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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#22 (reveal difficulty score)
An 18-year-old man comes to the physician 1 ...
Operative treatment ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: cardio surg

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submitted by โˆ—carolebaskin(109)
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Upper extremities more muscular and diminished pulses in lower extremities

Midsystolic or continuous systolic murmur that radiates to the back

= coarctation of the aorta

Treat surgically with surgical decompression

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submitted by โˆ—step_prep7(71)
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  • Young otherwise healthy patient with hypertension should prompt high index of suspicion for a secondary cause of hypertension (fibromuscular dysplasia, hyperaldosteronism, coarctation of the aorta, Cushingโ€™s syndrome, hypo/hyperthyroidism, pheochromocytoma)
  • In this patient who has increased muscular build and stronger pulses in the upper extremities and signs of LV hypertrophy on ECG (secondary to chronically increased afterload), the most likely diagnosis is coarctation of the aorta which requires operative treatment
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