Click Study Flashcards above to open the flashcard hub — hundreds of USMLE Step 2 CK cards you can flip, match, type, or quiz yourself on. Every card is drawn from the high-yield clinical knowledge Step 2 CK tests, so you study exactly what the exam measures.[1] Pair them with our free practice questions and study guide.
USMLE Step 2 CK Flashcard Study Modes
Flip mode carries the first pass, one card at a time, front then back. Match turns terms and definitions into a timed pairing game. Type hides the term and asks you to produce it from the definition, so a front like Wells score use has to come back cold. Quiz builds multiple choice from the same cards when you want a spot check.
Why Flashcards Work for USMLE Step 2 CK
Internal Medicine is the largest block at 88 cards, and it sets the tone for the rest of the deck: pattern recognition, first test, first treatment. Cards run from STEMI on ECG and SIADH lab pattern to Latent TB treatment, Sepsis early bundle, and DVT confirmatory test, so you are rehearsing the short chain from presentation to the next best step.
Cross-Cutting Clinical Science holds 45 cards covering biostatistics, study design flaws, and patient safety vocabulary. Expect definitions that have to be exact rather than approximate, including Recall bias, Type I error, p-value meaning, and safety terms such as Never event and Sentinel event, which are easy to confuse under time pressure.
Surgery & Emergency Medicine adds 43 cards on trauma, acute abdomen, and the imaging or physical findings that decide disposition. FAST exam purpose, Epidural hematoma, Perforated viscus signs, and Mesenteric ischemia clue are the kind of fronts here, along with management cards like Appendicitis treatment.
Pediatrics contributes 43 cards spanning infectious presentations and development, with Croup features, Bronchiolitis cause, APGAR score components, and milestone cards such as Social smile milestone. Obstetrics & Gynecology matches that with 43 cards on pregnancy complications and gynecologic diagnosis, including HELLP syndrome, Eclampsia treatment, Ectopic pregnancy clue, and Uterine atony treatment.
Psychiatry closes the deck with 43 cards on diagnostic criteria, drug monitoring, and adverse effects. Fronts like PTSD features, Panic disorder, Lithium monitoring, Tardive dyskinesia, and Delirium tremens keep the distinctions sharp, since several of these appear in medicine and emergency settings rather than a psychiatry clinic.
That matters on Step 2 CK, where a vast clinical fact base (the best confirming test, first-line treatments, diagnostic criteria, antidotes, and can’t-miss emergencies) must be instantly available under time pressure. Used alongside our practice questions and study guide, flashcards turn review time into measurable progress.
USMLE Step 2 CK Flashcards by Topic
The cards are organized by the clerkship disciplines you rotate through. Internal medicine carries most of the exam, so weight your time there — but the rule-based facts in every discipline (ABCDE, the four Ts, MUDPILES, antidotes) are pure recall and reliable points:[1]
| Flashcard topic | Approx. Step 2 CK discipline weight |
|---|---|
| Internal Medicine | 55–65% (the largest) |
| Pediatrics | 17–27% |
| Obstetrics & Gynecology | 10–20% |
| Psychiatry | 10–15% |
| Surgery & Emergency Medicine | 5–15% (surgery) + acute care |
| Cross-cutting (biostatistics, ethics, prevention) | Threaded through every discipline |
Ranges overlap because each Step 2 CK question maps to several axes at once. Because the rule-based associations are so reliably tested, they are some of the most efficient points you can bank with flashcards.
How to Get the Most Out of These Flashcards
- Start with Internal Medicine. At 88 cards it is nearly a third of the deck and its diagnostic and treatment reasoning reappears inside the surgery, obstetrics, and psychiatry cards.
- Type-drill the exact ones. Cards such as SIADH lab pattern and Hyperthyroidism labs reward precise recall, and typing them exposes the vague half-answers that Flip mode lets you accept.
- Match the look-alikes. Pair-based play works best on cards that blur together, like Epidural hematoma against Subdural hematoma, or the pediatric rash and airway presentations.
- Switch to the practice test early. Once a domain flips cleanly with few misses, move to the practice test and the study guide so you rehearse full vignettes, not isolated terms.
- Rotate rather than cram. With 305 cards, work one domain per sitting, then re-run yesterday’s misses in Quiz mode before starting the next domain.
USMLE Step 2 CK Flashcards FAQ
Hundreds of free USMLE Step 2 CK flashcards, spanning the highest-yield clinical knowledge the exam tests — internal medicine, surgery and emergency medicine, pediatrics, obstetrics and gynecology, psychiatry, and the cross-cutting biostatistics, ethics, and prevention topics. They're free with no account required.
Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective ways to make facts stick, especially in short sessions spread over several days. That matters for Step 2 CK's clinical fact base: the best test, first-line treatments, diagnostic criteria, and the can't-miss emergencies.
Every clinical discipline the content outline tests: medicine (the largest, 55–65%) and pediatrics (17–27%), plus obstetrics and gynecology, psychiatry, and surgery, along with the cross-cutting biostatistics and evidence-based medicine, ethics, patient safety, and preventive-medicine topics that thread through the exam.
Yes. Every card is written to the level the USMLE expects of a student applying clinical science to patient care under supervision — the diagnostic clues, the best confirming test, the first-line management, and the dangerous drug reactions — framed the way Step 2 CK tests them, through clinical vignettes.
Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself. Weight your time toward internal medicine (the majority of the exam) and the can't-miss emergencies, and turn the rule-based facts — ABCDE, the four Ts, MUDPILES — into instant recall.
Yes — 100% free, all four study modes, no paywall.
USMLE Step 2 CK flashcard bank
All 305 cards, by topic
A reference copy of every card in this deck. Each answer stays hidden until you choose to show it. To study with Flip, Match, Type and Quiz modes and track what you have mastered, use Study Flashcards at the top of the page.
Internal Medicine (88)
- First-line reperfusion for STEMI
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Primary PCI, door-to-balloon under 90 minutes; fibrinolytics only if timely PCI is unavailable.
- Initial workup of acute chest pain
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ECG within 10 minutes + troponin; aspirin, monitor, treat ischemia.
- STEMI on ECG
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ST-segment elevation in a coronary territory (or new LBBB); complete coronary occlusion.
- NSTEMI vs unstable angina
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Both lack ST-elevation; NSTEMI has a rising troponin, unstable angina has a normal troponin.
- Aspirin in suspected ACS
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Give chewed aspirin immediately to all patients with suspected acute coronary syndrome.
- Heart failure with reduced EF — survival drugs
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ACE inhibitor (or ARB/ARNI), beta-blocker, and aldosterone antagonist improve survival.
- Acute decompensated heart failure first step
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Diuresis for congestion (IV loop diuretic), oxygen, and address the precipitant.
- Atrial fibrillation management pillars
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Rate (or rhythm) control plus anticoagulation guided by CHA2DS2-VASc score.
- Aortic stenosis murmur
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Crescendo-decrescendo systolic ejection murmur at the right upper sternal border, radiating to the carotids.
- Mitral regurgitation murmur
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Holosystolic murmur at the apex radiating to the axilla.
- Most common cause of secondary hypertension (young woman)
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Fibromuscular dysplasia (renal artery); in older patients, atherosclerotic renal artery stenosis.
- First-line antihypertensives
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Thiazide diuretic, ACE inhibitor/ARB, or calcium channel blocker (per patient factors).
- Hypertensive emergency
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Severe hypertension with acute end-organ damage; lower BP with IV agents in a controlled fashion.
- Suspected pulmonary embolism — confirmatory test
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CT pulmonary angiography (V/Q scan if contrast contraindicated).
- Pulmonary embolism treatment
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Anticoagulation (heparin or a DOAC); thrombolysis if massive/hemodynamically unstable.
- Wells score use
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Estimates pretest probability of pulmonary embolism (or DVT) to guide D-dimer vs imaging.
- Obstructive vs restrictive lung disease
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Obstructive: low FEV1/FVC ratio (asthma, COPD). Restrictive: low volumes, preserved ratio.
- Asthma reliever vs controller
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Short-acting beta-agonist relieves; inhaled corticosteroid is the cornerstone controller.
- COPD exacerbation treatment
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Bronchodilators, systemic steroids, and antibiotics if increased/purulent sputum; oxygen as needed.
- Community-acquired pneumonia first test
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Chest X-ray; treat with empiric antibiotics by severity and setting.
- Sepsis early bundle
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Lactate, blood cultures before antibiotics, broad-spectrum antibiotics, and crystalloid fluids.
- Septic shock first-line vasopressor
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Norepinephrine.
- Definition of septic shock
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Sepsis with persistent hypotension needing vasopressors plus an elevated lactate despite fluids.
- Anion gap metabolic acidosis causes
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MUDPILES: methanol, uremia, DKA, propylene glycol, isoniazid/iron, lactic acidosis, ethylene glycol, salicylates.
- Normal-gap metabolic acidosis causes
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Bicarbonate loss: diarrhea and renal tubular acidosis.
- Diabetic ketoacidosis treatment order
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IV fluids first, then insulin infusion, with potassium replacement; treat the precipitant.
- Why replace potassium in DKA
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Insulin drives potassium into cells, so total-body potassium falls; hold insulin if K+ is dangerously low.
- When to switch DKA to subcutaneous insulin
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After the anion gap closes and the patient can eat.
- Acute kidney injury categories
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Prerenal (low perfusion), intrinsic (e.g., ATN), and postrenal (obstruction).
- FeNa interpretation in AKI
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Low FeNa (under 1%) suggests prerenal; higher FeNa suggests intrinsic (ATN).
- Hyperkalemia ECG changes
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Peaked T waves progressing to a widened QRS and a sine-wave pattern.
- Hyperkalemia emergency treatment
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IV calcium to stabilize the myocardium; insulin with glucose and albuterol to shift potassium intracellularly.
- Hyponatremia first step
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Assess volume status and serum osmolality; correct slowly to avoid osmotic demyelination.
- Microcytic anemia causes
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Iron deficiency, thalassemia, anemia of chronic disease, sideroblastic, lead poisoning.
- Macrocytic anemia causes
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Vitamin B12 or folate deficiency (megaloblastic) and other causes.
- Iron-deficiency anemia confirming test
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Low ferritin; microcytic, hypochromic red cells. Find the source of blood loss.
- Hyperthyroidism labs
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Low TSH with high free T4 (and/or T3); Graves disease is the most common cause.
- Hypothyroidism labs and first symptom set
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High TSH with low free T4; fatigue, weight gain, cold intolerance, constipation.
- Cushing syndrome screening tests
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Late-night salivary cortisol, 24-hour urinary free cortisol, or low-dose dexamethasone suppression test.
- Adrenal insufficiency labs
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Low cortisol; primary (Addison) shows high ACTH with hyperkalemia and hyponatremia.
- Type 2 diabetes first-line drug
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Metformin, alongside lifestyle change.
- Upper vs lower GI bleed
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Upper: hematemesis, melena (above the ligament of Treitz). Lower: hematochezia.
- Acute pancreatitis diagnosis
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Two of: typical pain, lipase (or amylase) 3x upper limit of normal, or imaging findings.
- Most common causes of acute pancreatitis
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Gallstones and alcohol.
- Cirrhosis decompensation signs
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Ascites, variceal bleeding, hepatic encephalopathy, and jaundice.
- Hepatic encephalopathy treatment
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Lactulose (and rifaximin); identify and treat the precipitant.
- Spontaneous bacterial peritonitis diagnosis
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Ascitic fluid neutrophil count of 250 cells per microliter or more.
- Inflammatory bowel disease — UC vs Crohn
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UC: continuous colonic involvement, mucosa only. Crohn: skip lesions, transmural, anywhere mouth to anus.
- C. difficile colitis treatment
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Oral vancomycin or fidaxomicin; stop the offending antibiotic.
- Stroke — ischemic acute treatment window
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IV thrombolysis within the eligible time window if no hemorrhage on CT; mechanical thrombectomy for large-vessel occlusion.
- First imaging in suspected stroke
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Non-contrast head CT to exclude hemorrhage before thrombolysis.
- Bacterial meningitis empiric treatment
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Empiric antibiotics promptly (do not delay for imaging or LP) plus dexamethasone where indicated.
- Community-acquired UTI vs pyelonephritis
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Cystitis: dysuria, frequency. Pyelonephritis: fever, flank pain, costovertebral angle tenderness.
- Gout acute attack treatment
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NSAIDs, colchicine, or corticosteroids; start urate-lowering therapy later, not during the acute attack.
- Rheumatoid arthritis hallmark
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Symmetric small-joint inflammatory arthritis with morning stiffness; treat with DMARDs (e.g., methotrexate).
- Systemic lupus screening antibody
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ANA is sensitive (screening); anti-dsDNA and anti-Smith are specific.
- Most common cause of hyperthyroidism
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Graves disease (autoimmune TSH-receptor stimulation).
- DVT confirmatory test
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Compression ultrasound of the legs; treat with anticoagulation.
- Anticoagulation reversal — warfarin
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Vitamin K plus prothrombin complex concentrate (or FFP) for major bleeding.
- Anticoagulation reversal — dabigatran
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Idarucizumab.
- Anticoagulation reversal — factor Xa inhibitors
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Andexanet alfa (or PCC).
- Statin indication
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Established atherosclerotic disease, LDL very high, diabetes (age-based), or elevated 10-year risk.
- Diabetic nephropathy protective drug
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ACE inhibitor or ARB (reduces proteinuria and slows progression).
- SIADH lab pattern
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Euvolemic hyponatremia with concentrated urine and low serum osmolality.
- Most common cause of community-acquired pneumonia
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Streptococcus pneumoniae.
- Aortic dissection — best initial imaging (stable)
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CT angiography of the chest; control heart rate and blood pressure (beta-blocker first).
- Most common cause of infective endocarditis (native valve)
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Staphylococcus aureus; obtain blood cultures and an echocardiogram.
- Tuberculosis treatment (initial phase)
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Rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE).
- Latent TB treatment
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Isoniazid (with B6) or a rifampin-based regimen; treat to prevent reactivation.
- Hyperthyroid storm treatment
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Beta-blocker, thionamide, iodine (after thionamide), and steroids; supportive care.
- Diabetic foot infection principles
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Assess perfusion and bone (osteomyelitis), debride, and give targeted antibiotics.
- Most common electrolyte cause of long QT
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Hypokalemia, hypomagnesemia, or hypocalcemia; correct to prevent torsades.
- Torsades de pointes treatment
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IV magnesium sulfate; correct electrolytes and remove offending drugs.
- Acute asthma exacerbation severity sign
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Inability to speak in full sentences, a silent chest, and a rising CO2 are ominous.
- COPD long-term oxygen therapy indication
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Resting hypoxemia (low PaO2 or SaO2); improves survival.
- Hyponatremia correction rate caution
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Correct slowly to avoid osmotic demyelination syndrome.
- Most common cause of hypercalcemia (outpatient)
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Primary hyperparathyroidism; in inpatients, malignancy.
- Acute gout vs septic arthritis
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Aspirate the joint: gout shows negatively birefringent crystals; septic shows organisms/high WBC.
- Pulmonary embolism in pregnancy imaging
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Compression ultrasound first; V/Q scan or CT-PA as needed with shielding.
- Anaphylaxis biphasic reaction
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Symptoms can recur hours later; observe after the initial event.
- Most common cause of acute pericarditis presentation
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Pleuritic chest pain relieved by sitting forward, diffuse ST elevation; often viral.
- Heparin-induced thrombocytopenia
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Platelet drop ~5-10 days after heparin with thrombosis; stop heparin, use a non-heparin anticoagulant.
- Acute upper GI bleed initial step
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Resuscitate, IV PPI, and urgent endoscopy; octreotide if variceal.
- Hypoglycemia treatment (conscious)
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Oral fast-acting glucose; IV dextrose or glucagon if unable to take oral.
- Most common cause of secondary headache to exclude
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Subarachnoid hemorrhage — 'worst headache of life'; non-contrast CT then LP if negative.
- Multiple sclerosis acute flare treatment
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High-dose corticosteroids.
- Diabetic retinopathy prevention
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Tight glycemic and blood-pressure control plus regular eye screening.
- Asthma vs COPD reversibility
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Asthma airflow obstruction is largely reversible with bronchodilators; COPD is largely fixed.
Surgery & Emergency Medicine (43)
- Trauma primary survey order
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ABCDE: Airway with C-spine, Breathing, Circulation, Disability, Exposure/Environment.
- Tension pneumothorax treatment
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Immediate needle decompression, then a chest tube — a clinical diagnosis, treat before imaging.
- Cardiac tamponade — Beck triad
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Hypotension, distended neck veins, and muffled heart sounds; treat with pericardiocentesis.
- Anaphylaxis first treatment
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Intramuscular epinephrine first, before antihistamines or steroids.
- Appendicitis classic presentation
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Periumbilical pain migrating to the right lower quadrant (McBurney point) with anorexia and rebound.
- Appendicitis confirming imaging
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CT in adults; ultrasound first in children and pregnancy.
- Appendicitis treatment
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Appendectomy with perioperative antibiotics.
- Cholecystitis first imaging
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Right-upper-quadrant ultrasound; positive Murphy sign.
- Perforated viscus signs
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Sudden severe diffuse abdominal pain with free air under the diaphragm; emergency laparotomy.
- Small-bowel obstruction findings
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Distension, vomiting, obstipation, and air-fluid levels on imaging.
- Most common cause of small-bowel obstruction
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Adhesions from prior surgery.
- Mesenteric ischemia clue
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Pain out of proportion to the exam in a patient with vascular risk factors.
- Abdominal aortic aneurysm rupture triad
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Hypotension, back/flank pain, and a pulsatile abdominal mass; emergency surgery.
- Postoperative fever — the five Ws
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Wind (atelectasis), Water (UTI), Wound, Walking (DVT), Wonder-drugs.
- Postoperative fever days 1-2
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Atelectasis (Wind) — encourage incentive spirometry and ambulation.
- VTE prophylaxis in surgical patients
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Early ambulation, mechanical prophylaxis, and pharmacologic prophylaxis when bleeding risk allows.
- Compartment syndrome signs
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Pain out of proportion, pain on passive stretch; emergency fasciotomy.
- Burn fluid resuscitation
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Calculate by body-surface area burned (e.g., Parkland-type formula); titrate to urine output.
- GCS intubation threshold
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Intubate to protect the airway when the Glasgow Coma Scale is 8 or below.
- Massive hemorrhage in trauma — resuscitation
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Control bleeding, give blood products (balanced transfusion), and find the source.
- FAST exam purpose
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Bedside ultrasound to detect free intra-abdominal or pericardial fluid in trauma.
- Bowel ischemia from a hernia
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An incarcerated, then strangulated hernia; tenderness and systemic signs require urgent surgery.
- Diverticulitis treatment
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Antibiotics and bowel rest for uncomplicated cases; surgery for complications (abscess, perforation).
- Acute limb ischemia — six Ps
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Pain, pallor, pulselessness, paresthesia, poikilothermia, paralysis; emergency revascularization.
- Necrotizing fasciitis clue
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Pain out of proportion, rapid spread, crepitus, systemic toxicity; emergency surgical debridement.
- Pneumothorax (simple) initial step in stable patient
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Chest X-ray; observe small ones, drain larger or symptomatic ones.
- Bowel perforation antibiotics
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Broad-spectrum coverage including anaerobes plus source control (surgery).
- Acute cholangitis — Charcot triad
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Fever, right-upper-quadrant pain, and jaundice; needs biliary drainage.
- Testicular torsion management
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Surgical emergency; immediate exploration/detorsion — do not delay for imaging if classic.
- Indication for emergent surgery in GI bleed
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Hemodynamic instability not controlled by resuscitation and endoscopy.
- Blunt abdominal trauma unstable patient
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Positive FAST with instability goes straight to the operating room.
- Surgical site infection prevention
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Timely prophylactic antibiotics, normothermia, glucose control, and sterile technique.
- Bowel obstruction — large vs small
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Large-bowel obstruction often from cancer/volvulus; small-bowel from adhesions/hernias.
- Sigmoid volvulus initial treatment
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Endoscopic detorsion if no peritonitis; surgery if ischemia/perforation.
- Acute appendicitis in pregnancy
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Still the most common non-obstetric surgical emergency; ultrasound/MRI, appendectomy.
- Epidural hematoma
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Lucid interval then deterioration; lens-shaped (biconvex) bleed; neurosurgical emergency.
- Subdural hematoma
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Crescent-shaped bleed, common in elderly/alcoholics after minor trauma.
- Increased intracranial pressure — Cushing triad
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Hypertension, bradycardia, and irregular respirations.
- Open fracture management
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Urgent antibiotics, tetanus prophylaxis, irrigation/debridement, and stabilization.
- Hip fracture in elderly
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Surgical fixation/replacement; early mobilization and VTE prophylaxis.
- Acute urinary retention treatment
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Bladder catheterization for decompression; treat the cause (e.g., BPH).
- Bowel perforation imaging clue
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Free air under the diaphragm on upright chest X-ray.
- Pancreatic pseudocyst
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A late complication of pancreatitis; drain if symptomatic or complicated.
Pediatrics (43)
- APGAR score components
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Appearance, Pulse, Grimace, Activity, Respiration; scored 0-2 each at 1 and 5 minutes.
- Physiologic vs pathologic neonatal jaundice
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Physiologic appears after 24 hours and resolves in ~2 weeks; jaundice in the first 24 hours or conjugated is pathologic.
- Unconjugated hyperbilirubinemia treatment
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Phototherapy; exchange transfusion at very high levels to prevent kernicterus.
- Conjugated (direct) hyperbilirubinemia in a newborn
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Never physiologic; suspect biliary atresia or hepatic disease and evaluate promptly.
- Social smile milestone
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About 2 months — the earliest social milestone.
- Sits unsupported milestone
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About 6 months.
- First words milestone
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About 12 months; two-word phrases by about 24 months.
- Walks independently milestone
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About 12-15 months.
- MMR and varicella vaccine timing
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About 12-15 months; both are live attenuated vaccines.
- Hepatitis B vaccine timing
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First dose at birth.
- Rotavirus vaccine route
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Oral, live vaccine given in infancy.
- Live vaccine contraindications
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Avoid in pregnancy and significant immunocompromise.
- Pyloric stenosis presentation
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Non-bilious projectile vomiting at 3-6 weeks with a palpable 'olive' mass.
- Pyloric stenosis lab abnormality
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Hypochloremic, hypokalemic metabolic alkalosis.
- Intussusception classic findings
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Currant-jelly stool and a target/'bull's-eye' sign on ultrasound; ages 6-36 months.
- Croup features
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Barking 'seal' cough, stridor, 'steeple sign'; usually parainfluenza virus.
- Epiglottitis features
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Drooling, tripod posture, toxic appearance; an airway emergency (now rare with Hib vaccine).
- Bronchiolitis cause
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Respiratory syncytial virus (RSV) in infants; supportive care.
- Febrile seizures age range
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6 months to 5 years; simple febrile seizures are usually benign.
- Most common pediatric malignancy
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Acute lymphoblastic leukemia (ALL).
- Kawasaki disease criteria clue
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Fever 5+ days plus conjunctivitis, rash, adenopathy, mucosal changes, and extremity changes; treat with IVIG and aspirin.
- Cystic fibrosis screening test
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Sweat chloride test (elevated).
- Developmental dysplasia of the hip screening
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Barlow and Ortolani maneuvers; ultrasound if positive.
- Vaccine schedule authority
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The CDC's Advisory Committee on Immunization Practices (ACIP).
- Non-accidental trauma red flag
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Injury pattern inconsistent with the stated mechanism or the child's developmental stage.
- Neonatal sepsis approach
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Low threshold for full sepsis workup and empiric antibiotics in an ill-appearing neonate.
- Failure to thrive definition
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Weight (or growth) falling across percentiles; evaluate intake, organic causes, and psychosocial factors.
- Most common cause of bronchiolitis hospitalization
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RSV.
- Meningitis in neonates — common organisms
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Group B Streptococcus, E. coli, and Listeria.
- Sickle cell — fever management
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Treat fever urgently with empiric antibiotics; high risk of encapsulated-organism sepsis.
- Tetralogy of Fallot — 'tet spell' maneuver
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Knee-to-chest positioning increases systemic vascular resistance and improves shunting.
- Childhood lead poisoning screening
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Blood lead level; common in older housing with lead paint.
- Reye syndrome association
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Aspirin use during a viral illness in children — avoid aspirin in kids.
- Roseola pattern
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High fever for days, then a rash appears as the fever breaks; HHV-6.
- Measles features
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Fever, cough, coryza, conjunctivitis, Koplik spots, then a descending rash.
- Whooping cough (pertussis)
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Paroxysmal cough with inspiratory whoop; treat with a macrolide.
- Slipped capital femoral epiphysis
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Obese adolescent with hip/knee pain and a limp; non-weight-bearing, surgery.
- Henoch-Schonlein purpura tetrad
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Palpable purpura, arthralgia, abdominal pain, and renal involvement.
- Neonatal respiratory distress syndrome
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Surfactant deficiency in preterm infants; antenatal steroids and surfactant.
- Jaundice in breastfed newborn timing
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Breastfeeding jaundice (early, suboptimal intake) vs breast-milk jaundice (later).
- Most common congenital heart defect
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Ventricular septal defect.
- Cyanotic congenital heart disease — the 5 Ts
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Truncus, Transposition, Tricuspid atresia, Tetralogy, TAPVR.
- Childhood immunization catch-up
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Use the ACIP catch-up schedule for late or missed vaccines.
Obstetrics & Gynecology (43)
- Preeclampsia definition
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New-onset hypertension after 20 weeks of pregnancy with proteinuria or end-organ dysfunction.
- Preeclampsia seizure prophylaxis
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Magnesium sulfate; the definitive cure is delivery.
- Eclampsia treatment
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Magnesium sulfate plus control of blood pressure and delivery.
- Magnesium toxicity signs
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Loss of deep tendon reflexes, respiratory depression; treat with IV calcium gluconate.
- Gestational diabetes screening timing
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24-28 weeks with a glucose challenge/tolerance test.
- RhoGAM (anti-D) indication
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Rh-negative mother — give around 28 weeks and after delivery of an Rh-positive infant.
- Placenta previa presentation
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Painless third-trimester vaginal bleeding; no digital exam — confirm with ultrasound.
- Placental abruption presentation
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Painful vaginal bleeding with a rigid, tender uterus.
- Postpartum hemorrhage — four Ts
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Tone (atony, most common), Trauma, Tissue (retained placenta), Thrombin (coagulopathy).
- Uterine atony treatment
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Uterine massage and uterotonics (oxytocin first-line), escalating as needed.
- Ectopic pregnancy clue
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Positive pregnancy test with an empty uterus on ultrasound and pelvic pain.
- Ectopic pregnancy treatment
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Methotrexate for stable, eligible patients; surgery if unstable or ruptured.
- Prenatal first-visit screening
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Confirm and date the pregnancy; blood type/Rh, CBC, infections, and Pap as indicated.
- Group B Streptococcus screening
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Rectovaginal culture at 36-37 weeks; intrapartum penicillin if positive.
- Naegele rule for due date
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First day of last menstrual period minus 3 months plus 7 days.
- Preterm labor definition
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Regular contractions with cervical change before 37 weeks.
- Magnesium for fetal neuroprotection
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Given for anticipated very preterm delivery to reduce cerebral palsy risk.
- Gestational hypertension vs preeclampsia
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Gestational hypertension lacks proteinuria/end-organ dysfunction; preeclampsia has them.
- HELLP syndrome
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Hemolysis, Elevated Liver enzymes, Low Platelets — a severe preeclampsia variant; deliver.
- Most common cause of abnormal uterine bleeding by reproductive age
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Anovulation (and structural causes); always exclude pregnancy first.
- First test in reproductive-age woman with abnormal bleeding
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Urine or serum pregnancy test.
- Cervical cancer screening
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Pap smear with HPV co-testing on the recommended interval.
- Combined hormonal contraception contraindications
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History of VTE, migraine with aura, or smoking over age 35.
- Emergency contraception options
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Levonorgestrel, ulipristal acetate, or a copper IUD (most effective).
- PCOS features
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Oligo-ovulation, hyperandrogenism, and polycystic ovaries; associated with insulin resistance.
- Ovarian torsion presentation
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Sudden unilateral pelvic pain with an adnexal mass; surgical emergency.
- Pelvic inflammatory disease treatment
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Empiric antibiotics covering gonorrhea and chlamydia; treat partners.
- Menopause definition
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Twelve months of amenorrhea; rising FSH.
- Most common gynecologic cancer (US)
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Endometrial (uterine) cancer; postmenopausal bleeding warrants endometrial biopsy.
- Postmenopausal bleeding workup
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Endometrial biopsy to exclude endometrial cancer.
- Down syndrome screening in pregnancy
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Combined first-trimester screen or cell-free fetal DNA; confirm with diagnostic testing.
- Hyperemesis gravidarum
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Severe nausea/vomiting with dehydration and ketonuria; treat with fluids and antiemetics.
- Shoulder dystocia first maneuver
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McRoberts maneuver with suprapubic pressure.
- Fetal heart rate late decelerations
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Suggest uteroplacental insufficiency; reposition, oxygen, fluids, and evaluate for delivery.
- Fetal heart rate variable decelerations
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Suggest cord compression; reposition and consider amnioinfusion.
- Gestational trophoblastic disease clue
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Markedly elevated beta-hCG, 'snowstorm' uterus, hyperemesis; evacuate and follow hCG.
- Endometriosis presentation
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Cyclic pelvic pain, dysmenorrhea, dyspareunia, and infertility.
- Threatened vs inevitable abortion
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Threatened: bleeding, closed cervix. Inevitable: bleeding, open cervix.
- Preterm premature rupture of membranes
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Manage by gestational age with antibiotics and steroids; watch for infection.
- Breast mass workup by age
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Ultrasound first in young women; mammography and biopsy as indicated; triple assessment.
- Cervical insufficiency treatment
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Cerclage in selected patients with painless cervical dilation.
- Mastitis (lactational) treatment
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Continue breastfeeding and give antibiotics; drain an abscess if present.
- Anti-D in miscarriage/trauma
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Give RhoGAM to Rh-negative women after bleeding events in pregnancy.
Psychiatry (43)
- Major depressive disorder criteria
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5 or more of 9 symptoms (SIG-E-CAPS) for at least 2 weeks, including depressed mood or anhedonia.
- First-line treatment for major depression
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An SSRI plus psychotherapy (e.g., CBT).
- Antidepressant onset of effect
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Several weeks; reassess for suicidality at start and dose changes.
- Manic episode duration (bipolar I)
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At least 1 week of elevated/irritable mood with increased activity.
- Bipolar I maintenance
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Mood stabilizer (e.g., lithium) or an antipsychotic; avoid antidepressant monotherapy.
- Schizophrenia duration
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Symptoms for at least 6 months (with active-phase symptoms).
- Schizophreniform disorder duration
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1 to 6 months.
- Brief psychotic disorder duration
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Less than 1 month, often after a stressor.
- Generalized anxiety disorder
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Excessive worry most days for at least 6 months; SSRI/SNRI plus CBT.
- Panic disorder
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Recurrent unexpected panic attacks with anticipatory anxiety; SSRI and CBT.
- OCD treatment
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SSRI (often higher doses) plus exposure and response prevention therapy.
- PTSD features
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Re-experiencing, avoidance, negative cognitions, and hyperarousal after trauma; SSRI and trauma-focused therapy.
- Serotonin syndrome features
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Within hours of a serotonergic drug: agitation, autonomic instability, clonus, hyperreflexia.
- Serotonin syndrome treatment
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Stop the drug, supportive care, and cyproheptadine in severe cases.
- Neuroleptic malignant syndrome features
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Over days after a dopamine antagonist: 'lead-pipe' rigidity, high fever, autonomic instability, very high CK.
- Neuroleptic malignant syndrome treatment
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Stop the antipsychotic, supportive care; dantrolene or bromocriptine if severe.
- Serotonin syndrome vs NMS quick clue
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Serotonin syndrome = hyperreflexia/clonus; NMS = rigidity/hyporeflexia.
- Lithium monitoring
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Narrow therapeutic window; monitor levels, renal function, and thyroid function.
- Lithium toxicity signs
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Tremor, ataxia, confusion, and seizures at high levels.
- Tardive dyskinesia
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Involuntary movements from long-term dopamine antagonists; consider a VMAT2 inhibitor.
- Alcohol withdrawal treatment
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Benzodiazepines; watch for progression to delirium tremens.
- Delirium tremens
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Severe alcohol withdrawal with autonomic instability and confusion 48-96 hours after the last drink.
- Opioid overdose antidote
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Naloxone; supportive ventilation.
- Opioid intoxication signs
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Pinpoint pupils, respiratory depression, and decreased consciousness.
- Benzodiazepine overdose antidote
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Flumazenil (use cautiously — can precipitate seizures).
- Wernicke encephalopathy triad
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Confusion, ophthalmoplegia, and ataxia from thiamine deficiency; give thiamine before glucose.
- Delirium vs dementia
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Delirium: acute, fluctuating, altered attention (find the cause). Dementia: chronic, progressive.
- Anorexia nervosa danger
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Low body weight with refeeding syndrome risk; monitor electrolytes (phosphate).
- ADHD first-line treatment
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Stimulants (methylphenidate or amphetamines) with behavioral therapy.
- Autism spectrum disorder
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Early social-communication deficits and restricted/repetitive behaviors; early intervention.
- Antidepressant for a patient with neuropathic pain or insomnia
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Consider an SNRI or a TCA (off-label) based on the comorbidity.
- Suicide risk assessment priority
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Directly assess plan, intent, means, and prior attempts; ensure safety first.
- Borderline personality disorder
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Unstable relationships, affect, and self-image with impulsivity; dialectical behavior therapy.
- Antisocial personality disorder
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Pervasive disregard for others' rights; must be 18+ with prior conduct disorder.
- Adjustment disorder
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Emotional/behavioral symptoms within 3 months of an identifiable stressor; resolves within 6 months.
- Acute stress disorder vs PTSD
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Same symptom clusters; acute stress disorder lasts 3 days to 1 month, PTSD over 1 month.
- Bulimia nervosa
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Binge eating with compensatory behaviors; often normal weight; SSRI and CBT.
- Conversion (functional neurological) disorder
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Neurologic symptoms inconsistent with disease, often after stress.
- Somatic symptom disorder
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Excessive thoughts/anxiety about physical symptoms causing distress.
- Major depression with psychotic features
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Add an antipsychotic to the antidepressant (or consider ECT).
- ECT indication
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Severe/refractory depression, psychotic depression, or when rapid response is needed (e.g., catatonia).
- First-generation vs second-generation antipsychotics
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First-gen: more extrapyramidal effects. Second-gen: more metabolic effects.
- Clozapine monitoring
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Monitor absolute neutrophil count for agranulocytosis; reserved for refractory schizophrenia.
Cross-Cutting Clinical Science (45)
- Sensitivity (SnNout)
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True-positive rate, TP/(TP+FN); a negative on a sensitive test rules a disease OUT.
- Specificity (SpPin)
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True-negative rate, TN/(TN+FP); a positive on a specific test rules a disease IN.
- Positive predictive value
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TP/(TP+FP); the chance a positive test is a true case — rises with prevalence.
- Negative predictive value
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TN/(TN+FN); the chance a negative test is truly disease-free — falls with prevalence.
- Sensitivity/specificity vs prevalence
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Sensitivity and specificity are fixed properties of the test; predictive values depend on prevalence.
- Number needed to treat
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1 divided by the absolute risk reduction; lower NNT means a more effective treatment.
- Relative risk source
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Calculated from cohort studies (risk in exposed / risk in unexposed).
- Odds ratio source
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Calculated from case-control studies; approximates relative risk for rare diseases.
- Gold standard for causation
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The randomized controlled trial.
- Type I error
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Rejecting a true null hypothesis — a false positive; its probability is alpha (often 0.05).
- Type II error and power
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Type II (beta) is failing to reject a false null; power equals 1 minus beta.
- Incidence vs prevalence
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Incidence is new cases over time; prevalence is existing cases at a point in time.
- Lead-time bias
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Earlier detection makes survival appear longer without changing the true outcome.
- Selection bias
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Systematic differences in who is included, distorting results.
- Recall bias
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Differential accuracy of memory between groups, common in case-control studies.
- Confounding
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A third variable associated with both exposure and outcome; control by randomization or adjustment.
- Informed consent elements
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Decision-making capacity, disclosure, understanding, and voluntariness.
- Capacity vs competency
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Capacity is a clinical, decision-specific judgment; competency is a legal determination.
- A patient with capacity refusing treatment
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May refuse — respect autonomy, even against medical advice.
- Minor consent exceptions
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Emergencies, STIs, contraception, pregnancy, substance use, and emancipated minors.
- Confidentiality exceptions
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Duty to warn/protect, reportable diseases, and certain abuse situations.
- Disclosure of medical errors
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Disclose errors to patients honestly; it is an ethical and professional duty.
- Root-cause analysis
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A reactive, after-the-event analysis of why an error occurred.
- Failure mode and effects analysis
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A proactive analysis to anticipate and prevent errors before they happen.
- Swiss cheese model
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Errors result when gaps in multiple defenses line up; build redundant safeguards.
- Primary prevention
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Prevents disease before it occurs (vaccination, smoking-cessation counseling).
- Secondary prevention
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Detects disease early (screening such as mammography and colonoscopy).
- Tertiary prevention
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Limits the impact of established disease (rehabilitation, complication prevention).
- Colorectal cancer screening start age
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Age 45 for average-risk adults (per current US guidance).
- Likelihood ratio property
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Independent of disease prevalence; combines sensitivity and specificity.
- Intention-to-treat analysis
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Analyze participants in their assigned groups regardless of adherence; preserves randomization.
- Beneficence vs non-maleficence
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Beneficence is acting for the patient's good; non-maleficence is 'do no harm.'
- Justice (medical ethics)
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Fair distribution of benefits, risks, and resources among patients.
- Surrogate decision-making order
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Follow the patient's advance directive, then the legal surrogate/next of kin, using substituted judgment.
- Advance directive vs living will
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An advance directive names a healthcare proxy; a living will states treatment wishes.
- Reportable conditions
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Certain infectious diseases and suspected abuse must be reported to public health/authorities.
- Number needed to harm
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1 divided by the absolute risk increase of an adverse event.
- Absolute vs relative risk reduction
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Absolute is the raw difference; relative is the proportional difference (can exaggerate small effects).
- p-value meaning
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The probability of results this extreme if the null hypothesis were true; below alpha is 'significant.'
- Confidence interval crossing the null
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A 95% CI that crosses 1 (ratios) or 0 (differences) is not statistically significant.
- Screening test choice
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Use a sensitive test to screen (rule out), then a specific test to confirm (rule in).
- Validity vs reliability
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Validity is measuring the right thing; reliability is consistency on repeat measurement.
- Sentinel event
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An unexpected event causing death or serious harm; triggers root-cause analysis.
- Never event
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A serious, largely preventable error (e.g., wrong-site surgery) that should never occur.
- Quality improvement PDSA cycle
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Plan, Do, Study, Act — iterative testing of a change to improve a process.
References
- 1.USMLE Program (FSMB and NBME). “Step 2 CK Content Outline and Specifications.” usmle.org. ↑
- 2.USMLE Program (FSMB and NBME). “Step 2 CK Overview.” usmle.org. ↑
- 3.USMLE Program (FSMB and NBME). “Change to Step 2 CK Passing Standard Begins July 1, 2025.” usmle.org. ↑
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