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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 1/Question#37 (reveal difficulty score)
A 72-year-old man with lung cancer comes to ...
Repetitive nerve stimulation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm rheum inc

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submitted by โˆ—step_prep(148)
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  • 72 year old patient with lung cancer presents with non-fatigable weakness affecting the eyes and proximal muscles (hip extensors, eyes), autonomic symptoms (dry mouth, constipation) and loss of deep tendon reflexes, most consistent with Lambert-Eaton syndrome (which can be diagnosed with repetitive nerve stimulation)
  • Myasthenia gravis: Associated with thymoma, oculobulbar weakness that worsens with repeated use
  • Lambert-eaton syndrome: Associated with small cell lung cancer, proximal muscle weakness that improves with repetitive use AND autonomic dysfunction and decreased/absent deep tendon reflexes

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