Master the Boards: USMLE Step 2 CK, Fifth Edition ISBN 978‐1‐5062-3594-3

Please note the following updates and corrections:

Page Change
24 Practice question: Correct answer is B (not A). The explanation is correct as stated.
63 Next to last paragraph: Once the ACTH level is elevated and suppresses with high
dose dexamethasone…
93 Lipid management algorithm, text after first and second purple boxes:
LDL <7 mg/dL or decreased by >50%?
94 PSK9 Inhibitors, replace first paragraph with the following:
Evolocumab and alirocumab inhibit proprotein convertase subtilisin/kexin type
9 (PCSK9). PCSK9 inhibitors (injectable medications) do the following:
 Increase LDL clearance from the blood by blocking the breakdown of
LDL receptors in the liver
 Decrease elevated LDL significantly in familial hypercholesterolemia
 Increase hepatic clearance of LDL massively, but do not lower mortality
With severe hyperlipidemia, if LDL is still not controlled with a statin at
maximum dose, try a PCSK9 inhibitor.
164 “What is the most likely diagnosis?” (VAP), first sentence: Because of multiple
concurrent illnesses….
177 Table, hypersensitivity pneumonitis symptoms, bullet 2: Symptoms arise 1–2 days
after exposure begins
178 Cryptogenic organizing pneumonia, paragraph 2: There is no specific finding on
imaging (x-ray or CT).
181 Ventilation-perfusion scan paragraph, replace first 2 sentences:
A patient with no intrinsic lung disease, but with normal ventilation scan and
areas of decreased perfusion on perfusion scan (as shown in the figure), is said
to have a high probability scan.
 15% of high probability scans have no clot on angiography (i.e., 15%
false positive).
 15% of low probability scans have a clot on angiography (i.e., 15% false
negative).
186 Central sleep apnea, bullet 2: … >5 apnea/hypopnea episodes per hour = CSA.
266 Swap 2 bullets in Scleroderma table: Anti SCL-70 + (goes under Diffuse) and
Anti-centromere + (goes under Limited).
325 Prevention of herpes zoster, line 1: Zoster vaccine is indicated in all persons above
the age of 50...
351 Last paragraph, last line: …myoglobin. Ascorbic acid (vitamin C) causes a false
negative test.
358 ATN definition, last sentence: Proteinuria is not significant since protein spills into
the urine when glomeruli are damaged, not the tubules.
380 Rename Figure 11.4: Hypernatremia Algorithm.
412 Breast cancer paragraph 1:
Mammography should be done starting at age 50 every 2 years. The reduction
in mortality is greatest above age 50. Screening can end at age 74.
413 Cervical cancer screening: (1) First sidebar (Pap smear is done...) is deleted.
(2) Replace first paragraph with the following:
There are 7,000–10,000 cases of cervical cancer a year in the United States. For
these, Pap smear definitely lowers mortality.
 Papillomavirus vaccine is routine for all women age 11–45 (rarely done
under age 30).
 First Pap smear should be done for all women at age 21. Then, do Pap
every 3 years age 21–65.
 If one combines Pap smear and HPV testing, testing can be done every 5
years age 30–65.
 HPV testing is rarely done in women under age 30.
542 Viral infectious diarrhea table, replace third head (Small, round): Norovirus
583 Replace first sentence of “Tip”: Indomethacin is extremely unlikely to appear on
the test as a potential tocolytic.
701 Paragraph 3: Dabigatran is an alternative oral anticoagulant for atrial fibrillation.
715 Replace last Sensitivity bullet:
 Sensitivity = TP / (TP + FN)
Replace last Specificity bullet:
 Specificity = TN / (TN + FP)