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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#32 (reveal difficulty score)
A 24-year-old primigravid woman at 18 weeks' ...
Inflammatory bowel disease ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI

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submitted by โˆ—sugaplum(487)
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According to UTD there is an increased risk of UC flairs during pregnancy. This is weird because the rule is "pregnancy causes these autoimmune/inflammatory stuff to go down" and they love testing the exceptions....

UTD" Fertility, pregnancy, and nursing in inflammatory bowel disease"

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submitted by โˆ—step_prep7(71)
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  • IBD should always be suspected in a young adult without a clear trigger (international travel, etc.) who presents with increased bowel movements, especially if stools are covered with blood and/or patient has associated abdominal pain
  • Diseases associated with erythema nodosum = IBD, tuberculosis, systemic fungal infections (cocci, etc.), sarcoidosis, Behcetโ€™s disease, strep pharyngitis (most common trigger)
  • Important to distinguish IBD from IBS because both can present in young adults and both can be described as having increased frequency of mucus-covered stools. Features that point towards IBS include lack of blood in stools, abdominal pain that is relieved with defecation and alternating periods of constipation and diarrhea
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submitted by โˆ—jlbae(159)
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Ulcerative colitis - young adult, blood/mucous in stools, erythema nodosum

Other answers:

Amebiasis - would expect travel history, liver involvement

Diverticulitis - would expect low-grade fever, LLQ pain, history of chronic constipation

Viral gastroenteritis - would expect watery diarrhea and maybe fever and signs of dehydration

Hyperperistaltic diarrhea - dunno wtf this is but a quick Google search says maybe it's a top secret code for Dumping syndrome

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