NBME Step 2 CK Form 7 Hypovolemia (NBME Answers)

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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#41 (reveal difficulty score)
A 47-year-old man comes to the emergency ...
Hypovolemia 🔍 / 📺 / 🌳 / 📖
tags: GI inc

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submitted by ∗jlbae(159)

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If you're silly and picked esophageal rupture like me:

Mallory-Weiss → incomplete tear (mucosa/submucosa) → no perforation → hematemesis

Boerhaave → complete tear → perforation → SubQ emphysema

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azibird So does this kid have a mallory-weiss leading to a change in vomit color? On top of the fact that he's just volume depleted from vomiting? +

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submitted by ∗step_prep5(246)

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Patient with a 3-day history of profuse nausea/vomiting after significant alcohol consumption who now presents with abdominal pain, hypotension, tachycardia and cool/clammy skin, most consistent with hypovolemic shock
Cardiogenic shock: Signs of volume overload (jugular venous distention, lower extremity edema, etc.)
Septic shock: Could be seen if patient had sign of perforation (guarding, rebound) and patient would likely have warm and dry skin (because cardiac output is normal/increased and peripheral arterioles are dilated)

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