Usmle step 2 question of the day

Questions assessing basic science concepts are covered on Step 1. However, foundational science knowledge will often be needed to answer items on Step 2 CK, even if the question is focused on diagnosis or management. You can see examples of Step 2 CK items that require foundational science knowledge here.

These examples include an explanation of why and how foundational science is needed to answer a test item that is not primarily focused on basic science. Foundational science knowledge is needed both for licensure examinations and for lifelong learning that continues beyond assessment.

Examinees who tested before the exam was updated in November 2020 saw slightly more Diagnosis items than Management items on Step 2 CK, whereas examinees who tested after the update saw equal amounts of both types of test items. The proportion of items allocated within Organ Systems did not change. More detail is available here.

Overview

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 includes emphasis on health promotion and disease prevention. Step 2 CK ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine under supervision.

Step 2 CK is a one-day examination. It is divided into eight 60-minute blocks and administered in one 9-hour testing session. The number of questions per block on a given examination will vary but will not exceed 40. The total number of items on the overall examination will not exceed 318.

Content Outline & Specifications

Review the Step 2 CK content outline, as well as specifications for the systems, physician tasks/competencies, and disciplines covered on the exam.

Scheduling Information

Step 2 CK is administered at Prometric test centers. Visit the Prometric website to schedule or reschedule an exam, locate a test center, confirm or cancel your appointment, and find information on test center policies.

Bulletin of Information

The Bulletin includes information on all aspects of the USMLE, such as eligibility requirements, scheduling test dates, testing, and score reporting. At the time you apply for Step 2 CK, you will be asked to certify that you agree to comply with the policies and procedures within the USMLE BOI.

Exam Eligibility

Examinees must meet certain requirements before becoming eligible to take the USMLE Step 2 CK. Click the link below to review these requirements and find information on time and attempt limits, retakes, what to do about a change in eligibility status, and more.

Prepare for Your Exam

Once you’ve completed the registration process, you can explore resources designed to help you get ready for test day, including the interactive testing experience, which provides tips on navigating the USMLE interface and access to sample test questions. 

Test Accommodations

The USMLE Program is committed to providing test accommodations to examinees with documented disabilities under the Americans with Disabilities Act (ADA). Click the link below to learn more about the types of accommodations available and for instructions on submitting a request.

Common Questions

In addition to contacting us directly, you can visit the Common Questions section for answers to the most frequently asked questions.

A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She is not yet on dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and mean corpuscular volume is 94 m3. A blood smear shows normochromic, normocytic cells. Which of the following is the most likely cause?

(A) Acute blood loss

(B) Chronic lymphocytic leukemia

(C) Erythrocyte enzyme deficiency

(D) Erythropoietin deficiency

(E) Immunohemolysis

(F) Microangiopathic hemolysis

(G) Polycythemia vera

(H) Sickle cell disease

(I) Sideroblastic anemia

(J) β-Thalassemia trait

(Answer: D)

Patient Information
Age: 18 years
Gender: F, self-identified
Ethnicity: unspecified
Site of Care: emergency department

History
Reason for Visit/Chief Concern: "My roommate took a lot of pills and said she wanted to die."

History of Present Illness:
•   patient brought by ambulance 2 hours after a suspected acetaminophen overdose
•   roommate had returned to their dorm and found the patient distraught; patient was holding an empty bottle of acetaminophen and said, "I just want to die."
•   roommate estimates patient consumed 20 to 30 tablets of 500-mg acetaminophen

Past Medical History:
•   generalized anxiety disorder
•   major depressive disorder

Medications:
•   citalopram

Allergies:
•   no known drug allergies

Family History:
•   noncontributory

Physical Examination

•   Appearance: awake and alert but distraught and fearful; patient says, "This was totally stupid."
•   Pulmonary: clear lung fields
•   Cardiac: regular rhythm; S1 and S2, with an early systolic murmur
•   Abdominal: soft and nontender; liver and spleen cannot be palpated
•   Neurologic: no abnormalities; fully oriented

Question: In addition to obtaining serum acetaminophen concentration, which of the following is the most appropriate next step in management?

(A) Administer N-acetylcysteine

(B) Arrange hemodialysis

(C) Gastric lavage

(D) Initiate sodium bicarbonate infusion

(Answer: A)

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