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NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 1/Question#40 (reveal difficulty score)
A 50-year-old woman with a 5-year history of ...
Pericardial window ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: cardio

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submitted by โˆ—buttercup(18)
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Beck's triad: muffled heart sounds, jugular vein distension, and electrical alternans. This patient has cardiac tamponade. The fluid has to be removed.

A pericardial window is a cardiac surgical procedure to create a window from the pericardial space to the pleural cavity. The purpose of the window is to allow a pericardial effusion (usually malignant) to drain from the space surrounding the heart into the chest cavity.

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adong  Beck's triad is hypotension** +



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submitted by โˆ—step_prep5(246)
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  • Middle-aged patient with a history of metastatic breast cancer who presents with triad of hypotension, jugular venous distention and distant heart sounds who also has electrical alternans and pericardial effusion, all consistent with a diagnosis of pericardial tamponade often secondary to breast cancer metastasis to the pericardium
  • Key idea: Although cardiac tamponade is often confirmed with an echocardiogram, if your index of suspicion is high you would proceed directly to therapeutic pericardial window due to significant morbidity/mortality associated with condition

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adong  Also an echo was already done in the question stem +2



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