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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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CSPO is docaeassit hwti nmlabaro incdrtupoo fo sxe dertio,ss inuicgnld tunnosfdicy of eesrtong pcrooinutd and oeerrspntgo.e ihlcoyaCrnl eaveedtl lvlsee of egesrnot nac csaeu deratlemoin aairpsph.yle

nia9ms:Ctn/1.Pbhm/Mpc3hc/lnrw9/s./w95iiwelv/t..pocgt7

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meningitis  Why stin ti enetrsiomiod?s ulodC eneooms leph em uot no i?hts +2
meningitis  r,Soyr I wsa uscfnnigo with grehih iksr orf ednmeraotil oacna.cmri +1
vi_capsule  sneotEgr si orliepesnsb fro lcalccyi elinedbg dna pain asacoeisdt tihw esonimrsoteid nehec grniotsep is a emttetarn yilm.doat tuB nroteges tnis a skri troacf orf ro.Edsmioitsne Rrateh hsreet oegderrrta ,lwof lctapaetmi mnonfirartstao etc eeorsthi rea eienlrosbsp for ein.erssodimot +1
sympathetikey  Twf uoy teg so rtownh off yb a tucpier taht uoy ont'd dear the etsniuqo prry.ploe +34
hyperfukus  ieii@tnmsgn kdi fi u itsll cear llo but sawyla go cbak ot csooetneoiscerpmdti=i ntlreeimoad usstei deotsiu fo eth trsueu os yuo can lreu ti tou ceisn cianedesr tneoegrs dlwou suaec ouy to avhe eedrsonw dmeisooitsren or a hterkci oen tbu ont dt.uyrel.ioc.y acn ese eth uscmpl of eth lllsfeoic ni eth evsrioa if uyo loko srpeu leocs so ttha nloga whti hte rinnttasoepe skaet uoy ot OCSP dan teynaim oyu ntod' hvea a byba or tysa in eht ifriralpeeotv epsoe(gsnharte seah)p oyu get dltomreinea ht-e-rrpou&ts-mipgy;igya-l-aetl&a;talpilirneotf omcraainc +2
lovebug  AF 91,20 apeg 613 +1
lovebug  htrOe aenswr sg)iMeH rsmeondy : d iart fo 1) iaaronv abor,fmi 2) tcsies,a 3) arlplue uoe.fsinf Plgโ€œโ€inlu naosnites ni inog.r FA ,9120 gp 263 +1
xw1984  'stnI intopo ,G aoiaoLymtme euti,r csditaeaso tiwh ihgh ntsregoe lel?ev reP AF 02,20 bidorif si ngeotrse .iseteivsn +2
ownersucks  48w9x1@ rssog geami wdlou sohw lmptilue heldwor sssaem +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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Ccniiospotaml fo O:PCS

dlsrviaorauaCc vseent

epTy 2 tbaeides lisetuml

nmerltaidoE raccenalpshipye=ar

sncIeedar iargrseicma aert

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