DEJA REVIEWTM USMLE Step 2 CK NOTICE Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work Readers are encouraged to confirm the information contained herein with other sources For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration This recommendation is of particular importance in connection with new or infrequently used drugs DEJA REVIEWTM 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 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have 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PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting there from McGraw-Hill has no responsibility for the content of any information accessed through the work Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise 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 Open angle glaucoma Ophthalmic artery Ophthalmologic disorders Opioids Opportunistic infections, in patients with AIDS Oppositional defiant disorder OPSS See Overwhelming postsplenectomy sepsis Oral advance directive Oral contraceptives advantages/disadvantages contraindications deep venous thrombosis and hepatic adenoma and hypertension and mechanisms of action Organophosphate poisoning Orgasmic disorder Orthopedic injuries Ortolani maneuver Osborne wave Oseltamivir Osgood-Schlatter disease Osler´s nodes Osmotic diarrhea Osteitis deformans Osteoarthritis Osteogenesis imperfecta Osteomalacia Osteomyelitis Osteoporosis Osteosarcoma Otitis externa Otitis media Ovarian cancer Ovarian cysts Overflow incontinence Overwhelming postsplenectomy sepsis (OPSS) Ovulation Oxacillin Oxazepam P P value Paget disease bone breast Pancoast tumor Pancreatic cancer Pancreatic disorders Pancreatic insufficiency Pancreatitis Panhypopituitarism Panic disorder Pap smear Papillary carcinoma, thyroid Papule Paracentesis Paranoid personality disorder Paranoid schizophrenia Paraphilias Parathyroid disorders Parathyroidectomy Parietal lobes, lesions of Parkinson disease Paronychia Paroxetine Paroxysmal nocturnal hemoglobinuria Partial seizure Partner abuse Parvovirus B19 Patau syndrome Patch Patent ductus arteriosus Paternal imprinting Pathologic gambling Pathologic jaundice PCOS See Polycystic ovary syndrome PCP See Phencyclidine hydrochloride PE See Pulmonary embolism Pediculosis pubis Pedophilia Pellagra Pelvic inflammatory disease (PID) Pelvic mass Pelvic organ prolapse Pelvic pain Pemphigus vulgaris Penicillamine Penicillin Penicillin G Peptic ulcer disease (PUD) Percutaneous transluminal coronary angioplasty (PTCA) Perforated ulcer Pericardial disease Pericardiocentesis Pericarditis Perimenopause Perimesencephalic hemorrhage Perinatal mortality rate Peripheral neuropathy Peripheral vascular disease (PVD) Peritonitis Permethrin Pernicious anemia Perphenazine Personality disorders Petechiae Peutz-Jeghers syndrome Phagocytic immunodeficiency syndromes Phakomatosis Pharyngitis Phencyclidine hydrochloride (PCP) Phenelzine Phenoxybenzamine Phentolamine Phenytoin Pheochromocytoma Phobia Physiologic jaundice Pick disease PID See Pelvic inflammatory disease Pigment stone Pigmentary lesions Pilocytic astrocytoma, juvenile Pimozide Pindolol Pioglitazone Pitocin Pituitary adenoma Pituitary gland Pityriasis rosea Placenta accreta Placenta previa Placental abruption Placental separation Plaque Pleural effusion Pleurodesis Plummer-Vinson syndrome PMDD See Premenstrual dysmorphic disorder Pneumococcal vaccine Pneumococcus Pneumoconioses Pneumocystis jiroveci Pneumonia Pneumonitis, hypersensitivity Pneumothorax (PTX) Podagra Podophyllin Polio vaccine Polycystic kidney disease Polycystic ovary syndrome (PCOS) Polycythemia vera Polyhydramnios Polymenorrhea Polymyalgia rheumatica Polymyositis Polyps, colon Pons, lesions of Porphyria cutanea tarda Portal hypertension Port-wine stain Positive predictive value Posterior cerebral artery Posterior urethral valve Postinfectious glomerulonephropathy Postmenopausal bleeding Postpartum complications Postpartum depression Postpartum endometritis Postpartum hemorrhage Poststreptococcal glomerulonephritis Postterm pregnancy Posttraumatic stress disorder (PTSD) Pott´s fracture Power PPD test See Purified protein derivative test PPi See Proton pump inhibitors Prader-Willi syndrome Precision Prednisone Preeclampsia Pregnancy See also Labor and delivery abortion amniotic fluid abnormalities dating diabetes mellitus in ectopic fetal diagnostic testing and monitoring hemorrhage during hypertension in intrapartum molar multiple gestation other medical conditions physiologic changes postterm premature rupture of membranes(PROM) prenatal care preterm labor (PTL) Rh incompatibility teratogens vaccines and Premature ejaculation Premature ovarian failure Premature ventricular contraction (PVC) Premenstrual dysmorphic disorder (PMDD) Prenatal care Prenatal genetic analysis Prevalence Preventative medicine Primary heart block Primary hypersomnia Primary insomniaPrinzmetal angina Probenecid Procainamide Progesterone Progestin Progressive multifocal leukoencephalopathy Progressive supranuclear palsy Prolactinoma PROM See Premature rupture of membranes Propionibacterium Propranolol Propylthiouracil (PTU) Propylthrouvnel Prostate Prostate cancer Prostate-specific antigen (PSA) Prostatectomy Proteus Proteus mirabilis Proton pump inhibitors (PPi) PSA See Prostate-specific antigen Pseudocyst Pseudogout Pseudohypoparathyroidism Pseudomembranous colitis Pseudomonas spp Pseudomonas aeruginosa Pseudotumor cerebri Psoas sign Psoriasis Psoriatic arthritis Psychogenic fugue Psychosis Psychotic disorders PTCA See Percutaneous transluminal coronary angioplasty PTL See Preterm labor PTSD See Posttraumatic stress disorder PTU See Propylthiouracil PTX See Pneumothorax; Tension pneumothorax Puberty PUD See Peptic ulcer disease Pulmonary edema Pulmonary embolism (PE) Pulmonary fibrosis Pulmonary hypoplasia Pulmonary internal medicine Pulmonary neoplasms Pulmonic stenosis Pulmonology, pediatric Purified protein derivative (PPD) test Purpura Pustule PVC See Premature ventricular contraction PVD See Peripheral vascular disease Pyelonephritis Pyloric stenosis Pyrizinamide Pyromania Q Quetiapine Quinidine Quinolone R r value Radiation Ranson criteria Rash, fever with Reactive arthritis Recall bias Rectal cancer Recurrent abortion Reducible hernia 5-α-Reductase inhibitors Reiter syndrome Relative risk Reliability Renal amyloidosis Renal artery stenosis Renal calculi Renal cell carcinoma Renal crisis Renal failure Renal infarct Renal internal medicine Renal tubular acidosis Renin Residual schizophrenia Respiratory acidosis Respiratory alkalosis Respiratory distress syndrome, neonatal Respiratory syncytial virus (RSV) Restless leg syndrome Restrictive cardiomyopathy Restrictive lung disease Retained placenta Retin-A Rett syndrome Reye syndrome Reynold´s pentad Rh incompatibility Rhabdomyosarcoma Rheumatic fever Rheumatic heart disease Rheumatoid arthritis Rheumatology RhoGAM Richter´s hernia Rickets Rickettsia rickettsii Rifampin Risperidone RMSF See Rocky Mountain spotted fever Rocky Mountain spotted fever (RMSF) Rose spots Roseola infantum Rosiglitazone Rotator cuff injury Rotavirus Rovsing´s sign RSV See Respiratory syncytial virus Rubbing alcohol poisoning Rubella Rubin maneuver Russel´s sign S SAAG See Serum-ascites albumin gradient SAB See Spontaneous abortion Sacroiliac joints Salicylate toxicity Salicylic acid Salmonella spp Sarcoidosis SBO See Small bowel obstruction Scabies Scalp stimulation Scaphoid fracture Scarlet fever SCFE See Slipped capital femoral epiphysis Schistosoma haematobium Schizoaffective disorder Schizoid personality disorder Schizophrenia Schizophreniform disorder Schizotypal personality disorder Schwannoma Sciatica SCID See Severe combined immunodeficiency syndrome Scleroderma Sclerosing cholangitis Screening, for cancer Scurvy Seborrheic dermatitis Seborrheic keratosis Secondary seizures Secretory diarrhea Sedative-hypnotic withdrawal Seizures β-Selective agonists Selective IgA deficiency Selective serotonin reuptake inhibitors (SSRIs) Selenium sulfide Self-selection bias Seminoma Senile keratosis Sensitivity Sentinel loop Separation anxiety disorder Sepsis Septic shock Seronegative spondyloarthropathy Serratia marcescens Sertoli-Leydig cell tumor Sertraline Serum-ascites albumin gradient (SAAG) Severe combined immunodeficiency syndrome (SCID) Sexual aversion disorder Sexual masochism Sexual sadism Sexually transmitted diseases Sézary syndrome Shared psychotic disorder Sheehan syndrome Shigella Shock See Septic shock Short gut syndrome Short stature Shoulder dislocation Shoulder dystocia Shunt procedures SIADH See Syndrome of inappropriate secretion of antidiuretic hormone Sickle cell anemia Sideroblastic anemia Sildenafil Silicosis Simple partial seizure Sinus headache Sinus tachycardia Sinusitis Sipple syndrome SIRS See Systemic inflammatory response syndrome Sister Mary Joseph node Sjögren syndrome Skin cancer Skin disorders Skin infections SLE See Systemic lupus erythematosus Sleep apnea Sleep terror disorder Sleep walking disorder Slipped capital femoral epiphysis (SCFE) Small bowel obstruction (SBO) Small bowel perforation Small cell carcinoma, lung Small intestine disorders Smoking cessation SMX See Sulfamethoxazole Social phobia Solitary pulmonary nodule Somatization disorder Somatoform disorders Somatostatin Somatostatinoma Somogyi effect Specific phobia Specificity Sperm count Spherocytosis Spider bites, brown recluse Spina bifida occulta Spinal disorders Spinal stenosis Spironolactone Splenectomy Splenic disorders Splenic laceration Spondyloarthropathy Spontaneous abortion (SAB) Spontaneous bacterial peritonitis Squamous cell carcinoma cervical esophagus lung skin vulva SSRIs See Selective serotonin reuptake inhibitors Stages of labor Staphylococcus aureus in endocarditis in food poisoning in meningitis in osteomyelitis in pneumonia in sepsis skin infection with Staphylococcus epidermidis Staphylococcus saprophyticus Statins Status epilepticus Sterilization Steroid responsive nephropathy Steroids for Addison disease anabolic for asthma for inflammatory bowel disease for kidney disease for leukemia for MS for psoriasis for rheumatoid arthritis for skin disorders Stevens-Johnson syndrome Stomach disorders Strangulated bowel Strangulated hernia Streptococcal pharyngitis Streptococcus Streptococcus agalactiae Streptococcus pneumoniae in meningitis in otitis media in pneumonia Streptococcus pyogenes, skin infection with Streptococcus viridans Streptokinase Stress incontinence Stroke Sturge-Weber syndrome Subacute sclerosing panencephalitis Subacute thyroiditis Subarachnoid hemorrhage Subdural hematoma Subependymal giant cell astrocytoma Substance abuse Suicide Sulfamethoxazole (SMX) Sulfasalazine Sulfinpyrazone Sulfonylureas Sunburst sign Superior cerebellar artery Suprapubic pressure Supraventricular tachycardia (SVT), paroxysmal SVT See Supraventricular tachycardia Sweat chloride test Swimmer´s ear Syncope Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) Syphilis Syringomyelia Systemic inflammatory response syndrome (SIRS) Systemic lupus erythematosus (SLE) Systolic dysfunction T t test Tachycardia, fetal Taenia solium Tamoxifen Tamponade See Cardiac tamponade Tanner stages Tardive dyskinesia Tay-Sachs TCAs See Tricyclic antidepressants T-cell immunodeficiency syndromes Temazepam Temporal arteritis Temporal lobes, lesions of Tension headache Tension pneumothorax (PTX) Teratogens Teratoma Terazosin Terbutaline Testes Testicular torsion Tetanus Tetanus vaccine Tetracycline Tetralogy of Fallot Thalassemia Thalidomide Theca lutein cyst Theophylline Thiazide diuretics Thiazolidinediones Thin membrane disease Thioridazine Third-degree heart block Threatened abortion Thrombocytosis, essential Thrombolytics Thrombotic thrombocytopenic purpura (TTP) Thrush Thyroid cancer Thyroid disorders Thyroid storm Thyroiditis Ticlopidine Tinea Tissue plasminogen activator (tPA) TMP See Trimethoprim TNF-α See Tumor necrosis factor-a Tobacco Tocolytic agents Todd´s postictal paralysis Tolerance Tonic-clonic seizure Tophi Torsade de pointes Torsion, testicular Total anomalous pulmonary venous return Tourette syndrome Toxic megacolon Toxicology Toxoplasma gondii Toxoplasmosis tPA See Tissue plasminogen activator Tracheoesophageal fistula Transient ischemia attack (TIA) Transitional cell cancer, bladder Transplantation, liver Transposition of the great vessels Transudate pleural effusion Transvestism Tranylcypromine Trauma Traumatic aortic rupture Trazodone Tremor Treponema pallidum Triazolam Trichinosis Trichloroacetic acid Trichomonas vaginalis Trichomoniasis Trichotillomania Tricuspid atresia Tricuspid regurgitation Tricyclic antidepressants (TCAs) Trifluoperazine Trigeminal neuralgia Trimethoprim (TMP) Triple A rupture Trisomy 13 See Patau syndrome Trisomy 18 See Edward syndrome Trisomy 21 See Down syndrome Troponin I Trousseau´s sign Trousseau syndrome Truncus arteriosus Trypanosoma cruzii TTP See Thrombotic thrombocytopenic purpura Tuberculosis Tuberous sclerosis Tubular adenoma Tubulovillous adenoma Tumor necrosis factor-a (TNF-a), for inflammatory bowel disease Turcot syndrome Turner syndrome Twins Twin-to-twin transfusion syndrome Type 1 diabetes mellitus in children Type 2 diabetes mellitus Type I error Type II error Tyramine U Ulcerative colitis Ultralente insulin Ultrasound (US) for appendix disorders for breast cancer for gallbladder disorders for pancreas disorders in pregnancy Umbilical cord prolapse Uncal herniation Undifferentiated schizophrenia Uremia Urinary incontinence Urinary tract Urinary tract infections (UTI) Urticaria US See Ultrasound Uterine atony Uterine bleeding, abnormal Uterine rupture UTI See Urinary tract infections V Vaccines Vaginal birth after cesarean (VBAC) Vaginismus Vaginitis Validity Valproic acid Valvular heart disease Vancomycin VAP See Ventilator-associated pneumonia Varicella adult immunization recommendations childhood immunization recommendations clinical manifestations Varices See Esophageal varices Varicocele Vasa previa Vascular dementia Vascular disorders Vasculitides Vasoocclusive crisis Vasopressin Vasospasm VBAC See Vaginal birth after cesarean Vector-borne illness Velcro crackles Venlafaxine Venous stasis Ventilation/perfusion scan Ventilator-associated pneumonia (VAP) Ventricular fibrillation Ventricular septal defect Ventricular tachycardia Verapamil Verruca vulgaris Vertigo Vesicle Vesicoureteral reflux Vesicovaginal fistula Vestibular neuronitis Vestibular system infarction Vestibulitis, vulvar Vibrio cholera Vibrio parahaemolyticus Vibrio vulnificus Villous adenoma Vincristine Violence VIPoma Virchow node Virchow´s triad Visual field defects Vitamins, prenatal Vitamin B12 deficiency Vitamin D supplementation Vitiligo Voiding cystourethrogram Volvulus von Hippel-Lindau disease von Recklinghausen disease von Willebrand disease Voyeurism Vulvar cancer W Waldenstrom macroglobulinemia Wallenberg syndrome Warfarin Waterhouse-Friderichsen syndrome Watershed infarction Wegener´s granulomatosis Well´s criteria Werdnig-Hoffmann Wermer syndrome Wernicke-Korsakoff syndrome Wernicke´s area, lesions of Wernicke´s encephalopathy West syndrome Westermark´s sign Western blot, for HIV Whipple disease Whipple procedure Whipple´s triad White blood cell neoplasia Wilms tumor Wilson disease Wiskott-Aldrich syndrome Withdrawal Wolff-Parkinson-White syndrome Woods corkscrew maneuver Wrist fracture X Xanthoma Xeroderma pigmentosum X-linked agammaglobulinemia Y Yersinia Yersinia enterocolitica Z Zanamivir Zavanelli maneuver Zenker diverticulum Zidovudine Zinc pyrithione Zollinger-Ellison syndrome ... 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... University of California Los Angeles SUNY Upstate Medical University Class of 20 08 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... This recommendation is of particular importance in connection with new or infrequently used drugs DEJA REVIEWTM USMLE Step 2 CK Second Edition John H Naheedy, MD Fellow, Pediatric Radiology Department of Radiology