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NBME 18 Answers

nbme18/Block 1/Question#33 (reveal difficulty score)
35 yo woman with pain and swelling of ...
Have a chaperone join them for the remainder of the examination ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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 +1  upvote downvote
submitted by โˆ—wishmewell(59)

In my opinion this is kinda rude as an intial action. if the person continues to go back to the topic, I would say having a chaperone would help.... idk why Interrupting the patient with a more neurtal topic isnt the answer

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wishmewell  NVM! i read the question again. The patient has visited already 4 times with cheif complains regarding sexual organs in a short period of time. According to FA page 262 (2018) at this point a chaperone should be added, if this doesnt help then the patient needs to be forwarded to another physician. +5
groovygrinch  Can someone explain why " Tell the patient that it is common for patients to fantasize about their physicians" is wrong? +7
mumenrider4ever  @groovygrinch I don't think it's normal for patients to have sexual fantasies about their physicians lol +20
abcdefbhiximab  @groovygrinch lmao +1
kindcomet  im dying of laughter +1
jurrutia  Switching to a neutral subject doesn't "address the problem". Never refer, always address the problem. +3
jbrito718  a 35 year old with a chaperrone doesnt sound right to me. but nothing in NBME sounds right. I really hope step isnt this retarded +
neurotic999  I was between chaperone and switching to neutral topic. With the chaperone I somehow felt it was against the patient's privacy and shi*. lol. +
leonelgonzalezdiaz  look at the chief complaint, it is pretty obvious why she is there when you add the rest of the information, you need a chaperone. +
payingforthisisbs  as a young woman I would just yeet them from my practice +

 +0  upvote downvote
submitted by dave_(3)

I just thought of the chaperone action as a CYA; if the patient tries to make a case, I'll have a witness. Plus, it'll probably make her come back with those complaints again. Switching to a more neutral topic likely won't work...the physician has probably tried that and she just comes back.

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