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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#43 (reveal difficulty score)
A 67-year-old woman is brought to the ...
Esophageal perforation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI

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submitted by โˆ—step_prep7(71)
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  • Older woman who received an upper endoscopy with associated procedure presents with severe chest pain, hematemesis, crepitus in the neck and positive blood in the GI tract most consistent with an esophageal perforation
  • Key idea: Best diagnostic test would be esophagography with water-soluble contrast and patient should be treated with IV antibiotics, PPIs and emergency surgery
  • Contrast with Mallory-Weiss tear, which is a partial tear and therefore would not lead to crepitus and would often lead to more profound hematemesis
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