Download USMLE Step 2 CS Sample Cases Test. Questions & Correct Verified Answers 2025-2026. Grade A and more Exams Health sciences in PDF only on Docsity!
USMLE Step 2 CS Sample Cases Test.
Questions with Correct Verified
Answers 2025-2026. Graded A
12 year old female with 4 pounds of weight loss in past four days. Poly uria, poly dip, phagia. What is your differential? โ ANS Type 1 DM DI Hyperthyroidism UTI 15 year old female with weight loss. What else should you think of? โ ANS Anorexia 16 y/o male with racing heart. Has an SAT book in his hand. Having insonia. Slight SOB. Coffee intake a lot. Sexually active, uses condoms. Smokes weed. What is your differential? - ANSGeneralized anxiety Substance abuse Cardiac Arrythmia Hyperthyroid 16 year old female with tiredness and heavy periods. She is sexually active. Weight gain. Sad and down. Has to take care of her siblings. What is your differential? - ANSAnemia Depression Hypothyroidism
17 year old female with dysuria. Had UTI in the past. Sexual history is slutty. What is your differential? - ANSUrethritis Cystitis UTI repeat 17 yo male with cough. Non-productive. Dry. Drinks 2-3 beers/weekend. FMH asthma. counsel on alcohol at young age What is your differential? - ANSAsthma Viral URI Foreign body Atypical pneumonia 2 year old male with fever and ear pulling. PMH for OM. Premature, NICU stay. +sick contact. What is your diagnosis? - ANSOM OE URI 20 yo female who is anxious. Drinks a lot of coffee. Heart racing Takes Adderol. - ANSAmphetamine induced insomnia Caffeine induced insomnia GAD Hyperthyroidism
30 yo AA male with weight loss and fatigue. Homosexual with a lot of sexual partners. What is your differential? - ANSHIV infection Mono Depression Hypothyroidsm 30 yo female with dizziness and light headedness x 2. Under a lot of stress. Has palpitations. No passing out, no hear loss, no infections, no vertigo. Drinks ETOH and has heavy periods. What is your differential? - ANSOrthostatic hypotension Alcohol intoxication Arrythmia 30 yo male with SOB and CP. Chest pain on right that worsens with breathing. Stabbing pain. Has a cough. Sweats at night. Has Hodgkins Lymphoma in PMH. What is your differential? - ANSUremic pericarditis Pneumonia TB Recurrence of tumor 31 year old female with groin pain. She has been training for a marathon. She was training and fell down and has had pain since. What is your differential? - ANSHip strain Hip sprain Femoral neck fracture Stress fracture
Avascular necrosis HERNIA 32 year old male presents with complaint of abdominal pain. He states that he has pain in his right testicle. There is yellow discharge, and burning with urination. He does not use condoms, and has many sexual partners. PE shows CVA tenderness. What is your differential? - ANSOrchiepidimytis Gonococcal Urethritis Non-gonoccal urethritis. 32 yo female who presents with 8 mo h/o fatigue. Falls asleep in cinema. Dry skin, cold intolerance, weight gain. Snores at night. Had hemorrhage from pregnancy. What is your differential? - ANSSheehan Syndrome Hypothyroid Obstructive sleep apnea 32 yo male with a headache. He is in the dark. Started 4-5 hours ago. Cocaine user. Had sex and starting getting headache. Has kidney problems in FMH. What is your differential? - ANSDrug induced vaso-spasm Meningitis SAH Tension headache Intracranial venous thrombosis 34 year old male with erectile dysfunction wants the blue pill. He has PMH of hypercholesterolemia. What are some endocrinological questions you should assess? - ANSPoly's (dipsia, uria, phagia)
Endometrial polyps Endometrial hyperplasia 40 year old female with right knee pain which started two weeks after going on a trail. She had the pain first week, and now she has a crutch to walk. What is your differential? - ANSMeniscal tear Ligament tear Lyme disease Pseudogout Gout Septic arthritis Reactive Arthritis 40 yo female with chest pain. Tachycardic and Tachypnic. Acute distress. Radiates to left shoulder, better with leaning forward, worse with lying down. On OCP, smoker, sitting for a while. FMH of MI. What is your differential? - ANSPE Pericarditis Pleurisy MI Pneumonia Pleurisy 40 yo male with chest pain on left side. Very acute happened in 4-5 hours. Stabbing pain that is pleuritic. SOB. Dry cough. URI last week. Smokes. Agressive. What is your differential? - ANSPneumonia MI
PE
Pericarditis Pleurisy Pneumothorax Muscle strain Coronary vasospasm thru cocaine 45 year old female presents with a chief complaint of abdominal pain. She says that the pain is an epigastric burning pain that started an hour after she ate food. It is a constant pain that does not radiate. She feels nauseas at times. What is important to assess in terms of her PMH? - ANSNSAID usage. 45 yo female with a cough for 5 months. Dry and nagging cough. Got worse. Wakes her up. Has pillows to sleep. PMH asthma as child. 1 glass of wine drinker. What is your differential? - ANSGERD Post nasal drip Heart failure Asthma 46 year old female presents with abrupt onset of RLQ abdominal pain. Has vaginal discharge with irregular periods. She is sexually active. PMH is + for PID and appendectomy at 13. What is your differential? - ANSEctopic pregnancy Ovarian torsion Ruptured ovarian cyst PID
60 yo male presents with 18 lb weight loss in past 8 months. Not depressed. He has poor diet. Gets tired. Has medicare. Has aortic valve replacement. What is your differential? - ANSCHF Hidden malignancy Hypercalcemia (stones, bones, and psychic undertones) Renal failure 60 yo male with SOB fatigued. Uncontrolled BP. Has check-up 20 years ago. Colonoscopy. Leg swelling. Smoker. What is your differential? - ANSCHF Colon cancer Lung cancer 62 yo female with hearing loss. She has decreased hearing in both ears, and takes osteoporosis meds. She stopped using her hearing aids. She has no support. What physical exam maneuvers are you going to perform? - ANSRinne Weber 65 y/o AA female presents with neck pain for two weeks after a yoga class. Has been getting worse. She has numbness and tingling in her right forearm and thumb. She says that it got worse yesterday after moving. What are two proper name physical exam maneuvers you will do? - ANSLhermite Spurling
65 yo female with 5 day h/o dizziness. She has had 3 episodes started when she bent over. Light headed. Decreased vision. Lower limb edema. Has hypertension, HCTZ, and diarrhea. What is your differential? - ANSBPPV Meniere's Vasovagal syncope Cerebellar tumor Orthostatic hypotension VBI Arrythmia 65 yo female with bitemporal headache and high BP. Has difficulty concentrating. Has nausea. Mother had migraine. What is your differential?
- ANSTension headache Hypertension induced Migraine TEMPORAL arteritis Intracranial mass 65 yo female with headache and BP of 180/85. She uses aspirin. Has band-like headache. No vision problems. What is your differential? - ANSHypertensive crisis SAH Tension headache Caffeine withdrawal TEMPORAL arteritis
Depression A 22 year old female presents with lower abdominal pain. What is the first thing you should conduct a history about? - ANSMenstrual history. A 50 year old male presents with abdominal pain. He states this this pain has been present for 2 days, and is located in the midepigastric region. He says that it is a tearing pain radiating to the back. He feels sweaty at times, and has some RUQ as well. He has a history of cirrhosis in his family, and does drink 10 beers a night. What standardized history taking approach would you do for this patient's social history? - ANSCAGE questionnaire.
- Cut down?
- Annoyed?
- Guilty?
- Eye opener? A 75 year old woman presents with back pain after tripping on the sidewalk. She has a PMH of breast cancer. - ANSVertebral fracture Mets Breast Cancer Osteoporosis Lumbar Muscle Strain Abdominal pain in a 28 year old female which occurs after bread, cereal, wheat. Bloating with chronic diarrhea. What physical exam maneuvers are you going to check? - ANSAbdomen Lymphadenopathy
Oral mucosa Joints Cardiorespiratory Cases - ANS... Diarrhea Cases - ANSCases: Know about: -Travel -Joints -Constitutional symptoms Female comes in with ankle sprain after twisting it on the curb. What is the differential? - ANSAnkle sprain Ankle fracture Ankle dislocation Female with burning pain, itching, vaginal discharge. Pain with penetration. Vaginal discharge (yellow, malodorous). PMH of HTN and DM. Takes metformin. Has some dryness in vagina. What is your differential? - ANSTrichmonas Candida BV Cervicitis Atrophic Vaginitis Female with jaw pain who says boyfriend hits her. What is your differential?
Hypoglycemia LOC male with HTN on vitals sign was at grocery with wife. Wife saw episode. He has no aura. No shaking, tongue biting or loss of bladder control. PMH of MI. What is your differential? - ANSArrythmia TIA Seizures Hypoglycemia Syncope Male who presents with blood in the urine after 3 weeks ago URI. What is your differential? - ANSKidney stone IgA nephropathy PSGN Tumor ('painless hematuria) UTI Musculoskeletal Cases - ANS Neuro-Psych cases - ANSCommence Patient is a heavy male that presents with severe back pain. He carries heavy boxes. Pain radiates to the left leg. What is your differential? - ANSDisc herniation Lumbar muscle sprain.
Patient is a smoker and requests birth control. Should this be indicated? - ANSNo. Contraindicated because she is a smoker and above 35 years old. Patient is here for a hypertension refill. He has 190/110 mm Hg BP, and was on HCTZ and ACE. He has fatigue and decreased energy for past 3- months. SOB on exertion. No CP or ED. Was diagnosed with diabetes with no treatment. Last check up 1 year ago. What is your differential? - ANSCHF Diabetic Polyneuropathy Anemia Pediatrics Cases - ANSThats my ish. Phone case: 3.5 week female with diarrhea. Brown and non-bloody. No fever. Patient has no milk in the house. What is the differential? - ANSGastroenteritis Osmotic Diarrhea She states that she had her LMP 4 days ago, with abundant bleeding. 2 days ago there was spotting. She is sexually active with her bf with no condom use. What is your differential? - ANSPID Appendicitis Ectopic pregnancy Spurling - ANSElectric shock. Urogyn cases - ANSCommence
What is the work-up for pediatric diarrhea? - ANSElectrolytes CBC O&P Stool exam/WBC FOBT What is the work-up you would order for this patient with abdominal pain? - ANSAmylase/Lipase CBC Electrolyte US Abdomen CT Abdomen What is the work-up? - ANSAnkle x-ray What is the work-up? - ANSCBC BMP CT head ESR What is the work-up? - ANSCBC Electrolytes ESR Non-contrast head CT PT/PTT/INR (she is on aspirin) What is the work-up? - ANSCXR
CBC
Peak flow Methacholine challenge Pertussis PCR What is the work-up? - ANSCXR CT Chest CBC diff Uric Acid LDH What is the work-up? - ANSHip X-Ray and MRI What is the work-up? - ANSPelvic exam Pelvic US Endometrial biopsy Pap Smear CBC What is the work-up? - ANSShoulder X-Ray and MRI CBC What is the work-up? - ANSSpine X-ray Spine MRI What is the work-up? - ANSUA Urine Culture
