Free 120 step 2 explanations Free 120 is a practice examination for Step 2 CK, consisting of 120 questions designed to simulate the actual test experience. Developed by the National Board of Medical Examiners (NBME), Free 120 provides an accurate representation of the content and format of the Step 2 CK exam. Here are 120 explanations for the Free 120 questions, organized by subject area: 1. Cardiovascular: A. A 65-year-old man with a history of hypertension presents with chest pain and shortness of breath. An ECG reveals evidence of a myocardial infarction. Which of the following medications should be administered first? Explanation: Oxygen, aspirin, and nitroglycerin should be administered first, followed by pain control, beta-blockers, and anticoagulants. 2. Pulmonary: A. A 45-year-old woman with a history of asthma presents with shortness of breath and wheezing. She is using her albuterol inhaler every 2 hours with minimal relief. Which of the following medications should be administered next? Explanation: Systemic corticosteroids should be administered next, either orally or intravenously, to reduce inflammation and improve symptoms. 3. Renal: A. A 55-year-old man with a history of diabetes presents with proteinuria and hematuria. His serum creatinine is 1.5 mg/dL. Which of the following is the most likely diagnosis? Explanation: The most likely diagnosis is diabetic nephropathy, a common complication of diabetes that can lead to kidney failure. 4. Gastrointestinal: A. A 35-year-old woman presents with abdominal pain, nausea, and vomiting. A CT scan reveals evidence of appendicitis. Which of the following is the most appropriate treatment? Explanation: The most appropriate treatment is appendectomy, either open or laparoscopic. 5. Neurology: A. A 70-year-old man with a history of hypertension presents with sudden onset of weakness and numbness on the right side of his body. An MRI reveals evidence of an acute ischemic stroke. Which of the following medications should be administered first? A. A 50-year-old woman presents with a breast mass and axillary lymphadenopathy. A biopsy reveals evidence of invasive ductal carcinoma. Which of the following is the most appropriate treatment? Explanation: The most appropriate treatment is surgical resection, either lumpectomy or mastectomy, followed by radiation therapy and adjuvant chemotherapy. 8. Infectious Disease: A. A 25-year-old man presents with fever, cough, and chest pain. A chest x-ray reveals evidence of pneumonia. Which of the following is the most likely causative organism? Explanation: The most likely causative organism is Streptococcus pneumoniae, a common cause of community-acquired pneumonia. 9. Rheumatology: A. A 40-year-old woman presents with joint pain, stiffness, and swelling. A ...
Explanation: The most appropriate treatment is appendectomy, either open or laparoscopic. 5. Neurology: A. A 70-year-old man with a history of hypertension presents with sudden onset of weakness and numbness on the right side of his body. An MRI reveals evidence of an acute ischemic stroke. Which of the following medications should be administered first? Explanation: Tissue plasminogen activator (tPA) should be administered first, if the patient is eligible, to dissolve the blood clot and improve symptoms. 6. Hematology: A. A 60-year-old woman with a history of iron deficiency anemia presents with fatigue and shortness of breath. Her hemoglobin is 8 g/dL. Which of the following is the most likely cause? Explanation: The most likely cause is chronic blood loss, such as from menstruation, gastrointestinal bleeding, or a malignancy. Port St. Joe, a city located in Gulf County, Florida, is in the Eastern Time Zone (ET) of the United States. The Eastern Time Zone is also known as America/New\_York in the IANA Time Zone Database. This time zone is five hours behind Coordinated Universal Time (UTC-5) and observes daylight saving time (DST), changing to Eastern Daylight Time (EDT) during the summer months, which is four hours behind UTC (UTC-4). Explanation: The most appropriate treatment is surgical resection, either lumpectomy or mastectomy, followed by radiation therapy and adjuvant chemotherapy. 8. Infectious Disease: A. A 25-year-old man presents with fever, cough, and chest pain. A chest x-ray reveals evidence of pneumonia. Which of the following is the most likely causative organism? Explanation: The most likely causative organism is Streptococcus pneumoniae, a common cause of community-acquired pneumonia. 9. Rheumatology: A. A 40-year-old woman presents with joint pain, stiffness, and swelling. A ...