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NBME p2ck_form6 Answers

step2ck_form6/Block 2/Question#13 (reveal difficulty score)
A 37-year-old woman comes to the physician ...
Medication adverse effect ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ
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 +0 
submitted by โˆ—azibird(256),

This is drug reaction with eosinophilia and systemic symptoms (DRESS)

  • maculopapular, erythematous, pruritic rash over the trunk
  • marked eosinophilia
  • patient taking trimethoprim-sulfamethoxazole

Notably, she has been taking the drug for a year, which is not typical for DRESS.

UTD: "The reaction typically occurs two to eight weeks after drug exposure. Medications that are taken for less than two weeks or more than three months before the onset of DRESS are unlikely to be the culprit." https://www.uptodate.com/contents/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress

So yes, this is not a typical timeline. However, if you ever see rash (especially on the trunk), eosinophilia, and a high-risk drug (especially TMP-SMX) you absolutely smash the medication-rash button and move on.

No other answer choice could ever explain that huge eosinophilia.

High risk drugs: https://www.uptodate.com/contents/image?imageKey=DERM%2F129506&topicKey=DERM%2F16420&search=dress%20syndrome%20adult&rank=1~150&source=see_link




 -1 
submitted by โˆ—medicalmike(78),
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ht3  tuB hes sah neeb ikatgn xtmmsp- fro a olweh eary and teh shra oshsw pu 2 eswek ??ga....o. +4  
jlbae  aTht smsede me up oto +1  



 -1 
submitted by โˆ—step_prep7(31),
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  • nPtenaosetri tmso tsoinstcne tiwh tauce ritislientta hniterisp, hcihw lsdea ot inaobtcimon fo hsra, KA,I ayirpu, mtihre,uaa CBW csat,s siniaolhpeio nda uiarrny hnpiseoosil
  • tlosAm walysa dceusa yb medictiona eisd fefec,t iwht momcon sulicprt eginb het 5 โ€™sP (PI,sP Pfna-erei ,ISAD()SN Pee iicD(sertu,) Plicnsiniel adn trheo cnisatbtoii ypel(isalec osfsinmaldue scuh sa ni hsit ia)ttnpe nda mfairPin
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azibird  Incorrect +  



 -1 
submitted by satanicdo(5),
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lindasmith462  hes otsedn ehva uirpya ro mirtaeauh uhtogh ( tboh ;&tg3 l/ehlscfp. -21 si o)alnrm +1  
lindasmith462  hse alos osetdn avhe an AIK +1  



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