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NBME 21 Answers

nbme21/Block 4/Question#38 (34.4 difficulty score)
A 62-year-old woman is brought to the ...
Instruct the patient to keep notes and lists to help her memory🔍,📺

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submitted by chandlerbas(106),
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Teh rshrecaeres dunof hatt plopee who raapctdpieit ni yaltlenm negnlchliga csetaviiit tosm et,fon othb yrlae adn ealt ni f,ile had a lesowr aert fo ecelndi ni yermmo ampdrceo ot steoh woh idd ton egenag ni chsu saiecvtt.ii neEv wehn peopel ahd lpuqsae adn asegtln and ohert gsnsi fo egdaam ot ehrit bri,nas tlnmae limsntitaou edeems ot elph terotcp meyorm and ngkiniht sls,ilk tnncucgaoi for oautb 14 ecerpnt fo teh ncdreiffee ni nelidec enobyd thwa wudlo be edtpecex h(arinhPast ,ueVrmi D,hP ltahbezEi C. o,nMmior PD:h ntgv“iCeio uitaSmgtlin itcvseiAti ot epeK nmaeDite at Bya”. ruo,lyoNge olV 81. 210)3

osal eht ayw i see it, DA spt heva rslompeb twhi ppophmiasuc (ie.. strho etmr ymorme ewpor huso)e so engpike tseno dan sitsl or vweatvhaa ithmg ehlp olsw ihetr einvotgci einldce sa tyellh be gpeinek het pcpmipuahso more atcevi

submitted by niboonsh(369),
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i otg hsit sueintoq grhti tbu ywh dluotcn ti be okign olb?bai

nor16  and why no therapy, i.e. cognitive training` +  
jessica_kaushal  first step is to make the patient's environment accomodating for the patient. +3  
jessica_kaushal  first step is to make the patient's environment accomodating for the patient. +  
tryntofigritout  Because this is a western medicine test. Even though it has shown great protection against AD and memory protection, this test won't allow that. I initially clicked on ginko but thought to myself... na this test doesn't accept an eastern idea. so clicked on the one I know they wanted me to say, and I got it right. ha +6  
mumenrider4ever  Wikipedia says "Gingko extract has also been studied in Alzheimer's disease, but there is no good evidence that it has any effect." +3  
skonys  The only TCM that is actually used in western med is clove oil for pain from dry-socket in 3rd molar extractions. We even use a fancy product called "socket paste" which is literally collagen and clove oil. Fun fact: Ginko Biloba is the only species in it's genus. I'm fun at parties +  

submitted by paperbackwriter(123),
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Not rues tahw eth pcaiilntoim wsa eggdrnrai het sdasetis nlivig fayiltci (I vreen thotghu of mthe sa a ltas oetrsr )tnuti,oasi abesuec ti ash enbe wsohn tath lsacoi citaivtesi era ycedirnilb aieibncelf in wgnlois owdn teh genporsrsio fo et.aemnid I psuepso she si ni eht ylear gastse fo dasesie dan stn'oed rartanw hgnyiant os daisctr leki gminov utsj .tey

submitted by lovebug(32),

really curious about why not (C) Suggest that the couple to a therapist together.? T.T

drdoom  thou shall not punt nor refer thy patient to another +5  
lovebug  Oh, thank you! +  
drdoom  yeah, think about it this way: the Step exams are here to certify “this person can practice medicine in your state without supervision.” even the most worshipped and glorified neurosurgeons have to pass the Steps. that’s because, at the end of the day, all responsibility (and liability) falls on the physician of record. “the buck stops here,” as they say. so, the Step needs to assess that you can make a decision when no one else is around. it couldn’t do that if it allowed you to choose “refer this problem to someone else.” +3  
csalib2  @drdoom fantastic point. never thought of it that way. +  
lovebug  @drdoom THX! very sweet explanation! +  

submitted by kevintkim4(2),

When I read "ginkgo biloba" as my answer choice (E) I thought I was getting delirious lmao