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Retired NBME 24 Answers

nbme24/Block 3/Question#11 (reveal difficulty score)
The pedigrees of patients with schizophrenia ...
Diabetes mellitus, type 1 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +16  upvote downvote
submitted by โˆ—kchakhabar(52)
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The way I approached this problem was, schizophrenia doesn't have a clear pattern of inheritance. Among the option choices, only Type 1 DM doesn't have a clear inheritance pattern (eg: CF is auto recessive, Fragile X is XD, and so on).

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karthvee  lol same here +



 +14  upvote downvote
submitted by โˆ—lsmarshall(465)
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Monozygotic ("identical") twins have 50% of getting schizophrenia if their twin has it. Dizygotic twins have ~ 20% chance though. This is often mentioned when Schizophrenia etiology is discussed (i.e., we don't know but concordance studies suggest a genetic link). T1DM has less of a genetic link than T2DM but it also has 50% concordance between monozygotic twins. This fact is mentioned in First Aid 2019, page 346... I got this NBME question wrong but it's content is in board sources.

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 +2  upvote downvote
submitted by 270onstep1(4)
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The way I approached this question was by thinking that schizophrenia has a multifactorial inheritance pattern(lots of enviroment influence). So I looked for a disease that also has a multifactorial inheritance pattern, thought of DM1 because it is an autoimmune disease and most of them have a multifactorial inheritance(ie you may have DR3 or DR4, but you need the enviromental influence to actually attack your own pancreas)

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 +0  upvote downvote
submitted by โˆ—monoloco(155)
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If anyone wouldnโ€™t mind: How am I supposed to know that T1DM has a similar pedigree to schizophrenia? Teach me how to think, ples.

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ankistruggles  I think they were getting at how developing T1DM and schizophrenia are both multifactorial. I donโ€™t remember what the other choices were off the top of my head, but they had clear inheritance patterns. +10
pathogen7  Just as a slight tangent, is there a difference between "multifactorial" and "polygenic" inheritance? +
ac3  polygenic = multiple genes affect phenotype while multifactorial = genes, environmental factors, etc that can affect phenotype +2
sars  Multifactorial: cleft lip, cleft palate, type 1 diabetes mellitus, sjogren syndrome, pyloric stenosis, congenital heart disease, neural tube defects +1
sexymexican888  @pathogen7 idk according to FA 2020 Pg 347 Type I DM is polygenic, as well as Type II DM +
sexymexican888  I meant @ankistruggles +



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