NBME p2ck_form7 Intravascular volume depletion (NBME Answers)

NBME p2ck_form7 Answers

step2ck_form7/Block 1/Question#26 (reveal difficulty score)
A 47-year-old woman comes to the physician ...
Intravascular volume depletion 🔍 / 📺 / 🌳
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+6
submitted by ∗jesusisking(28),

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dDi eonayn lese nhtik aotmincuo cinffsnceiiyu eivng het dst?eibae I oknw ti saw yivelosupr wlle ertondllco but siltl a 01 year rithosy

seagull ya dude. +

charcot_bouchard You wouldn't expect baseline low BP at that case. Also other features like fever suggest alt dx +

+3
submitted by ∗step_prep5(213),

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didalMd-ege wonma tihw naiolttep sfcitiueno aseedsi r)eev(f endilag ot eno ewek of uotecnlonrdl ryapmglechiye who has ngsis fo osatctrihot yonntpsehoi dop(r in oscltisy BP tg;&20 ro diicatslo PB &tg0;1 hnew onmivg fmro sigttni to adintsng) dna si nfdou to veha ilcuagsoru, ostm noicsstten whit aricanrluavts uemovl tndlepieo eud to ugceslo anictg sa an miotocs tagen dan ialgden to iplouyra
eyK eiad: tesocInifn nofte aeld to anscrdiee snunlii eenretimrqu yb nsacuig a ycetainaror eyyemgclarhpi

pppp:g-th//eunsoe.tgrrr//iotstt

antwon Would this be stress hyperglycemia? meaning stress would lead to gluconeogenesis, glycogenolysis, and insulin resistance. Therefore more glucose in the urine and therefore glucosuria. +

+2
submitted by ∗buttercup(19),

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sitcoOm disuries deuacs yb cisraougul si neo fo eth omts mcomno eusacs of exessvcei nrlea aslt dna earwt os.sl

russnels What would cause the acute increase in blood glucose concentrations? +1

study_dude_guy I think this question is getting at HHS. The glucose levels are way lower than typical HHS but the patient has a fever and WBCs in the urine so MAYBE a UTI (even though it doesn't say anything about UTI symptoms) +

+2
submitted by russnels(15),

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I was yaltliiin innhiktg lanerda ncincsuyff,iie ubt that is wognr cb/ you douwl yaalctul ctxpee to see ,yPgOcmHelYai nto edowsenr .lepygycraimhe ouY doluw iltls ctxpee ot ees nnsyiotep,oh wevhero.

+0
submitted by ∗charcot_bouchard(502),

Adrenal insufficiency will cause - If primary (i.e loss of both cort and aldo) : u have refractory hypotension. not only postural

Only aldo loss (like drug induced) can cause postural drop but thats highly ulikely here and its not called adrenal insufficiency.

here, infection > Fever (both cause vasodilation)

Infection > stress hyperglycemia > oosmotic diuresis > Fluid loss