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NBME Step 2 CK Free 120 Answers

step2ck_free120/Block 3/Question#114 (reveal difficulty score)
A 56-year-old man with adenocarcinoma of the ...
Increased total protein concentration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: oncology Pulm cancer

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submitted by โˆ—len49(42)
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Pt has malignant effusion, which you would expect to be exudative. Exudative is characterized by protein pleural/serum > 0.5 LDH pleural/serum >0.6, and a LDH >2/3 upper limit of normal. So that would be increased protein or increased LDH, LDH is not an answer, so easy to rule out.

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 +1  upvote downvote
submitted by โˆ—bwdc(697)
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Malignant pleural effusion. Cancer is full of protein.

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nbmehelp  ??????????? +
drdoom  hi @nbmehelp. if you are confused about a comment or unhappy with an explanation, please pose a specific question so we can help answer or clarify. thanks! +
rthavranek  But malignancy effusion also has glucose < 60 mg/dL so I was between that and increased protein. My reasoning was that cancer cells have high metabolic rate so they require increased energy/glucose +1
cbreland  I thought the same thing @rthavranek , all exudative effusions should have increased protein. That being said, still picked decreased glucose +

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