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NBME 20 Answers

nbme20/Block 4/Question#21 (reveal difficulty score)
A 47-year-old woman comes to the physician ...
Contact with parakeets 🔍 / 📺 / 🌳 / 📖
tags: pulm

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 +36  upvote downvote
submitted by ∗masonkingcobra(408)
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egPa 2 has a egrat epuctir

7.8/96l-ijrn-ol/.i:gdnr063ah(ea/o0sc/11fw6t09ptp4/i1)wetw2cS

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kamilia20  hicayhlapmodl ia?ct?ipst +1

FA 2019 P. 661 Hypersensitivity Pneumonitis is a mixed type III/IV hypersensitivity reaction to an antigen in the environment. Commonly seen in farmers and people exposed to birds. Presents with Dyspnea, Cough, Chest tightness, headache. It is reversible in the early stages if the allergen is removed.

+7/- lilyo(94)


 +9  upvote downvote
submitted by ∗hayayah(1212)
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inytritiveypsesH iutn—opmmiixnsede epyt III/IV rntshipesviyyite etarinco ot inmnavneorlet itga.enn euCass sne,dpay cghuo, hecst ssnhettg,i .cdaehahe eOntf sene in fraemrs adn htoes dxposee ot dbs.ir vibRerelse ni yreal aesgst fi uutssiml si doai.dve

s'tI a yetp of tesvrtircei lgnu eadse.is

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A type of hypersensitivity pneumonitis associated with animal exposure is bird fancier’s lung, in which the major antigens are proteins in avian serum, feces, and feathers, including bloom, the waxy powder coating them (18). Pigeons and parakeets, including budgerigars (a type of parakeet), are the birds most commonly implicated, but poultry, finches, doves, canaries, and other birds also have caused the disease. Exposure to live birds is not necessary to produce hypersensitivity pneumonitis: the illness has resulted from using feather pillows and duvets (19), being exposed to a wreath made from the feathers of a dead pet bird (20), and laundering a pigeon keeper’s overalls (21). Other examples of animal proteins that are known to have caused the disease when inhaled include proteins from the dust of mollusk shells used to make buttons (22) and from animal fur used in garment manufacture

https://pubs.rsna.org/doi/full/10.1148/rg.297095707

+7/- alexp1101(11)


 +6  upvote downvote
submitted by ∗neovanilla(57)
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hWy hte hroet swrnea ccsoieh 'rnaet ctceorr

A - Nto na lticapaacnhy cetainro miylan deu to royhcntici noitn(pcsmuo of y,os chwhi ash grytolscpnoei thta ppeleo mya avhe rgeailesl asdwtro)

B - tNo amhtsa dizer(acactehr by orem caute pdssoeei of srbort,hiotnocnccoin negihez)w

D - nAmeia 6B,( B9, ,B)12 or bymae a yumnlpaor lommiesb ued ot B9 ro 21B cceidnyefi t;--g& edlvaeet cmynhsietooe slelev t;--&g obhtssrmoi -;g-&t VDT?

E - Pnaorlumy nrahx;at ehT eitm serouc odluw eb hcmu eomr ,ceuat nad uwodl olas rtpesne whti sopmmyts fo k-lelfiu mtsyomp.s idRpa eahdt too

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 +3  upvote downvote
submitted by ∗monoloco(155)
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iThs ttaeinp si enrcgpeiiexn yvetpihtsnesriiy pousmnniiet ormf het ar.eestkap I aws ignnihtk M. mvAiu nweh I dtelseec eptsraaek -- I iknth ym cgoil swa wedalf nvgei the siepcfsci fo teh aesnpt'it yots.r

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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Hwo uowdl yuo wokn hatt ti sint' loow otersrs siead?se

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cienfuegos  FA 0812 3:71 oinltnaahi fo repsos deals ot lfeuk-li yomtssmp ahtt gerssrop cuiylqk ot ever,f yoralpmun rehhmgoaer, eadnitimtsiis dan oc,ksh ihwt nmaiigg sipyosbl wginsoh dwidnee ntsiuiemdam +10



 +0  upvote downvote
submitted by ∗endochondral1(24)
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cridcagon ot uwdolr repisevyynitisht sominpetiun si eud ot stdu adn that swa olas an ..op..tino

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amarousis  os ist' nyetidilef udts tub eht ceisifpc ptey fo dtsu wsa teh tsmo mtnopairt ni tish ituoq.sen het tafc tath ythe oniemdten het ibsdr si nttmoa.pir the duyts oosbk luowd caues it btu hte bidr tusd si moer tapirmotn .-- +
charcot_bouchard  tHseivpsetriiyny nniiutomesP - Oinacgr stdu k(eli ldmyo onai) uyochnsmeiPs - gacIorinn odstnen u ehlp eehr ughhto sabeuce bhto llwi speertn hiwt esma eitsircervt lgun isadees .e pcuitri knhit inecs sdtu in abilrry tnaer riteneh nogirca ro iiconnrga nad laos u nodt ese amny barinliras htiw ugnl aeesdsi but idrb nosewirhp si psiaflycicel dtioenenm sa secua of HP diasse.e +



 +0  upvote downvote
submitted by ∗beeip(141)
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I alos swa inihnktg M. avmui rehe, but srsyphieinvyttei noneiiputsm esmse ot itf hwit teh rlaruoglaeuintrc n.gcshea

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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woh od we wnok arsepaetk uscae iersvsytneypih sepmitiounn

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smc213  81AF 57p.6 irbd re;pus&o-xegt- HNS stneuimnopi tvi(cetriers lngu saeesd)i adn F1A8 .p241 ranoagtusolum sesaseid: ernfogi lNta-taei&SHgrm-; inn.uostmipe I ahd to kaem essne of ti iensc I dtdi'n okwn it wsa SNH pimesuontni at sifr.t +5



 +0  upvote downvote
submitted by ∗breis(56)
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sPiaotisstc meeo(mtssi ecldal sirisothno or aortpr seasedi or parrot e)rvfe is an oeinnitfc of eth nulg )pa(minoenu asedcu by hte maeucrbit oaylhapldCmih (dy)aCmhlai aictt.psi

ngSsi adn :o e hru,tgyos.evsmmfcp luasylu ithouwt mhcu mlha leehsc. e cgh.eup.rhdamas ssheh c.atce sionsahrts.pne fo taorrbeehs . t.ratho

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charcot_bouchard  etdaUp on ym prev cetommn : sYe tihs si siscsaot.tip nto vieihyyisrttpnse .timnnieosup How od u kw?no yhemyLctpo adn ecPnsere of aonlGraum - rnpeseos to rnlllreaatiuc N.iwchmdy aalo SH cna asol ecsua esloo ulnoramga too and eht nlccliai truipce ltsil omre kolo keil u HSoY ownk tawh ......... kufc htis sequ +2
shemle  eerH Pt. etds'no ehav rveef! +9
shakakaka  niaNsctneoag lau,nagrom ychtap ilympcyhtco rninlaoi,titf dna iisobsrf rea snee in itiieypertnvsHys iiusnmtnope , rdgacicno to rodwlU . +

https://pubmed.ncbi.nlm.nih.gov/7569404/#:~:text=The%20inflammation%20is%20often%20followed,than%20in%20women%20and%20children.

you get granulomas in both

+1/- j44n(141)


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