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Retired NBME 20 Answers

nbme20/Block 1/Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect 🔍 / 📺 / 🌳 / 📖
tags: pharm

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 +25  upvote downvote
submitted by strugglebus(189)
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heerwNo evha I nbee elab to nfid hyw eht elhl ihst si a gnhi.t

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yotsubato  Its ton in ,FA t,eySchk ro thoam,Pa ro U w.drol I nkew it wsnta cacnre eceabus sit lair.blaet nAd abDteeis mdea no nsese to me. So I jtsu rtwhe wndo Durg efecft nad kdlewa wa.ya +10
breis  a^^s^em +
feliperamirez  eTh lony esplobis ioannlpaxet I htnki si ttha ehs saw duern a K npaisrg ictuire,d chus as eonnlacpisoort ihhw(c luodw edal ot nsgma.i)yteoac +
chandlerbas  you hda em at sti not in ythkces ); +3
j44n  i thhguto THN dnuedic typem sleal ouwld ucase hits caesbeu yeth otg etpy II .tsiaedebu oS fi uyo deen a orp rzeba tuenrh loelhr at em. +

https://www.mayoclinicproceedings.org/article/S0025-6196(11)61587-5/pdf#:~:text=Other%20classes%20of%20medications%20that,dis%2D%20turbance%2C%20and%20impotence.

if you want to save your time and not read an 8 page research article like I did heres the summary

Other classes of medications that cause hyperprolactinemia include antidepressants, antihypertensive agents, and drugs that in- crease bowel motility. Hyperprolactinemia caused by medications is commonly symptomatic, causing galactorrhea, menstrual dis- turbance, and impotence.

+1/- j44n(141)

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 +21  upvote downvote
submitted by hello(429)
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onljaG adh a ueeltcr that imendoetn atht f"I a eaittnp sha eo,atglahrcar viewre eveyr dgur e'theyr naiktg snice myan srgud cause a.htralrea"gco

ehT only htign of sbispoel veealnrec ni stih meQs-t si thta seh kesat a oacit,mndei efherrteo eth wserna fo ugrd" teceff" is teh osmt kleliy esrnoa rfo hre roa.traaghecl

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hungrybox  I isllt thikn this tnsueioq is ettyrp S.B Btu hagivn isddute mose o,mer I nhtki s'ti essl SB hatn I iylniralgo ohtghu.t atPhamo vesgi the heter rjoma sscaue fo aaratrlcgoeh sa plpien tosm,auiilnt inltoacrompa fo anreirot uriaiy,tpt nda urdgs (ese 611. - tsarBe o.tayhP)glo lynO gurd tefecf is an earnws hiocec ofr hits etsiunq.o +9
hungrybox  To put rhoatne ywa - ebfroe ouy rty to og hhgtruo reyve awsnre ieohcc, asgnki osfulrye "ldwuo tshi suace eloha"ca?ratrg ,Iaedstn aks leruyofs, "thWa ear eht sacsue of ?alrartc"ahoeg cidgAncor to r.D aS,attr hyet are plie"np n,omuiitstal maoptinlcora of tarnrioe ruy,atipti nad urgs".d +3
hungrybox  The seqiunto 'tsedon asy antynghi atht dlouw ponit oyu wdraot ippnel mnl,uostiiat eikl "ti nlyo eesms to aaprep nehw ehs tusp no a aryhips/slt p.ns/sottscer/"ru tI also kesam no teonnmi of abrelpitom esnsdnilb ih(wch udwlo npoit uyo to an rtnaoire rpauyitti otur)m, os oyu anc elur out lcnmporiao.at hTe ynlo ipnoto flet is gdru fetecf. +2
drdoom  xgbonyhur’s lluf ocnmmte )bwloe( :hree penn9m/0/se#rhmb.40axs/e3/wc7oetm:msb1atn2/0 +1


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 +14  upvote downvote
submitted by strugglebus(189)
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sA na 1t0d0081ei:, ppeleo tpedoerr ot vhea sied etfcfes wenh gikatn iohHa.zodyh gdnelitmcrooAr t,hem 25 popele ()200.% vaeh Bestra cdraehisg

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neonem  I tinhk het bets awy to nrwsea ihst tiqesuno saw yb ssoecpr of el.tminoaiin +1
sympathetikey  as'Tth esmo tibllsuh lol +9
karljeon  haaH I elmdtnieia teh nsewar by rcspose fo intmaio.line +25
medschul  I neiiledmta izhitsdae yb ropcses of iiaoimntlen (: +3
medstudent65  hiSt I adtineimel azihitsde besuaec fo alnoieimnti etnw ihwt TNH ignntihk iecatilanrrn deleb ifefetcng teh uiayttirp +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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cssPoer of oleiamtinni si eht lnyo ywa ot tge this snaerw othiwut aanvtS selevl fo sitmua, as osme towibe raigewn eodhcru who etwor het tsqeionu yaplobbr a.sh

rcCaen si eaturianll tasoml lal teh ,temi MD detos'n emka nsese for any esaon,r HNT tefsli u'nolwdt ausec ilkmy osobb, nda mast celsl ngndgluaartei sdoent' eakm kmyli bosob re.ethi oS, dna eebusca aymn durgs nca vhae lkmyi sobo,b u'eoyr etfl twhi rdgu ectseff yb secpros of aletiin.nimo

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djinn  I dtno hnkit hte taoru wsa a a.nvats sAol I nhkit is ihgtr oepssccr to nkhti "rc"acne nac be laabirtel dan manntlgia tub teh "udr"g thta cuseas stih nist CT.H ihsT nsetquoi is dba .itrwten +1
hungrybox  cdArgncoi to mtaa,hPo ehogcalarart is NTO aadsteocsi whit eccran veer ees( .611 - sabtre lt)aog.hyop +
djeffs1  racigcdon to bgueutg'slrss menbsur ist moer ilelyk ot be /lb narcce anth eh.stdia.i.z +


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 +2  upvote downvote
submitted by niboonsh(409)
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" tOreh scsasle of oamndisctie htat ucsae roliampypaicrethen nieudcl iedssrnas,pteatn yereennvitptaihs teasn,g adn sugdr htat icesrean wbeol tyiiltom. tpHalecpriyanroime uasdce by mioesitndca is ylcmonom toysaimcm,pt icnsuag ,aaaltrhcegor setmrlaun ,ibecnasurdt nad cmnee.pito tI is omrtanpIt ot esuern tath ceepriahmoytiapnrl ni an vdiduIialn aitpent is edu ot tiaimdecno dan otn to a urrulsactt isoenl ni eth t/liairtycpaiyuaothhmp ;aaer this nac be cchdpslmioae yb )(1 nppgiost teh ationmecdi marpiytorle to idreetnme hhrtewe npoliratc lelesv rnuetr ot lnao,mr (2) icshwintg to a mienaitcod hatt dsoe not suaec eprcaoinaymiehpltr "

94.bip0w6din82ctn.w:bo/wnp/lmu.hhg5mv./1et/s

noNs-eed"-epndotdne esid tefcfse — tulgohAh wslo-deo thaeypr seesm to meinzimi the ioacelbmt oncptcilomsai udidcen yb a izhtadei ro -iezhiaitlekd i,ctdireu it may ont aessyiclner limeetain troeh iesd teef.csf As na eex,paml as nmay as 52 ctpnere of nme readett with 25 /gydam of holdolcehnatri oevelpd a eidlecn in xuslae utfonnic 4[.3] pleSe bdritsncsaeu nac lsoa ocruc, ryicaurlalpt if eth aniptet si on a wolso-iudm teid [.3]4 woH eshet smopelbr occru si ont now.nk"

phtt-/9r/0aeo.p5ei3wutdisiei/et-tnipaas5suwwhesos-h#c.0etpeniyHe9ies:hcr2disymctp--ir--n2soarwm-to/ztte-tnnadufnitt8oln

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 +2  upvote downvote
submitted by hungrybox(1277)
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amtPaoh ivsge eth theer moraj esscua of raclhgroatea sa eippnl utmtsi,lniao apilamotrnco fo rtioaern ,payriutit nda ugrsd es(e 6.11 - aetrsB .lPatgo)yoh lnyO dugr fetcef si na sarenw iceohc orf isht enutqiso.

To put nearoht yaw - ebeofr ouy ryt ot go oghrhut yveer arswne hoeci,c giksan slfoeryu "uldwo tish sceau hroe?agcat"rla tdsInea, kas ,yuselorf aWh"t era teh ecssau fo hralc?tgaora"e ncriogAdc to rD. S,attra yteh are nipepl" nmsoi,ialutt ioamnrltaocp of narrotei pairityu,t adn rdug."s

ehT qisnoeut seond't yas taingynh atht dluwo piotn uoy wrdtoa ilepnp iunatmstl,oi lkie i"t nlyo sesme ot epraap hwne hse utps on a hslptis/yar cs"./stupensrt†/ro So ouy nca luer otu nepipl ulniamisto.t

tI oals keams no teniomn of eibrplmoat bndsilens hhiw(c wudlo piton uyo to na renairot pyatiitur rtm)o,u os oyu nca lrue tou naotlacr.opim eTh noyl oitonp letf si urgd efcfte.


v'Ie vrnee enes gytnhnia ielk ihts on a uqtneios btu I msesau het BMEN oudlw drwo ti in eosm enctuvlodo ayw ikel .htta


I iiltynlai teorw siht as a bt,scmnueom btu I fele leki ti sesrveed sti won ocn.memt I aws vnree eylrla iaedsifst hitw nya of het eantipxnalos fro tish ormbe,lp nad I nlaflyi idvarer ta eon ahtt makse het osmt enses to m.e

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hungrybox  hO, dna s,disebe iplpen ntuiolitsam nad aracloinoptm 'enatr vene rwnsesa oll +
drdoom  mt[ssye iar]mle uroy ucocnat ahs eben gedadrp:u OMAFTR AIJNN +1

One more thing: Pathoma specifically says cancer is NOT a cause of galactorrhea.

So the people who are saying you can rule out cancer because it's bilateral are completely wrong. You rule out cancer because it doesn't cause galactorrhea.

Besides, breast cancer can be bilateral. Bilateral breast cancer is almost always invasive lobular carcinoma.

This is analogous to serous cystadenocarcinoma. Bilateral ovarian cancer is almost always serous cystadenocarcinoma.

Idk how this "breast cancer can't be bilateral" myth started propagating.

+9/- hungrybox(1277)

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 +2  upvote downvote
submitted by dave_(3)
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ziahdTeis reedcu RFG -;t&g ecRuded cleancear of ronilctap ;g&t- pcmiertlhiypaaone t-&;g adgs.ierch

Nto uesr hwo cctrero thta is, btu aiesd romf naecrc gnieb elatnlu,rai I oduwl astcsaioe gihh lcrpiatno whti slso of nadeopmi dcibo/edrunthiieni caenrcale fo alntiopcr .iseflt

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 +1  upvote downvote
submitted by sam1(22)
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eTszaiihd acn acues ectau neilttriaits ehinrsitp, a orfm fo naler r.euiafl hiWottu eht relan eotxcneri fo cornia,tpl it nca lbiud up in the esmur dna elstur in rocharalt.eag

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coccidioinmytitties  ealuxS iyuscfnndto sedire[ asdeb = dlio]ib can eb due to dugr desi sefctfe ipr]tiyhsv[tnsne,eae erp sfrit dia. inEtd: io 120ae8P g: 5notce 15i:S yrhePc, Ps tsAds1'i oerneidcn ce:tsion ecse"xsvei utsmano fo ncpoialtr coseastida tiwh dl↓iboi ][42.3 s Thi seog gertoteh hitw oru xalues unsodtncfiy whti shstir.eti"evnpa"eyn lny O llgiaco yeihtsssn I nac khnit f:o thzia dei = aclropnt↑i = iob↓dli + trol.eagrcaah tI loudw alos maek esnse secni ew rae dnligea twhi na teceepdx ot be ons-oeplutapmsa fleaem mi[kl utoinrpcod dolwu vahe ot eb eud to neosuogex gros.Duc]u e tion ym eceturl osent nda doufn teh olw:figoln e-rbsblokcate nad hdiztaeis ueacs sluaxe ncIdfnu.iy tos asol klie s'ma1s eta.pxilonna Wee'r inheracg e,rhe ubt sti het ebst I can .od +
g8427  yoMa clcini wssho creal or loybdo lipepn iscerhgad as sied tcfeaf of s.Tidezaih Btu otensd staet ylimk che.isgdar +


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 +1  upvote downvote
submitted by namira(39)
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sselPbio nlanoxptae:i

If teh pt is agitkn a dhezitai (ichhw is K pden)t,eilg it ghitm heav soal enbe gnvei htwi a K apnsrgi gudr uhsc as nsoratolc.pneii

epntiaolSrcnio hsa rconigdeonolci tffeecs cuhs sa ciaeatsongym and ha.cotrgleraa

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sugaplum  I tnikh uyo lcudo noly aekm itsh mpitaosuns if they idsa "ettinpa si on stdaadnr htn "tx utb neisc htey aveg teh emna ct,zh uwlod nto be rfia to useasm eyht ear also agkint apeitoricslno.n I ntwe wtih ssceopr fo nlnaimeitio no hist .eon vneE ekhcced ssacce i'isdnemce rugd vedersa ftfece rlha.eocrarpt.lief.gao nto ltseid orf zhct +2


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 +0  upvote downvote
submitted by j44n(141)
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ossbPeli usscae fo aarltecaorgh ducei:ln ciMs,oindtae husc as naritec tev,iseads arpessdnta,stien nashptctsyicoi dan high ldobo pusreesr ug.rds podiOi seu. rHlaeb p,mnpeslteus hcsu sa nfe,enl eains or fregnkeeu esed

^ frmo the moya i.icc.l..n ihmepsas on teh HNT dgusr

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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az=h;dti&Tegi emgcilerc&ya;athp= Onoyxxit Gq( eocpdlu ;&prntgot-ie incr +=C&ag)2;t epinlp raehgscid

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arkanaftus  xOtinyoc will ont kowr on arbest ieslgtrun on kyilm cdrheaigs fi het ldasng ewre ton d"eeparrp" by pao.rinclt It's iekl nrigyt ot zeseeuq tpeym laoobnl - toinhgn gsoe to.u +1


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