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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 3/Question#21 (reveal difficulty score)
A 21-year-old primigravid woman at 37 weeks' ...
Measurement of platelet count ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: repro

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submitted by โˆ—thomasalterman(181)
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My reasoning: We know she has preeclampsia, so what other information might be helpful? - platelets could evaluate for HELLP and AFLP - everything else has no indication. US pelvis is a weaker choice given patient has no documented signs of abruption (pelvic pain, vaginal bleeding, FHR abnormalities)

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 +1  upvote downvote
submitted by โˆ—step_prep5(246)
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  • Patient with signs of pre-eclampsia (hypertension and proteinuria) who should have delivery of the baby (because patient at 37 weeksโ€™ gestation) and work-up for other end-organ complications associated with severe pre-eclampsia (platelet count, BUN/creatinine, etc.)
  • Pre-eclampsia (uncomplicated โ€“> delivery at 37 weeks) = New-onset elevated blood pressure at >20 weeks gestation AND Proteinuria (Urine protein:creatinine ratio > 0.3 or 24-hour urine collection > 300 mg) or signs of end-organ damage
  • Features that point to severe pre-eclampsia requiring delivery at 34 weeks: BP > 160/110, thrombocytopenia, pulmonary edema, visual/cerebral symptoms, increased creatinine, increased LFTs

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