NBME 20 Contact with parakeets (NBME Answers)

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

+36 upvote downvote
submitted by ∗masonkingcobra(408)

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aPeg 2 ash a tgare ecrutip

iwi9ctlda.0no4l8cw(6.6/Ste2//0a19er0i6s/po1g3-/tr)f1:-wnphj7

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kamilia20 homhiypaladlc i?p?itsact +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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ynsryHieivepstit mmietx—dsuipnnioe ptey II/VII ntseetihivyrpsiy roenatic to neartvinenolm n.tneaig sCsaeu yasdpn,e gohc,u estch ieghnts,st .hehacead eftOn nees in farsmre nda hseot dseoxpe ot bd.ris brReslevie in ryeal assgte fi lmustuis is eai.ddov

sI't a ypte of tivrsictree glun sseaied.

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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 eth throe rasenw shcceio 'raent crteorc

A - tNo na lctancpayahi anitorec aynlim due to rciotiyhnc instmpounoc( fo ,oys chhiw ash lptoognrsiyce ttha polpee may avhe esleilrag t)rasodw

B - oNt amhtsa (crazderhetaci yb emro taceu pediesos of hcooonntitr,cbsicorn ghwn)eiez

D - Aamnei B(,6 9B, 1)B2, ro ybeam a orymulapn iesomblm deu to 9B or B12 ccyiefdnei -gt;-& etldavee tcieoohynmse selevl t-&-;g isosmhorbt -&;-gt V?TD

E - oPumyanrl a;htnaxr The etim scruoe uodwl be mchu orme e,tcua dna lowdu lsoa pertsen hwit ostysmpm of u-feikll stym.pmso piadR aethd oto

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+3 upvote downvote
submitted by ∗monoloco(155)

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hsTi ttienap is xpecgerienni iptryvhieytsnsei msntineupio rmof eht s.tkaeraep I asw tkigihnn .M iAvum ewhn I eeecltds spakteear -- I htink ym iglco wsa wldeaf vgnie teh escsiipfc of eth t'patsien yost.r

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+1 upvote downvote
submitted by ∗imnotarobotbut(184)

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oHw lwudo uyo wkno thta ti 'itns oowl stsorre ees?iads

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cienfuegos AF 2801 7:31 ahiinnolta of ersops aseld to iekll-uf ysotmsmp taht osprregs qykiluc to rfee,v onyauprlm eagomh,hrre mttsiediasnii dna hskco, twih nagmigi lysopbsi inowsgh ewdined tudmnismiae +10

+0 upvote downvote
submitted by ∗endochondral1(24)

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dogcnrcia ot rdlowu yiitipnesthsyerv inutnsmiope is deu to dust adn ttah wsa slao an .ti..o.pno

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amarousis os si't ifedetlniy dstu tbu hte ispfciec tyep fo dstu aws eht msto amtpoitnr in itsh soqneut.i hte tfca htta yeth neidontme eht isdrb is om.tnrtapi the ustyd kbsoo dwulo ecuas ti ubt eht brid dust si remo iomtatnrp .-- +

charcot_bouchard ieiviytsHpetyrns etimisonPun - cngOira stdu ekli( oymld ciu) osniheamysPno - rngcnaIoi ntoesun d ehpl eehr oughth eeuasbc htob lwli reenpts with meas virseercitt nlug daeiess r ui.eitpc nikht senic dtsu ni rrabyil nrtea tehrein nicgaro ro nnroagcii dna soal u tnod ese ynma sraibnlari hitw lugn ediaess but brdi iserphwno is cflaylipceis moedtenin sa aesuc of PH esesai.d +

+0 upvote downvote
submitted by ∗beeip(141)

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I also asw kghtinni M. umaiv re,eh tub styiivsreethinyp pnoeusmiitn ssmee ot tif tiwh the luurnelroagaicrt eagsh.nc

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+0 upvote downvote
submitted by ∗endochondral1(24)

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woh od ew nkow pseeraakt suaec vpsysernhieiyt tnsnomuipei

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smc213 A8F1 765p. dibr &xg-etreo;s-pu HSN npitunoisme itriesrevc(t nlug dsaesei) adn F81A 142.p oulgasrutamon eass:edsi fnreigo g-HaiNatlm-;reSt& noinpmi.uset I dha to make esens fo ti ncies I id'tnd know ti saw SHN tmionusneip ta itsfr. +5

+0 upvote downvote
submitted by ∗breis(56)

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sissoatciPt eo(esmimts celadl nosrsthoii or orpatr seeadis ro arorpt evfer) si na tencnfioi of hte lugn pinnam(ueo) dseuca by teh bmteacuir oCaiylaldhmhp a(myadhCil) tsiiactp.

Ssngi adn vseuhg cmo:ysm,tp orfe. uslluya tutohiw muhc lscgspm d r.aeeehl h.eaa.cuhmh .tehseacshc irepaons .sntsh of e.rre ahbtos aothr.t

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charcot_bouchard Uapetd on ym rvep etmocnm : esY sthi si iossitstac.p ton nytvrpieistyiesh tesnp.nuimoi woH od u w?okn pytyhoecLm nda ecrnPsee fo aGmraonlu - seerpnos to ctireullrnlaa ilhy.cwNadoma SH anc oals sucae oolse oulmrnaag too dna hte aclnciil tcipuer iltsl eorm kolo keli uoSY H wokn thwa ......... fkcu isht esuq +2

shemle erHe t.P ns'tdeo have fvre!e +9

shakakaka noNcteagnias loguaanmr, yhacpt cphltmoyiyc ntirnoftial,i nda bofirsis ear eens in sHystyrnieiietvp etouspimnin , oirgaccnd to Ulordw . +

https://pubmed.ncbi.nlm.nih.gov/7569404/#:~:text=The%20inflammation%20is%20often%20followed,than%20in%20women%20and%20children.

you get granulomas in both

+1/- j44n(141)

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