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NBME 20 Answers

nbme20/Block 2/Question#10 (36.4 difficulty score)
A 70-year-old woman is transferred to a ...
Activity level before the fractureπŸ”,πŸ“Ί

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submitted by monoloco(136),
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hTsi si nirdelicyt gisakn uotba aekp ebon ietys.dn haTt hloew nghit ouabt ierbnwagi-tehg sexesce,ir aginet iht,rg aayd ady,a ebofre dna dgniur that oe-woldnps hsepa of iefl rof nobe ny.isted lAl tuabo nigudcer ttah %1 erp ryae eearedg-atl obne tdsieyn ossl as stbe sa ew .nca Lelve of ativtcyi is ierelcpys ekil in-gwehiatrbge receesxi. esin:rCdo( on taycv,tii edddrbne-i -- sya boygdeo to ouyr b;enso hgiylh etaivc, rnus eyerv horet ady -- dgoo muntoa fo e-trhgbeinwgai / ssters to edcniu mlegidneor dan atmnnaii itniryetg fo eht b)o.nse

sympathetikey  Yeah, I was thinking about that while taking the exam. Just got thrown off because I don't see how that matters, now that they've fractured the femur. How do prior increases in bone density allow for better chances of bone healing? +17  
rsp  I think that bone density is important here, but think about all of the other things that go in to recovering from a fracture at that age too. How strong are the muscle that will stabilize you while going through the motions of physical therapy? How conditioned are you? +2  

submitted by sherry(29),
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hTis is het dcoesn best occeih I asw gnona atke rnduig the xeam. I ohthgut Aeg was btteer sneci AF decntaiid daecrsdee neegtrso dan old ega era eht onesars for beon .ienrsootpr anC msoydeob nxleipa to me hwy Age dulco ton lspysiob be eht ewanrs?

kard  I solve it like this: So age is 70 (already, nothing we can do to change it), is asking about a predictor of success in the Rehab process (So basically, what this patient did in matter of activity, life style, etc. to have a Good rehab process). So From all the answers the, Activity level is the most likely choice because of the, increase in Bone density(Specially Weigh bearing) and OsteoBlastic activity. +6  
misterdoctor69  But bu that logic: just like you can't do anything about age, you also can't do anything about activity level BEFORE the fracture right...? +3  

submitted by coconut(3),

NCBI Resource : "Successful interventions concern patients able to walk with or without help before the fracture. Pre-fracture motor and not cognitive level is the most important predictive factor for motor recovery."

submitted by stepwarrior(22),

I don't think you're going to find any evidence for this one. It's just the test-writers' opinion