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NBME 23 Answers

nbme23/Block 1/Question#1 (45.0 difficulty score)
An asymptomatic 30-year-old woman comes to ...
Anovulation🔍
tags: FA19p634 reproductive 

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 +9  upvote downvote
submitted by welpdedelp(198),
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ewhn a lollecfi osdent' upeurtr ak(a o)alaivnnuot neth it lwli omrf a t.ysc

uslme123  n premenopausal women, simple adnexal cysts (image 1) that are <3 cm in diameter typically represent normal follicles or may be a corpus luteal cyst (these may appear simple or complex) and may be considered a normal finding. Even when up to 5 cm in diameter, these simple cysts are so commonly due to normal menstrual physiology that the Society of Radiologists in Ultrasound (SRU) does not recommend follow-up when asymptomatic +6  



 +2  upvote downvote
submitted by ber1ber1(2),

for anyone who thought it was endometriosis its not because endometriosis of the ovary would have multiple blood filled "chocolate cysts" and presents bilaterally and patient would typically have pelvic pain as well FA 2019:p634




 +1  upvote downvote
submitted by diabetes(15),

the key here is (asymptomatic) the only amswer is anovulation




The most common cyst in a young female is Follicular cyst; this is a cystic dilatation of an unruptured Graffian follicle.

Failure of Graffian follicle to rupture --> Anovulation

Ref FA2019 Pg 631-632




 +0  upvote downvote
submitted by pk33(0),

Why i think this is a bullshit question. Asymptomatic, so it rules out Endometriosis because there will be pain every menstrual cycle because endometrium in ovaries also bleeds. Also rules out PID because no Sx such as fever and vaginal discharge. Also rules out ectopic pregnancy No unilateral pain, and other sign and Sx of pregnancy Now stuck with 2 Malignancy and Anovulation cyst. so They say patient is asymptomatic and in case of anovulation cyst there will be prolong abscence of menses and then massive bleeding so that is a symptom and it must be present if anovulation because there will be prolong follicular phase and unopposed estrogen release. so i picked ovarian neoplasm which is usually asymptomatic over long period of time but it does not fit with the age. So you have to chose between age demography and ignoring irregular menses as a symptom.




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feAtr neievtrghy sit jsjtu na eemipd e.qus oeBlw 55 sv Abeov 55 rsyea

ls3076  can you elaborate please? +