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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 4/Question#15 (reveal difficulty score)
A 52-year-old man is brought to the physician ...
Surgical debridement ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: infectious_disease

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submitted by โˆ—step_prep2(66)
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  • Middle-aged man with diabetes who presents with severe pain in the scrotum, fever, and confusion with bullae and crepitus over the scrotum/perineum and a leukocytosis and elevated glucose concentration, most consistent with Fournier gangrene
  • Key idea: Fournier gangrene is a form of life-threatening necrotizing fasciitis of the perineum/scrotum most commonly seen in patients with obesity or diabetes mellitus who require urgent surgical intervention (should NOT be delayed for imaging)

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tinylilron  not even if the patient is clinically stable... wouldn't the surgeons want a CT scan to help prepare them for surgery??? +1
adong  Doesn't matter bc this would be a surgical emergency +



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submitted by holdmystethoscope(3)
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More about Fournier

Cutaneous breakdown in the perianal and genital region allows for entry of genital and colonic organism.

Infections spreads, causing microthrombi of cutaneous vessels, causing gangrene.

Poorly controlled diabetes and obesity are greatest risk factor

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