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NBME 24 Answers

nbme24/Block 3/Question#47 (19.9 difficulty score)
A 22-year-old woman comes to the physician ...
Intrauterine device🔍

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 +14  upvote downvote
submitted by m-ice(272),
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heT teipnat asttes hatt she odes otn wnat a oohnlmra mofr fo hirtb ltro.con S,o eth useqtoin si llraye iagkns iwchh of eth hrnmolnao-on sntoipo si mtso ffeivece.t Teh kiyrtc rpta ee,hr I tk,ihn is ttah teh nsuoqtie makes yuo wtna to ton pcki ,IUD ebcasue ynma sIUD era holanmorly saeb.d e,ovwrHe a lronnhoonma- DI,U ikel a preocp U,ID is siltl mreo ceevfefit tahn eht terho sioontp

bullshitusmle  copper intrauterine devices are hormon free FA2017 page 622 +1  
medguru2295  they needed to specifiy. I eliminated IUD bc patient states no hormones. +  
abhishek021196  The question doesnt make sense. IUDs are typically contraindicated in nullipara because of increased risk of expulsion and intractable abdominal pain, among other things such as perforation. The pt is 22, likely to be a nullipara. Why cant we prescribe a diaphragm instead which is a non hormonal method too, and remove the vaguity of hormonal vs non hormonal IUD? :/ +3  
123ojm  in practice many nullparious women have IUDs. I think this question was seeing whether you knew that some forms of IUDs are non-hormonal and that the other methods are far less effective, +  
covid  IUDs are definitely not contraindicated in nulliparous women. +1  

 +1  upvote downvote
submitted by centeno(2),

The patient asks about the most effective treatment. FA 2019 page 642: Copper IUD = long-acting reversible contraception, most effective emergency contraception. Although FA refers to emergency situations, maybe the word most effective is the clue.