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=> Step 2 CK Free 120
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Recent comments (see more)

... eghafoor made a comment (nbme16)
 +0  submitted by eghafoor(1)

Anyone else got thrown off by the wording of "......each kidney" when the question is referring to A (singular) horseshoe kidney?

... l0ud_minority made a comment (nbme13)
 +0  submitted by l0ud_minority(0)

I got this wrong I thought Decreased Myosin Light Chain Phosphatase activity would play a factor from the long leg cast immobilization for 6 months. Not being able to use the leg would cause atrophy. But I was wrong.

... kbizzitt made a comment (nbme24)
 +0  submitted by kbizzitt(1)

Article describing Sertoli-Leydig cell tumor

https://www.medscape.com/viewarticle/565147_2

... nala_ula made a comment (step2ck_form7)
 +0  submitted by nala_ula(100)

I got this wrong, thinking it was myositis ossificans due to the history (six days ago he was evaluated for twisted knee at a game with improvement of sxs until one day ago).. guess i should have payed more attention to his PMH

... saffronshawty made a comment (step2ck_form8)
 +0  submitted by saffronshawty(0)

I get that the bruit = Renovascular disease. But why is it not hyperaldosteronism when there is hypertension + hypokalemia + elevated bicarb

... faus305 made a comment (nbme18)
 +0  submitted by faus305(6)

I think @beastaran1 has the correct explanation but I just want to say his kidney is "abnormally small and nonfunctional" which means that it is not being used. When the body doesn't use something (like a muscle) it atrophies. So tubular atrophy makes sense.

Atrophy = gradual decline in effectiveness or vigor due to underuse or neglect.

When a question seems wildly complicated and you have no idea what's going on, take a deep breath and explain it to yourself like you're five.

... welpdedelp made a comment (step2ck_form6)
 +0  submitted by welpdedelp(216)

She met the Centor criteria for empiric antibiotics, why was is culture?

... welpdedelp made a comment (step2ck_form6)
 +0  submitted by welpdedelp(216)

Always best to discuss pregnancy prevention prior to pt participating in sex, if not it will be too late

... welpdedelp made a comment (step2ck_form6)
 +0  submitted by welpdedelp(216)

Dementia is a risk factor for aspiration

... welpdedelp made a comment (step2ck_form6)
 +0  submitted by welpdedelp(216)

Just as another POV, you might have seen well-demarcated and thought erysipelas..but remember that is not bullous. Plus, everything else fell more in line with Type 4 HSN.

... welpdedelp made a comment (step2ck_form6)
 +0  submitted by welpdedelp(216)

Ca Gluconate must be given immediately if K > 6.5; think of it as "no point in hydrating or pushing K into cells with insulin if they will die rn of an arrhythmia"

Ca will stabilize immediately, which is why its initial tx.

... joga made a comment (nbme22)
 +0  submitted by joga(0)

LOW FLOW (HYPOTENSION) ...> LOW SV...> ^SYMPATETIC

... trazobone made a comment (nbme13)
 +0  submitted by trazobone(5)

Normal hormonal, male sperm study and normal semen: still can’t conceive then give TYR (???) with clomiphene, that is antagonist at GnRH receptor at hypothalamus, block estrogen mediated inhibition of GnRH hence increase release of LH surge Bromocriptine - would be helpful if the pt has infertility due to INCREASE LPEDS CTIRAON (??? I am assuming its PROLACTIN) - is stopped in US due to clear cell carcinoma in young female born to term. Ethinyl estradiol - bind estrogen & GnRH; LH surge: no use. (Inc risk of endometrial carcinoma) Medroxyprogesterone - is progesterin bind progesterone eonis(oeeccn.rprpmot..t. (???) of morning after pill)

trazobone  Clomiphene: a SERM, antagonist at estrogen receptors in hypothalamus (FA18 637) +
... trazobone made a comment (nbme13)
 +0  submitted by trazobone(5)

If anyone else is on the dumdum boat and didn’t know what a paranganglioma was: a neuroendocrine tumor that begins in nerve cells, closely related to a pheochromocytoma

... studentdoc1996 made a comment (free120)
 +0  submitted by studentdoc1996(0)

Aminoglycosides are synergistic with beta lactam antibiotics (and penecillin is a type of beta lactam antibiotics). The question is saying "what will make this work faster?" basically

... ht3 made a comment (step2ck_form6)
 +0  submitted by ht3(10)

why can't this be chronic bacterial prostatis?...ughh the gram stain and leukocytes on UA threw me off

ht3  according to Uworld, chronic prostatitis* could be nontender +
... godby made a comment (nbme18)
 +0  submitted by godby(0)

Motor + Sensory + rapid progress :: may be R/O Acute inflammatory demyelinating polyradiculopathy

... kingfriday made a comment (step2ck_form6)
 +0  submitted by kingfriday(3)

i think this was tested in a similar way in another question in this form. the patients have a right to know or not know their resuts.

... godby made a comment (nbme18)
 +0  submitted by godby(0)

MM will be induced a AL(primary amyloidosis).

Some notes
❧ Comments submitted this year are scramble–resistant (Scramble–resistant Staphylocomment aureus)
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Help your fellow humans! (see more)

eghafoor asks (nbme16):
Anyone else got thrown off by the wording of "......each kidney" when the question is referring to A (singular) horseshoe kidney? help answer!
welpdedelp asks (step2ck_form6):
She met the Centor criteria for empiric antibiotics, why was is culture? help answer!
benwhite_dotcom asks (step2ck_free120):
How many people with sats in 80s have you seen not getting O2? help answer!
benwhite_dotcom asks (step2ck_free120):
This is a potentially fatal decision. Patients can choose to deny care, but when someone is making the “wrong” choice, it’s important to make sure they have the capacity to do so: do they understand their situation, their options, and the possible consequences of their actions? If so, that’s fine. help answer!
benwhite_dotcom asks (step2ck_free120):
Source control followed by symptomatic relief. Have you seriously ever heard of anyone doing any of that other crazy stuff? help answer!
trazobone asks (nbme13):
SMH it all boiled down to what does tyrosine kinase do? Kinase phosphorylates stuff. So therefore the homodimer would still form but since the key thing thats being messed up here is the kinase, it’s the phosphorylation process that gets disrupted. help answer!
trazobone  SMH it all boiled down to what does tyrosine kinase do? Kinase phosphorylates stuff. So therefore the homodimer would still form but since the key thing thats being messed up here is the kinase, it’s the phosphorylation process that gets disrupted. +
kingfriday asks (step2ck_form6):
This one got me :( i had the right answer but i switched because i kept getting hung up on his PPI treatment (rereading the stem now, it seems he's off treatment) but can someone explain to me what the answer would be if the guy were on a PPI and had intractible vomiting? help answer!
whoopthereitis asks (nbme19):
can anyone elaborate why they chose this answer? help answer!
hiroshimi  Even though legally the wife has the right to make the decision first, then the adult children. However, it's still best the wife and children come to a consensus that reflects pt's wish. If there is a disagreement between them that can't be resolved, then the doctor will need to follow what the wife said. In these difficult situations, you are not only treating the patient, but also the whole family so you would try to integrated the family into the process. In short, i feel like the point of this question is don't be an asshole, and don't choose answer that have absolute words in it like "only" +
misrao asks (nbme21):
Can someone explain the correlation between 450 mOsmol/day and needing to excrete 1 L of water? Thanks help answer!
llpierso asks (nbme22):
I understand why K+ is increased. But why isn't chloride also increased? This is a metabolic acidosis, so bicarb will be low and H+ will be high. You need an ion to balance charges --> increased chloride? help answer!
lickmyass asks (nbme20):
Why not Multiple renal artery aneurysms? I was thrown off by the description of hyperplastic arteriolosclerosis and so I went with this choice. I thought hyperplastic arteriolosclerosis may lead to fibrinoid necrosis of the vessel wall with hemorrhage. help answer!
brise asks (nbme23):
How do you rule out LSD? It also causes tachycardia! help answer!
ht3 asks (step2ck_form7):
If the chin is deviated to the right, then wouldn't the "mass" (which I assume is the tight SCM muscle) be on the LEFT side of the neck?? help answer!
benwhite_dotcom asks (step2ck_free120):
You know that granulomatosis with polyangiitis (née Wegener’s) causes lung disease, but did you know it also causes peripheral neuropathy? Keep in mind that “not all that wheezes is asthma.” Wheezing is a sign of obstructive lung disease, not a diagnostic feature, so consider asthma alternatives in adults. Hemoptysis and fever change the game. help answer!
brise asks (nbme23):
Why is it that you can use acetaminophen in aspirin induced asthma and not here? I literally chose acetaminophen bc in another nbme it said to use it in aspirin induced asthma help answer!
brise  Acetaminophen is not an NSAID and therefore it will not treat gout. +1
carolebaskin asks (step2ck_free120):
Eeaaasy there, partner. They said they don't want insulin and you're gonna kick them to the curb? One step at a time, bud. Offer the insulin, let them refuse (they seem to have capacity), but who ever said anything about discharging them. Where would they go!? Haven't they been through enough? help answer!
carolebaskin asks (step2ck_free120):
Hypercalcemia + lytic spinal lesions = multiple myeloma What about the fever, leukocytosis, and consolidation? MM predisposes to infection! It's PNA. help answer!
letsdothis asks (step2ck_form8):
Anyone else get thrown off by the laboratory abnormalities (hyponatremia, hyperkalemia, hyperchloremia, metabolic acidosis)? help answer!
brise asks (nbme22):
Can anyone explain why complement C5-9 is listed? help answer!
drdoom  don't have the stem in front of me but the Fc “handle” of antibody allows for opsonization (by macrophages and other APCs) but more immediately it activates circulating complement -> terminating in the formation of the Membrane Attack Complex. MAC is great way to kill nonself intruders without having to wait for macrophages to mature or neutrophils to arrive. FAST ACTIN’ TANACTIN! +1
brise  Thank you so much! +1
faus305 asks (nbme24):
You know why I don't get chronic granulomas? Because I've got NADPH Oxidase. It makes OXYGEN FREE RADICALS THAT WIPE AWAY STAINS. AND THAT'S THE POWER OF OXY-CLEAN. help answer!
kingfriday asks (step2ck_form8):
Why would increasing fluids be incorrect? help answer!
kingfriday  nvm, someone whose kidneys dont work means they not able to get rid of fluids anyway so giving them fluids can make things worse +
letsdothis  Yeah, I feel like increasing fluid in any chronic renal conditions is always correct, but I like the steppreps explanation. +
carolebaskin asks (step2ck_form7):
Tricky! Yes, fecal occult blood test would pick up hemorrhoid blood and this is a male <50yo, so case closed right? Wrong! Hematocrit = 35% --> hgb = 35/3 = 11.7 < 13.5 (normal) Why is he anemic? Do a colonoscopy. help answer!
carolebaskin asks (step2ck_form7):
thajoker's comment is spot on And: decreased upward gaze is a normal sign of aging, not always parinaud syndrome https://pubmed.ncbi.nlm.nih.gov/15114040/ Can dogs look up? help answer!
faus305 asks (nbme24):
Was I wrong to just pick the only answer with the word nociceptor in it? help answer!
meryen13 asks (nbme16):
am i the only one who forgot what was lamellar bodies? :D lamellar bodies (otherwise known as lamellar granules, membrane-coating granules (MCGs), keratinosomes or Odland bodies) are secretory organelles found in type II alveolar cells in the lungs, and in keratinocytes in the skin help answer!
veggievendor asks (step2ck_form7):
Can someone please enlighten me why this is hypothyroidism? help answer!

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