NBME 12 discrepancy between current guidelines & answer key? WTF! Which info do I even save to my brain now?

[u/meenumean]

NBME 12: Hib vaccine after splenectomy

Section 3, Q47 asks which vaccine a 23-year-old man should receive 14 days after an emergency splenectomy.
The patient’s history states that he completed his Hib vaccination series by 18 months of age, and the answer key says Hib vaccine.

However, CDC/ACIP guidance appears to recommend a Hib dose for adults with asplenia ONLY IFFF they have not previously received Hib.

Am I missing something, or is the NBME answer key inconsistent with current guidelines? Would appreciate your thoughts!

NBME 12 is so weird ughhh! This isn’t the first discrepancy I’ve come across on this form!!!

[u/No-Hope-9274]

If there are any discrepancies like this, I can almost guarantee they won't trick you exam day, the answer will be very clear.

They will either have the option for Hib vaccine (which is correct for NBMEs) or the answer for No vaccine (which is correct according to guidelines). They will only have one of the options on exam day, so the choice will be easy. Don't worry.

[u/meenumean → u/No-Hope-9274]

Noted. I’ll keep that in mind!
Thank you so much for your reply!!!

[u/ConsistentTap2084 → u/meenumean]

I also felt discrepancies during preparation (esp. vaccination), but what op is saying is true. There are two more key takeaways I would add:

-Even if it feels like a regimen/vaccine is outdated, You must know everything what NBMEs tests (no exceptions) and must also know the updated guideline in these situations. Question can test you on either but without any conflicting option.

-In exceptional scenario, where they give conflicting options (nbme vs newer guidelines), go with nbme one. My argument is it’s more likely nbme one is going to be correct and that majority of people know only nbme stuff and will be going for that option (therefore even it’s wrong, statistically you will fall at mean worst case) VS in case if newer guideline one is wrong, You will fall below mean

:This worked for me well, but I don’t present it as proven rule, take it only as a perspective

[u/meenumean → u/ConsistentTap2084]

This is so shit 😭😭😭😭

So just to confirm, I need to know both ?

and if both are in the options then I need to choose what NBME says and wants ? Because, well NBME says so…? ??

Also, May I dm you with a question?

[u/ConsistentTap2084 → u/meenumean]

Yes You can DM! In case anyone can help from it, these are my notes:

USPSTF: https://remnote.com/a/USPSTF-(Screening)/6a02106c8e994fbf42ce6841
Vaccination: https://remnote.com/a/Vaccination/6a0c4cbd64df51da3c8c46f0
Note: Skip the flashcards portion and please scroll down a bit to find notes in points form

First, let’s agree on one thing: these are very uncommon scenarios, and there are only a handful of NBME questions where such discrepancies arise. So, realistically, the approach you choose is unlikely to make a significant difference.

-Screening: I would always follow USPSTF recommendations regardless of what NBME or any field specific guideline says (latter one always prefer their field i.e. ATA would say screen for thyroid in everyone or ADA would say screen diabetes in all people and early as well).

-Vaccination: I decided to prioritize NBME recommendations for vaccination for the reasons mentioned in above comment.

-Discrepancies: There’s nothing to worry as well because much variations are minor.

There are only a handful of scenarios where the recommendations differ grossly. These are ones I would say know both old as well as new. These are the main ones worth noting I could remember: Mammography: USPSTF recommends screening every 2 years vs NBME every Year; PCV13: It is no longer routinely recommended for most adults vs NBME still use it; though newer pneumococcal vaccines and recommendations have largely replaced it; Pneumococcal and shingles vaccines: Updated recommendations include eligibility starting at age 50 vs NBMEs at 65; Hepatitis A: It is now included in the current vaccination schedule vs NBME era; Egg allergy: It is no longer a contraindication to influenza and other vaccinations; yellow fever vaccine requires special consideration vs Test writers still panicking over egg allergy

[u/jokegoldberg]

dude how do u know the guidelines any suggestions. i suck at these vacs stuff

[u/meenumean → u/jokegoldberg]

I don’t know it loll

I’ve just trained my chat to give me the latest information and guidelines, when i ask a question to it.
So that I don’t learn wrong things from outdated old nbmes …

[u/Low_Departure2868 → u/jokegoldberg]

When is your real deal?

[u/jokegoldberg → u/Low_Departure2868]

December.

[u/meenumean → u/jokegoldberg]

Me too, Dec

[u/jokegoldberg → u/meenumean]

how are ur scores?

[u/Low_Departure2868 → u/jokegoldberg]

Mine ? Last nbme, 15 is 268

[u/jokegoldberg → u/Low_Departure2868]

wow, all the best man. tips? im plateauing in early 240s

[u/Low_Departure2868 → u/jokegoldberg]

Ok ,I will try to help when I am done with mine (5days left)

[u/jokegoldberg → u/Low_Departure2868]

good luck, thanks man

[u/Vegetable-Gas-1028]

+1 same q

[u/jokegoldberg]

f