Exam preparation
USMLE Step 2
- Multiple choice
- United States
- Medicine
- United States Medical Licensing Examination (USMLE)
3 guides for this exam — how to prepare, what to practise, and how to know it has gone in.
Plan your USMLE Step 2 revision: a day-by-day calendar up to your exam date, free and without an account.
A written answer, marked
A question from a USMLE Step 2 mock paper, answered and marked. From How to Prepare for USMLE Step 2 CK: A Practical Guide.
A 58-year-old man has sudden pleuritic chest pain and dyspnoea after a long flight. He is alert, blood pressure is 124/76 mmHg, heart rate is 106/min, oxygen saturation is 95% on room air, and examination shows no shock. What is the next best step?
3/4I would obtain CT pulmonary angiography immediately because pulmonary embolism is the most likely diagnosis.
You recognised pulmonary embolism, but moved directly to imaging without first establishing whether the patient is in a group where D-dimer is useful or whether another finding makes imaging the appropriate first test.
Missed
−State the pretest probability before choosing D-dimer or imaging.
−Explain why haemodynamic stability matters to the initial pathway.
Model answerRepresent the problem as a stable patient with suspected pulmonary embolism after a provoking risk factor. Assess clinical probability using the history and examination. If the probability is low or intermediate and there is no contraindication, D-dimer can be used to decide whether imaging is needed; higher probability generally proceeds to appropriate imaging. Reassess immediately if instability develops.
Yours are written from your own notes, and the free plan needs no payment details.
Guides
- How to Prepare for USMLE Step 2 CK: A Practical GuideA practical USMLE Step 2 preparation method for clinical reasoning, timed blocks, error review, spaced repetition and high-yield revision.
- USMLE Step 2 Study Plan: A Practical CK MethodBuild a practical USMLE Step 2 CK study plan with diagnostic testing, question review, clinical reasoning drills, and a final revision strategy.
- USMLE Step 2 Practice Questions: Clinical ReasoningWork through 10 USMLE Step 2 practice questions on diagnosis, next steps, management, prevention and patient safety.
Preparing for USMLE Step 2? Build your USMLE Step 2 board from your own notes — the cards, papers and lectures are written from it. Free plan: 20 cards, a paper, a lecture and a viva to try.
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