USMLE Step 2 CK and Shelf Exams Review

Introduction

• Speaker: Rahul Deania, Pediatric Critical Care Physician
• Objective: To prepare for and excel on USMLE Step 1 and Step 2 CK exams
• Teaching Strategy: Emphasis on strategy, active learning, evidence-based methods, vignette-focused learning, and test-taking psychology

Unique Aspects of Learning

• Integration across organ systems
• Focus on both small details and overarching strategies
• Emphasis on understanding pathophysiology as a basis for diagnosis and treatment

Exam Strategies

• Step 2 CK:
  • Builds on Step 1, requiring mastery of basic sciences
  • Questions often focus on diagnosis, etiology, risk factors, and management steps
  • Importance of understanding pathophysiology for treatment and management

High Yield Topics for Step 2 CK

• Preparation of specific topics frequently tested on NBMEs and UWorld

Important Timelines in Pregnancy

• 24 weeks: Oral glucose challenge test
• 28 weeks: Rhogam for Rh-negative mothers
• 34 weeks: Focus on fetal lung maturity
• 36 weeks: GBS screening

Pathologies and Management

Obstetrics

Ectopic Pregnancy

• Symptoms: Unilateral adnexal tenderness, positive Beta-hCG, no intrauterine pregnancy
• Risk Factors: PID, IUD, endometriosis
• Management: Laparoscopy for unstable patients; Methotrexate for stable patients with no fetal cardiac activity

Molar Pregnancy

• Signs: First trimester bleeding, elevated Beta-hCG, large uterus
• Management: Dilation and curettage, follow Beta-hCG levels

Pre-eclampsia

• Symptoms: Hypertension, proteinuria, edema
• Complications: Placental insufficiency, HELLP syndrome
• Management: Magnesium sulfate and delivery if severe

Labor and Delivery

• Complications: Cord prolapse, uteroplacental insufficiency
• Management: Emergency C-section for cord prolapse

Gynecology

Polycystic Ovarian Syndrome (PCOS)

• Symptoms: Hirsutism, obesity, anovulation
• Management: Lifestyle changes, metformin, spironolactone, clomiphene for fertility

Endometriosis

• Symptoms: Cyclical pelvic pain, dysmenorrhea
• Management: OCPs, NSAIDs, laparoscopy for refractory pain

Vaginitis

• Types: Bacterial vaginosis, candidiasis, trichomoniasis
• Management: Metronidazole for BV and trichomoniasis, fluconazole for candidiasis

Screening Recommendations

• HPV Screening: Starts at age 21, every 3 years, co-testing after age 30

Conclusion and Additional Resources

• Resources: Online courses for Step 1 and Step 2 CK
• Community: Encouragement to join online learning communities and follow social media for additional learning and support

Key Takeaways

• Emphasis on active and engaged learning, integrating content knowledge with test-taking strategies
• High yield topics and management strategies for OB/GYN and internal medicine