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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 1/Question#12 (reveal difficulty score)
A 62-year-old woman is admitted to the ...
Intravenous fluid therapy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: renal

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submitted by โˆ—deathbystep1(21)
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IV contrast dye used for pulmonary angiography worsened the renal insufficiency(inc in serum CR). Adequate hydration before IV contrast in patient with renal insufficiency can prevent this.

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submitted by โˆ—seagull(1933)
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SO Pulmonary Angiography has dye that shouldn't be used in CKD.

Why does the question need to be like a book in length. I was balancing like 20 ideas with her F**King diabetes and HTN. WTF

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nala_ula  literally +1



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submitted by โˆ—step_prep5(246)
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  • Middle-aged woman with CKD (likely due to type 2 diabetes) who presents with concern for heart failure exacerbation (shortness of breath, inspiratory crackles, intermittent S4, pedal edema) in the setting of community-acquired pneumonia (fever, CXR finding) and therefore is likely given decreased amounts of IV fluids and potentially is given diuretics, later found to have an acute kidney injury most likely due to decreased effective circulating volume (either pre-renal or acute tubular necrosis due to hypovolemia)
  • Key idea: In patients with heart failure exacerbation, you often have to carefully balance pulling fluid off while avoiding development of an AKI

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