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NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#32 (reveal difficulty score)
A 3-year-old girl is brought to the emergency ...
Organophosphate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: toxicity

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submitted by โˆ—step_prep5(246)
  • Young child who was unsupervised with chemicals and presents with cyanosis, diaphoresis, miosis, rhinorrhea, drooling, signs of bronchoconstriction, and increased bowel sounds, all of which is associated with organophosphate poisoning โ€“> Decreased acetylcholinesterase activity โ€“> Increased acetylcholine โ€“> Increased parasympathetic functions, increased sweating, muscle paralysis (due to repetitive stimulation)
  • Key idea: Treated with atropine (muscarinic receptor antagonist) and pralidoxime (regenerates acetylcholinesterase)
  • Lead poisoning would not present acutely
  • Ethylene glycol โ€“> Anion-gap metabolic acidosis and kidney injury (classically renal stone)
  • Carbon monoxide poisoning โ€“> Cherry-red skin, head, altered mental status

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