What are the most high-yield (HY) topics in veterans' medicine for the United States Medical Licensing Examination (USMLE) Step 2?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: April 29, 2025 • View editorial policy

From the Guidelines

For USMLE Step 2 preparation on veterans medicine, focus on PTSD, traumatic brain injury (TBI), substance use disorders, depression/suicide risk, chronic pain management, and service-related exposures like Agent Orange and burn pits, as these topics are highly relevant to the healthcare needs of veterans and are emphasized in the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder 1.

Key Topics to Focus On:

  • PTSD: Know first-line treatments including SSRIs (sertraline 50-200mg daily or paroxetine 20-60mg daily) and trauma-focused psychotherapies, as recommended by the 2023 VA/DoD Clinical Practice Guideline 1.
  • TBI: Understand the Glasgow Coma Scale assessment and management of post-concussive symptoms.
  • Substance use disorders: Recognize the high prevalence among veterans and be familiar with screening and treatment options.
  • Depression/suicide risk: Know the screening tools, such as the PHQ-9, and treatment options, including SSRIs and psychotherapy.
  • Chronic pain management: Understand the complexities of managing chronic pain in veterans, including the use of non-pharmacological interventions and opioid safety.

Best Sources to Study:

  • First Aid for USMLE Step 2 CK: Provides a solid foundation for USMLE Step 2 preparation.
  • UWorld question bank: Offers excellent practice cases with veteran-specific scenarios.
  • AMBOSS and Online MedEd: Have dedicated sections on veteran health issues with high-yield clinical presentations.
  • The 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder: A key resource for understanding the latest recommendations for managing PTSD and acute stress disorder in veterans 1.

Additional Tips:

  • Be familiar with the screening tools for veteran populations, such as the PCL-5 for PTSD and the PHQ-9 for depression.
  • Understand the biopsychosocial approach to caring for veterans, including the impact of military service on mental and physical health.
  • Recognize that many veterans have multiple comorbidities that require integrated care approaches, and be prepared to identify service-connected conditions that qualify for VA benefits.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

High-Yield Topics for Veterans Medicine

  • Post-traumatic stress disorder (PTSD) is a common mental disorder in military and veteran populations 2
  • PTSD treatment includes psychotherapy and pharmacotherapy, with trauma-focused therapy (TFT) emerging as the first-line treatment 3
  • Pharmacologic options, such as selective serotonin reuptake inhibitors (SSRIs), are often used as second-line or adjunctive treatments 3, 4
  • Prazosin, an a1-adrenoceptor blocker, has shown promise in treating chronic PTSD, particularly for nightmares and sleep disturbances 5, 6

Best Sources to Study

  • International review of psychiatry (Abingdon, England) for studies on PTSD treatment and management 2
  • Journal of psychiatric practice for reviews on prazosin in the treatment of PTSD 5
  • Australian family physician for information on the role of prazosin in PTSD treatment 6
  • Current psychiatry reports for updates on advances in PTSD treatment research 3
  • The Cochrane database of systematic reviews for evidence-based reviews on pharmacotherapy for PTSD 4

References

4
Research

Pharmacotherapy for post traumatic stress disorder (PTSD).

The Cochrane database of systematic reviews, 2022

5
Research

Prazosin in the treatment of PTSD.

Journal of psychiatric practice, 2014

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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