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NBME p2ck_form7 Answers

step2ck_form7/Block 3/Question#46 (3.2 difficulty score)
A 77-year-old man is brought to the physician ...

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submitted by veggievendor(1),

Can someone please enlighten me why this is hypothyroidism?

zazzy  depression-like symptoms, bradycardia, 1+ DTRs make hypothyroidism more likely than the other answers! +  
step_prep5  for more, see comment: +  

submitted by step_prep5(25),
  • Older patient with dementia, decreased DTRs, non-pitting edema of the lower extremities and slow movements, most consistent with hypothyroidism
  • Huntington disease –> Dementia, depression, chorea
  • Multi-infarct (vascular) dementia –> Step-wise dementia with focal neurologic defects (weakness, sensation, etc.)
  • Pernicious anemia –> Atrophic gastritis + B12 deficiency (lower extremity weakness, paresthesias, sensory disturbances, etc.)
  • Syphilis –> Lymphadenopathy, diffuse rash involving the palms and soles