NBME 20 Answers : Block 1 : #17 = A 50-year-old woman comes to the physician because ...

nbme20/Block 1/Question#17

A 50-year-old woman comes to the physician because ...

Drug effect

+7 upvote downvote
submitted by strugglebus(43),

Nowhere have I been able to find why the hell this is a thing.

yotsubato Its not in FA, Sketchy, or Pathoma, or U world. I knew it wasnt cancer because its bilateral. And Diabetes made no sense to me. So I just threw down Drug effect and walked away. +

breis same^^^ +

+5 upvote downvote
submitted by strugglebus(43),

As an edit: 108,001 people reported to have side effects when taking Hydrochlorothiazide. Among them, 25 people (0.02%) have Breast discharge

neonem I think the best way to answer this question was by process of elimination. +

sympathetikey That's some bullshit lol +

karljeon Haha I eliminated the answer by process of elimination. +1

medschul I eliminated thiazides by process of elimination :( +

medstudent65 Shit I eliminated thiazides because of elimination went with HTN thinking intercranial bleed effecting the pituitary +

+2 upvote downvote
submitted by hello(22),

Goljan had a lecture that mentioned that "If a patient has galactorrhea, review every drug they're taking since many drugs cause galactorrhea."

The only thing of possible relevance in this Q-stem is that she takes a medication, therefore the answer of "drug effect" is the most likely reason for her galactorrhea.

+0 upvote downvote
submitted by namira(1),

Possible explanation:

If the pt is taking a thiazide (which is K depleting), it might have also been given with a K sparing drug such as spirinolactone.

Spirinolactone has endocrinologic effects such as gynecomastia and galactorrhea.