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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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orNweeh vaeh I bnee labe to fndi ywh eht lelh ihts is a h.nigt

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yotsubato  tsI nto ni ,AF hkytSce, or aPota,hm ro U wrdo.l I nkew ti snatw crenca ecseuab tsi bie.trllaa Adn siDeteba emad no ensse ot .em So I stju ethrw nwdo gDur ftefce adn walekd ya.aw +10
breis  ^sae^^m +
feliperamirez  heT oynl osspblei tanepnlixoa I ntikh is taht esh was ndeur a K arsngpi uct,riide suhc as eroonntiopclas h(cwhi owudl aeld ot m)agsnyaciteo. +
chandlerbas  uoy adh me ta its otn in tyckshe ); +3
j44n  i tugothh THN neiucdd myept ellsa wdluo cuase shti usaeecb ythe tog eypt II eetdua.ibs oS if you nede a rop barez hurten lhelro at me. +

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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naloGj adh a elteruc ttha tndeeniom that "fI a ptaneti has glaaecrtrho,a wrivee yeerv gudr yeetr'h nkigta inces amny drugs auesc realocght"aar.

ehT lnyo hitgn of lbieopss erlnvecae ni thsi Qmes-t is htta hse tasek a oadti,cemni fhereoter the nwesar fo ur"dg fc"fete is hte osmt eilylk reosan fro her rreactalha.go

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hungrybox  I illts ktnhi sith inosuteq is ptyret .SB utB hvniga deusdit emos omr,e I nkhit 'tis sels SB atnh I rgniolialy t.hhtugo tPaahom eisgv eht erhet aormj auessc of taorarehglac sa ppeiln t,iuaosnltmi lotoamranpci of aeirrnto ai,tyirtpu adn sgdru ee(s .116 - Bartse ylo.Phgaot) nlOy rdgu ftefec is an ersnwa choiec rof ihts qonei.tus +9
hungrybox  oT utp rhenato wya - beerfo yuo ytr to go uhhtogr eryev nwears och,ice siankg erusoyfl uwld"o htsi ueasc tlagaoarerch?" Insaed,t ask eloy,rsuf t"aWh are the uacsse fo eaahg?taol"rcr grdccniAo to Dr. aar,ttS yhte aer epnp"il mnosut,laiit olacipmarton of earnitor iapiytr,ut dna gd.rs"u +3
hungrybox  ehT oseunqit os'dent asy ighnatny atht wudol otpin uyo ordwta elppin m,lsnititauo eilk "ti lony sseem ot peaarp nweh ehs tspu on a tiprsa/shly s"rts.cre/o/tnups tI oals eamks no tnoenmi fo mpletraiob nlsdensib c(iwhh uoldw nipto oyu ot na eniroatr tatiyruip ,)murto os uoy can uerl uot maplan.tooicr Teh nyol poiotn fetl si grdu t.fecef +2
drdoom  rhnxbgyosu’ lufl tnemocm lowb)e( he:re 2p4srs9entmwxn/h/#ast7mo/0e0m0.anmcb1e/:eb/3 +1



 +14  upvote downvote
submitted by strugglebus(189)
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As an 8,ied0t :0011 leopep orrdetep ot vahe deis fescetf hwen tngiak rhcmd.roAtonl iHidhgezooya t,hem 52 lpoeep (.)02%0 ehva aetsrB eicsadhrg

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neonem  I khitn teh tesb yaw to seranw isth qtneiuso swa yb spesroc fo .niaeomtiiln +1
sympathetikey  at'hsT esmo blitluhs oll +9
karljeon  aHah I nlmetiiade eht arenws yb cospsre of neo.amlintii +25
medschul  I iletadienm stheizaid by posecrs fo ilimaonient (: +3
medstudent65  Sthi I niltaemdie tesiizhad becueas fo miatlneonii entw htwi NTH nknigtih itcriralanne belde gfteienfc het uritiptya +2



 +3  upvote downvote
submitted by fkstpashls(23)
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Pessorc of ameintionil is eht lyno way ot get tsih aernsw wiotuth Sntvaa esllev fo am,iuts as esom wbetoi neawgir uhreodc hwo reotw the sqtinuoe aylopbbr s.ah

nCacer is ateuilalnr lsaotm all the et,mi DM dos'tne amke esesn orf ayn r,aneos HNT teilsf tun'dowl usaec imkyl bsb,oo nda amst ellcs raligunaetgnd o'netsd aemk yikml osbob hertie. o,S nda eubceas myan usdrg nac ahve kyilm ,bsoob yue'ro ltef tihw urgd fetscef by rsspceo of tniinelioa.m

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djinn  I tdno htnik the aotru was a sva.ant Aols I kihtn is hitgr psrocsec ot nihtk ancrce"" anc be blrtailea nda angimtnla utb teh rd"ug" thta ecsusa sith stni HT.C siTh qonistue si bad n.wirtte +1
hungrybox  dcnAicgro ot oPha,tma artoglacearh is ONT cetaosidsa thiw rnccea evre e(es 16.1 - rstbea h)tpygaolo. +
djeffs1  nrcoacgid to uslste'sbrggu bmsuern sti emro yilkle ot eb bl/ recacn tnha a.edh.tzi.si +



 +2  upvote downvote
submitted by niboonsh(409)
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" rtOhe selacss fo acimnsietdo thta eacsu nocmlhieyrpepiaatr dliunce tssraeapine,ntsd natpyveiesehtnir egnsat, dan ugdrs atht iercsaen loweb t.miyloit nrtcirapeHmeilpyoa cuasde by oicsadmnite is cooymmnl ,tsotmcampiy iugnsac ohaaca,rgrlet asumtrenl s,craeiubndt adn .neoeipctm tI is mprIatotn to srenue atth poiahlrairectpmnye in an iIlidavndu eptniat si edu to ctaeonmidi nda ont to a strultaurc enisol ni teh aarcaphmpioyuitt/hitly e;ara sthi nac be hilpdcscoame yb (1) ingsoppt het ocaeitndmi rteryapmoil ot remidtene hethewr noparclti lveles rentur ot nral,mo (2) hwtisngci ot a dmaetcnoii htta odes tno cesau temrpaieahocinpyrl "

lht.wnbvipcmm9.sne4/n8o/hi5t0.1.pu:wb26w/dg/

dso--tnpeedo"Nndeen eisd sfecetf — Alhutogh dwoelos- rhetypa semse to mnzeiimi teh bielomtac oiticsmpanclo dcduine yb a iitadhze or aeidlt-ihzkie iiud,crte it yma ont iycenralsse mtneiaeli hreto sied ecet.sff As na ex,eplam as ynma sa 25 eertcpn of enm edretat ithw 52 /ydamg fo tidllorhenchoa deplvoe a celiedn ni eaxuls nuncfoit 4.[3] eSlpe cuntaedisbsr nac aslo rcc,uo caaryltpurli if teh nttapei is no a -umlsowiod deti 34.][ wHo esteh smploebr ocrcu si ont nn.o"wk

-mtreawounehr0hutc.nenspyy9oh5oe/8i2t5Hn-wawtewp9epeept0ttitfiie-sitle-sdar-cd.msrcst/-tdo/3/si-ins-n#oaastipiznuih:-2t

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 +2  upvote downvote
submitted by hungrybox(1277)
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taPmhao igsve teh teher omraj cuesas fo hetalaacogrr sa pneipl naio,itumlts itoprcnmalao fo oirneart at,rupiyit adn usrgd (ees 1.61 - tBreas tyh.aPo)olg nyOl durg teffec si na neswra hcocei rfo sith sioneutq.

oT tpu ohterna way - eefbro ouy ytr ot go rohgtuh every rnaswe he,icco inksga sryoluef o"uwdl hits uscae acgte?olrahr"a e,sIndat sak ore,lyusf Waht" are hte ecssau fo ghcraaaoe"tr?l coinAgcrd to .rD r,ttaSa teyh rea pneil"p itsiaulm,not opaotniracml fo aneitorr rpttyua,ii nad .r"udsg

The uteqisno dostn'e ysa ynhaignt hatt lowdu ipont uoy rowdat inpple notastu,imil ekil ti" nyol sesem to rppeaa ehnw hse pust no a ast/iyrlhps t/sr"e/pot†r.sncsu oS yuo cna ulre tuo plnipe ausmotiil.nt

tI oasl kemas on tionmne fo petmiorlba einsbdlns h(hwic ldouw nptoi oyu to an roineart itytpriau ,u)rtom so you nca relu uot mroncao.pailt heT olyn niootp letf si rudg fefc.te


veI' enevr enes taygnhin keli this on a nseutioq tbu I mssaue eht BMNE dwluo dorw it in osme oucvdetnlo yaw ikle th.at


I naliiltiy rewot htis sa a uomtbsemnc, tub I lefe ekli it everseds sti won .mecntom I saw vener erayll diaeistfs whit nay of hte epalnxsnoati fro this elromp,b dan I anylilf iadrrev ta eon tath meask eht sotm eesns to .em

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hungrybox  ,Oh dan e,esbsdi nipple imisauttoln dna aaprlimcntoo eatr'n even ersnwsa oll +
drdoom  sys[mte il]rame royu nccotua ash been :rpauedgd ORTAFM NAINJ +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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diesTaizh eeucrd RFG g;&t- udRcdee nearelacc of rcpotainl -;g&t eachltnppioariyme t-;g& ghaeics.dr

Nto resu woh rrectco ahtt is, tub aides rfom nacrce negib ru,ltiaanle I olwdu asitcaose hghi rtaipcnlo ithw sols of pmniodea uoinedtinid/hbceri eaarcelcn of irapoltnc sli.etf

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 +1  upvote downvote
submitted by sam1(22)
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edzihsiaT anc cseau ceuat tisileitrant iet,rphisn a mfro of lrena uielf.ra iotWhut eht anrel xeirntoce fo rtclinp,ao it nca ldbiu up in eth usemr and truels ni thrglaaoc.rea

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coccidioinmytitties  eSxula oinuysnfdct r[sdeei ebsad = iodb]il nac eb edu to gdur ieds tfeecsf ehneirspvi[]ay,etnts erp rtfsi d.ai n o:Eiidt P:g80e12a e51i:5tconS scyPe ,Phr Atsd'si1 rcnednieo cn:esoit csvexesei" smnatou fo roplintca aioscastde twhi bilodi↓ .[34]2 h isT esgo thtgoere ihwt rou asluxe ioynfcsundt htiw yaenvr".itnte"hsspei lyn O ogclila sinsyetsh I nac itnkh :of teiahd iz = rlnoaicpt↑ = idobi↓l + rhat.grlaoeca It ulodw oasl meka essne inecs ew aer idnelga htwi an tdcpexee ot be neusmtpp-aoloas meefla mkl[i ontoipcrdu wdlou heva ot be deu to xunosgoee .us ugD]coer onti ym eurletc oetns adn oudfn het :gnolowlfi lak-tsbrbeoce dna sziatdhie uasce laexsu .sInudin oyctf saol ekli msa1's teniaaxpo.nl er'eW gcherina e,ehr tub sit eth steb I nac do. +
g8427  oaMy iniccl soswh ecrla ro byoodl ileppn rechasigd sa edis eacftf fo i.zsdTiaeh tuB dntose ttsea kyilm erdh.iscag +



 +1  upvote downvote
submitted by namira(39)
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elPssboi oti:nxeapanl

fI het pt si nitkag a zeaidhti hwcih( is K ,nepei)dltg it mgthi ahev olsa nebe ivegn iwht a K iarspng durg cush sa aconrpole.tiins

nlcoproeinitaS ash gdonoiccleinro sffctee hscu sa gtamsncyoeia adn .hraeroglacat

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sugaplum  I tnikh yuo udocl nylo meka itsh tpmouaniss if teyh sdai tapinet" si no ndarstda tnh x"t but snice thye avge eth nema cz,th uwldo tno eb iraf to musaes yeth are aols gtakni pooan.stlciiner I tewn iwth roepssc of itlnmniieao no itsh n.oe vn Ee hdkecec cacess cees'dmiin drug searvde fetefc lg..hrroacptirlaefeoa. not tildes orf htcz +2



 +0  upvote downvote
submitted by j44n(141)
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lobePsis caessu fo aothagaerlcr ne:licdu dsMneoc,itia suhc as rcaietn vsaedti,es sasesdptneir,tna pscitatoynschi and hhgi lodbo euprrsse g.sdur Odipoi su.e Halreb pusnpte,mlse usch as ,neelfn sinae or neergfkeu eeds

^ romf hte ymao n.cilc.i.. meaphiss no het NHT dgurs

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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zdTai&tihe;=g =alcet&miyrehpac;g ioOxtxny G(q ludpoce gr;&pnott-ei cnir )&t;+aC=2g npliep egcsaidhr

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arkanaftus  Onityxoc lwil otn krow on reasbt lesrnigtu on mlkiy igcrhdsae fi eht dnagsl erew tno rpp"re"ead yb potailc.nr tI's elik ynigtr to uqezees pymte onolabl - gionnht eosg tuo. +1



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