what am i missing?

[viper]

---

Members do not see this ad.

was in q-bank

patient comes in complains of sexual problems with wife - unable to achieve erection. What is the next question?

a. how much alcohol in a week do you consume
b. what is your wife's rxn to this
c. is that tthe reason you feel distressed, or is there something else you would like to tell me.


i went with c - get more info right. q-bank says a, not c because that is assuming patient is not telling everything etc and does not establish rapport. How the hell does directly "how much you drink dude" establish rapport. At the least, the wife rxn may be important. Skip the marital problem and go straight for the booze huh. Does anyoone have a better way to approach this and how i should be thinking about these.

thanks

 

[Shah_Patel_PT]

was in q-bank

patient comes in complains of sexual problems with wife - unable to achieve erection. What is the next question?

a. how much alcohol in a week do you consume
b. what is your wife's rxn to this
c. is that tthe reason you feel distressed, or is there something else you would like to tell me.


i went with c - get more info right. q-bank says a, not c because that is assuming patient is not telling everything etc and does not establish rapport. How the hell does directly "how much you drink dude" establish rapport. At the least, the wife rxn may be important. Skip the marital problem and go straight for the booze huh. Does anyoone have a better way to approach this and how i should be thinking about these.

thanks

I think this tests epidemiology rather than patient care. You had to know the most common cause of ED in the USA is alcohol abuse, 2nd to diabetes. .I think...correct me if i am wrong!

 

[Ramoray]

I think this tests epidemiology rather than patient care. You had to know the most common cause of ED in the USA is alcohol abuse, 2nd to diabetes. .I think...correct me if i am wrong!

z

I wouldnt believe someone from ross

 

[viper]

z

I wouldnt believe someone from ross

what does his going to ross have anything to do with it? Let's get over this minor crap.

I dont' think its testing epidemiology or I don't think that was the intent. The question was what is the next appropriate response in that situation. I don't think what qbank says seems correct. It is an issue that needs to be discussed, but I don't think patient comes in and says he has a problem with ED and then you say, so "how much do you drink." Working your way into this would be more appropriate. But what do I know, I got that question wrong.

 

[a_ditchdoc]

z

I wouldnt believe someone from ross

I usually refrain from commenting, but that was inappropriate...

 

[Pox in a box]

z

I wouldnt believe someone from ross

That comment was ignorant. I wouldn't start saying those things in public. You'll meet an attending or resident one day from Ross or another offshore school, say something like that, and wish you'd kept your mouth shut.

 

[Shah_Patel_PT]

z

I wouldnt believe someone from ross

First of all...Ramoray....your arrogance is going to bite u in the a++ someday!!

Back to the question...when Barbara Fadem (author of BRS behavioral science) taught us, she gave us that very example.

She told us that alcohol is a very important and common cause of ED. Now the transition to suddenly asking the Q (how much he drinks?) seems inapproriate...it is still the answer because it gives a strong physical cause for the ED...although it does not rule out other causes. Thats my 2 cents!

 

[Doc Ivy]

Back to the question...when Barbara Fadem (author of BRS behavioral science) taught us, she gave us that very example.

She told us that alcohol is a very important and common cause of ED. Now the transition to suddenly asking the Q (how much he drinks?) seems inapproriate...it is still the answer because it gives a strong physical cause for the ED...although it does not rule out other causes. Thats my 2 cents!

Exactly! If this is a behavioral science question then the focus should be on establishing the rapport. If you want to make this a pathophys question then there are a lot of review of systems question that might be relevant to ED: diabetes, vascular disease, hx of SSRIs? but the good thing is that the real step 1 questions of this nature of less ambiguous

 

[rad_one]

If nocturnal erections occur, then the physiologic problems are eliminated.

 

[bigfrank]

z

I wouldnt believe someone from ross

Credibility, Rammie, credibility. 🙄

To the OP, I came across the same question on QBank and missed it, also putting "c." On the Step I, I thought the most difficult questions were those types. I really believe it depends on WHO writes the answer, really I do.

 

[bulletproof]

z

I wouldnt believe someone from ross

Interesting the way ones view shifts so rapidly...."I feel bad for the IMGs , and i think its ridiculous that they have such a hard time getting to america. Its not like medschool in US is that great or you learn that much. I mean how much do you really know after 4 years of medschool that any IMG wouldnt know. I think us schools are overrated and im surprised residency directors do not know that. It seems to me that if someone has the step 1 scores than they shoul be competitive as the next person. If someone gets a 230 then they should be able to be compeitive for a residency the same as a US student who got a 230. anyway this is not true from what i have read and it IS hard for an IMG but all im saying is i feel for ya but im sure if you work hard youll have no probs" as posted by our friend Ramoray in an allopathic forum thread a week or so ago. I am not trying to start a pissing match...just found the inconsistency amusing. Back to working on that ED...
😉

 

[Pox in a box]

Interesting the way ones view shifts so rapidly...."I feel bad for the IMGs , and i think its ridiculous that they have such a hard time getting to america. Its not like medschool in US is that great or you learn that much. I mean how much do you really know after 4 years of medschool that any IMG wouldnt know. I think us schools are overrated and im surprised residency directors do not know that. It seems to me that if someone has the step 1 scores than they shoul be competitive as the next person. If someone gets a 230 then they should be able to be compeitive for a residency the same as a US student who got a 230. anyway this is not true from what i have read and it IS hard for an IMG but all im saying is i feel for ya but im sure if you work hard youll have no probs" as posted by our friend Ramoray in an allopathic forum thread a week or so ago. I am not trying to start a pissing match...just found the inconsistency amusing. Back to working on that ED...
😉

Is Ramoray an FMG?

 

[bigfrank]

Is Ramoray an FMG?

Now Pox, please don't say that about FMGs. 😉

All of the FMGs I've ever met have been compassionate, kind-hearted, and highly intelligent.