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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 1/Question#41 (reveal difficulty score)
A 27-year-old woman comes to the physician ...
Small-bowel obstruction ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI

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submitted by โˆ—gh889(154)
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โ€ข Severe SBO presents with:

โ€ข โ†“ bowel sounds when it is a complete block (hyperactive/high pitched when less than 100% b/c the body is trying to push pass it) โ€ข Distended and tympanic abdomen โ€ข Postprandial pain โ€ข Pain relieved with vomiting (relieves some intra-abdominal pressure)

โ€ข SBO initially has high pitched bowel sounds but a complete obstruction has โ†“ or absent bowel sounds

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jlbae  Crohn disease -> likely a stricture complicated by bowel perforation, peritonitis, and/or bowel ischemia +1
305charlie94  Why was her last menstrual period 7 weeks ago? Any correlation +2
nicspabi  probably a side effect of the steroid she's taking @305charlie94 +



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