Step 2 CK NBME Form 7 with complete solution
Impaired fertility in a man w/high-riding bilateral scrotal mass. Underlying cause?
Varicocele.
82 year old with decreased vision. Dilated veins, widespread retinal hemorrhages
intermixed with white plaques on fundoscopic exam. Diagnosis?
Central retinal vein artery occlusion.
15 year old girl on chronic steroid therapy presents with acute back pain. Most
likely cause?
Osteoporotic compression fracture.
Patient with flank pain with radiation to the groin and normal vital signs. Pain
relieved with morphine. Next best step?
Increase fluid intake and send home.
Terminal cancer patient that comes in with acute onset lower back pain. She is
taking morphine Q4 which works for a bit but then subsides. What should you do
to her regimen?
Make the morphine Q3 so she has adequate pain control.
A young infant that has bilateral retinal hemorrhages and tense fontanelle. What
is the most likely cause?
Child abuse
What is the treatment for an acute gout attack?
1. NSAIDs: Indomethacin
2. Steroids
3. Colchicine
Patient who is sick in the ICU, and has (comatose level) hypernatremia. She has a
low urine specific gravity. Normal kidney function. What is the underlying cause
of hypernatremia?
Diabetes Insipidus. She cannot concentrate her urine.
4 year old boy. Suddenly develops a pancytopenia, has hepatosplenomegaly and
adenopathy. Some mild gingival bleeding. Next best step?
Bone marrow biopsy. This kid has ALL.
Patient has a first time positive PPD and a negative chest X-ray. What is the next
best step?
This patient has latent TB. This means that he needs to be treated with INH for 9
months.
Furthermore, if he had a negative PPD. B/c this is his first time, he would come back in
two weeks.
Patient that is mute. Has bilateral nystagmus, hypertonia, decreased sensation to
skin prick. What is the most likely overdose?
Intoxication with PCP. Remember he does not always have to be aggressive.
Patient has a family history of ovarian cancer. What is the best thing to do if she
is worried that she may get an ovarian malignancy?
Put her on OCP. They prevent risk of ovarian and endometrial cancer.
Elderly patient with increased ESR. Decreased hip motion, and a 20 degree hip
flexion contracture. What is the most likely cause?
Impaired fertility in a man w/high-riding bilateral scrotal mass. Underlying cause?
Varicocele.
82 year old with decreased vision. Dilated veins, widespread retinal hemorrhages
intermixed with white plaques on fundoscopic exam. Diagnosis?
Central retinal vein artery occlusion.
15 year old girl on chronic steroid therapy presents with acute back pain. Most
likely cause?
Osteoporotic compression fracture.
Patient with flank pain with radiation to the groin and normal vital signs. Pain
relieved with morphine. Next best step?
Increase fluid intake and send home.
Terminal cancer patient that comes in with acute onset lower back pain. She is
taking morphine Q4 which works for a bit but then subsides. What should you do
to her regimen?
Make the morphine Q3 so she has adequate pain control.
A young infant that has bilateral retinal hemorrhages and tense fontanelle. What
is the most likely cause?
Child abuse
What is the treatment for an acute gout attack?
1. NSAIDs: Indomethacin
2. Steroids
3. Colchicine
Patient who is sick in the ICU, and has (comatose level) hypernatremia. She has a
low urine specific gravity. Normal kidney function. What is the underlying cause
of hypernatremia?
Diabetes Insipidus. She cannot concentrate her urine.
4 year old boy. Suddenly develops a pancytopenia, has hepatosplenomegaly and
adenopathy. Some mild gingival bleeding. Next best step?
Bone marrow biopsy. This kid has ALL.
Patient has a first time positive PPD and a negative chest X-ray. What is the next
best step?
This patient has latent TB. This means that he needs to be treated with INH for 9
months.
Furthermore, if he had a negative PPD. B/c this is his first time, he would come back in
two weeks.
Patient that is mute. Has bilateral nystagmus, hypertonia, decreased sensation to
skin prick. What is the most likely overdose?
Intoxication with PCP. Remember he does not always have to be aggressive.
Patient has a family history of ovarian cancer. What is the best thing to do if she
is worried that she may get an ovarian malignancy?
Put her on OCP. They prevent risk of ovarian and endometrial cancer.
Elderly patient with increased ESR. Decreased hip motion, and a 20 degree hip
flexion contracture. What is the most likely cause?
