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NBME p2ck_form8 Answers

step2ck_form8/Block 2/Question#6 (reveal difficulty score)
A 1-day-old male newborn had the onset of ...
Pancreatic enzyme ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ
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 +0 
submitted by โˆ—step_prep(142),
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  • Newrbon whti iamfyl sohtryi fo ytiscc issobfri ohw sha pisrntneoeta ntesoiscnt twih omunemic isule (ifarlue ot ssap mc,muioen oiisulb im,tginvo pessnditisa etlrik-a c,eimmnuo c,.et) and rfhrteoee ohsldu eb aertdet twih ecacirtnap nmyeze
  • yeK aie:d sytciC obsfriis sleda ot aft npolotbaiarsm seubace tcraaiecnp eyemnsz aehv rtlobeu iarncheg teh GI ,actrt os saittpen can beeiftn rfom artccipean menyez

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 +0 
submitted by โˆ—link981(207),

The majority of infants with CF and MI, whether simple or complex, have pancreatic insufficiency (PI). Confirmation of PI is most efficiently and effectively done by obtaining a fecal elastase. However, the fecal elastase sample should be collected from rectally delivered, formed stools and not from an enterostomy. Watery stools from either an enterostomy or rectally delivered can result in falsely low fecal elastase values. Therefore, in infants with MI and an enterostomy, PI should be assumed and fecal elastase collected at a later date after the gastrointestinal tract is back in continuity and stools are at least of a pasty consistency to confirm diagnosis. Once the infant is able to take a minimal amount of formula or breastmilk by mouth or feeding tube, PERT should be initiated at 2000โ€“4000 lipase units per 120โ€…mL of formula [[37]]. PERT contains lipase to digest to lipids, amylase to digest carbohydrates, and protease

https://www.cysticfibrosisjournal.com/article/S1569-1993(17)30809-3/fulltext#secst0030




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