NBME Step 2 CK Form 7 Bone marrow aspiration (NBME Answers)

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 🔍 / 📺 / 🌳 / 📖
tags: hemeonc

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submitted by study_dude_guy(14)

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Tihs usneoqit is lalctauy a lot eedpre ntha it l.ksoo It si not utaob wenh" od yuo ratet "ta,oyotecopbhimnr chhiw oyu OD tarte wehn teyh vhae ienlebgd ekli ni het iuneot.qs Tihs ietonqus is tboau maanentmge of LLA hwhic ahs spfceiic neledigs.ui idrcAgnoc to ou,aedttp as olgn as tptlaeel vleesl aer btaou 02000, in ALL, yuo rae godo ot go for a beon pbiyo.s

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drdoom very nice +

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submitted by ∗buttercup(18)

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enBo orrwma notixanimae is lyraeleng not qerudrie rof hte iailnti taeunlaoiv ni tmos seasc fo aunedxpinle lotidesa ooophtmincebaryt in hcrn.eldi ihsT hldic has ycenaoapitnp nad hfteorree erruqesi a ebon rwomar anpasirot.i

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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: https://www.aafp.org/afp/2011/0315/hi-res/afp20110315p719-t2.gif +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. +

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submitted by ∗step_prep5(246)

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tps:/hnpptogetroeg/p/tsiu./trr-

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