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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(670)
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OSCP si aiescotdsa whit nlaboram opdirctnuo fo exs iotsesrd, iundlincg ctnudnfioys fo tnrosege cpiodruton nda sp.rengoeeotr iChnolycarl elaedvet slvele fo senroegt acn eucas eetdmorianl irlehpsaa.yp

./niconw/MwlstsCb//9/i1tmpt59n9:.clchhp73avr.igw.eP/m

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meningitis  Why nsti it osetismne?odri luodC esoneom pelh me otu on i?hts +2
meningitis  ,roryS I wsa isonucfgn itwh hihgre ikrs for erndamlotei naroim.cac +1
vi_capsule  Etseonrg is eslrnopbise rof ilclcacy bldneeig dna npia isdoecaats htiw eosoterminisd nhece geoptrnsi is a eettarnmt dliytamo. uBt goretesn itsn a srik afoctr rfo sim.nsoetroEid Rhtrea ehstre odrtrragee lfw,o ctmaltpaie oatnaomtfrsnri cet hsteeori era rbseolpsnie ofr itrsensmo.deoi +1
sympathetikey  fwT you teg so rnohtw fof by a rcuteip hatt oyu odtn' edra the qsoientu errp.lopy +34
hyperfukus  t@niiimgsen kdi if u tlils ecar oll tub ayaslw go kcba to indottpioorssi=cmceee maednteirol teusis suidteo of teh eusutr so oyu cna urle ti uot cisne rcadenise eogtnesr olduw easuc uoy to evha sewornde sortmoeedisin or a rhctkie noe but otn y.ltire.u.ycdo can ees hte pcusml of het eillfsocl in hte iaeovrs if uyo kool rpeus cosle os tath laong iwht the nntoaestirpe kaste uoy to CPOS dan iyenmta ouy odnt' hvea a bbya or tays in the eftarrivplioe eprensghsoe(at sah)ep uyo teg etlaidmnore yotema;ori-;ayhgieaptgiupltl&-a-rtr-isf&ptlln-e iarcmcnao +2
lovebug  FA 0921, page 613 +1
lovebug  rheOt rweasn ies)MHg ndrsmyoe : rdati of 1) oranavi aof,brmi 2) i,tcaess 3) ullpear onuis.ffe lgnliuPโ€โ€œ eioasntsn in ro.nig FA 1029, pg 263 +1
xw1984  'ntsI noiotp G, amyoLemaiot tre,ui tosiasdaec iwth high geretosn ?lvlee ePr FA 20,02 dibifro is eestnrog ieivts.nes +2
ownersucks  1xw8@94 sgsor iameg wldou oshw elumiptl ohwdler smessa +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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tiioasclonmpC fo OPCS:

aaadliurcvCrso neestv

peyT 2 deiatbes iseultml

tinlmdoreEa arncceesralp=phyia

drescInae agmrcreaiis aetr

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