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Retired NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 2/Question#60 (reveal difficulty score)
A 40-year-old woman is admitted to the ...
Acyclovir therapy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: infectious_disease

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submitted by โˆ—bwdc(697)
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Vesicular rash in the immune-compromised is a common scenario for Varicella-Zoster reactivation. Visceral zoster involvement can result in severe pain that can be mistaken for an acute abdomen. Treatment with acyclovir or valacyclovir.

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etherbunny  Shingles! +
etherbunny  (ignore that, its not shingles, multiple dermatomes are involved here). +
lindasmith462  apparently primary/reactive varicella is associated with subclinical hepatitis (note she also has elevated ALT/AST), as well as myocarditis, rhabdo w/ renal failure, arthritis, and glomerularnephritis. Immunocompromised patients are more susceptible to visceral involvement. +2
charcot_bouchard  It is shingels... yes reactivation is usually dermatomal. But it can be severe and bilateral in severly immunocompromised patients. +1



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