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NBME 21 Answers

nbme21/Block 3/Question#21 (43.5 difficulty score)
A screening program is instituted for ...

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submitted by drdoom(632),
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050,2 tstneuds ... utb oyu fdin tuo rdguni yoru aiitnli crnees tath 050 eardlay vaeh hte saseide. ,oS tstiureok steho e.ppleo Ttha aesevl 0200, ntsestud owh n’tod hvea eht aei.ssde

verO het rcosue fo 1 rae,y uyo eiordvcs 020 sdtsnteu pldvodeee eht icfntoien. :huTs

200 wen sesca / 0002, oplpee owh idtnd’ evha hte essedai nwhe yuo tartdes uory utsdy = 10 tepnrce

,yircTk crkyit NBEM ...

sympathetikey  Ah, I see. Thank you! +  
niboonsh  Im mad at how simple this question actually is +2  
sahusema  Incidence is measured from those AT RISK. People with the disease are not considered to be at risk. So 2500 - 500 = 2000 people at-risk. Of those 2000, within one year 200 develop the disease. So 200/2000 of the at-risk population develop the disease. 20/2000 = 10% = incidence +2  
daddyusmle  fuck im retarded +1  

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submitted by drdoom(632),
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Dnto’ oetrgf atht cnidineec is het mnbreu of wne esasc hiwch emereg in na futndeafce itoplaonup. cceIeinnd is ngtryi ot etg at hte iqsutneo &-;tg nI“ a evnig eay,r owh ymna wen peloep ldopeev siht es”edsia?

In teorh d,wosr uyo oantnc cuont eoppel hwo alyreda aehv teh adeises. ouY aevh to ldceuex those oeplpe rofm uroy ctanclaoiu.l Yuo nawt to n,wko gaomn all het pepeol tuo hreet hwo OD TON veha the d,sesiea owh nyam metis hsti yrea was ooemens ne(wyl) oiegsd?nda

iadS nefrdtifyel l,itsl uoy nto’d tnwa ot et“oulcnub-o”d lopeep hwo edeveodpl hte aeeissd oerebf royu .tyuds As an edomgsitoiilep, htat wdoul srecw pu uoyr ensse fo how ievfecnti or rlesstambsini a sseidae si. ouY atwn to nwok, “rmfo meit1 ot mtei2 owh aynm wen scsea ?eemr”edg

questioneverything  You would count the total risk pool. Chlamydia is not a chronic disease so you would treat those 500 people and they would return to the risk pool. +  
drdoom  But you would first have to determine that they CLEARED the infection. What if you gave them tx and then they come back and say, "doc i got the chlamydia" -- is this a new case or did the tx fail? You're assuming it cleared but maybe it didn't. That's why you want to EXCLUDE from the start anyone who might already have disease of interest. +7  

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kO I gte htat if 500 rdyalea evha eth sseedai htne the srki lopo si dpdrpeo ot 0200 etssuntd tub het qeonisut fcaispelylic ssya tath the tset si eodn a eyra .i.trf.eal 050 eloepp hda adali,hcym ouy owudl etart .mhet ouY 'tdno ecomeb unmmei ot aclhymdia artfe eitnnfoic so etyh wlduo og kacb tion eth ikrs ,lpoo ninmaeg hte lpoo luowd ternru ot 5200. The seanwr sohlud be 8%, shit swa a adb t.uesnoiq

thepacksurvives  Yeah, this was my issue. I got it wrong because of this-- still don't understand the logic bc you can get chlamydia multiple times +5  
hungrybox  FUCK you're right. Damn I didn't even think about that. That's fucking dumb. I guess this is why nobody gets perfect scores on this exam lol. Once you get smart enough, the errors in the questions start tripping you up. Lucky for me I'm lightyears behind that stage lmao +6  
usmile1  to make it even more poorly written, it says they are doing a screening program for FIRST YEAR women college students. So one year later, are they following this same group of students, or would they be screening the incoming first years? +5  
dashou19  I think the same at first, but after a second read, the question stem said "additional" 200 students, which means the first 500 students don't count. +  
santal  @hungrybox You are me. +1  
neovanilla  @usmile1 I was thinking the exact same thing... +1  
happyhib_  I agree this is a trash question; I was like well if this is done yearly for new freshman the following year would be of the new class (but the word additional made me go against this). Also you could assume that they were treated and no longer have the disease... I dont like it honestly but know for incidence they want you to not include those with disease so i just went with dogma questions on incidence to get to 10% +  

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submitted by drdoom(632),
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olsA onescird isht tgera eidpotcsirn ormf eth ’NHIs SeHM aast:beda

CINNEECDI: heT nbemur of nwe csaes of a vnieg sdieaes rgnidu a ingve opider ni a ipsdefiec uat.lpponoi tI soal si sude rfo hte eart at hcwhi wne envets ucocr ni a dfnidee oa.olnpuitp tI is eetaefrdinftdi mofr NAEVECELRP, hhciw rreesf ot lal ssac,e nwe or l,od in eht puntoiapol at a vngie e.imt


questioneverything  The prevalence of chlamydia in this group would be 0. It is not a chronic disease. +  

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submitted by usmle11a(65),
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het etsoinqu oesntd say hatt hte 500 gto u,cdre so it lliw eb 0200 woh era at ikrs.