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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#19 (reveal difficulty score)
A 52-year-old woman with a 2-year history of ...
Add lisinopril to the medication regimen ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: endo

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submitted by โˆ—step_prep5(246)
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  • Key idea:ย ACE inhibitors or ARBs should be initiated at onset of microalbuminuria in all diabetic patients
  • Key idea:ย Two most common causes of CKD include hypertension and diabetes, with diabetes leading to nephropathy because it leads to preferential arteriosclerosis of the efferent arteriole > afferent arteriole, thus leading to high pressure in glomerulus, resulting elevated GFR and damage to glomerulus over time (ACE inhibitor or ARB can reduce this damage by dilating the afferent arteriole, leading to a decreased GFR)
  • Key idea: Typical HbA1c goal for patients with diabetes is <7.0% (and therefore in this patient no need to switch diabetes meds)

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