NBME Step 2 CK Form 6 Pulmonary tuberculosis (NBME Answers)

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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#4 (reveal difficulty score)
A previously healthy 16-year-old boy is ...
Pulmonary tuberculosis 🔍 / 📺 / 🌳 / 📖
tags: pulm inc

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submitted by ∗step_prep7(71)

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Patient with clear exposure (Albania and other Eastern European countries are endemic TB countries) showing signs of infection (cough and fever) with adenopathy
Pulmonary aspergillosis would more commonly be seen in somebody who is immunocompromised (acute angioinvasive aspergillosis) or somebody with cystic fibrosis or asthma (allergic bronchopulmonary aspergillosis)

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submitted by ∗jlbae(159)

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Had to google where tf Albania is. God I'm such a stupid American

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lindasmith462 dude I couldn't even tell you where most of western european countries are in relation to each other. I know italy is the boot. On more way Scrubs mirrors medicine reality - geography is my achilles heel. +

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submitted by ∗sugaplum(487)

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I got this wrong too. but thinking more we should think about the travel hx, to TB endemic area. This isn't a hemorrage cuz its been happening for 2 weeks, aspergillous usually settles in TB cavities.

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submitted by ∗beeip(141)

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Guess one needs to bank on "hilar lymphadenopathy with fever" here.

Lacking upper lobe findings, I got this one wrong.

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boeboeboe Patient likely has primary TB presenting with fever, chest pain. Lower lung fields are affected, but usually nothing seen on CXR. Secondary TB affects upper lobes, and is when cavitary lesions will be seen on CXR +1

kingfriday There's a uworld question that mirrors this presentation, it got me then- the adenopathy is huge +2

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