Sample Questions

USMLE Step 2 CK Sample Questions

3 practice questions with complete answer explanations.

Sample Questions

Question 1cardiology

A 58-year-old man presents to the ED with crushing substernal chest pain radiating to the left arm. ECG shows ST elevation in leads II, III, and aVF. Aspirin has been given. What is the most appropriate next step?

A.IV tPA

B.IV metoprolol

C.Emergent percutaneous coronary intervention✓ Correct

D.Stress echocardiography

Explanation

Inferior STEMI — primary PCI within 90 min of first medical contact is the preferred reperfusion strategy when available.

Question 2gi

A 42-year-old woman with BMI 34 presents with episodic right upper quadrant pain occurring after fatty meals. Ultrasound shows multiple gallstones without wall thickening. What is the most appropriate next step?

A.IV antibiotics

B.ERCP

C.Elective laparoscopic cholecystectomy✓ Correct

D.MRCP

Explanation

Symptomatic cholelithiasis — elective cholecystectomy is recommended; antibiotics/ERCP are for acute cholecystitis or stones in the duct.

Question 3pulm

A 72-year-old man with COPD presents with worsening dyspnea, increased sputum production, and purulence. SpO2 88%. What's the FIRST priority?

A.Inhaled bronchodilators + steroids + antibiotics✓ Correct

B.Intubation

C.Chest CT

D.BiPAP

Explanation

Acute COPD exacerbation: bronchodilators, systemic steroids, and antibiotics are first-line. BiPAP for hypercapnia; intubation if BiPAP fails.

Test-Taking Tips

1.UWorld is again the gold standard — do all 4,000+ Qs at least once.
2.Watch Online MedEd or Boards & Beyond clinical sciences during clerkships.
3.Take NBME CCS practice exams every 1–2 weeks in dedicated prep.
4.Prioritize: internal medicine, surgery, pediatrics, OB/GYN, psychiatry — 80% of the test.
5.Master ethical scenarios — they're high-yield and easy points.
6.Plan for a 4–8 week dedicated study period after clerkships.

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