-Onset DKA in a Child: Fluids, Insulin Timing, and a Mid-Course Neurologic Collapse

A 9-year-old boy is brought to the emergency department with 2 days of vomiting and abdominal pain. He has had 3 weeks of polyuria, nocturia, and 4 kg of weight loss.

901 words, about 5 min 4

Preeclampsia with Severe Features at 33 Weeks: Medications Now, Delivery When

A 33-year-old G3P1 at 33 weeks 2 days presents with a 3-day history of frontal headache and new right-upper-quadrant discomfort. BP is 166/112 mmHg on two readings 15 minutes apart, with 2+ proteinuria on dipstick.

588 words, about 3 min 5

Lithium Toxicity After a Thiazide Is Added: Level, Dialysis, and What Comes After

A 61-year-old woman with bipolar I disorder, stable on lithium 900 mg nightly for 8 years, is brought in by her daughter with 3 days of vomiting, coarse tremor, unsteady gait, and confusion. Two weeks ago hydrochlorothiazide was added for hypertension.

880 words, about 4 min