Kaplan USMLE Step 2 prep: Men's health drives these 10 stumpers

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 10 cases from Kaplan Medical involving men’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 men’s health? Find out now.

1. Determine the next step in managing chest pain

   A 59-year-old ranch hand presents to the outpatient department with chest pain. Over the past eight months, he has noticed a dull, central chest pain that radiates to his left arm and jaw while walking. The pain subsides after about two minutes of rest but quickly returns upon walking again. What is the next best step in management?

2. How should AAA repair complications be managed?

   A 71-year-old man is brought to the operating room for elective repair of a growing abdominal aortic aneurysm (AAA). The aneurysm has been followed closely for three years, but has grown 1 cm over the past year, to 5.8 cm. The operation is uncomplicated, and the patient is extubated and brought to the surgical ICU postoperatively for management. What is the next step in management?

3. Man has unusual mole on upper back

   A 50-year-old man comes to the physician because of an unusual appearing mole on his upper back. He says that his wife has noted a recent change in its color and shape. The lesion measures 0.7 cm and has ill-defined margins and irregular pigmentation. The patient is otherwise healthy and takes no medication. Which of the following is the most appropriate next step in management?

4. Which culprit is behind man’s symptoms?

   A 52-year-old man with a history of chronic low back pain complains of three days of a cough productive of purulent sputum, fever, and left-sided subcostal pain worsened by breathing. A single episode of shaking chills accompanied the onset of the illness. He has no gastrointestinal complaints. Which of the following is the most likely pathogen?

5. Awakened by headaches five days in row

   A 35-year-old man has had nocturnal attacks of severe periorbital headache for the past five days. Each episode awakens him at night within two hours of falling asleep, lasts for less than an hour and is associated with ipsilateral rhinorrhea and lacrimation. Which is the most likely diagnosis?

6. Two-day history of severe epigastric pain

   A 39-year-old man comes to the emergency department because of a two-day history of severe epigastric pain that radiates to the back, nausea, and vomiting. He reports that he had three similar episodes during the past year that required hospitalization. He drinks 16 to 20 beers daily. He has smoked two packs of cigarettes daily for 20 years. Which complication is most likely in this patient?

7. Two-month history of hypercholesterolemia

   A 61-year-old man with a two-month history of hypercholesterolemia comes for a follow-up visit. He denies abdominal pain, nausea, vomiting, diarrhea, or constipation. He reports mild, chronic bilateral ringing in his ears. Which is the most likely diagnosis?

8. Severe perianal pain for five days

   A 59-year-old man comes to the physician because of severe perianal pain for the past five days. He has always been healthy and exercises three times a week. His regular diet consists mainly of fruits, vegetables, and fish. Which is the best course of action at this time?

9. Man with HCV, blisters, crusted lesions

   A 50-year-old alcoholic man with chronic hepatitis C infection is brought to the emergency department by the police, because he has blisters and crusted lesions on sun-exposed skin of his face and lower arms. Plasma porphyrins are elevated, and follow-up studies demonstrate elevated uroporphyrin I in urine and isocoproporphyrin in feces. Which is the most likely diagnosis?

10. One year of worsening symptoms

    A 32-year-old man comes to his physician with one year of worsening nausea, abdominal pain, constipation, diffuse bone pain, and intermittent headaches. The patient has a 10 pack-year history of smoking and denies use of alcohol or recreational drugs. What is the most appropriate next step?

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