need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

Retired NBME 19 Answers

nbme19/Block 3/Question#19 (reveal difficulty score)
30 yo man and 24 yo woman; best estimate that ...
1 in 600 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +12  upvote downvote
submitted by โˆ—shadowbox(18)
get full access to all contentpick a username

Since the father's sibling is affected, we know that the father's parents are both carriers. That means the possible genotypes of the father are AA, Aa, aA, or aa.

We know the father is unaffected, so that means he cannot be aa, and must be either AA, Aa, or aA.

Since there are only 3 different genotypes he could have, with 2 of them being carrier genotypes, there is a 2/3 probability he is a carrier.

So we obtain the probability of the father passing on a recessive allele as 2/3 (probability of being a carrier) x 1/2 (probability of passing on a recessive allele if he is a carrier). The 2/3 is not relevant to the probability that the mother is a carrier.

We know the frequency of affected individuals in the population at large is 1/40,000 (=q^2), so q=1/200.

P+q=1, so p=199/200 and 2pq=2(199/200)(1/200).

To make multiplication easier we assume 199/200=1, so:

2pq=2*(1/200)=1/100 --> this is the carrier frequency (a.k.a., heterozygotes) in the population, which we can assume for the mother.

So, to answer the entire question we multiply the probability that father is a carrier (2/3) and passes on the allele (1/2) times the probability that mother is a carrier (1/100) and passes on the allele (1/2); putting it all together we have:

(2/3)*(1/2)*(1/100)*(1/2) = 2/1200 = 1/600

get full access to all contentpick a username
cbay0509  thank you +1
garble  Why is it assumed that the mother is a carrier? Couldn't it also be possible the mother is unaffected and not a carrier? +1
garble  Turns out the difference is negligible, nevermind. +
chaosawaits  Who added all these questions with abbreviated stems? fml +
chaosawaits  The chance of the mother being a carrier is 2/3 because she's obviously not homozygous (so there are only three possibilities for her, 2 of which she is a carrier). Take the square root of 40,000 to get q = 200. (2/3) * (1/2) * 200 = 600 +1
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states) Probability that he passes the gene 1/2 Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1) Probability that she passes the gene 1/2 2.3 x 1/2 x 1/100 x 1/2 = 1/600 +1
neurotic999  For people like me who royally messed up: Probability that the father is a carrier 2/3 (since we know he isn't affected i.e he isn't aa. So only things he could be are AA, Aa & aA. 2 of the 3 options are carrier states). Probability that he passes the gene 1/2. Probability that the mother is a carrier-->2pq. q^2=1/40,000. q=1/200. 2pq=1/100 (considering p as 1). Probability that she passes the gene 1/2. 2/3 x 1/2 x 1/100 x 1/2 = 1/600 +



Must-See Comments from nbme19

aliyah on Retinal cells
ajguard26 on Confined placental mosaicism
blueberriesyum on Frontal lobe disinhibition
ajguard26 on Omeprazole
cassdawg on Basophilic stippling
cassdawg on Anemia
aliyah on CD8+ T lymphocyteโ€“mediated killing
peteandplop on Coronary vasospasm due to alpha1-adrenergic ...
cassdawg on Histamine
shadowbox on 1 in 600
drdoom on Libido: decreased; Noctural erections: normal
cassdawg on Ewing sarcoma
corndog on Decreased lysosomal hydrolase activity
cassdawg on Decreased functional residual capacity

search for anything NEW!