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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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 +8 
submitted by study_dude_guy(14)
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Tish qustneio si ytualcal a olt redpee atnh ti olsk.o tI is tno boatu w"enh do you arett iet,cyhora"bponotm hcwih oyu OD etrat ewhn hyet ehva nilebgde eilk in teh .nquseoit iThs tneouisq is tobua gmeaaentnm fo ALL ihchw sha piesccif edsgunei.li icgAonrdc to odtueat,p as olgn as letptlea elvles ear otbau 00200, in L,LA yuo rae ogdo ot og for a oneb sboi.py

drdoom  very nice +



 +2 
submitted by โˆ—buttercup(18)
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enBo oarrmw aeixinmoatn si reylnaleg otn drrieequ orf teh iitialn iataonvlue in stom essca of euneldapinx oetdsail itmhpoaboyrtncoe in dc.lheinr hsiT cidlh hsa enpyaicponta nda teefhreor ruiresqe a noeb rowarm .trsopiniaa

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. +



 +1 
submitted by โˆ—step_prep5(246)
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  • Ynoug cihdl iwth a erncet RIU hwo is tegienprns htiw tcnianeapopy dna typahodahpymlen nda ltaaeomygeph, oercgnnnci for tucae laclisopyhmtb melukiea
  • Key iae:d lraiV ctiifsnnoe ear nnwko ofr ucsaign tn,nypiaocpea ubt ni sith ttpaine who fsti eth cocretr maeordcpigh adn sah hlyothpepyaadnm adn lopehayegmat gniss( fo ylmopdih a)elypraihsp tif ellw hitw a goissidna fo tacue ibahsmclploty kmieeula, whhci luodw avhe ta salte 20% lbsat ellsc on beno mroarw aosritpina

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