PrepTest 127, Section 1, Question 1
Many newborn babies have a yellowish tinge to(69 more words not shown)
Which one of the following,(14 more words not shown)
- AThe treatment that(15 more words not shown)
- BSome diseases that(14 more words not shown)
- CIn newborns the(18 more words not shown)
- DBilirubin neutralizes certain(10 more words not shown)
- EAmong doctors who(21 more words not shown)
Reading the argument
Yellowish skin tells us that these babies have a lot of bilirubin in their blood. Does it tell us that they are in danger? Not yet. The first doctors identify a possible danger if bilirubin reaches the brain. That makes me want to know how likely it is to get there.
The second doctors say the brain normally keeps bilirubin out. That is reassuring, but “normally” leaves room for exceptions. If even a small number of babies develop the problem, perhaps treatment is worthwhile. On the other hand, perhaps treatment has risks of its own.
Imagine, just for comparison, a 1 percent risk of bilirubin entering the brain and a 5 percent risk of a serious treatment complication. Those are invented numbers, but they show why the question is about comparing risks. Knowing that something might go wrong without treatment does not settle whether treatment is the better choice.
What we’re looking for
We want to support the second group: leave the bilirubin levels high. Evidence that bilirubin very rarely enters the brain would help. So would a reason that reducing it could hurt the baby. I would look for something making intervention less attractive or leaving the pigment alone more attractive.
Working the answers
- A
This makes treatment more attractive by removing a concern about its side effects. That helps the first group, which recommends reducing bilirubin. We need support for the doctors who recommend leaving the levels high.
- B
Now we have a way for the brain's defenses to fail. A newborn with one of these diseases could be vulnerable to bilirubin entering the brain. That gives the first group another reason to worry; it does not support leaving the levels high.
- C
Finding bilirubin in digestive fluids does not tell us whether it reaches the brain or whether reducing it helps the baby. The issue is the consequences of intervening, not simply all the places where the pigment occurs.
- DCorrect
Here is a reason to leave bilirubin alone: it protects newborns from certain potentially damaging substances. Reducing the pigment could cost the baby some of that protection.
This does not show that bilirubin can never enter the brain. Instead, it adds a benefit on the other side of the comparison. The first doctors have identified a possible danger; D shows why removing the pigment is not automatically an improvement. That supports the second group's position.
- E
Agreement about the threshold for an excessively high level is different from evidence that reducing that level is a good idea. The doctors could all use the same cutoff and still disagree with the second group about whether intervention benefits a baby. Their agreement does not support leaving bilirubin levels high.
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