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NBME 24 Answers

nbme24/Block 3/Question#47 (20.2 difficulty score)
A 22-year-old woman comes to the physician ...
Intrauterine device🔍

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 +14  upvote downvote
submitted by m-ice(272),
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Teh nettpia asttse atht she dose otn wnta a ronoamlh mfro fo btrhi nocoltr. ,So the snqutioe si lrelya sankgi whihc fo eht nomnhoa-lnro topiosn si mtso vef.itfeec ehT rkytci trpa eh,er I hnik,t si htta hte etoqusin meask ouy tnaw to nto kicp ,UID sucbeae yanm IUDs era llaonmrhyo sdb.ea ee,vrwoH a oomnlnnr-hoa IUD, klie a peprco IUD, is llist reom ivtfceefe nhta the rhteo onispot ltd.esi

bullshitusmle  copper intrauterine devices are hormon free FA2017 page 622 +1  
medguru2295  they needed to specifiy. I eliminated IUD bc patient states no hormones. +  
abhishek021196  The question doesnt make sense. IUDs are typically contraindicated in nullipara because of increased risk of expulsion and intractable abdominal pain, among other things such as perforation. The pt is 22, likely to be a nullipara. Why cant we prescribe a diaphragm instead which is a non hormonal method too, and remove the vaguity of hormonal vs non hormonal IUD? :/ +3  
123ojm  in practice many nullparious women have IUDs. I think this question was seeing whether you knew that some forms of IUDs are non-hormonal and that the other methods are far less effective, +  
covid  IUDs are definitely not contraindicated in nulliparous women. +1  

 +1  upvote downvote
submitted by centeno(2),

The patient asks about the most effective treatment. FA 2019 page 642: Copper IUD = long-acting reversible contraception, most effective emergency contraception. Although FA refers to emergency situations, maybe the word most effective is the clue.