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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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eagP 2 ash a gtera icreutp

/1Sgs2cn)16.1ll:t/apta6je-.f0ri997(4p/t-80roci/hod/ww3w0i6en

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kamilia20  lmaphyldhacoi piaittc?s? +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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siHetisypvienrty tnmp—neiumodiesix eytp IIIV/I ehsviytiytieprsn rtneciao to rnelntnimevao anniteg. sCusea ynsadp,e guoc,h hstce nh,steisgt hdcaee.ha Oftne sene in mfrraes and eosth edoepsx ot i.rsdb rbivReesle ni yrale egsast fi mlsuutis si vod.aeid

s'tI a eytp fo tvitescirer unlg adisese.

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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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yWh eht heotr snawer ochcies 'rnate trorcec

A - Nto na atlaiyachnpc onatrice ynlmai ude to coniycithr nomptoscin(u fo oys, chiwh has grtipslncyooe atht lopeep yma hvae lelresgia rtd)wosa

B - Not mahtas arrcech(atdeiz by emor uctea eseodpis fo hsboonnoncirctr,otci wizghn)ee

D - imnaAe B6,( B9, )B2,1 or ymeab a nuprlamoy esmiblmo deu ot B9 or 1B2 ydcnecfiei gt-&-; vdelteea etyeoiomshcn eevlls t;-g-& orbithosms t-&;g- T?DV

E - mloPuarny nra;hxta hTe meti eocsru odlwu be uhmc omer e,tauc and luwdo losa renepst htiw mspomtsy fo -fuillke ympsomst. adipR adthe oto

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 +3  upvote downvote
submitted by monoloco(155)
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hsTi apettin is xeigeneicpnr vneieisptityhyrs epimoiutnns omrf eht ekptaa.ers I swa intgnihk .M vimAu nweh I edcltese espearatk -- I kthin ym gcoli saw aedfwl vigen hte cspeciifs fo the sept'atni tysro.

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 +1  upvote downvote
submitted by imnotarobotbut(184)
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Hwo ludow uoy nkow tath ti 'stni wloo erossrt ?sasidee

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cienfuegos  FA 8120 731: naionaliht fo psseor deals to -iulkfel syommtsp ttah oerrgssp luqkciy to vfeer, punarlymo ehom,gharre nissiaieimtdt nda ,hcsko ihtw gimangi ysilbosp wnhosig wedndie dmneumiasti +10



 +0  upvote downvote
submitted by endochondral1(24)
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gcnradico ot rwolud yiiyhtvtrpenssie usnnteipiom is eud ot sutd nda ahtt aws alos na ..ni.poto.

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amarousis  os si't eetlyniifd tdus btu hte fpeiiscc tyep of dtus aws het omst prttaoimn ni htsi oituesq.n eth fcat atth they tneiendmo het disbr si tapnmio.tr the dsuyt ooskb udwlo aescu it btu het bdri utds is omre pnortiamt -.- +
charcot_bouchard  rsnesipetHvyiity oPnmitsuien - nairOcg duts lki(e molyd mnyacih s)Pinsouoe - oiaIcrnng sndu ento help reeh hutgho uesecab tbho wlli snrtepe iwth smae ervscrtieit lung iasdese iperit.cu think insec tusd in raibrly raten hreniet gocnrai ro cngianoir dan lsao u dnto ees myan nliaiabsrr wthi nulg easiesd tub rbid wnreihpos is lfeaypslicic timoenedn sa uecsa fo HP .dsaeeis +



 +0  upvote downvote
submitted by beeip(141)
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I oasl saw ikhngitn .M amiuv hree, tub shytiseyietnivrp iopmneuistn essem to tif htiw teh aueauicrlrgortnl ncsh.gae

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 +0  upvote downvote
submitted by endochondral1(24)
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who od we ownk pesearkta esuac ivnseirtpeshyy iupnmesoitn

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smc213  18FA 7p5.6 ibrd &;por-s-geexut NSH uonsimiptne evcetr(iirts gnul s)seeiad dna AF18 .1p24 oaausmuortgln sas:iesed orneifg gNei-SHlaa-r;tt&m mntusnp.eiio I hda ot kmae ensse fo it nisec I it'dnd nwok it was HNS ontiimnueps at rti.fs +5



 +0  upvote downvote
submitted by breis(56)
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tscisPasiot oet(emsims elclad oionissthr or oarrtp ssaidee ro ortrpa )eervf is na foinnteic fo hte lgnu (mueanno)ip acsedu by eht riumtcabe oyhahmliCdapl hay(aCdlim) ptci.iats

sngSi adn ,mut o:esp oecvy.rgfmhs lsulyau htuwoit uchm he.recml.spcd heuh s hgameaal. eesc.sht ach r.snshp osteain of sb.re roetha trhtoa.

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charcot_bouchard  Udteap on ym vrep emtmcon : Yse iths is otssptia.isc not etynyhpivisiestr tpnsneiimuo. woH od u kown? pcyyoetLhm dna ceePners fo anlomrGau - eopnssre ot cartlraulilen m calN.hodiawy HS acn oasl sauce eloos roagamnlu oto dan eht aclnilic uicterp slitl reom olok klei uYSHo nwok htaw ......... ucfk stih seuq +2
shemle  eHer Pt. snde'to aehv !ferve +9
shakakaka  gcataoisnNen a,gramnuol tpcayh yltphymocic iirniotln,atf nda srbfsioi rea snee in etisiynetiypsvHr mesnnopitui , noriagccd to wdUrol . +

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