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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#25 (reveal difficulty score)
A 42-year-old man comes to the physician ...
Emphysema ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm

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submitted by โˆ—step_prep7(71)
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  • Young man with family history of โ€œlung and liver problemsโ€ and 25 pack-year smoking history presenting with chronic progressive shortness of breath with expiratory wheezes found to have elevated LFTs on exam, most consistent with emphysema in the setting of alpha-1 antitrypsin syndrome
  • Key idea: Alpha-1 antitrypsin is a co-dominant disorder, with homozygous patients developing emphysema and cirrhosis and heterozygous patients being highly prone to emphysema with smoking
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submitted by โˆ—keyseph(99)
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Progressive respiratory difficulty and bilateral expiratory wheezes before age 50 with abnormal LFTs and a family history of "lung and liver problems" suggests alpha-1 antitrypsin deficiency. Pulmonary presentation is panacinar emphysema.

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