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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#7 (reveal difficulty score)
A 70-year-old man comes to the physician ...
Outflow obstruction of the bladder ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: renal GU

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submitted by โˆ—notyasupreme(48)
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Cardi B voice: WHAT WAS THE REASON for the goddamn Gram - stain, like whyyyyyyyyy. That's why I put prostatitis, even though the non-tender prostate threw me off. Damn, these questions are really just read the first and last sentence huh?

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submitted by โˆ—ht3(25)
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why can't this be chronic bacterial prostatis?...ughh the gram stain and leukocytes on UA threw me off

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ht3  according to Uworld, chronic prostatitis* could be nontender +2
shastri96  chronic prostatitis: Manifestations last >3 months and typically include recurrent urinary tract infection (eg, dysuria, frequency, peritoneal discomfort), pain in the genitourinary region, and/or pain with ejaculation. Prostate examination is often normal but may show hypertrophy, tenderness, or edema. Diagnosis requires urinalysis before and after prostatic massage (or examination of expressed prostate fluid), but patients with chronic/recurrent urogenital symptoms and bacteriuria are often treated presumptively. +2
qfever  Is this patient having a normal UTI because of outflow obstruction of bladder? Because if it's just outflow obstruction there won't be leukocytes and bacteria on UA (and that's why I chose wrong) +1
ddub  Looking at it now, I guess it's the annoying "most likely cause of this patient's condition?"... outflow obstruction (enlarged prostate) causing UTI causing sxs, etc.. lame +1

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