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NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 1/Question#6 (reveal difficulty score)
A 4-year-old boy has had increasing fatigue ...
Bone marrow aspiration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: hemeonc 

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submitted by study_dude_guy(14)
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drdoom  very nice +

submitted by โˆ—buttercup(18)
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jesusisking  Why wouldn't it be platelet transfusion 1st? +
jesusisking  Just found the answer. Patient was stable and not actively bleeding w/ 30K platelet count. For this type of patient, start transfusing at <10K: +4
deathbystep1  well the question said "his gums started bleeding when he brushed his teeth". So wouldn't that be considered active bleeding? I was aware about the aafp guidelines as there was a similar question in Uworld as well. The only reason i chose platelet transfusion was because he was "actively" bleeding from the gums. Otherwise it was clear that he had pancytopenia and you need to do a bone marrow biopsy. +
zalzale96  Isn't bone marrow aspiration considered an invasive procedure and thus we should transfuse since his platelets level is below 50k? +
osler_weber_rendu  Acc to UW, in children transfuse ivig, steroids, anti D only if child has more than mucocutaneous bleeds. In adults it is done if the count is below 30k irrespective. +

submitted by โˆ—step_prep5(246)
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