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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 2/Question#22 (reveal difficulty score)
A 5-week-old boy is brought to the physician ...
Hypertrophic pyloric stenosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: GI

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submitted by โˆ—step_prep7(71)
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  • Classically leads to non-bilious (stenosis occurs above the duodenum) projectile vomiting in a newborn at 2-6 weeks of age that is refractory to dietary changes
  • Key idea: In questions asking about management, you want to first correct fluid and electrolyte abnormalities before proceeding with a corrective pyloromyomectomy
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 +0  upvote downvote
submitted by โˆ—carolebaskin(109)
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Non-bilious vomit in a young boy a few weeks old

  • can't be lactose intolerance (switched to soy)
  • mustard colored stool

Would also expect

  • olive sized abdominal mass
  • succession splash on auscultation

Non-bilious ddx

  • pyloric stenosis
  • TEF

Bilious ddx

  • duodenal atresia
  • annular pancreas
  • malrotation/volvulus
  • intestinal atresia
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