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Retired NBME 24 Answers

nbme24/Block 2/Question#11 (reveal difficulty score)
A public health consultant is contacted by a ...
Regular exercise ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +9  upvote downvote
submitted by โˆ—sajaqua1(607)
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Primary prevention is an active step taken to head off or mitigate a disease- think of vaccinations. In this case, it is lifestyle modification (exercise) to help 30-40 year old women (weight bearing exercise can mitigate osteoporosis, benefits of aerobic exercise).

Seconday prevention is early detection of a disease, promoting early intervention. This could inclue things like HIV testing every 6 months, or or annual mammography.

Tertiary intervention is therapy aiming at reducing complications, allowing relapse, or improving function. Abstinence from alcohol may be here because of substance abuse problems, or because some damage previously done by alcohol cannot be prevented. Similarly for a low carbohydrate diet we may be mitigating the effects on metabolism that have already been done.

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sunshinesweetheart  p 269 FA 2019 +
motherhen  [P]rimary= [P]revention [S]econdary= [S]creening [T]ertiary= [T]herapy +7
rockodude  almost picked alcohol because that may lead to fetal alcohol syndrome, relevant to women of childbearing age, but regular exercise made more sense. complete abstinence of alcohol is a little extreme for a general recommendation +
jurrutia  Abstinence from alcohol is a form of primary prevention, because alcohol causes many bad outcomes. However, exercise is more important. +1
faili7777  I think this is a trash question. How am I supposed to know it's exercise. Low carb diet & alcohol abstinence are also forms of primary prevention. +1
cmeacham  I think it is because there is no "proof" that Abstinence from alcohol or a low-carb diet prevents disease, and there are no formal guidelines for these recommendations. Obviously, high carb diets and high alcohol intake can lead to problems, but a low carb diet may not be effective for decreasing obesity/heart disease, and up to three glasses of red wine a week may be cardioprotective. +



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submitted by โˆ—gonyyong(131)
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Wasn't sure about others, but mammography for general population isn't recommended until 40

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_yeetmasterflex  Also wouldn't mammography be secondary prevention since you'd look for asymptomatic disease already present? +24
suckitnbme  USPSTF recommends starting screening at age 50. 40 by patient choice if there's risk factors. +2
j44n  @_yeetmasterflex thats a good point i didnt think about that +



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