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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#13 (reveal difficulty score)
A 57-year-old man comes to the physician ...
Interferon-alpha ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI inc

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submitted by โˆ—step_prep5(246)
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  • Patient with signs/symptoms of mixed cryoglobulinemia (weakness, arthralgias, palpable purpura, positive cryoglobulins on labs) most likely secondary to hepatitis C contracted during blood transfusion (positive Hep C viral RNA), and therefore the patient should receive interferon-alpha therapy against the hepatitis C
  • Key idea: This test question is a bit outdated, with hepatitis C now being treated with combination of NS5A/B inhibitors (ledipasvir, velpatasvir, sofosbuvir, etc.) and NS3/4A inhibitors (simeprevir, etc.)
  • Key idea: To confirm diagnosis of hepatitis C, antibody testing needs to be followed up by viral RNA because hepatitis C will be spontaneously cleared by the body in 15-25% (no chronic Hep C)

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