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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 3/Question#26 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharm inc

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submitted by โˆ—medpsychosis(147)
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PCP Intoxication: Violent/abnormal behavior, confusion, disorientation, amnesia. may have hallucinations/psychosis. Hypertension, Tachycardia. In cases of overdose -> vertical nystagmus

LSD: Optical hallucinations, illusions, depersonalization, flight of ideas, confusion

Another one that has been showing up in UWORLD: Inhalants glue, paint thinners, etc

Px w/Dizziness, confusion, lethargy within โˆผ 30 minutes of use Nystagmus, muscle weakness, tremor, hyporeflexia, ataxia Lingering odor of inhaled substance Overdose: coma and death (due to respiratory depression)

Source: AMBOSS

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submitted by โˆ—azibird(279)
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The only reliable way to differentiate between PCP and cocaine on these exams: + nystagmus (not present here) + catatonia/sedation

Weird facts about PCP intoxication: + May wax and wane between extreme agitation and sedation + Blank stare and flat affect + Rigidity + May not have hypertension or tachycardia

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azibird  Formatting :( +
drdoom  Start lists on new lines; maybe also leave a blank line between the list and preceding paragraph +



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submitted by โˆ—charcot_bouchard(574)
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I want to know how everyone exclude cocaine....i ruled it out because of 6 hours mark...any other clue?

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submitted by โˆ—charcot_bouchard(574)
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If you want to know about the unknown - Methaqualone is a sedative that increases the activity of the GABA receptors in the brain and nervous system, similarly to benzodiazepines and barbiturates. When GABA activity is increased, blood pressure drops and breathing and pulse rates slow, leading to a state of deep relaxation. These properties explain why methaqualone was originally mainly prescribed for insomnia An overdose can lead to nervous system shutdown, coma and death.[4] Additional effects are delirium, convulsions, hypertonia, hyperreflexia, vomiting, kidney failure, coma, and death through cardiac or respiratory arrest. It resembles barbiturate poisoning, but with increased motor difficulties and a lower incidence of cardiac or respiratory depression. The standard single tablet adult dose of Quaalude brand of methaqualone was 300 mg when made by Lemmon. A dose of 8000 mg is lethal and a dose as little as 2000 mg could induce a coma if taken with an alcoholic beverage.

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djtallahassee  Watch wolf of wallstreet to see quaaludes in action +1



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submitted by โˆ—drdoom(1206)
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via @azbird

The only reliable way to differentiate between PCP and cocaine on these exams:

  • nystagmus (not present here)
  • catatonia/sedation

Weird facts about PCP intoxication:

  • May wax and wane between extreme agitation and sedation
  • Blank stare and flat affect
  • Rigidity
  • May not have hypertension or tachycardia
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