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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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eheorNw haev I eben ealb to fndi why eth lelh hsti si a nht.ig

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yotsubato  stI ont ni FA, e,kcSyht or a,oPamht ro U drlwo. I wekn it answt rcanec aebecus sti iblaretal. And etaseiDb daem no nsees ot m.e oS I ujts twhre down Drug cfeeft dan delwka aw.ya +10
breis  ^ae^^sm +
feliperamirez  eTh onyl pseslboi xlpnanoaeti I tihkn is atht esh wsa rdneu a K sngairp cr,ideuti cush sa etnincoraslopo (icwhh ludwo elda ot .gyaatmi)onces +
chandlerbas  yuo hda me at tsi otn ni teckshy ;) +3
j44n  i ohgtthu THN idudnce emtpy llase ldwuo sucae sthi esuebca hety tgo teyp II .ietbduase So fi uoy deen a pro arbez hrentu lrlheo at .me +

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)


 +21  upvote downvote
submitted by hello(429)
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nljGoa dah a rueletc tath otednnmie thta "fI a naeptti has rgraoehlacta, irweev eyevr gdru heteyr' aignkt inesc nyma srugd acsue rtoraelg.ch"aa

hTe ynol tinhg of elsspboi cvenereal ni tshi ts-eQm is tath esh tkeas a tocanem,idi oehetrerf het rsanew of ru"dg fcf"ete si the tsom keilly nrasoe rof hre gcretoaa.lrha

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hungrybox  I ltisl ihnkt tsih ousteiqn is ttyerp B.S tuB hngvai tseudid meso eomr, I hkitn si't lsse BS than I lnioraygli tthohu.g Potamah isegv het etrhe jaomr aessuc fo laotrhcaeagr as nilepp tsulo,tmiina mtnarioapolc fo inaeorrt paurtti,yi nda dugsr es(e 1.61 - esBrat Ployag.t)oh ynOl ugdr tfcfee is an earswn iehcoc ofr hsit qnist.oeu +9
hungrybox  To upt reothna wya - oebrfe uoy tyr to go uhohtrg rveey snarew eohc,ci ankisg yufrosel lou"dw ihts seauc rthlrceo"aaag? adItse,n ask u,ysrfoel "htaW ear het suaesc fo rrataoac?lhge" nrcoidAgc to .Dr t,taSra eyht rae "lippen itml,oiastnu mapoticnolra of eoitrran tipruytai, dna "sdu.rg +3
hungrybox  The tneqoius ondste' sya atygninh atht udwlo pitno uyo trwdao elpinp uoiitalnm,ts like t"i olny eemss to rpaaep nhew she stpu on a s/lhstaypri ut"rscer/s.ntpso/ It lsao saemk on iomnnte fo aeoibmltpr lssidbnen cwih(h dlouw ipotn uyo to an eaoinrtr iitypatur mr,out) so uoy acn eulr tuo omo.liacntrpa hTe lnyo noopit flte is grud feect.f +2
drdoom  nybu’rsghox lufl cetmnmo oel)(wb :rhee /m/et0an0texn/cpmwnhss/1m9b#ar3.0/bo74sem2:e +1



 +14  upvote downvote
submitted by strugglebus(189)
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As na i:810e 01,dt0 pleepo edrterpo to have side sfefcet nhew tniagk ocnlohddoht .iamoHyArizerg eh,tm 25 eelppo ).2%00( vaeh starBe rdihcsaeg

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neonem  I nihtk the ebst way to rsewan this qnstiueo aws yb orcpsse of iamnn.eloiti +1
sympathetikey  thsaT' msoe lblihsut l l o +9
karljeon  ahHa I inidetlema het ewrnsa yb osrceps fo ai.lnmneioit +25
medschul  I lmniidteae tshzaiedi by espcsor of eiiomtinnal :( +3
medstudent65  htiS I eiltmdaein dtheizsai ucbeeas of lenminaitio ewtn ihwt HTN niihgntk naeriancrlit eedlb gtfineefc het iipyrutat +2



 +3  upvote downvote
submitted by fkstpashls(23)
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sorcseP fo miitennaoli is teh yoln yaw ot get tshi aersnw touthwi avStna lsveel fo ms,atui as esmo ioebtw ngweira duecohr ohw terow eth etsqiuon blrpaybo .sha

eanrcC is uilnraatle motasl lal het itm,e DM 'osnted emka esnse fro yan esor,an NTH ilstfe 'wtonuld acesu ykmli ,bbsoo adn tsam lsecl uigglendatarn 'ndeost aemk miylk soobb trieh.e oS, dan saceueb naym dursg can aehv kylim b,oobs ory'ue eftl htwi rgdu ftecfes yb orscsep of .linatneiimo

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djinn  I tdno itknh teh uarot was a naasv.t loAs I ithnk si right rceocpss to kntih cc"anr"e nca be rialleabt adn aagnlinmt ubt het u"rdg" ttha seuacs ihst inst HCT. hiTs ueoqnits is bad trt.einw +1
hungrybox  ciocgndrA ot a,ohmPat atghcalreroa si TNO taaodssice wiht erccan erve ese( 1.61 - rbtaes .ytolphao)g +
djeffs1  darioccng ot gebtr'uusgssl mnerbsu ist rmoe ekylil ot eb /lb cnacre ntha aie.t.hz.ids +



 +2  upvote downvote
submitted by niboonsh(409)
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" etOrh aseslcs of dmaenotcisi ttah cseau pothireecayramlipn duneicl a,tnpsnieedrtass nntpryieesaheivt nsaetg, and gudrs that nreiasec woleb itoml.iyt etHrnrpcliampaioye uasdce yb macsiidtneo is mynmoclo t,picomasymt ugnscai reorlata,hgac laemnsurt itd,uebanrsc nda eitecomn.p It si otIantprm ot uesnre ahtt eamtrpcyeoahnpilir in na ianuidvIdl petaint si eud to mceaniidot dan ton to a usructrlta snolie ni eth tiihaicptatapumlhyo/ry a;era siht acn be slchaepcmoid by )1( oppntigs the icmidtaeon irtmloaryep ot demnetire retwehh ialctrnop vleesl rternu to oal,nmr )(2 wicgntshi ot a mtdaiocnie taht odse otn cusae mentiiohparclrapye "

.u9v.m5wnin/ewom4/1.gpwndt/h:.8tcbp/l62bsh0i

nd-ted-ed"esoopneNn sedi ffctees — ghthuloA dlo-weso erpayth eesms to imznemii the biocatelm oalmsitpcocin cdedinu by a hiaeztdi or ahiiekzleitd- ti,deiurc it yma not eealriyscsn mieaienlt roteh desi fce.tsfe sA an epmaxe,l sa ynam sa 25 crtneep fo emn readtet hiwt 25 gdmy/a of anoorhtiehdcll opdeelv a ndlceei in axlseu oufnntci [.3]4 peeSl iusdtsenabrc nca sola ocuc,r lpiyrluatcra if hte neaptit is no a umsoodw-il tied 4.[3] wHo sheet orsplemb corcu is ont nwkno."

y5eofm9p-euhe3m:etpn-ywc/-t.iz-tpissinnettsdr/icesei2s5t-oooew/tp0-lpwe2aners.--irsswd9r#uhhtu-ahn0coiHtnatdati/itina8t

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 +2  upvote downvote
submitted by hungrybox(1277)
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Pomaath esivg eth hrete jrmao ceasus fo atagrerahclo sa plepin mlnto,iuiast rnooctapiaml fo narierto p,iiutarty nda rdugs s(ee 16.1 - taerBs hot.yoPgl)a yOln gdur cfetef is an snrewa cocihe for stih tnie.oqus

To utp eotnarh awy - eobfre yuo rty to go rtohuhg vyree rnwesa e,cochi nsigka yufesrlo u"olwd tshi acsue gahcloe"r?aart a,tesIdn ask rlsofeu,y h"Wat aer hte saceus fo e?r"aaclotgrha dgccAroni to D.r Satr,at yhet era inp"ple ,tomsutlaini ntpmaarcoiol of aeointrr ut,ipyitra and g.d"rsu

eTh iutoqsne s'tnoed asy hgnynati that owlud ipnto yuo wtdrao ielpnp toiliasumt,n keil it" nyol emess ot apearp nhwe seh utsp on a ss/rpiahlty /t."/ercnspust†rso So uoy acn leur uot lepipn aon.iumilstt

It alos ekmsa on netoimn of embarpiolt nldinssbe (whcih wdluo intop uyo ot an iertaonr pyatiirut rutm,)o os oyu nac leur tou nlci.arotmaop ehT ylno otopin eflt is rgud eef.ctf


e'Iv verne eesn tgyhainn keli tihs on a nioeqtsu tbu I ssumea eth EBNM woudl wdro it in eoms doelotucvn awy keil .htta


I iilnlatiy wtoer tsih sa a nsm,emoctub tub I eelf ikel it devseers ist won c.meomtn I aws rvene rlleay siafdsite itwh yna fo eth enislaotnaxp for htis lb,moepr and I nifally veairdr ta eon htta askem eth msot esens ot e.m

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hungrybox  O,h nda ,sbsiede lippen simaulinott nad ioralcamntpo ne'rta eenv wnseasr lol +
drdoom  tyems[s irmlea] yuor aoctnuc has nebe darpgu:de RFTAMO NNIAJ +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)


 +2  upvote downvote
submitted by dave_(3)
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eisThdaiz rdeecu RFG -;tg& euedcRd ccraeenal of rinoltcap g&t;- aopplymetiehnacir g&t;- se.chiagrd

Nto reus who crroetc atth s,i tub aesdi rmof eacrcn geinb ,letanurila I uwdol ositecaas hihg ncloptair ihtw sslo of iedaonpm iibdtrn/cnhodiueie cnaeelacr fo ntcaolpri t.lfesi

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 +1  upvote downvote
submitted by sam1(22)
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hazisTied anc sceua teuca ierlisitntta enispt,hri a rmfo of elnra ul.fiera Whouitt hte ralen cxroteein fo roli,cnpat ti cna dlibu up in het uesmr dan serltu ni rat.lgoachrea

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coccidioinmytitties  lexuSa nsiudyotfcn d[isree baeds = libod]i nac be deu to rgdu edsi fftscee tsetniyhis[,vreaep]n rep fsrti ai.d ni:Etdi o Pga10 8e:2 onti5c 5Se1: sPcr,he Py 'sAdst1i ecdoenirn oeitcs:n xvs"iesece smauotn fo arictlpon istdcseaoa hwti i↓oldbi 3]4.2[ Tihs esgo rethgoet hwit our exausl snycdnuoitf htiw .etsai""rtsinevnpyeh Oy nl aliolgc nythsseis I anc ithnk f:o aieiz tdh = ilnporca↑t = blo↓idi + oa.arrlahtecg tI wuold asol akme esesn cinse we ear deganli twhi an txpcdeee ot eb tansu-lepsmpaoo efmeal limk[ cpduntioor dwuol ahve to be ude ot eosngxeuo e]cug uorD.s noti my rulctee onste dan nudof het iwl:gonflo oskb-tbcelrea and hezaiitsd auces xaelsu yo.fuidsIntcn lsoa kile s1sa'm n.xaapeontil rWee' gnhricea ere,h utb ist hte ebts I nca d.o +
g8427  aoyM cnlcii shsow alecr ro odbyol pnlepi edcarsihg sa iesd fcaeft fo iTdhasei.z utB dtoesn tsate milky shie.gcdra +



 +1  upvote downvote
submitted by namira(39)
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lsPoebis nielxapo:nat

fI het tp si kiatgn a eaihditz hwic(h is K dgepitel)n, ti ihgmt ehva oals ebne ngeiv tiwh a K apsirng gdur schu sa .rnipcilseontao

ntplaicoSroeni ahs nrcogdelncoiio fcefset schu sa secgiomatyan dna cgr.taaaherlo

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sugaplum  I nkiht ouy lodcu nylo emka shit snopusiatm if ehty asdi iae"nptt is on drdatsna nht tx" tbu cnesi ethy agve eht nema tcz,h owudl nto be ifra ot sseuam yeth rea aosl akignt ooieip.nlsatcrn I ntew iwht ercposs fo mtiienoinla no hist no.e ev En heedckc ascesc n'dsieecim dgur eeasdrv ftcfee o.tarlico.egrrlaef.pah ont lditse for zhct +2



 +0  upvote downvote
submitted by j44n(141)
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Pslbiose sasuce of rataglercaho cdneilu: Mtinc,eodsia ucsh sa rentcai da,seviste satitnnsdaes,epr panostihisycct dna hihg olbdo resuepsr d.grus iopOid .use erbHla etpslspenum, shuc sa ,nfenle aeins or efrngueek dese

^ ofrm the ymao cn.l..ii.c easpmihs on het NHT rgsdu

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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dei&Tg;aizth= ithya&er=epcag;lcm yoixOtxn (Gq ouedlcp ;&pi-onretgt icrn ;Cg&a+)=t2 peilnp hgeracdis

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arkanaftus  nyitcoxO lwli ont wkro on beasrt ntelriugs on ykilm degrsahic fi teh lgnsad eewr otn rpr"daee"p by ron.lpicat s'tI keil tyignr to eezsueq yepmt bonoall - ithognn oegs o.tu +1



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