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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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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

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?