91 clinical algorithms · gamified

Play your way through Step 2 CK algorithms.

Step into the clinical decision. Pick the next move. Climb the diagnostic tree. Reinforce high-yield management with active recall — not passive review.

91
Algorithms
16
Specialties
Active
Recall mode
Algorithm Library

Pick your battle.

91 clinical decision trees, organized by specialty. Tap one to enter the active-recall game.

Showing 91 of 91
EmergencyEasy

Acetaminophen Intoxication

Charcoal early; NAC if level above the Rumack–Matthew line.

4 decisionsPlay
EmergencyEasy

Anaphylaxis Diagnosis

IM epinephrine is the only life-saving intervention — give it now.

1 decisionPlay
EmergencyHard

Adult Cardiac Arrest (ACLS)

Shockable vs non-shockable → epinephrine cadence + reversible causes.

2 decisionsPlay
EmergencyHard

Suspected Aortic Dissection

Tearing pain, pulse deficit, BP differential — image with CTA or TEE.

2 decisionsPlay
NeurologyMedium

Initial Management of Stroke

Non-contrast CT to triage ischemic vs hemorrhagic.

3 decisionsPlay
EmergencyEasy

Management of Drowning

Rescue breaths come FIRST in drowning arrest. Observe asymptomatic patients ≥8 h.

2 decisionsPlay
Infectious DiseaseMedium

Rabies Postexposure Prophylaxis

Animal type and availability decide PEP.

3 decisionsPlay
CardiologyMedium

Initial Stabilization of STEMI

MONA-BASH plus PCI in 90 minutes (or thrombolytics in 120).

2 decisionsPlay
CardiologyMedium

Outpatient Chest Pain (Pretest Probability)

Pretest probability of CAD selects the testing strategy.

3 decisionsPlay
EmergencyMedium

Chest Pain in the Emergency Department

ECG + CXR + cardiac markers, with hemodynamics first.

3 decisionsPlay
CardiologyHard

Wide-Complex Tachycardia

AV dissociation/fusion = VT. Then ask stable vs unstable.

2 decisionsPlay
CardiologyMedium

Adult Tachycardia (ACLS)

Unstable = cardioversion. Stable narrow = adenosine/vagal. Stable wide = consider VT.

3 decisionsPlay
CardiologyEasy

Sinus Bradycardia

Atropine → pacing/chronotropes if unresponsive.

3 decisionsPlay
CardiologyMedium

Electrical Alternans → Pericardial Tamponade

Alternating QRS amplitude → think large pericardial effusion.

2 decisionsPlay
EmergencyMedium

Unstable Abdominal Aortic Aneurysm

Stable + AAA on CT vs unstable + bedside US → OR.

3 decisionsPlay
TraumaMedium

Blunt Chest Trauma

Unstable → resuscitate + eFAST + CT. Stable + high-risk → CT.

4 decisionsPlay
TraumaMedium

Blunt Abdominal Trauma

Unstable + free fluid = OR. Stable = CT.

5 decisionsPlay
TraumaMedium

Penetrating Abdominal Trauma

Most require laparotomy; some stable stab wounds can be observed.

3 decisionsPlay
MusculoskeletalMedium

Supracondylar Fracture Complications

Watch for median nerve and brachial artery injury.

2 decisionsPlay
PulmonaryMedium

Suspected Pulmonary Embolism (Initial Approach)

Stabilize, check anticoagulation contraindications, then risk-stratify.

6 decisionsPlay
PulmonaryEasy

Diagnostic Strategy in Suspected PE

Wells score → D-dimer or CTPA.

4 decisionsPlay
PulmonaryMedium

Hemoptysis Evaluation

Massive bleeding = airway, bleeding side down.

3 decisionsPlay
Infectious DiseaseMedium

Ventilator-Associated Pneumonia

Culture, empiric broad coverage, then narrow to results.

3 decisionsPlay
PulmonaryEasy

Lung Cancer Screening

Annual low-dose CT in heavy smokers age 50–80.

2 decisionsPlay
PediatricsMedium

Neonatal Cholestasis

Conjugated hyperbilirubinemia → US splits the workup.

2 decisionsPlay
PediatricsEasy

The Straining Infant

Red flags vs functional constipation vs infant dyschezia.

2 decisionsPlay
GastroenterologyEasy

Suspected Appendicitis

Imaging tailored to age and pregnancy.

2 decisionsPlay
OncologyMedium

Staging of Gastric Adenocarcinoma

CT first, then EUS + PET + laparoscopy for full staging.

3 decisionsPlay
GastroenterologyHard

Suspected Gastrinoma (Zollinger–Ellison)

Multiple ulcers + thick gastric folds → check gastrin off PPI.

4 decisionsPlay
GastroenterologyEasy

GERD Management

PPI trial vs endoscopy depending on alarm features.

4 decisionsPlay
GastroenterologyMedium

Elevated Alkaline Phosphatase

GGT distinguishes hepatobiliary from bone origin.

3 decisionsPlay
GastroenterologyMedium

Hyperbilirubinemia in Adults

Conjugated vs unconjugated, then enzyme pattern.

3 decisionsPlay
GastroenterologyEasy

Minimal Bright Red Blood Per Rectum

Age + red flags decide anoscopy vs colonoscopy.

2 decisionsPlay
GastroenterologyMedium

Dysphagia Evaluation

Oropharyngeal vs esophageal; mechanical vs motility.

3 decisionsPlay
GastroenterologyHard

Variceal Hemorrhage

Octreotide + abx + urgent endoscopic ligation.

2 decisionsPlay
GastroenterologyMedium

Cirrhosis Management

Surveillance for HCC and varices; treat each decompensation.

2 decisionsPlay
Infectious DiseaseMedium

HIV Odynophagia / Esophagitis

Empirical fluconazole for mild; endoscopy for severe.

2 decisionsPlay
Infectious DiseaseMedium

Vertebral Osteomyelitis

Suspect with fever + back pain + focal spinal tenderness.

3 decisionsPlay
HematologyMedium

Treatment of Deep Vein Thrombosis

Proximal DVT → anticoag; check for thrombolysis/IVC filter triggers.

3 decisionsPlay
HematologyMedium

Anemia Evaluation

MCV splits the workup; reticulocyte count clarifies normocytic anemia.

3 decisionsPlay
OncologyEasy

Cancer Pain Management (WHO Ladder)

WHO ladder: non-opioid → weak opioid → strong opioid.

2 decisionsPlay
EndocrineMedium

Hypercalcemia Workup

PTH splits PTH-dependent vs PTH-independent.

4 decisionsPlay
EndocrineMedium

Hypocalcemia Workup

Always check magnesium before chasing PTH.

3 decisionsPlay
EndocrineEasy

Thyroid Nodule Evaluation

TSH + ultrasound; iodine scan only if TSH is low.

3 decisionsPlay
EndocrineMedium

Hyperthyroidism Evaluation

TSH + free T3/T4 → RAIU pattern.

5 decisionsPlay
EndocrineHard

Water Deprivation Test

Distinguish primary polydipsia, central DI, nephrogenic DI.

3 decisionsPlay
EndocrineMedium

Suspected Polyuria

Confirm volume, then classify diuresis.

3 decisionsPlay
EndocrineEasy

Hypertriglyceridemia

Secondary causes → lifestyle; >500 → fibrate/fish oil.

2 decisionsPlay
RenalHard

Hyponatremia Evaluation

Serum osm → urine osm → volume status.

4 decisionsPlay
RenalEasy

Proteinuria Diagnosis

First-morning urine to confirm; orthostatic is benign.

3 decisionsPlay
PediatricsMedium

Hematuria in Children

Glomerular vs nonglomerular splits the workup.

2 decisionsPlay
NeurologyEasy

Unilateral Facial Weakness

Bell palsy vs red-flag mimics.

2 decisionsPlay
MusculoskeletalEasy

Carpal Tunnel Tests

Phalen + Tinel; diagnosis confirmed with nerve conduction.

2 decisionsPlay
DermatologyEasy

Visual Assessment of Melanoma

ABCDE, 7-point checklist, ugly duckling sign.

1 decisionPlay
OB/GYNHard

Primary Amenorrhea

Uterus presence + FSH/karyotype guide the workup.

5 decisionsPlay
OB/GYNMedium

Secondary Amenorrhea

β-hCG → prolactin/TSH/FSH/testosterone.

3 decisionsPlay
OB/GYNEasy

AUB / Secondary Amenorrhea — Age-Based

<45 vs ≥45 changes the workup tier.

3 decisionsPlay
OB/GYNMedium

Hydatidiform Mole Management

Suction curettage + β-hCG surveillance until undetectable.

3 decisionsPlay
OB/GYNMedium

Suspected Ectopic Pregnancy

TVUS + quantitative β-hCG drive decisions.

4 decisionsPlay
OB/GYNEasy

Gestational Diabetes 2-Step Screening

1-h 50 g, then 3-h 100 g if abnormal.

3 decisionsPlay
OB/GYNEasy

HSV in Pregnancy

Suppression at 36 weeks; C-section if active lesions in labor.

2 decisionsPlay
OB/GYNEasy

CIN 3 Management

Excisional treatment then surveillance.

2 decisionsPlay
OB/GYNHard

Postpartum Hemorrhage (Atony)

Step-wise: massage, TXA, uterotonics, balloon, surgery.

5 decisionsPlay
OB/GYNEasy

Migraines in Pregnancy

Step-wise: lifestyle → acetaminophen → antiemetics/butalbital → NSAIDs (2nd trimester) → opioids.

5 decisionsPlay
OB/GYNEasy

Menopause Treatment

Hormones if no contraindication; intact uterus needs progestin.

3 decisionsPlay
OB/GYNHard

Preterm Prelabor ROM

Gestational age + presence of infection guide management.

3 decisionsPlay
OB/GYNEasy

Endometriosis Management

NSAIDs + OCPs vs laparoscopy for definitive diagnosis.

2 decisionsPlay
OB/GYNMedium

Preterm Birth Prevention

Prior preterm vs cervical length.

3 decisionsPlay
OB/GYNEasy

Normal Postpartum Lochia

Three stages: rubra → serosa → alba.

1 decisionPlay
BreastEasy

Palpable Breast Mass

Age decides imaging modality.

2 decisionsPlay
BreastEasy

Breast Pain Management

Cyclic/bilateral usually benign; noncyclic/focal warrants imaging.

4 decisionsPlay
BreastEasy

Nipple Discharge

Bloody/serous = pathologic. Milky = endocrine workup.

3 decisionsPlay
BreastEasy

Breast Discharge Evaluation

Bilateral vs unilateral; age-based imaging for unilateral.

1 decisionPlay
BreastEasy

Breast Cyst Management

Simple cyst: observe if asymptomatic. Complex: biopsy.

2 decisionsPlay
PediatricsEasy

Acute Pharyngitis in Children

Viral features → supportive. Otherwise rapid strep.

3 decisionsPlay
Infectious DiseaseEasy

Pharyngitis in Adults (Centor)

Centor criteria: 0–1 none, 2–3 RADT, 4 empiric.

2 decisionsPlay
PediatricsEasy

Food Protein-Induced Allergic Proctocolitis (FPIAP)

Eliminate triggers, reintroduce around 1 year.

2 decisionsPlay
PediatricsMedium

Suspected Foreign Body Ingestion

X-rays first; endoscopy for high-risk objects.

3 decisionsPlay
PediatricsMedium

Ingestion of Multiple Magnets

Multiple magnets = surgical emergency risk.

2 decisionsPlay
PediatricsHard

Bilious Emesis in the Neonate

Always abnormal — rule out malrotation with volvulus.

4 decisionsPlay
CardiologyMedium

Stable Narrow-Complex Tachycardia

Vagal → adenosine → rate control.

3 decisionsPlay
EndocrineHard

Thyroid Storm

Block synthesis, release, and conversion all at once.

1 decisionPlay
EndocrineHard

Diabetic Ketoacidosis

Fluids → insulin → potassium replacement.

3 decisionsPlay
EmergencyMedium

Hypertensive Emergency

Lower MAP by 10–25% in first hour; choice depends on end-organ.

2 decisionsPlay
RenalMedium

Acute Kidney Injury

Pre-renal vs intrinsic vs post-renal; FENa and UA help.

3 decisionsPlay
EmergencyMedium

Sepsis / Septic Shock

Hour-1 bundle: lactate, cultures, abx, fluids, vasopressors.

2 decisionsPlay
NeurologyHard

Intracranial Hemorrhage Management

Reverse anticoagulation + BP control + ICP management.

2 decisionsPlay
GastroenterologyMedium

Ascites Evaluation

SAAG splits portal hypertension from non-portal causes.

4 decisionsPlay
MusculoskeletalEasy

Acute Low Back Pain

Red flags decide imaging; otherwise conservative.

1 decisionPlay
PulmonaryMedium

Acute Asthma Exacerbation

SABA + ICS/oral steroids + adjuncts by severity.

1 decisionPlay
EmergencyMedium

Alcohol Withdrawal

Benzodiazepines first-line; CIWA-guided.

2 decisionsPlay
How it works

Four steps to mastery.

The game distills each UWorld-style algorithm into clickable decision points so you train recall, not recognition.

Step 1
Pick an algorithm

Browse 30+ clinical decision trees by specialty or difficulty.

Step 2
Active recall play

Each node poses a clinical question. Choose the next correct step.

Step 3
Instant feedback

Wrong choices show why. Build streaks. Climb to the management.

Step 4
Review the flow

Finish the algorithm and reveal the entire decision tree visually.