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NBME p2ck_form7 Answers

step2ck_form7/Block 3/Question#10 (4.6 difficulty score)
An otherwise healthy 40-year-old woman comes ...
Physiologic dischargeπŸ”,πŸ“Ί

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submitted by keyseph(44),

Let's break this down algorithmically.

Unilateral discharge in a patient >30 years warrants a mammography. Mammography for this patient was normal.

Next step should be to get a prolactin level, but the prompt didn't specify, so let's assume it was normal.

Given a normal mammography and presumed normal prolactin level, physiologic discharge would be the most likely diagnosis.

submitted by step_prep5(74),
  • Physiologic discharge: Non-spontaneous, non-bloody and minimal discharge with normal physical exam and mammogram
  • Pathologic discharge: Unilateral discharge, bloody/serous discharge and/or palpable lump or skin changes