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NBME 20 Answers

nbme20/Block 2/Question#1 (reveal difficulty score)
A 17-year-old girl comes to the emergency ...
Speak with the patient and her parents about the findings ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: ethics

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 +1  upvote downvote
submitted by โˆ—yotsubato(1208)
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"physicians should always encourage healthy minor-guardian communication."

Also you're going to do some serious things to cure this girl's disease, leading up to amputation. You cant hide that from her.

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djjix  Non sense ... you can hide the amputation from her +22
charcot_bouchard  Just show her one leg twice. +8
pg32  I picked "request that an oncologist..." because I figured it would be better to have someone with more knowledge of next steps and prognosis discuss the disease with the family as compared to someone working in the ED... why is that wrong? +7
ibestalkinyo  @pg32: Referring to another physician is almost never an answer for NBME/USMLE questions. Plus, I feel like this would be hiding the patient's problem from her and the patient's parents. +8
dunkdum  I think the reason that you requesting the oncologist isnt the most correct answer here is because... even if more tests needed to be done... you would still discuss with your patient about that fact and say "Hey these results came back suggesting that you might have this disease, we will need to do more testing to make sure we can get it taken care of if you in fact have this disease." and you'd probably do that before you go and get the oncologist. +6
peteandplop  @pg32 I was kind of with you, but I went with the correct answer because it says STRONGLY suggestive. If you're giving me a powerful word to really emphasize this is osteosarcoma, there's no need to delay passing that information to patient, and in this case of a minor, her parents. +5

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submitted by โˆ—epiglotitties(29)
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This isn't the scenario in this question, but I was wondering what would happen if you had told the parents the diagnosis and they didn't want their child to know?

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 -2  upvote downvote
submitted by โˆ—stepwarrior(29)
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You should find out whether or not she wants her parents to know first

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misterdoctor69  She's a minor though. +2

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