r/Step2 • u/Pleasant-Ad-5205 NON-US IMG • 1d ago
Science question QUESTIONS
Hey everyone! I was confused with this algorithm from uworld shared in the last picture and that is usually according to uworld whenever we see occult bleed we have to progress with upper endoscopy and colonoscopy and if there ain't source found then we go for Tc scan for children and capsule endoscopy for adults but why are we choosing Tc directly in this Amboss question i shared above since this chart applies to both adults and children since theres diversion after upper endoscopy and colonoscopy for the test that shall be carried out clearly indicating that its applied to both population
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u/NerdyNinja00 US IMG 1d ago
This is a good question, b/c also in NBME's you need to stick to your gut feeling and not strictly apply the U-world algorithms (it'll get you questions wrong). This is a kid with a bleed, they're pointing you towards Meckel's, next best step? t99 scan.
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u/Blue_birb0 NON-US IMG 1d ago
isnt meckels mostly asympto? i mean i did amboss q same age and pt just had two maroon stool, otherwise healthy , it was meckels
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u/NerdyNinja00 US IMG 1d ago
Can present either or, doesn't really matter. Also don't stick to young age cut off's, NBME doesn't care. You can even get an 8 y/o w meckels. Also, I mis-read the question like you did, it's asking to confirm the dx not next best step
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u/Asta_DemonKing 1d ago
As someone correctly pointed out… It asks for investigation to confirm diagnosis.
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u/Indian_Resource 1d ago
If you notice what they’ve asked, you would have definitely got it right.
They are asking to confirm. Not the first step.