NBME Step 2 CK Form 8 Lymphangitis (NBME Answers)

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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 2/Question#39 (reveal difficulty score)
A previously healthy 32-year-old woman comes ...
Lymphangitis 🔍 / 📺 / 🌳 / 📖
tags: derm

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submitted by ∗seagull(1933)

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I was desperately looking for cellulitis. I never did see it. Some say I'm still looking for it to this day.

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welpdedelp Same lol. A question I had was I thought lymphangitis was supposed to precede some sort of injury, obv not lol but was the lymph node the main giveaway? +1

keyseph I think the key distinguishing features are the red streaks leading to an area of local lymphadenopathy. Otherwise, cellulitis would be a viable option if given. +6

charcot_bouchard Cellulitis can lead to lymphangitis +1

notyasupreme I thought lymphangitis is seen more with erysipelas +

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submitted by ∗step_prep(148)

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Patient with an inflammed area of the distal radius with red streaks extending from the area towards the elbow, most consistent with lymphangitis
Key idea: Most common pathogens are MSSA and Group A strep, and therefore empiric treatment is cephalexin

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step_prep https://en.wikipedia.org/wiki/Lymphangitis +

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submitted by ∗link981(208)

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Lymphangitis is an infection of lymph vessels, while being a complication of some bacterial infections.

-Key words in vignette is "red streak extending to elbow".

Look at this picture: https://www.jpeds.com/article/S0022-3476(13)00037-1/fulltext.

The form is made because the streak follows the shape of the lymph node. Very noticeable once you see the image.

-Superficial thromphlebitis can't be the answer because it is generally caused by clotting in woman over 40 or 6 months post partum.

Remember the question asks "most likely" but many of some of these choices can definitely be in the differential diagnosis.

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