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. Check out this example from Kaplan Medical, and read an expert explanation of the answer. Also check out all posts in this series.
A 68-year-old man comes to the physician for a routine maintenance examination. He denies chest pain, dyspnea, cough or shortness of breath. He has a five-year history of hypercholesterolemia controlled with atorvastatin. He recently retired from his job as a mail carrier. He has smoked one pack of cigarettes daily for 45 years. He drinks three to five beers on the weekends. His mother had a myocardial infarction at age 52 years, and his brother had a myocardial infarction at age 48 years. Complete blood count, metabolic panel and lipid panel were within normal limits eight months ago. He had a colonoscopy three years ago that showed no abnormalities. Which of the following is the most appropriate screening test for this patient?
A. 12-lead electrocardiography
B. Abdominal ultrasound
C. Chest radiograph
D. Lipid panel
E. Prostate-specific antigen
The correct answer is B.
Kaplan Medical explains why
All male patients aged 65 to 75 years of age who have ever smoked should undergo one-time AAA screening via abdominal ultrasonography.
Why the other answers are wrong
Choice A. A 12-lead electrocardiography (ECG), although a very sensitive test for myocardial injury or ischemia, is not recommended to screen for coronary heart disease. The USPSTF did not identify convincing evidence to recommend ECG as a screening test for asymptomatic patients.
