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NBME 21 Answers

nbme21/Block 3/Question#21 (50.2 difficulty score)
A screening program is instituted for ...

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submitted by drdoom(874),
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0250, senudtst ... utb uyo fnid out rugind uroy lnaiiti creens thta 005 erlayad veha teh .essidea o,S euirtksot tseho plee.po That vaelse 020,0 udensstt ohw ont’d heav teh

veOr eht oeucsr of 1 are,y yuo dviseocr 020 dsttunes peveoldde teh fncn.teiio :Tsuh

020 nwe sesac / 02,00 people owh dtdi’n aevh het ieeassd newh yuo asdtrte ouyr uytds = 01 pceetnr

iTk,cyr yckirt BEMN ...

sympathetikey  Ah, I see. Thank you! +  
niboonsh  Im mad at how simple this question actually is +7  
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 +3  
daddyusmle  fuck im retarded +2  

submitted by drdoom(874),
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to’Dn feotgr taht ieeicnncd is het ubmern of nwe csesa ihchw megeer ni na aceentffdu oplaiptnou. cdIcennie is ynigrt to tge ta het suoqiten t&g;- “In a geivn ya,er hwo mnay new peoepl eovledp ihst eaeds”?is

In orhet ,dwsor you noanct utcno eoeplp ohw realayd vahe het aeisdes. Yuo veha ot ecxueld thseo ppeloe ofrm yuro llaacncuo.ti uYo tawn to wkon, mngao all hte plopee otu reeht ohw DO OTN hvea het eaeds,si how ymna stmei ihst yrea was mooesne newl()y edaisngdo?

dSia efelntdryfi tlis,l uoy nd’ot antw ot obcnou-”d“tule lppeoe hwo ldveeodep het issedea reefob yoru ustdy. sA an mi,diosoetpigel atht wuldo rcsew up uoyr sense fo how iftcveine or mitsnsrlaiseb a seiesda .si Yuo want to know, mfr“o iemt1 ot mtie2 woh naym enw caess dree”gme?

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. +1  
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  

submitted by questioneverything(4),
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Ok I teg taht if 050 aadleyr heva the iessaed ehnt hte sikr lpoo si pdoedrp to 2000 sdenutst tub eht uiotsqen eficisllcpya assy hatt eht test si dnoe a reya ..lrte.afi 500 eolpep dha ayidclhma, uoy duwlo taret .tmhe Yuo dton' bmeoce emiumn ot dhcaiylma efart ientfcion so yhte dlwou og bcak otni eht risk ,lopo iagnenm het polo lwduo trenru to 5.200 ehT arnsew slodhu be ,%8 shit saw a dba ue.noitqs

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 +9  
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. +2  
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% +  

submitted by drdoom(874),
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lAso reisodnc htis garte onrptdcieis frmo hte IsHN’ HeMS tadb:eaas

IIDNECCEN: heT eunrmb of wen eacss fo a egvin dssaeei uinrdg a gnvie iprdeo in a sidecipfe pnoiulta.po tI salo is edsu for teh taer ta ciwhh wen eesnvt ruocc in a edfdien aoonpplt.iu It is atrfiedteenfid form PLEVAENECR, iwchh eerrfs to all essa,c ewn ro ol,d ni het iaoltpupon ta a viegn .teim


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

submitted by usmle11a(74),
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hte qetuosin tonsde asy ahtt teh 050 gto ec,udr os ti lwli eb 0200 hwo ear at .isrk