![]() You obtain a sample of the exudate and order a gram staining, which shows gram-negative, rod-shaped bacteria arranged in parallel strands. On examination of the genital region, you notice that the ulcer is covered by exudate in addition, Mark has inguinal lymphadenopathy, which is tender. Upon further questioning, he mentions that he’s sexually active, but doesn’t always use protection. You decide to perform a biopsy of the lesion, which reveals the presence of multiple vacuolated epithelial cells with enlarged, irregular nuclei.Ī few days later, a 30 year old male named Mark comes to the clinic concerned about a painful ulcer that recently developed in his genital region. On physical examination, you notice that the skin lesions are soft and flesh-colored, and have a unique cauliflower-like appearance. ![]() Upon further questioning, Rae tells you that her husband also developed the same lesions over the same region a few weeks ago, but hasn’t seeked medical attention. Which of the following is the most likely diagnosis?Ī 35 year old female named Rae comes to the clinic one day with complaints of multiple verrucous skin lesions that have appeared over the anogenital region. The patient is started on appropriate pharmacologic treatment, but she returns to the clinic two days later after experiencing a continued fever plus chills, headaches, myalgias, and worsening of the maculopapular rash. An image of the initial genital examination is demonstrated below. ![]() ![]() Physical examination reveals diffuse cervical lymphadenopathy and a maculopapular rash over the trunk, abdomen, and extremities, including the palms and soles of the feet. Temperature is 37.7☌ (100☏), pulse is 99/min, respirations are 20/min, and blood pressure is 120/75 mmHg. Past medical history is significant for an episode of cervicitis and pelvic inflammatory disease in her teens. The patient is sexually active and began a relationship with a new partners six months ago. She lives in New Hampshire and goes hiking in the woods often. Two months ago, she was treated for a urinary tract infection with oral nitrofurantoin. I hope it helps - let me know what you think! And if you find any errors, please do let me know (for my sake and also for others’).A 58-year-old woman presents to the clinic with a history of fever and painless genital lesions that she first noticed a week ago. You can make comments and add suggestions, but cannot edit the actual text. Furthermore, there are probably mistakes or things that you deem as common sense (but which I might not understand, for example), so please keep in mind that these notes are tailored to me and my brain! Access my Step 2 CK notes here! I’m more than happy to share a link with you: whether you want to use it to study or you simply want to get an idea of how someone else takes notes, it’s there for your perusal.ĭisclaimer: I didn’t take the test yet, and don’t know if my method ‘works.’ It also may not ‘work’ for you, which is totally normal - everyone’s different. As I do NBMEs, I will cover those in this document as well, with large “SPOILER ALERT” warnings in the page/title of the page so that you don’t accidentally ruin it for yourself. I am concurrently making flashcards on Anki as well - those are for high yield factoids I want to memorize. I will be making notes for the remaining couple hundred questions of UW first pass, as well as all of my 2nd pass of UW on Google Docs. (We are referring to this document as a ‘snippet’ of my Step 2 CK notes because they don’t include the massively detailed UW notes I made during my first pass.) I made those notes very detailed these are much more high-yield and to-the-point. For Step 2 CK, I made comprehensive notes over the past few months, which I unfortunately cannot share due to copyright reasons. For Step 1, I put together a set of notes on a Google Doc that I shared with those interested in it.
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