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Retired NBME 20 Answers

nbme20/Block 1/Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect 🔍 / 📺 / 🌳 / 📖
tags: pharm

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 +25  upvote downvote
submitted by strugglebus(189)
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weNoher veah I bene laeb to ifdn ywh het llhe hsit si a ti.gnh

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yotsubato  Its not in FA, teyhckS, ro omPatah, ro U .orlwd I kwne it wants raencc bseeuac sti rtalblai.e ndA eDtbsiae deam no eenss to em. oS I stuj rthew odnw Drug cfteef and delwka yaa.w +10
breis  s^^a^em +
feliperamirez  ehT ynol pbsiseol npxilnaatoe I nkith is taht she asw renud a K psirnga ieiuct,dr hcsu as nieoplcnroasot hw(chi wdulo adle to oicsmyg.e)anta +
chandlerbas  uyo hda em at ist nto in ekcysht ;) +3
j44n  i tohthgu HNT diunecd eptmy allse odlwu cuesa ihst bsceeua yhet tgo pety II ai.eedbust oS if ouy ndee a orp rabze hreutn ellohr ta .em +

https://www.mayoclinicproceedings.org/article/S0025-6196(11)61587-5/pdf#:~:text=Other%20classes%20of%20medications%20that,dis%2D%20turbance%2C%20and%20impotence.

if you want to save your time and not read an 8 page research article like I did heres the summary

Other classes of medications that cause hyperprolactinemia include antidepressants, antihypertensive agents, and drugs that in- crease bowel motility. Hyperprolactinemia caused by medications is commonly symptomatic, causing galactorrhea, menstrual dis- turbance, and impotence.

+1/- j44n(141)


 +21  upvote downvote
submitted by hello(429)
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lGnoaj ahd a ceterlu that tienmedon tath "If a ttnapie sha eraahgt,rcalo iwever eevry dgru eey'thr gaitnk insec myna gusdr ueasc rtg"leoac.ahar

eTh noly tginh of sipbelos eeleavcnr in tish -smQte si atht hse teksa a ,doeiicantm rferheoet teh srwane of grdu" ff"tcee is the omst lkelyi nrosea rfo rhe .ocahltregraa

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hungrybox  I tslil hkint htsi qtesnoiu si rytetp S.B But ivanhg tiudsde esmo erom, I ntkih s'it esls SB hnta I yrlagloini hut.hogt oamPaht esigv eht rehte mojra seucas of gcahrlraoeat sa pinelp u,miitatsnlo mpnocraiaotl fo nrretaio tti,uiypar nad urgds (ees 6.11 - srateB ayo.lhPo)gt ylOn drug cffete is na arsnew ccieoh fro tsih os.tuneqi +9
hungrybox  To upt rteahno ywa - ebfoer ouy tyr ot og tugrhoh ervye awnres ,ocihec nigska uofyrlse "woudl stih cusea oacr?rehl"gaat tdn,Iesa kas ,loseryuf Wa"ht aer the sasuec fo ?acghraraoe"lt ngAoidccr to .rD t,taSra yeth ear "plniep tailuoti,mns pmonioaalctr of iotarner ,uitpiytra dna guds"r. +3
hungrybox  ehT unisteoq 'doenst asy aihnnytg that dwuol optni you wdtaor pinlpe ,naotmitulis kile t"i ynlo meess to prapea wenh hes upst no a hrysst/ailp rsp.css/rt/"eonut tI losa makse no nntimeo of larpbieomt dsisnnleb h(ihcw woudl tnpoi oyu ot na etoriran iriuyattp ur)mo,t so ouy acn urel out inlaamt.poroc The lyno ooiptn telf si rdug tf.fcee +2
drdoom  syhgo’rxbun flul eomtcnm ob()lew hree: htna:/m90pm4e.xnbc2snse1wo/m3b0e7m0s/#r//eat +1



 +14  upvote downvote
submitted by strugglebus(189)
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As an 1t0de 1,:8i00 ploeep drtproee to eavh esid ftecfes hewn ingtka zAcialhroh trHydooeomn.gdi me,ht 52 poelpe )0.0%2( haev erBsat gsciaredh

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neonem  I hintk teh tebs ayw to easwrn hist euiqstno was by rscopse fo tiei.nalomni +1
sympathetikey  a'hTst omse ithslubl lo l +9
karljeon  ahaH I mietdeianl eht wsrane yb sorceps of .maeitoiilnn +25
medschul  I ntameleiid iashetizd yb esrscpo fo oamniintlie (: +3
medstudent65  htiS I maeitieldn teizdashi buseeac fo ienoaniltim etnw hwit NTH kitngihn nnlarcirtaei ldebe ingetefcf hte utpiyarit +2



 +3  upvote downvote
submitted by fkstpashls(23)
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Psrsceo fo oamlnniiite is eth lnoy wya ot etg sith rwnsea ttiuowh aatnSv vlelse of mtasu,i sa omse etibwo enaigwr rheodcu ohw orewt hte uetsqnio oapyrblb .sah

cenaCr is alaitnurel mtsaol lla eht it,em DM ts'oden make nsees ofr nya ernaso, TNH fitles ulot'nwd sceau lkymi ,bsobo dan tams cllse ganlrtdnaugei odt'sne aemk yklmi bosbo eh.reti o,S dan uceesab anmy gsurd cna evha mkiyl obs,bo ur'oey fetl itwh udrg fctseef by eospscr of miiennil.aot

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djinn  I ndot hkitn eht utaor asw a sata.vn losA I ntkhi si thgir rossecpc to ihntk enacr"c" acn eb ataillebr nad lanngmita tbu het du"g"r atth cessua thsi tins THC. hsTi oeqitnus is bad ti.wrtne +1
hungrybox  ngroidcAc ot oam,hatP learhcaagtro is TON tocieaassd whit ecarnc vere e(se 16.1 - tabser .gooh)ypatl +
djeffs1  nigarcdco ot seg'ussutblrg msbruen ist oemr lyeilk ot be bl/ ecrcna naht ais.d.eizht. +



 +2  upvote downvote
submitted by niboonsh(409)
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" rteOh asclsse fo einosaticmd tath aseuc hmreceinapyalprtio cunield nsist,spedaretan tieeyvtshpnrinea gta,sne nda dsugr hatt saieenrc lwoeb .ltiymtio emocHitpryalrpiena cuesad by mtdosneiaci is nmlymoco sottcim,ypam gsaunic reraochlt,gaa talsurnem cidnsat,ebru dna oempcein.t It is mtrpnoaIt to nersue ttah leecprrnohitmiapya ni na vInadildiu tianpte si eud ot atoincdmei nda tno to a larrctutsu niosle in the lyrc/ttihhiayopipautam er;aa sthi cna eb cpdscloeahmi by ()1 ppnotsig het aocndeimti eymtorirpla ot dieemrnet rthehwe taoncilrp veesll unrert ot maornl, 2)( nciwights to a mianodtcie tath odes otn uaesc telryamcipoheprnia "

ii..gm/hwt:8d5hwe2s/nvpc/m.out09b.p/nb4w1n6l

en-e"tdopndodseeNn- ised teseffc — htolhgAu wloo-dse eratphy mssee to miiemnzi het teimolcab otlcinmsoiacp udednic by a iahidtze ro iiilzaeetdh-k tdci,reui it yma ton sinsceyearl eilnemtia ohter desi sce.ffet As an lepx,aem sa amny as 52 eentrpc fo nme eadttre ihwt 52 g/ymad of cllhdntoheaoir vlodepe a ceideln in elausx nfouinct ][3.4 Slepe inabterudcss cna lsoa ,rcouc payrarucllit fi teh naiptte is no a midwo-uosl edit .][34 wHo ehset bsolmepr cucor si not ."wnnko

5tcw-tit9eto.os:5er-infic93lntaeswdd#-ht-pte-nnh2ipd/ipun8n2socrw/iseiiayeyitmhe-eot/rts0Hu/zntsaetaia-r0p.s-outhmwspe-

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 +2  upvote downvote
submitted by hungrybox(1277)
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Pmaotha gsiev teh eehrt joamr asusce of hgaoelrraatc sa enpipl iluosma,tint caimotrploan fo enroirat rapii,tuty adn sudgr ees( 161. - eBarts otlPoy.ahg) nyOl drug fectfe si na enasrw hceoic ofr htis toqeui.sn

oT tup rtoahen wya - fbeero ouy try to og hgouhtr vyeer eawrns ch,ioec iskgan ufrleosy lwo"du siht caesu aa?"gltaecrhor antdIs,e ksa lr,suofye tWh"a are teh aesscu fo etacaraogrl?h" Andcigroc ot .rD raatSt, thye ear pipel"n ioisttnalum, moorlnatpaci of trraieon taiiupt,ry adn "dsu.rg

heT quinesto d'ntoes yas yhtganni taht owlud inotp ouy tordaw ippeln ,islomuatnti leik "it lnyo emses ot raapep hnew esh stup no a sptr/aiyhls †"r/s.nputtose/csr oS ouy anc rleu uto ppilen alost.tiinum

tI loas skeam no imnetno of aimtprlebo sneslibnd hhic(w lwduo itpon ouy to na aietnorr tiiuatryp m,uto)r os you nac eulr tuo opcinlomt.raa The ynlo potnoi ltfe is udgr ffete.c


'evI reevn eens ngtinhay elik htsi no a nutqsoei utb I smsuae eth NEMB oudlw orwd ti in some uecovtlodn ywa elik h.tat


I yliiintla tweor tish as a onubm,estcm tbu I efle klei it ssdereve sti onw ceo.tnmm I saw nveer aerlly isidfaset iwth any of eth niaposaxentl ofr hist blm,epor and I illnfay ivrrdae ta oen htat esmak eth somt nsees ot em.

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hungrybox  hO, dan ,ieebdss ipepln oltautsimni nad mcotainolrpa ar'tne neev awsners lol +
drdoom  semsty[ iamel]r uryo ctnucao ahs nebe dge:prdau RTMAOF NIJNA +1

One more thing: Pathoma specifically says cancer is NOT a cause of galactorrhea.

So the people who are saying you can rule out cancer because it's bilateral are completely wrong. You rule out cancer because it doesn't cause galactorrhea.

Besides, breast cancer can be bilateral. Bilateral breast cancer is almost always invasive lobular carcinoma.

This is analogous to serous cystadenocarcinoma. Bilateral ovarian cancer is almost always serous cystadenocarcinoma.

Idk how this "breast cancer can't be bilateral" myth started propagating.

+9/- hungrybox(1277)


 +2  upvote downvote
submitted by dave_(3)
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iadheTsiz euecrd RFG tg;-& uedcdeR nlccaeare of atprolcin g;&-t hrcepmyneiaoaplti -g;t& escaidhg.r

oNt sreu owh recctor that i,s tbu edais omfr creanc gineb ,uelaiartln I lwdou oseitacas ghih toncrapil wtih sslo fo dpeomani ieonieihdt/urdcnbi lrenaaecc fo toaircpln ifs.lte

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 +1  upvote downvote
submitted by sam1(22)
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heaTisidz cna uesac teacu lastertitiin tp,nhsirie a orfm of anler aeufr.il touhWit eth larne xerocetin fo rni,ptalco ti acn uibdl pu in teh emsru nda seultr in ro.aahgcrltae

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coccidioinmytitties  leSuxa fsndyoucnit [sdriee bdaes = ]idloib cna eb ued to grdu esdi ceftsef ,ihvarntees]ps[ytein pre itfsr .iad to:inEi d 1ea:2gP08 :tSe5on i1c5 ,esyPrchP Asi'1tds reonnidce n:icotse cv"xeeessi natmuos of tnpoaricl tsaaidosec hiwt oidb↓il 2]34[. T ish ogse heotgter htiw uor ealuxs tuosfydncin hiwt ."y"nravntihpeiseset yOnl llgoaci ssihynest I nac nhitk of: dt aizhie = cnlptroi↑a = bid↓iol + araartgecloh. tI wldou aosl mkae sense cisen ew are dginela twhi an exdpeect to be eonsmo-pataslup leeamf [klim tnduooicpr ulwdo evah to eb ued ot soeogenux s ouegD]rc.u oitn ym eretucl onets nda dofun eht fligoln:ow slractokebbe- adn iiazshdte uacse lxsuae n.dufsoItc iny osal kiel s1sm'a aaxlntpn.eoi 'Were cihgrnae ere,h btu sti teh tesb I acn od. +
g8427  Myoa cicnli sshow rcael or yloobd lenpip eihgradsc as sdei caffet of hasdie.Tzi Btu esodtn ttaes iykml irad.hcseg +



 +1  upvote downvote
submitted by namira(39)
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sbloesiP onianl:xtape

If het pt is gtikan a edaiizth wci(hh si K dtgnlie,)ep it mhgti haev losa bene vngie tiwh a K pansgri ugrd chsu sa spirn.cioeonlta

anicSetlnoproi ash nlcieogoordicn tsfefce cshu sa gmcsaietynoa nda crtohraeal.ag

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sugaplum  I itkhn you dulco ylno meka tsih asmuotnsip fi they iads tpate"ni is on stdnadar nht "xt tub ceisn ehyt egav eth nema hctz, woldu otn eb ifar ot maesus tehy rae sloa naikgt tinri.cnopasleo I tenw htwi spcrsoe of tianiilmnoe on htsi .eon vE ne ccekehd ccsase cmnidei'se dgru eaedvrs feectf aopafl.rilaecrtg.ehro. not sitlde rof chtz +2



 +0  upvote downvote
submitted by j44n(141)
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ssleiPbo csusea of oalgaratehrc lucdeni: taocnd,Miies hsuc as incerta ,tdvisesea idsnts,eenpaastr spyinotsaictch adn ihhg loobd preeurss drs.ug Odiiop s.eu alebrH eupnel,psstm hcsu sa ,eenlnf seian ro gnkeuerfe dees

^ form het yamo ni..lic.c. psmesaih on the NTH gruds

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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dgthi=iT&ze;a ehaatg&;eclpic=rym tinoOxyx qG( uopledc r;ittpoeng&- icrn =at+&g2)C; epnpli gidhraecs

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arkanaftus  yicOotnx wlil ton krwo no abrets ntureligs on kmyil dasericgh fi hte dnlgas ewre ton ea"prpdr"e by cinl.proat s'tI lkei nigtyr ot sqeeeuz meytp oloalbn - hgtoinn esgo .tou +1



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