USMLE Step 2 CK key terms

Life-threatening organ dysfunction caused by a dysregulated response to infection, with persistent hypotension requiring vasopressors and elevated lactate despite fluids. Recognize early and treat with antibiotics, fluids, and source control.

Hyperglycemic emergency marked by insulin deficiency, ketone production, metabolic acidosis, and dehydration. Treatment includes isotonic fluids, intravenous insulin, potassium replacement, and correction of precipitating causes.

Spectrum of myocardial ischemia including unstable angina and myocardial infarction. Patients often have chest pain, ischemic ECG changes, and elevated troponin; immediate aspirin and risk stratification are essential.

Sudden worsening of heart failure symptoms with congestion or low output, often causing dyspnea, edema, and pulmonary crackles. Treat with oxygen, diuretics, vasodilators, and therapy for precipitating triggers.

Abrupt decline in kidney function with rising creatinine or falling urine output. Causes are prerenal, intrinsic renal, or postrenal; management focuses on fluids when appropriate, stopping nephrotoxins, and relieving obstruction.

Kidney disorder with heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Minimal change disease is common in children; adults need evaluation for primary glomerular disease and systemic causes.

Advanced liver scarring with portal hypertension and fluid accumulation in the abdomen. Manage with sodium restriction, diuretics, and paracentesis; spontaneous bacterial peritonitis is a serious complication requiring antibiotics.

Blockage of pulmonary arteries by thrombus, causing dyspnea, chest pain, tachycardia, and hypoxia. Risk stratify with clinical probability, D-dimer, and imaging; anticoagulation is mainstay for confirmed disease.

Irregularly irregular supraventricular rhythm that raises stroke risk. Assess symptoms and stroke risk, control rate or rhythm, and use anticoagulation when indicated based on validated risk scores.

Acute infection of lung parenchyma acquired outside hospitals, causing fever, cough, dyspnea, and infiltrates. Severity scoring guides site of care; empiric antibiotics target common bacterial pathogens.

Inflammation of the appendix, typically causing periumbilical pain migrating to the right lower quadrant, anorexia, and fever. Diagnosis is clinical with imaging; treatment is appendectomy or, in selected cases, antibiotics.

Mechanical blockage of the small intestine causing colicky pain, vomiting, distension, and absent flatus. Assess for strangulation; manage with fluids, nasogastric decompression, and surgery when ischemia or complete obstruction is present.

Inflammation of the gallbladder, usually from a blocked cystic duct, causing right upper quadrant pain, fever, and positive Murphy sign. Treat with antibiotics, fluids, and early cholecystectomy.

Systematic initial assessment of trauma patients to identify and treat immediate life threats: airway, breathing, circulation, disability, and exposure. Resuscitation and reassessment occur alongside the survey.

Increased pressure within a closed fascial space that compromises tissue perfusion, causing severe pain, paresthesia, and pain with passive stretch. Urgent fasciotomy is required to prevent muscle and nerve necrosis.

Elevated temperature after surgery with causes varying by timing, including atelectasis, infection, urinary tract infection, and deep venous thrombosis. Evaluate symptoms, wound, lungs, lines, and urine rather than assuming a benign cause.

Viral lower respiratory infection in young children, commonly caused by respiratory syncytial virus, with wheezing, cough, and tachypnea. Treatment is supportive; reserve oxygen, hydration, and suctioning for needed cases.

Febrile vasculitis of childhood causing prolonged fever, conjunctivitis, rash, oral changes, extremity changes, and cervical lymphadenopathy. Treat with intravenous immunoglobulin and aspirin to reduce coronary artery complications.

Yellowing of newborn skin from elevated bilirubin. Assess timing, feeding, and risk factors; phototherapy is used for significant hyperbilirubinemia to prevent kernicterus.

Seizure associated with fever in a child usually aged six months to five years, without central nervous system infection. Most are benign; evaluate for meningitis when signs suggest it.

Telescoping of one bowel segment into another, typically causing intermittent abdominal pain, vomiting, and bloody stools in young children. Ultrasound confirms; air or contrast enema is often diagnostic and therapeutic.

Hypertrophy of the pyloric muscle in infants causing projectile nonbilious vomiting, hunger, and dehydration. Diagnosis by ultrasound; correct electrolytes and dehydration before surgical pyloromyotomy.

Pregnancy-specific disorder with new hypertension and proteinuria or organ dysfunction after twenty weeks. Delivery is definitive; magnesium sulfate prevents seizures and antihypertensives treat severe hypertension.

Implantation outside the uterine cavity, often in a fallopian tube, causing pain and bleeding. Diagnose with pregnancy testing and ultrasound; treat urgently with surgery or methotrexate depending on stability.

Glucose intolerance first recognized during pregnancy. Screen with oral glucose testing, manage with diet and exercise, add insulin if needed, and monitor for fetal and maternal complications.

Excessive bleeding after delivery, commonly from uterine atony. Treat with uterine massage, uterotonics, fluids, blood products, and escalation to surgery or embolization when needed.

Placenta covering or near the cervical os, causing painless vaginal bleeding late in pregnancy. Avoid digital vaginal examination; stabilize the mother and plan delivery by cesarean when indicated.

Persistent depressed mood or loss of interest with cognitive and somatic symptoms causing impairment for at least two weeks. Treatment includes psychotherapy, antidepressants, and safety assessment for suicide risk.

Mood disorder with at least one manic episode, often alternating with depression. Mania causes elevated mood, decreased sleep, grandiosity, and risky behavior; treatment includes mood stabilizers and antipsychotics.

Acute fluctuating disturbance in attention and awareness due to medical illness, medications, or withdrawal. Identify and treat the cause, reduce restraints, and use environmental measures; antipsychotics may help severe agitation.

Cluster of symptoms after reducing heavy alcohol use, ranging from tremor and anxiety to seizures and delirium tremens. Treat with benzodiazepines, thiamine, fluids, and monitoring for complications.

Toxic reaction from serotonergic drugs causing agitation, autonomic instability, hyperthermia, and neuromuscular hyperactivity such as clonus. Stop offending agents, provide supportive care, and use benzodiazepines; severe cases need cyproheptadine.

Life-threatening reaction to dopamine-blocking drugs causing fever, rigidity, altered mental status, and autonomic instability. Stop the drug, provide supportive care, and treat with bromocriptine or dantrolene.

Sensitivity is the proportion of diseased people correctly identified by a test; specificity is the proportion of healthy people correctly identified as negative. Both help interpret screening and diagnostic tests.

Number of patients who must receive a treatment for one additional person to benefit. It is the reciprocal of absolute risk reduction and helps compare clinical usefulness.

Apparent survival improvement caused by earlier diagnosis that does not actually delay death. Screening can make survival seem longer simply by starting the clock earlier.

Indirect protection of susceptible people when a sufficient proportion of a population is immune, reducing transmission. High immunization coverage helps protect those who cannot be vaccinated.