USMLE Step 2 CK Practice Questions - USMLE Step 2 Clinical Knowledge Exam

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A 58-year-old man presents with crushing chest pain radiating to his left arm. The pain started 30 minutes ago while he was at rest. He is diaphoretic and short of breath. Vital signs: BP 100/60 mmHg, HR 110 bpm, RR 22/min, SpO2 92% on room air. ECG shows ST-segment elevation in leads II, III, and aVF. Which is the most appropriate next step in management?

Start aspirin and clopidogrel, then perform stress testing Immediate percutaneous coronary intervention (PCI) within 90 minutes Administer thrombolytics and transfer to a PCI-capable center Start heparin drip and monitor serial cardiac enzymes

Correct Answer:

Immediate percutaneous coronary intervention (PCI) within 90 minutes

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