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Retired NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 1/Question#4 (reveal difficulty score)
A 42-year-old woman is brought to the ...
Laparotomy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI inc

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submitted by โˆ—bwdc(697)
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Unstable and hypotensive patients after blunt trauma get laparotomies (donโ€™t put an unstable patient in the CT scanner). In addition to saline and blood products, definitive surgery is how you address the C in ABC.

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tinylilron  Why not a Thoracotomy??? +3
bigjimbo  no thoracotomy because thats for unstable lung injuries like persistent hemothorax. The question is tricky because it says SOB and ABDOMINAL pain. paired with the green fluid (boerhaave or pancreatic), laparotomy is a safer answer +1
beans123  I looked it up and it truly depends on where the rupture is... thoracotomy could very well be the answer for a higher up rupture even if the patient is unstable... +1



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submitted by โˆ—azibird(279)
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Step Prep has the answer on this one: diaphragmatic hernia.

https://step-prep.org/nbme-step-2-free-120/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473789/

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