Standardized Test Cause & Effect Questions

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

CaptainSSO

Full Member
10+ Year Member
Joined
Jan 29, 2010
Messages
1,001
Reaction score
64
So, for the NMBE tests, I've noticed that sometimes the questions are hard to discern cause and effect. Here's just an example I'm making up:

What physiological values would be seen in someone with Vitamin D deficiency:

A. Ca2+ down, PTH up, calcitonin down, increased renal Ca reabsorption, increased osteoclast activity
B. Ca2+ down, PTH down, calcitonin up, decreased renal Ca reabsorption, decreased osteoclast activity
C. Ca2+ up, PTH up, calcitonin down, increased renal Ca reabsorption, increased osteoclast

This is the best I can come up with, but I'm not capturing the nuances well enough to really give a good example of what I'm talking about.

Basically I never know where exactly to distinguish cause and effect. Do we start with Ca2+ down, and then assume that PT increases to counteract that? Or if they say Ca2+ up, do they mean [Ca2+] is increasing due to PTH?

I hope I'm expressing myself clearly, or at least some of you will know what I'm talking about, and maybe come up with a better, more nuanced question, because this one isn't quite as tricky as I would like it to be.
 
Last edited:
You're expressing yourself clearly, to me anyway. The answer I would always pick would be A. It seems to me like they usually want you to rationalize based on the main idea of the question stem (I know that doesn't sound clear... don't know how to rephrase it). In other words, I guess, think primary responses to the question stem without going through infinite cascades.

Low vit D? Impaired ability to maintain serum Ca++ (low Ca++), so you're going to bump up PTH to try to respond to the low Ca++ (which is still a primary effect of the vit D deficiency), low calcitonin (same deal), etc. I guess the osteoclast activation is really a secondary effect of the PTH. So I guess for primary effect I would mean don't go more than one step deep in the hormone response, then attribute additional effects due to those primary hormone responses

Sorry, clear as mud
 
Top