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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 1/Question#28 (reveal difficulty score)
A previously healthy 72-year-old man comes to ...
Pneumoconiosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm DDX

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submitted by โˆ—step_prep(148)
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  • Elderly man with significant smoking history and occupational history of being a coal miner who presents with clubbing and hypoxia with bilateral upper lobe masses and areas of consolidation on chest x-ray most consistent with COPD and/or coal workersโ€™ pneumoconiosis
  • Key idea: Of the common pneumoconioses, the majority affect the upper lobes (silicosis, coal workersโ€™ lung, berylliosis) except for asbestosis (lower-lobe predominant)
  • Tuberculosis can also lead to upper lobe opacities, but it would more commonly lead to acute fever, night sweats and weight loss in a patient with exposure

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