NBME Step 2 CK Form 7 Increased serum lactate dehydrogenase activity (NBME Answers)

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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#9 (reveal difficulty score)
A previously healthy 18-year-old woman comes ...
Increased serum lactate dehydrogenase activity 🔍 / 📺 / 🌳 / 📖
tags: hemeonc inc

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submitted by ∗step_prep5(246)

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Young previously healthy woman with a large (>1 cm), firm supraclavicular lymph node and splenomegaly, most consistent with Hodgkin lymphoma (which is associated with an increased LDH)
Key idea: Enlarged supraclavicular lymph node is never normal!
Key idea: Hodgkin lymphoma also commonly associated with pruritis (particularly on the NBME exam)

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submitted by ∗jlbae(159)

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LDH is used as a prognostic indicator in Hodgkin Lymphoma.

Of note, HL can also present with hypercalcemia due to paraneoplastic production of 1,25-dihydroxyvitamin D, but it would be highly unlikely that the patient would be asymptomatic if this were the case.

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