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Retired NBME 21 Answers

nbme21/Block 1/Question#12 (reveal difficulty score)
A 25-year-old nulligravid woman comes to the ...
Endometrial hyperplasia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—mcl(671)
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CPOS si adesaotsic hiwt narmabol prouncodti of sxe iesors,td ngcuiidnl finsudyntco of eregstno niuocprotd adn n.rrsoeetegpo Clahyilocrn evlteade velles of geternso nac seacu niadoteelrm eppylarh.ais

slvo:7ibt9aews3/9lhw/mciP5.ic.th.nngprm9n//.wCp/t1cM/

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meningitis  hWy nsti it eieismsrdno?ot oluCd osoneme lphe me otu on hti?s +2
meningitis  ,Syrro I asw unfcgsoin whti rgiehh skri fro aneimdeoltr o.aaccnimr +1
vi_capsule  nsgeEort si opesrleibsn for lciccyla ebnlegid and pnia edacosaist hwit ormsoteisdine ncehe oeringstp is a mttnertea aymidolt. tBu ostrgene stni a kisr ocftra rof sroidiemnt.osE htreRa ethres drreoeargt olwf, plmcettaia rsoonmanitraft etc esoreith rae eonbsleiprs orf niosrteidms.oe +1
sympathetikey  wTf yuo teg so tonwrh fof yb a rpteciu htat yuo ndt'o edar eth ntsqueio pylor.rpe +34
hyperfukus  mis@netiing kdi fi u ltils acer llo tub saylaw go kabc ot emrptcti=esdscneoioio eamiotdenlr esisut suediot fo eht rustue os uyo anc lrue ti out nesci eirncsdea egstoenr oluwd csuae you to vhae oerwsdne iieorsmsdeton ro a crthkie eno but tno eticou...yldyr nac see teh cupmsl fo het iolelflsc in eth saveior fi yuo okol prseu scoel so ahtt galon wtih eth aontepisrtne kaste yuo ot SPCO and nyeamti yuo no'dt veah a ybba or ayst in hte peeialoitfrrv soaheespe(nrtg psh)ea you egt oeeldmrnita srtef-&yy--rit-oia;ptha-ptailp&gmiulgt;orlelaen acimaocnr +2
lovebug  AF 9,210 apeg 631 +1
lovebug  hteOr ewasnr H)egsiM reonysmd : i ardt of 1) viranao r,oabmif 2) csteais, )3 lalrupe ief.oufns โ€œlโ€ugnlPi nnitoasse in gnri.o FA 091,2 pg 263 +1
xw1984  tIns' noiotp ,G ammoioaeLty riu,te osasteiacd thwi hihg rtoeseng ve?lel Pre FA 0220, fdribio si geenostr etnv.eissi +2
ownersucks  @wx1948 rgsso giaem wdulo sowh mlteluip dwrleho esamss +1

I feel the clearest way to understand this question/answer hasn't been stated yet. Recall that the cysts in PCOS are unruptured follicles. If follicles don't rupture, you won't have corpus lutea, which won't secrete progesterone and therefore menstruation won't occur. This leads to unopposed estrogen and disruption of the menstrual cycle, which can cause endometrial hyperplasia.

+20/- pg32(218)

The patient here is obese and has hirsutism. Her androgens are converted to estrogens in peripheral fat, causing hyperestrogenism.

The exact reason for increased androgens in PCOS is unclear, but it involves an increased LH:FSH ratio. Relative decrease in FSH inhibits estradiol synthesis in granulose cells and favors androgen production in theca cells.



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submitted by โˆ—pparalpha(93)
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notclsopimaCi of O:PSC

rrloaicuasavCd etsven

Teyp 2 saeebdit mluietsl

lmoEraedtin crceana=ylhaeiprps

dnrIeecsa irimgeascra tear

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