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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#2 (reveal difficulty score)
A 67-year-old man is examined 3 days after ...
Remove the urinary catheter ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: renal surg

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submitted by โˆ—jlbae(159)
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Urinary catheters are the most common cause of iatrogenic or nosocomial UTIs

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submitted by โˆ—tinydoc(276)
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I got this based on the causes of post op fever. Mostly just a guess really.

The 5 "W's"

1-2 Days post op: WIND - Lungs - post op atelectasis

3-5 days post op: WATER - UTI

5+ days post op: WALKING - DVT/ PE

7 days post op: WOUND - wound infections

8-15 days post op: WONDER DRUGs - Drug fever

The question says pt is 3 days post op so I just went with prevention of UTI. Uworld says the best way to prevent UTI is to remove catheter as soon as it's not needed.

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medicalmike  Other answer choices can be eliminated as follows: subQ heparin is unnecessary as the patient is now ambulating Patient should stay on furosemide since it appears this is a home med for his CHF Acid suppression is used for critically ill patients (he is extubated and on his way to recovery) Morphine can be continued as this patient just had his chest split open. He will be transitioned to PO opioids prior to discharge. +4
lindasmith462  IDK why this guy wasnt ALREADY on VTE prophylaxis w/ heparin on post op day 1 (cardio surgery makes him a high bleeding risk so mechanical methods for that but they can be started on heparin prophylaxis relatively soon post op) +



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