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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 2/Question#25 (reveal difficulty score)
A 9-year-old boy is brought to the physician ...
FEV1: Decreased / FVC: Normal / TLC: Increased ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pulm inc

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submitted by โˆ—step_prep(148)
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  • Child with a family history of asthma who has presentation of cough-variant asthma (cough that is worse at night and with exercise), thereby leading to an obstructive pattern on PFTs (FEV1:FVC < 70% predicted, increased TLC)

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submitted by โˆ—charcot_bouchard(574)
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SERIOUSLY! SERIOUSLY!!

we gonna totally forget asthma can cause total normal PFT. including FEV1

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merpaperple  That wasn't an option though, only normal FEV1 and FVC but with increased TLC. I almost went with that option but reconsidered. My thinking was, either he is not actively bronchoconstricting (in which case the PFTs could be totally normal), or he is in which case you would see an obstructive pattern on PFTs. The only option that matched an obstructive pattern (ie FEV1 lower than FVC, and with increased TLC) was this one. +



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