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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#16 (reveal difficulty score)
A 32-year-old woman is brought to the ...
Hemothorax ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: Pulm

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submitted by โˆ—medicalmike(82)
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Absent breath sounds and opacification on XR suggests fluid or atelectasis. Hemothorax is the only possible answer choice.

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jmorga75  Diaphragmatic hernias are typically on the left side due to the protective effects of the liver. Furthermore an xray would likely show air or fluid filled stomach or bowel in the thorax if it were acute diaphragmatic hernia +



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submitted by โˆ—step_prep7(71)
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  • Opacities involving an entire lung lobe most consistent with collapsed lung tissue (atelectasis) vs. accumulation of blood/fluid/pus within that space
  • In this patient involved in a traumatic situation + signs of hemodynamic instability (tachycardic, borderline hypotensive) with complete opacification of right hemithorax and absent breath sounds on right most consistent with hemothorax
  • Pneumothorax would lead to lung lucency (increased air), diaphragmatic hernia almost always left sided (due to liver protecting right diaphragm) and ruptured bronchus often leads to persistent pneumothorax and/or pneumomediastinum
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