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NBME 21 Answers

nbme21/Block 3/Question#21 (48.4 difficulty score)
A screening program is instituted for ...

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submitted by drdoom(819),
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0250, sttseudn ... ubt yuo fndi uto rdunig ouyr laiiitn seernc atth 005 learyad hvea het .eaesids ,So estoutkir those epel.op haTt vaeles 0,002 unsedtts how no’td ahve the eaesis.d

vOer het csroue of 1 eya,r yuo iedovcsr 002 sntduets deopvlede the ifon.eitnc sTuh:

002 nwe ecass / 020,0 plepeo ohw i’dntd vhae het eidases nehw yuo rdtsate uryo dtsyu = 01 pntrece

iyrTkc, citryk NMEB ...

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(819),
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t’Don trefog htta cecneinid is teh uernbm fo enw essca hchwi emeerg in an fcautdefen nopopultai. encceidnI is intyrg ot tge ta hte touenqsi &-;gt “In a nvgie eray, hwo mayn enw oeeplp veopled tihs s?dae”sie

nI troeh wsor,d uyo cnnaot ctonu peolep how aeraldy ahve eth aeesdsi. ouY heav to eclxeud eohst leepop omfr ryuo luinlat.coac oYu want to okw,n nagom lal teh elpepo uto ereth hwo DO NTO haev teh sd,iseae ohw ynam stiem hsit reay saw oenmseo n)(wyel idos?egdan

aSid dilefnytefr ilt,ls you ton’d ntaw to n”ul-coeo“udbt elppoe who oedeevdlp hte iadeess ebrfoe rouy .dystu sA na eoiit,olipsedgm that odulw swrce up ruoy ssnee of how teiicfvne or nssbaietmrlsi a asseeid si. oYu antw ot ownk, mr“of etmi1 ot itme2 hwo amny enw sseac gm?”reeed

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  

submitted by questioneverything(3),
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kO I etg htta if 500 edlarya heav eth desaies tenh eht kris oolp si rdpepod to 0200 ttsusend utb teh steqonui faeispicllyc assy ttah het estt is neod a yaer 005 ploepe ahd ahlacmydi, uyo lwoud arett ehtm. ouY 'tdno mcoeeb imeunm to lchimaayd traef otinfinec os yhte uwlod go acbk otni the irks o,lop maneing het lopo ulowd nteurr ot 25.00 ehT sarewn douhsl be 8%, tshi asw a bda qei.untso

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 +8  
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% +  

submitted by drdoom(819),
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Alos dcesoinr shit eartg noisiedtcrp rfom the H’IsN MHSe adetas:ba

NCCIIDNEE: eTh bmrune of ewn cases of a nvgei daesies rgndiu a iveng edorip ni a fdseeicpi ilnotupapo. It asol si euds ofr teh trea at ciwhh ewn netsve rcocu ni a ndeefdi pnoutloia.p It si etfidarfedtien fmro REAENPVLCE, hwcih erserf to lla c,ssea enw ro ,dlo in het ulntopiaop ta a gienv .meit


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

submitted by usmle11a(73),
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teh toisqune sneodt yas taht teh 500 got rdc,ue os ti illw eb 2000 hwo aer at srk.i