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  #1  
Old 02-16-2012
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Arrow NBME 2 Concept

Please answer the following questions

Block 1, Q18
A 59 year old man comes to the physician coz he had malaise, fatigue and anorexia after losing his job 3 months ago. Serum GGT is increased. Which of the following question is most appropriate to start discussion about his use of alcohol?

A. Do you think you are a problem Drinker ?
B. How much do you drink in a typical week?
C.Is there something you have not told me so far ?
D.So, do you like to hit the bottle sometime ?
E. What is your favorite drink ?
F. you are not a drinker are you ?

Pls answer with explanation
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  #2  
Old 02-16-2012
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The ans is B ....... since you know from the test that he drinks (ggt)
asking him about it wont be a problem

if confused with F which i did , i feel F makes him feel guilty to accept that he drinks ........... and he might feel offended ...
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  #3  
Old 02-16-2012
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I guessed C thinkikng of the fact that the pt. still does not know thta his GGT is increased so instead of asking leading question why not just ask him if he has to share something more.

I suck at BS
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  #4  
Old 02-16-2012
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i know , i also felt that may be that would be correct ... but its like the pt would feel offended that do you think that i dont tell you the truth or i am hiding something from you ........ i guess this is what usmle wants ... not to offend him or make him feel guilty .......

think the diff if you were the pt and then i asked you B and C ?? which one would have positive reply ........

i would have definitely done this wrong on the exam ......
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  #5  
Old 02-16-2012
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Quote:
Originally Posted by Hitman View Post
i know , i also felt that may be that would be correct ... but its like the pt would feel offended that do you think that i dont tell you the truth or i am hiding something from you ........ i guess this is what usmle wants ... not to offend him or make him feel guilty .......

think the diff if you were the pt and then i asked you B and C ?? which one would have positive reply ........

i would have definitely done this wrong on the exam ......
Wont the pt. get offended if you ask this how much he drinks.Its you who know that he drinks(coz of the raised GGT level, pt. doesnt know the report) so wont it be better that we ask if he would like to say something more.

confused confused confused......:confu sed:
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  #6  
Old 02-17-2012
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Can anybody else chip in.......
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  #7  
Old 02-17-2012
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B.

theres like those question u ask to determine if someone is alcholoc, B is one of them
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  #8  
Old 02-17-2012
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Default neither B or C...

CAGE questions:

Do you ever...

  1. try to cut down on your drink?
  2. get angry when someone comments on your drink?
  3. fell guilty about your drinking?
  4. take a drink as an eye-opener in the morning?
So... I will go for A because, because we want to know if he has a problem with alcohol. CAGE questions are not about amount, are about how does a patients feels about his/her alcohol consumption.
A. Do you think you are a problem Drinker ?
Is asking about how does he feels about it.
__________________
"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
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  #9  
Old 02-17-2012
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seems very acusing, patient might get offended.

damn nbme people why dont they give u an answer key after. asdf. !@#
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  #10  
Old 03-05-2012
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I think Its C!
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  #11  
Old 03-05-2012
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i think its c...thats the most open ended qs and doesnot lead the patient anyway..i wud opt c..
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  #12  
Old 03-05-2012
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when I originally did I also thought C was the best answer.

This is a very confusing question.
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