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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 4/Question#31 (reveal difficulty score)
An 82-year-old nursing home resident is ...
Peripheral vasodilation ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: renal

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submitted by โˆ—step_prep3(25)
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  • Elderly nursing home patient presents with altered mental status, fever, hypotension, warm extremities and a positive urinalysis (pyuria if >10 WBC/hpf), most consistent with urosepsis (infection leading to peripheral vasodilation and distributive shock)
  • Key idea: Distributive shock (anaphylaxis, sepsis, CNS injury) is the only type that will lead to warm and dry skin
  • Key idea: Patient needs to have symptoms in order to be diagnosed with UTI > Asymptomatic bacteriuria in the setting of a positive urinalysis, but in addition to dysuria and suprapubic tenderness, altered mental status is often attributed to UTI and considered a symptom

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