This is concept is already being voted on. Had lots of support but never went through because UWorld only tested on electrophoresis while there was a single AMBOSS question testing that peripheral blood smear is first test and electrophoresis is confirmation
I would like to double down on my preference for a new card instead. Just yesterday I got a question wrong on a CCSSA about gut volvulus. It was a pretty clean cut presentation and then asked “Which of the following is most likely to establish the diagnosis?”
An X-ray was not done yet and was an answer choice that was WRONG.
The right answer was “Upper gastrointestinal series”
nid:1537213312930
Because of this card I went for xray because it hadn’t been done yet 
The subtle difference between “next step in diagnosing” and “establish a dx”
I think this subtly applies to this discrepancy with potential SCD:
Next step: PBS (does not establish a dx, and electrophoresis is still required)
Establish dx: Electrophoresis
100% agree
imo these step 2 focused cards that have 2 clozes for which is next best step and step required for diagnosis are soooo helpful
In this case, would we mark this card as duplicate if we went with the route of this card (which I support, I think its clean having it like this. Ideally UWorld would also test this but since AMBOSS does I think it’s fair to add):
New card may be best route?
What card is a dupe?
Wait nvm (ignore me)