Step 2CK NBME Review questions and answers Latest 2023 with complete solution

NBME 4 2mo infant is exclusively breastfed. What nutritional supplement? - Correct Answer Oral VitD to prevent rickets What HTN drug causes peripheral edema, flushing, dizziness? - Correct Answer CCB eg nifedipine 15yo girl with recurrent candida infections of skin and mucous membranes since childhood. Dx? - Correct Answer Chronic mucocutaneous candidiasis (T cell dysfunction) 57yoM with impotence for 1 year rand bronze colored skin. Ferritin concentration is 4050 NG/ml. Increased risk for what complication? - Correct Answer 1. Liver (primary organ)--hepatocellular carcinoma 2. Others: pancreas (DM), heart (CHF), skin, thyroid (hypo), gonads, joints (arthritis) 87yo's daughter: "we want my mother to receive hospice care at home but no one wants her to die at home. Can she still have hospice services?" - Correct Answer Yes. Hospice can provide home based care and attempt to transfer the pt to another site before death. 32yoF with 4d of fever with lymphatic obstruction. PE: the left lower extremity is diffuse lay red and edematous from just below the knee to the ankle, with a sharp demarcation separating the erythematous area from the normal skin at the knee. The erythematous area is painful and hyperesthetic to touch. The left oral nodes are enlarged and painful. Dx and cause? - Correct Answer Erysipelas - usually caused by group A strep - Tx: IM or oral penicillin/erythromycin 16yo girl with painful genital lesions or 2d. Lots of sexual partners. Exam shows two 3x3mm ulcerated lesions on the anterior vaginal vault. How prevent transmission with new partner? - Correct Answer Consistent condom use (NOT pharmacological treatment) 37yo primigravid at 25 weeks' gestation with confusion for 12 hours. Fever and intermittent nausea and vomiting over the past 2 weeks. No contractions, but decreased fetal movement. Family Hx of T1DM, seizure disorder. T 38.8, P 168/min, BP 187/84. Mildly enlarged thyroid gland. Lungs clear. 3/6 systolic ejection murmur. Fetal heart rate 182/min. Labs show: Hb 9.9, platelets 282k, Serum: Na 134, Cl 94, K 2.9, Thyroid-stimulating hormone 0.01, AST 33, LDH 112, Uric acid 5.4. Dx? - Correct Answer Thyroid storm - Precipitants: infection, DKA, stress (childbirth, trauma, surgery, illness)