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Welcome to saturdaynightpalsy’s page.
Contributor score: 10


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 +7  visit this page (nbme24#49)
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So we are just supposed to know that poodles are hypoallergenic...

I put "get an air cleaner" because I thought asking the roommate to stop smoking would be beyond the scope of the physician and since I didnt know poodles were hypoallergenic, I thought "well, even if the roommate stopped smoking, she'll still have issues because of the pet dander."

cries

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luciana  Same here, I got confused because it seemed that the smoke AND the dog were the triggers, so I picked "Move back to the dormitories" so all the triggers would be gone. Who would imagine poodles were hypoallergenic +
luciana  For those like me who didn't know there was 1 hypoallergenic dog, there are 23 to you memorize :) https://blog.homesalive.ca/dogs-that-dont-shed-23-hypoallergenic-dog-breeds +2
jamaicabliz  The way I thought about it was that she's had the poodle for longer than 3 months, since she brought it with her, and didn't seem to have problems beforehand +1




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submitted by deathbystep1(21), visit this page
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option B) (the correct option as per nbme) :the patient has a mini mental state of 23/30, so that should mean that she isn't capable of making her own decisions! so whats the point in talking to her privately without her daughter?

option A) is wrong because you cant just hide the diagnosis from the patient and share it with the family

option C & D)you cannot disregard the test or repeat the test as both the test are positive, RPR is a screening test with less specificity but microhemagglutination is a highly specific test so she definetly has syphillis!

option E) doesnt make sense because why would you do lumbar puncture for syphillis?!

i think they forgot to give an option F) just freakin treat her for syphillis!!!

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saturdaynightpalsy  "Patients with suspected neurosyphilis should undergo lumbar puncture and subsequent VDRL, FTA-ABS and/or PCR of cerebrospinal fluid" per my notes and the internet Lumbar puncture is used to diagnose neurosyphilis, so that's what I put. +2
saturdaynightpalsy  To add to that, I didnt choose the other answers you listed for the same reasons you listed. +1
ac3  which of the following is the NEXT BEST STEP meaning you wouldnt want to jump straight to a lumbar puncture especially when there are answer choices that suggest discussing the diagnosis with the patient first. If you went to the doctor and they diagnose you they will discuss this with you before ordering additional testing. +1
yerpderp  23/30 is also just mild cognitive impairment so I just thought she still had decision making capability as 24/30 is still normal +3
cbreland  Are we expected to interpret MCI scores +
madamestep  Mild memory impairment does NOT mean decreased decision-making capacity. An 83 year old with an almost normal mental status exam who maybe has a new boyfriend at her nursing home probably wouldn't want her daughter to know that she has an STI. And if this is elder abuse, you'd also want to talk to her privately to see if she's safe. No matter what, older adults with mild dementia are still normal people and you need to assess their decision-making capacity decision to decision. This woman most likely has the capacity to decide if she wants to undergo syphilis treatment. +


submitted by deathbystep1(21), visit this page
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option B) (the correct option as per nbme) :the patient has a mini mental state of 23/30, so that should mean that she isn't capable of making her own decisions! so whats the point in talking to her privately without her daughter?

option A) is wrong because you cant just hide the diagnosis from the patient and share it with the family

option C & D)you cannot disregard the test or repeat the test as both the test are positive, RPR is a screening test with less specificity but microhemagglutination is a highly specific test so she definetly has syphillis!

option E) doesnt make sense because why would you do lumbar puncture for syphillis?!

i think they forgot to give an option F) just freakin treat her for syphillis!!!

get full access to all contentbecome a member
saturdaynightpalsy  "Patients with suspected neurosyphilis should undergo lumbar puncture and subsequent VDRL, FTA-ABS and/or PCR of cerebrospinal fluid" per my notes and the internet Lumbar puncture is used to diagnose neurosyphilis, so that's what I put. +2
saturdaynightpalsy  To add to that, I didnt choose the other answers you listed for the same reasons you listed. +1
ac3  which of the following is the NEXT BEST STEP meaning you wouldnt want to jump straight to a lumbar puncture especially when there are answer choices that suggest discussing the diagnosis with the patient first. If you went to the doctor and they diagnose you they will discuss this with you before ordering additional testing. +1
yerpderp  23/30 is also just mild cognitive impairment so I just thought she still had decision making capability as 24/30 is still normal +3
cbreland  Are we expected to interpret MCI scores +
madamestep  Mild memory impairment does NOT mean decreased decision-making capacity. An 83 year old with an almost normal mental status exam who maybe has a new boyfriend at her nursing home probably wouldn't want her daughter to know that she has an STI. And if this is elder abuse, you'd also want to talk to her privately to see if she's safe. No matter what, older adults with mild dementia are still normal people and you need to assess their decision-making capacity decision to decision. This woman most likely has the capacity to decide if she wants to undergo syphilis treatment. +


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