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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#46 (reveal difficulty score)
An 87-year-old nursing home resident with ...
Decreased gag reflex ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: neuro

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submitted by lubdub(14)
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She's got PNE. RLL so keep aspiration in mind. Something recurring since it happened <1 yr ago, too. Aspiration works best, caused by decreased gaga with age and dementia.

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submitted by โˆ—welpdedelp(270)
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Dementia is a risk factor for aspiration

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submitted by โˆ—step_prep7(71)
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  • Patientโ€™s with Alzheimerโ€™s disease are very prone to aspiration pneumonia both due to dysphagia and problems protecting their airway due to decreased gag reflex and impaired consciousness
  • Clues to aspiration pneumonia = Older patient (often demented) who presents with pneumonia in the right lung base (most common location due to right mainstem bronchus being wider, shorter and more vertical)
  • https://www.ncbi.nlm.nih.gov/pubmed/14577062
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