Nbme 6 spoiler.

[badasshairday]

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The ethics questions. What do you do with the 13 y/o boy who smokes?

What do you do with the 12 y/o girl who is a potential carrier of an x linked disease?












The ethics questions have been bugging me.

What do you do with

 

[hartbot]

Vaguely remember answer choices, but..

13 y/o smoker- I thought either ask him at what point it would be a problem, or ask him if he is aware of long term consequences; the latter sounds a bit cheesy so Im thinking the first one is better choice

12 y/o girl- I think i said wait until she is closer to reproductive age to give her the choice of being screened for fragile x...she's 12 so no sense in doing it now, it will be her option, and I don't know if you should assume she wants to get married and have a family so that prob isnt the best answer

 

[golfman]

Vaguely remember answer choices, but..

13 y/o smoker- I thought either ask him at what point it would be a problem, or ask him if he is aware of long term consequences; the latter sounds a bit cheesy so Im thinking the first one is better choice

12 y/o girl- I think i said wait until she is closer to reproductive age to give her the choice of being screened for fragile x...she's 12 so no sense in doing it now, it will be her option, and I don't know if you should assume she wants to get married and have a family so that prob isnt the best answer

I don't remember the girl one, but the smoking one I got wrong and it pissed me off. From what I now understand, don't try to get teenagers to not smoke by scaring them with long term consequences. Scare them with short term consequences or immediate things. I was looking for the answer "It will make your teeth yellow and girls will be scared of you", but that didn't appear. So, you would have to ask him something like at what point would it be a problem, which I think would be the right choice.

 

[greg1184]

BRS Behavioral sciences is an excellent source to study ethics. It directly addresses both of those questions... especially if you do the end of chapter questions.

 

[FutureDoc4]

Speaking of that, does anyone knowthe answer to the suicide question on there?

I am always confused by the order of things: I looked up the section in BRS. It didnt provide clarification to much. Does anyone have a goood way to approach these. Here is my understanding.

Highest to lowest risk factors:
1) Previous attempt
2) Age
3) Male

 

[Ableton]

The ethics questions. What do you do with the 13 y/o boy who smokes?

What do you do with the 12 y/o girl who is a potential carrier of an x linked disease?

For the smoker, I chose the "long-term consequences" response... although I assume the "at what point would smoking become a problem" question is the correct answer (more of an open ended question?), but it just seems too confrontational to me. 🙄

For the girl, wait until she is older and ask her if she wants to be tested

I know this is a stupid method, but I find that when I can narrow it down to two choices that I am completely split on, picking the one that I would never do in real life is more often than not the right answer... some doctor I'll be!

Speaking of that, does anyone knowthe answer to the suicide question on there?

I am always confused by the order of things: I looked up the section in BRS. It didnt provide clarification to much. Does anyone have a goood way to approach these. Here is my understanding.

Highest to lowest risk factors:
1) Previous attempt
2) Age
3) Male

I put male gender and was wrong. My initial response was marital status, since being widowed is basically why so many old males attempt suicide. Although upon reading the question more carefully, I noticed it says that he is married, which led me to pick male gender... so I really have no clue.

On a somewhat related and highly disgruntled note, what the **** was with that agar plate question?! I was not a huge fan of the questions in NBME 6.

 

[badasshairday]

I remember the suicide one. You know what I think it really is? I payed for the extended feedback and upon examining the question closer (male gender is wrong btw), I realized it was, "finding out if the patient thought the benzodiazepines would kill him.". It makes sense, because they asked what is the most important factor to assess whether or not he was suicidal.

For the boy smoker, he long term consequences choice is wrong. I am thiniking the better answer is, "when do you think smoking will be a problem for you." I am not sure about this though.

 

[MilkmanAl]

Like our behavioral sciences course director told us before the NBME, "Pick the answer that's sappy and stupid, not the one you'd actually do." That advice has served me well so far.

 

[PokerDoc]

Vaguely remember answer choices, but..

13 y/o smoker- I thought either ask him at what point it would be a problem, or ask him if he is aware of long term consequences; the latter sounds a bit cheesy so Im thinking the first one is better choice

12 y/o girl- I think i said wait until she is closer to reproductive age to give her the choice of being screened for fragile x...she's 12 so no sense in doing it now, it will be her option, and I don't know if you should assume she wants to get married and have a family so that prob isnt the best answer

Actually, I think I picked the long-term consequences one, and I dont recall that showing up in my wrong answers list, so i think that was right.

for 12 yo thats what I picked as well.

 

[xanthomondo]

Don't parents get to pick what goes on for their children (whether or not they know about their condition) until they're 18?

 

[badasshairday]

Don't parents get to pick what goes on for their children (whether or not they know about their condition) until they're 18?

Yeah, but the question stipulates that the parents are asking for your advice on the matter.

 

[xanthomondo]

Yeah, but the question stipulates that the parents are asking for your advice on the matter.

Ohhh, sorry. I didn't take the test. 😳

 

[TheFranchise]

I believe if I remember this one correctly one of the choices named a couple risk factors for depression (something and early morning awakenings), and that may have been the correct answer (an NBME attempt at a multi-step in a behavioral question). I put male gender and got it wrong.

 

[Sol Rosenberg]

Actually, I think I picked the long-term consequences one, and I dont recall that showing up in my wrong answers list, so i think that was right.

for 12 yo thats what I picked as well.

No, I picked the long term consequences answer and I definitely got it wrong, so I think it was the when will smoking become a problem for you answer....

 

[Texas4508]

Yep, BRS Behavioral Sciences makes a big deal about how scaring the patient (of any age) isn't the right choice. And especially with younger patients, talking about long term consequences aren't right because 13 yr olds don't think too long term.

 

[macabi]

On a somewhat related and highly disgruntled note, what the **** was with that agar plate question?! I was not a huge fan of the questions in NBME 6.

If there are people out there still reading this thread, I believe that question is the one pointing at the white colony. I searched for S. epidermidis plates and they are always white and are common contaminants. that would be my choice if I happened to get that question again on a test.
Good luck