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Retired NBME 21 Answers

nbme21/Block 4/Question#39 (reveal difficulty score)
A 46-year-old man comes to the physician ...
1/15 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: biostats

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 +12  upvote downvote
submitted by โˆ—hello(429)
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q^2 = 1/900 --> q = 1/30

Carrier frequency per Hardy-Weinberg formula is 2pq.

Now, for rare autosomal recessive diseases the carrier frequency of 2pq โ‰ˆ 2q.

2q = 2(1/30) = 2/30 = 1/15

Answer = 1/15

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 +7  upvote downvote
submitted by โˆ—taway(35)
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Just as a note for anybody else who was WTF at how 2(29/30)(30/30) = 1/15...a lot of question banks round 29/30 (or any similarly large fraction) out to 1

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gh889  I think you meant 2(29/30)(1/30) just to clarify! +7
niboonsh  i am confusion +5
arkmoses  You have to use the hardy weinberg formula (1=p^2+2qp+q^2)and p + q = 1 they basically tell you that q^2=1/900 which makes q=1/30 now you can figure out (p=1-q) so p=1-(1/30), p=29/30 then to figure out carrier you solve for 2qp, 2(29/30)(1/30)=1/15 I got it wrong cuz I forgot how to figure out p but hopefully wont happen on the real deal. +5
garibay92  2pq= 2(29/30)(1/30).... Transform this to 2 1 1 2 1 x x = _ = ____ 1 1 30 30 15 +
garibay92  Nevermind :/ It didn't come out as planned :( +
garibay92  /Users/carlosgutierrez/Desktop/IMG_2423.jpg +
pg32  How do we know this disease is autosomal recessive? I assumed it was just because they love these carrier frequency questions with AR diseases, but how do we know it's AR? +
turtlepenlight  Sounds like Gaucher (ish?) if i'm remembering correctly +5
ownersucks  Niemann Pick disease is characterized by foam cells, which are lipid-laden macrophages. Question stem also mention HSM +
amsizar714  thought this was fanconi anemia +



 +2  upvote downvote
submitted by โˆ—link981(208)
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p^2 + 2pq + q^2 = 1 p+q= 1

q^2= 1/900 q= 1/30 p= 29/30 which rounds to 1

They are asking for carrier frequency which is 2pq.

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 +1  upvote downvote
submitted by โˆ—whoissaad(102)
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Where is this even from? My mind's going hay wire trying to understand this.

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sahusema  Hardy Wineberg equilibrium square root 900 = 30 1/2 of all offspring will be carriers so 30*.5 = 15 simple as that +6
maxillarythirdmolar  this deserves a million upvotes. +1



 +1  upvote downvote
submitted by โˆ—eacv(46)
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If u are not goot in math like me xD. I did it this way: They gave me p^2=1/900 so p=1/30.

Now I need to find P, so use p+q=1. p= 1-(1/30)= 1-0.03= 0.97

So, 2pq= 2(0.97)(0.03)= 0.064 = (1/15) :D I got it right, this is my way to do it cause im not good at fractions.

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eacv  **** q=1/900 +
bdaines8  you literally have a calculator to use.... use it +



 +0  upvote downvote
submitted by electrosalt(0)
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Here's how I did it

X is the frequency a parent will be a carrier of the disease. 1/4 is the probability the parents will have a child with the disease. Therefore

X * X * 1/4 = 1/900

X = 1/15

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