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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 3/Question#13 (reveal difficulty score)
A 72-year-old man comes to the physician ...
Increased parathyroid hormone-related peptide concentration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm

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submitted by โˆ—step_prep2(66)
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  • Elderly man with known squamous cell carcinoma who presents with elevated calcium and otherwise normal labs, most consistent with PTHrP production
  • Key idea: Squamous cell carcinoma, breast cancer, renal cell carcinoma, ovarian cancer and bladder cancer are known for producing PTH-related peptide, which has the same effects as PTH (increased calcium, decreased phosphate)
  • Key idea: If answer was metastases to bone (commonly seen in breast cancer, multiple myeloma, prostate cancer) then patient would have back pain and/or imaging with osteolytic changes
  • Key idea: Lymphoma leads to hypercalcemia by leading to increased vitamin D levels

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namesthegame22  Lymphoma --> increase 1 alpha hydroxylase in macrophages +



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