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NBME p2ck_form7 Answers

step2ck_form7/Block 1/Question#35 (5.5 difficulty score)
A 27-year-old woman comes to the physician ...
Small bowel obstrution🔍,📺
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 +1 
submitted by step_prep5(196),
  • Young woman with Crohn’s disease who has severe abdominal pain, nausea/vomiting, and a distended tender abdomen, most consistent with small bowel obstruction likely due to a stricture in setting of Crohn’s disease
  • Key idea: Elevated amylase is NOT specific for pancreatitis and can also be seen in patient with vomiting
  • Key idea: Small bowel obstruction classically leads to 5 symptoms: (1) Obstipation (constipation, no flatulence) (2) High-pitched bowel sounds (bowel working hard to try to get past obstuction) (3) Abdominal distention (4) Abdominal pain (5) Nausea/vomiting
  • Crohn’s disease leads to transmural fibrosis and can therefore damage underlying stem cells and lead to fibrotic strictures through healing process

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 +0 
submitted by embeemee(1),

the change from green liquid to yellow liquid threw me off. i was thinking gastric outlet obstruction that initially let out bile until it progressed further until letting out only stomach acid?