Kaplan USMLE Step 2 prep: 5 cases involving women’s health

Over the years, the AMA has run dozens of example questions from Kaplan Medical. If you’re preparing for the United States Medical Licensing Examination® (USMLE®) Step 2 exam, you might want to know which questions are most often missed by test-prep takers. We’ve compiled five cases from Kaplan Medical involving women’s health. Each question comes with an expert explanation of the answer. You can check out all posts in this series.

The AMA and Kaplan have teamed up to support you in reaching your goal of passing the USMLE® or COMLEX-USA®. If you're looking for additional resources, Kaplan provides free access to tools for pre-clinical studies, including Kaplan’s Lecture Notes series, Integrated Vignettes, Shelf Prep and more. 

Think you can answer these questions involving women’s health? Find out now.

1. Young woman has rash for two weeks

   1. A 24-year-old woman comes to the physician because of a rash. For the past two weeks, she has had small red, non-blanching, non-pruritic spots on her arms and legs. Additionally, she has suffered from easy bruising and occasional nose bleeds. She has never had such symptoms before and has been healthy all her life. She takes no medications aside from an oral contraceptive pill and denies the use of any over-the-counter supplements. She does not drink alcohol nor smoke cigarettes, and her family history is unremarkable. What findings would be expected on a bone marrow biopsy?

2. Woman with pain in her back

   1. A 72-year-old woman comes to the physician because of a three-day history of mid-back pain. She denies any trauma to the back. Examination shows point tenderness over the T8 vertebra. X-ray of the spine shows a compression fracture of the T8 vertebral body. Dual energy X-ray absorptiometry shows a bone mineral density T-score of -2.7. What is the most likely diagnosis?

3. Next step for young girl with heavy menstrual flow

   1. A 14-year-old girl comes to the physician because of heavy menstrual bleeding that began with menarche two years ago. Her menstrual periods last eight to 10 days and occur approximately every 28 days. Her last menstrual period ended three days ago. Vital signs are temperature 37.0º C (98.6º F), blood pressure 110/70 mm Hg, pulse 90 beats per minute and respirations 18 breaths per minute. Physical examination shows a slender, calm girl who is in no distress but appears pale. The remainder of the examination is unremarkable. Which is the most appropriate next step in management?

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4. Woman with metastatic cancer, severe leg pain

   1. A 65-year-old woman with metastatic cancer is admitted to the hospital because of severe pain in her left leg for two weeks. The pain is in the left thigh near the hip. She has been having trouble walking because of the pain. The pain is worse at night. She has had no fever, morning stiffness, or trauma. Serum alkaline phosphatase level is 400 U/L. Plain X-ray shows a lytic lesion in the proximal femur. Where does this patient most likely have a malignancy?

5. Diagnosis of a breast lump

   1. A 27-year-old woman has a 14-by-12-by-9 cm mass in her left breast. It has been present for seven years and has slowly grown to its present size. Her grandmother has breast cancer, and her father has prostate cancer. Physical examination shows that the mass is firm, nontender, rubbery and completely movable, and it is not attached to the overlying skin or the chest wall. There are no palpable axillary nodes or skin ulceration. What is the most likely diagnosis?

For more prep questions on USMLE Steps 1, 2 and 3, view other posts in this series.