MTB USMLE Step2 CK 6e 2p

Master the Boards USMLE Step 2 CK, Sixth Edition ISBN 978‐1‐5062-5458-6
Please note the following updates and corrections:
Page Change
31 Recommended frequency of screening, bullet 1 (colon cancer guideline
change): Routine testing beginning at age 45 …
40 Table (hepatitis B serologic patterns), surface antigen for acute or chronic
infection: Positive
51 Symptoms bullet 3 (hyperprolactinemia): While men may experience
gynecomastia, men very rarely experience galactorrhea
81 Diagnostic tests (chest pain), bullet 4 sub-bullets:
• Alternate methods …
– Dipyridamole or adenosine …
– Dobutamine plus echocardiogram
∘ Dobutamine will increase myocardial oxygen consumption and provoke
ischemia detected as wall motion abnormalities on echo …
∘ Contraindications …
81 Bullet after “Tip,” last sentence:
• … Abnormalities on echocardiogram will be detected by seeing decreased
thallium uptake.
82 “Tip,” bottom of page: The 2 methods that can detect ischemia in terms of
using nuclear isotopes or echo are essentially equal in terms of sensitivity
and specificity.
106 Table, Diastolic Dysfunction treatment:
Clearly not beneficial: Digoxin
Benefit uncertain: ACEIs, ARBs, Beta blockers
116 Treatment bullet 3 (aortic regurgitation), last sentence: … Replace or repair
the valve before the left ventricle dilates excessively, while EF is <55% or left
ventricular end systolic diameter >55 mm.
121 Text passage is misplaced; moves to p122 after “Tip.”
Begins with: Restrictive Cardiomyopathy (section head)
Ends with: Treat the underlying cause. Diuretics may relieve some of the
pulmonary hypertension and signs of right heart failure.
155 Sidebar 2: If the PPD is positive, the patient must be treated, regardless of
past BCG immunization.
158 Last sub-bullet (VATS):
– … Frozen section in the operating room allows for immediate conversion
to an open thoracotomy and lobectomy if malignancy is found.
163 Table, ILD symptoms:
• Lung only (no fever)
• No fever
• Chronic/progressive
182 Practice question 1 (encephalitis) answer explanation, sentence 2: Viral
culture is a test of skin and genital lesions, but it is not as accurate as
PCR.
194 Treatment sub-bullets (acute prostatitis):
– Ceftriaxone or quinolone (first-line); if age <30, add doxycycline to
ceftriaxone
– Ciprofloxacin (oral for outpatient)
195 Table, delete last 3 rows:
Treatment of Culture-Negative Endocarditis
Coxiella (does not grow in regular culture) Ceftriaxone
Bartonella (does not grow in regular culture) Ceftriaxone
198 Treatment bullet 2 (Lyme disease):
• Rash: doxycycline or amoxicillin or cefuroxime
269 Treatment sub-bullet 2 (autoimmune hemolysis): … azathioprine, and
mycophenolate mofetil are alternative ...
289 Hemophilia bullet 2:
• Prolonged aPTT, but mixing study corrects to normal (as occurs
whenever there is a deficiency of clotting factors)
301 Migraine treatment paragraphs & bullets are replaced:
Abortive treatment for migraine and cluster headache is as follows:

• Both migraine and cluster: ergotamine or a triptan (e.g., sumatriptan,
eletriptan, almotriptan, zolmitriptan)
• Cluster only: 100% oxygen
• Migraine only:
– Lasmiditan (5-HT1 inhibitor that does not cause vasoconstriction)
is used when there is a contraindication to triptans (hypertension,
coronary disease)
– Ubrogepant (calcitonin gene-related peptide [CGRP] antagonist)
Prophylactic (preventive) treatment for migraine and cluster headache
is as follows:
• Migraine: propranolol, CGRPs (erenumab, fremanezumab,
galcanezumab), CCBs; tricyclic antidepressants (amitriptyline),
SSRIs; topiramate; and botulinum toxin injections
• Cluster: verapamil, prednisone, lithium
308 Essential tremor, lines 1–2: Essential tremor is an action tremor that is
activated by voluntary movement or when the arms are held in a fixed
posture against gravity. It may affect some manual skills …
355 Diagnostic tests (SIADH), delete last sentence: The most accurate test is
measurement of ADH showing a high level.
382 Practice question (breast cancer) answer explanation: Answer: B. Selective
estrogen receptor modulators …

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Master the Boards USMLE Step 2 CK, Sixth Edition ISBN 978‐1‐5062-5458-6

Please note the following updates and corrections:

Abortive treatment for migraine and cluster headache is as follows:

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