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NBME 24 Answers

nbme24/Block 4/Question#24

A 13-year-old girl who has a 6-year history of type ...

Discuss further the impact of the patient's illness on the family

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submitted by subclaviansteele(1),

Ugh... got tripped up with "Refer both patient and her parents to a dietician"

Over thinking...I thought the source of their arguments were at meal times especially...so maybe they can find a good solution with a dietician.

OCCAMs RAZOR THIS SHIT. keep it simple stupid. The answer fits the best after re reading it.

nwinkelmann  SAME.... ugh! +  
johnson  Also - you're almost NEVER referring/passing on a patient with the USMLE. +  

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submitted by nwinkelmann(56),

I just thought of a way to (hopefully) avoid getting these types of answers wrong. First, when I read them I always look for the least "asshole" answer. Then, if you're still stuck, try to put the statement into a quote that you would say to a patient as a physician, remembering that open-ended, non-judgmental questions are ideal.

The answer for this could be phrased as a question/statement by the doctor, to the family, as "Tell me more about how this impacting your family and daily life." Had it been phrased like that, I DEFINITELY wouldn't have gotten it wrong. I would have never even had the opportunity to make an assumption about the family's fighting being due to diet concerns and thus needing a nutritionist referal (which is what I chose).