NBME 23 Why don't you continue with what you're doing, and let's try changing her to a different formula. (NBME Answers)

NBME 23 Answers

nbme23/Block 4/Question#48 (reveal difficulty score)
A 2-week-old female newborn of Mexican ...
Why don't you continue with what you're doing, and let's try changing her to a different formula. 🔍 / 📺 / 🌳 / 📖
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+14 upvote downvote
submitted by ∗seagull(1933)

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"why don't you stop what you're doing because it's ridiculous". --actual answer

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sympathetikey Mam--mam. Put down the egg, mam. +19

woodenspooninmymouth I spent sometime in Guatemala last year, and someone told me that the egg thing is uncommon. What is common is giving their children a small gold bracelet. The bracelet is supposed to prevent the evil eye, dunno how. +1

arcanumm I think this is a terrible question, but "not a lot" of evidence to support what she was doing is what I had picked. I realize now that is a lie which must be why it is wrong: there is NO evidence to support it. +

skonys My friend got a fullbright to study shamanism and she came back convinced that she wants one of the people she met to deliver her kid one day. This particular shaman is skilled in "guinea pig reading" where in she takes a live guinea pig and basically rubs it all over your body until it is crushed to death, then she skins it and wherever the guinea pig hemorrhaged and bled internally is where your illness stems from. Come in with a head ache? Well the guinea pig I just murdered on you is bleeding from it's liver so looks like you should do some coca-leaves about it. I'm like "friend, please go to an OB" +

fatboyslim @arcanumm Technically choice D is wrong not only because there is no evidence supporting the egg thing but also she IS causing harm to the baby if you don't intervene to change the baby's diet. Sort of like "obstructing justice". +

+13 upvote downvote
submitted by ∗link981(208)

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However weird, you have to respect the patient's beliefs as long as they aren't putting the newborn at harm. In these types of questions you have to build patient-physician relationships because the patient might become offended if you disregard their beliefs. So while the newborn most likely has gas and not "the evil eye", choice E is the least "offending" answer that suggests treatment.

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charcot_bouchard Exactly. If she was cracking the egg on Baby's head u stop her lol (i am cracking up on my own jokes) +6

jesusisking I feel it but dang, she lowkey drizzlin salmonella all over that baby +2

thrawn But what if the next step of this tradition is feeding the raw egg to the child. It happens in some cultures... I think telling her to continue is wrong - catious indifference seems prudent +

kavarthapuanusha I knew this would be the answer , but i dint put this coz i am not crazy !!! Tbh no one asked the physician if she should continue or not ! Thats like an unnecessary addition , may be " i understand your concern , but why dont we try to change the formula" Would have made more sense!! +

+4 upvote downvote
submitted by ∗imgdoc(183)

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I just realized that the answer I selected would've been considered passive aggressive: "Have you considered talking to a faith healer to see if there are any other measures you should try?"

lmao

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+3 upvote downvote
submitted by ∗cathartic_medstu(37)

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I came here just to read the comments

MJ at the movie theaters eating popcorn meme

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azibird Same! +

chaosawaits Yup. Got it right, was pretty obvious to me, but still came here to read the entertainment +

+1 upvote downvote
submitted by ∗chaosawaits(92)

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I think if you got this question wrong, you may be over-concerned in the weirdness of the way the correct response was worded. Had the doctor said, "Your daughter has gas and so let's try switching her formula. In the meantime, since your cultural practices are not jeopardizing the health of your daughter, I see no reason to ask you to stop." If you can see that the answer choice and this reworded answer are similar, then that's all you need.

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+0 upvote downvote
submitted by ∗praderwilli(87)

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Shout out to Dr. Bergman. If you know you know. .

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+0 upvote downvote
submitted by ∗whk123(23)

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How I get it right was the approach that all of the other four options sound so harsh to the patient based scenario. In ethics, you have to accept what the subject is doing (If it is causing no harm). In this case, for example, a lot of the people have this concept of egg passing on the whole body-diminishes the evil eye effects. Well keep patting the mother with whatever she thinks is relieving her with her spiritual concept and you (The Doctor) should do their own real work of treating the patient. If the doctor is so rude and making fun of her unharmful beliefs there is a 99.9% chance that the mommy will leave your treatment and go somewhere else where her act is acknowledged too. This is very naturally fixed in our brain whatever we believe does happen in our real life and bring positive results and if in case any time they are not bringing something positive they are highly self satisfactory. I hope that makes sense.

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-18 upvote downvote
submitted by ∗dr.xx(176)

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... that and a psych consult for the schizo mother...

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