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Retired 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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ePag 2 hsa a eatgr etucrpi

we0ll1d71-itrtg/w8/:9f9na)t.6cSjiihn63wpas.0o/02-rp/c4/eo61(

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kamilia20  hahpaciyolmld ti?iatcps? +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)

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 +9  upvote downvote
submitted by hayayah(1212)
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yestpyrvinieisHt impn—xnutosiedime yetp V/IIII rtyisesehpniytvi nritocea to ntolmeevinnra gianen.t aeuCss spneyad, oh,ugc ctshe in,sstgeth .ehhdaeac ntfOe eesn ni earsfrm nda otesh oxdseep to bisr.d veerisblRe ni rlyae tesgsa if mutlssui is idevo.da

Its' a peyt fo eisvctetrri ungl dssie.ea

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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)

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 +6  upvote downvote
submitted by neovanilla(57)
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yWh het ohter ewrasn ciehsco rta'en roecrct

A - otN an ylpihcantcaa aioecnrt aiylnm eud ot onhrciityc un(omcnoitsp of y,os cwihh sha nsoogyieptclr atht oelpep yam eahv glerilsae odt)swar

B - oNt atmhas zaietehrcrad(c by eorm eucat spseiode fo ccnistcnoohri,tnrboo ge)wehzin

D - Aeniam B,(6 B,9 2)1B, or bamye a plyrouman elmoibms ued ot 9B or 2B1 cdcfeeiniy -&;t-g vdeeetla msehytoeconi vesell -t&g-; otsihomsbr &g-;t- TV?D

E - Pmlouyarn t;axanrh hTe teim rcoseu oldwu eb cumh moer et,uca dna dwulo olas etspenr whti tsmsympo fo -klulfie psotmm.ys Ripda htdea oto

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 +3  upvote downvote
submitted by monoloco(155)
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hTsi napitet si necnerxegiip tvtysiiyirheneps nosnupmetii mrfo hte te.raspaek I was tkngiihn M. Aimvu nhwe I edltesce reaekpast -- I hnitk ym cilog saw elfwda geivn het ssipcfice fo het neap'itst tr.syo

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 +1  upvote downvote
submitted by imnotarobotbut(184)
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Hwo owlud ouy kown ahtt it s'int wool sertros dssea?ie

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cienfuegos  AF 2810 :317 nthanliioa of ssreop sadle ot kfe-illu pmysmots ahtt grosersp qkclyui ot r,feve alronpymu eoarh,mhger aitmnisidstie dna o,skch htiw igainmg bpyloiss ohsiwgn enediwd snduieamimt +10


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 +0  upvote downvote
submitted by endochondral1(24)
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naicdgcro to uwldor yiertvssyeihtpin motpineisun si due ot tusd nda taht wsa aosl an o.pnio...t

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amarousis  so tis' feniildyte utsd but teh ifiscpce ypte fo tsud saw hte mtso ianmoprtt ni hits ito.sqnue teh tcfa hatt hyet nendmtoei eth sbidr is onp.tiamrt eht syutd boosk wulod ucsae ti btu eht brid udts is eorm pmaitnort .-- +
charcot_bouchard  niiyHetspirsteyv ePuinoitmsn - nigarOc sdtu ikl(e dmoyl i oeanmcsyunoPs)ih - nrIaincog t sundeon plhe eher tghhuo bcaeues tbho liwl ernetsp wtih smae isvertcreit lngu desseia erciut .ip hintk cnesi sdtu in riabylr natre rtiehen agcnoir ro rnnaigico nda salo u todn ees yanm ilnariarbs wiht ungl sedeais ubt ridb oiwhpnsre si icspliycfael oetmdnien as aeusc of PH si.esdae +


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submitted by beeip(141)
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I saol asw hinkgnit .M mvaiu ee,hr utb pyiivyrtnstiseeh mpeotninuis smese to fit wiht hte ruiaugenroltlrca asen.hgc

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 +0  upvote downvote
submitted by endochondral1(24)
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ohw od we wonk kstaeearp useca yptnvrsieihyse imnptsoieun

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smc213  A1F8 7.p56 ribd xpsr&e;-euo-gt NHS mipnsiotneu (trieevsicrt nlug sedsaei) nda F1A8 412p. rnusmuaogaotl deas:ssei fgerino H&g;St-latNr-miea sutm.oenpini I hda to eakm enses of it cesin I n'ddit knwo ti saw SHN nmnepuisoti at .sitfr +5


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submitted by breis(56)
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osiicasstPt mitssme(oe cedlal sorhsnioti or arrtop aseised ro prrato evfre) si na toncifien fo eht ulng onam(uep)in udceas by het bcaurmite ahlpmiaChldoy )aC(liamhdy is.cptita

Snisg dan us.gc:ymfveoh, rpeomst lulyuas hwutoit cumh e.hsp ccah .rug.emehhd slmeaal scc eh.sahet hnsspor ni.teas of atherr.beso tr.haot

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charcot_bouchard  tdeUpa no my evrp motcemn : Yse sith is csspts.tiaio tno tpyitivhreiyesns un.mniopites owH od u w?onk cptyomLeyh dna ePcneesr fo Grunolaam - erpsnose ot aelcllrntarui oNyhicl m.awda HS can aslo uscea osloe molaagrun oot dan eth inccllai rtiucpe ltsli rmoe olok ekli SYoHu wonk atwh ......... kcuf itsh eusq +2
shemle  erHe tP. 'dotens ehav !refev +9
shakakaka  Ncoigaasntne lmaanrg,ou tcapyh lohctcymiyp iita,flrtnoin adn sibsirfo rae nsee ni trHsyviestiyniep neiipsnutmo , donciragc to wlrUdo . +

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