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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 3/Question#42 (reveal difficulty score)
A 57-year-old woman comes to the physician ...
Osteophytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: msk inc

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submitted by โˆ—step_prep2(66)
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  • Presentation most consistent with osteoarthritis because the woman is heavy, the stiffness resolves quickly upon waking, the joint pain is asymmetric and, most importantly, it involves the DIP joints of the hand. The only two diseases that will involve the DIP joints are osteoarthritis and psoriatic arthritis. It is weird that it gets better as the day progresses, but the overall picture is most consistent with OA
  • Key idea: Osteoarthritis characterized by osteophytes, joint space narrowing, subchondral sclerosis and cysts

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dlw  Also, Q stem specifically states most likely to find on imaging of her KNEES, not her hands. The hands improve with movement but the knees worsen on walking. +3
cbreland  What would "subchondral lucency" reference?? I was assuming that it would be OA as well so that's why I didn't pick osteophytes. That being said, I chose erosions... but not for a good reason +
namesthegame22  I think "subchondral lucency" is osteonecrosis +
namesthegame22  Osteophytes can be causing the crepitus +



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