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Retired NBME 20 Answers

nbme20/Block 4/Question#50 (reveal difficulty score)
A previously healthy 16-year-old girl is ...
Prescribe antibiotics without notifying her parents ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: ethics

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 +3  upvote downvote
submitted by โˆ—strugglebus(189)
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There are certain situations in which you don't need to notify parents about anything when treating a child--STIs are one of them. The reason being that untreated STIs will cause more spread as well as can lead to PID

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ibestalkinyo  Mnemonic for things not needing parental consent: Sex, Drugs, Rock and Roll (Emergency Trauma)(except HIV) +3
bfinard1  There are exceptions to the rule where minors have the right to confidentiality and do not need consent from a parent. The way I remember these exceptions is the phrase โ€œsex, drugs and rock nโ€™ roll.โ€Sex stands for contraception, treatment of STDs, treatment of pregnancy or just the fact that they are having sex which might be found during the history. Drugs stand for knowledge of alcohol or drug related activities as well as medical situations that may arise as a result of these substances. Rock Nโ€™ Roll stands for emergency situation in which a parent may not be able to be contacted in time to provide care. https://www.stomponstep1.com/ethical-principles-confidentiality-capacity-medical-ethics-beneficence-bioethics-law/ +
epiglotitties  Also, parental consent isn't needed if the minor is legally emancipated (eg, married, self supporting, or in the military). +



 +3  upvote downvote
submitted by โˆ—hello(429)
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The reason "do not prescribe antibiotics until testing results are available" is incorrect is because we already have a gram stain that shows gram-negative diplococci in pairs. This is Neisseria gonorrhoeae. So, no need to wait for test results come back.

The Q-stem stating that "Testing for Neisseria and Chlamydia" is ordered" after already having done the Gram stain seems to be a distractor.

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misterdoctor69  I think even in a situation when you don't have the results yet, you'd still prescribe antibiotics just based on history and patient presentation. +
misterdoctor69  In THIS situation** +
stresssweat  For Neiserria and Chlaymida, you want to treat prophylactically to reduce risk of PID complications +1



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