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STEP 2 CK NBME FORM 7 QUESTIONS WITH 100% CORRECT ANSWERS

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Impaired fertility in a man w/high-riding bilateral scrotal mass. Underlying cause? Correct Answer Varicocele. 82 year old with decreased vision. Dilated veins, widespread retinal hemorrhages intermixed with white pla ...

Impaired fertility in a man w/high-riding bilateral scrotal mass. Underlying cause? Correct Answer Varicocele. 82 year old with decreased vision. Dilated veins, widespread retinal hemorrhages intermixed with white plaques on fundoscopic exam. Diagnosis? Correct Answer Central retinal vein artery occlusion. 15 year old girl on chronic steroid therapy presents with acute back pain. Most likely cause? Correct Answer Osteoporotic compression fracture. Patient with flank pain with radiation to the groin and normal vital signs. Pain relieved with morphine. Next best step? Correct Answer 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? Correct Answer 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? Correct Answer Child abuse What is the treatment for an acute gout attack? Correct Answer 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? Correct Answer 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? Correct Answer 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? Correct Answer 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? Correct Answer Intoxication with PCP. Remember he does not always have to be aggressive.

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