NBME Step 2 CK Form 8 Toxin-induced inflammation of the colonic mucosa (NBME Answers)

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Retired NBME Step 2 CK Form 8 Answers

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A 57-year-old woman comes to the physician ...
Toxin-induced inflammation of the colonic mucosa 🔍 / 📺 / 🌳 / 📖
tags: GI

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submitted by ∗step_prep(148)

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Patient with recent antibiotic usage develops severe diarrhea and abdominal pain, which is most consistent with C. difficile infection
Key idea: C. difficile leads to diarrhea by producing two main toxins that lead to enterocyte damage
Key idea: Toxic megacolon can be seen secondary to C. difficile infection and ulcerative colitis (at least for NBME purposes)

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seagull I choose sterilization because C-diff is essentially an imbalance of colonic flora due to antibiotic "sterilization" leading to expansion of C. Diff. However, I ca see how toxin- mediated is the true mechanism but the question seems dirty to me. +8

jd1 I think also technically sterilization refers to inactivating spores (as opposed to disinfection which would not), so would imply Cdiff would be killed off too +7

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submitted by ∗kstudy(9)

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this is a great example of why I struggle with this silly nbme and steps. Are we testing knowledge here or semantics?

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merpaperple It's important that we learn to be as pedantic as possible, that's what makes for good doctors +

cbreland Truer words were never spoken +

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submitted by ∗charcot_bouchard(574)

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I also first chose sterilization but later move it to toxin. Its very straight if u look at it that toxin is the one causing diarrhea. Sterilizing gut flora occrs everytime u take antibiotics, its predisposing to C. DIff but not actually causing diarrhea otherwise everyone would get it.

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submitted by ∗jlbae(159)

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IMO, this was a shitty question. Pun very much intended.

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