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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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rowheeN evha I been leba to dinf hyw eht hlel stih is a thign.

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yotsubato  stI nto in AF, tyehk,cS or thoPaa,m ro U owldr. I nekw ti nswta cnecar suabcee tsi ril.tabeal dAn eiDastbe emad no nsese ot em. So I tjsu whert wdon rugD efftec dan adkelw a.way +10
breis  ^^^aesm +
feliperamirez  eTh lnoy isoslpeb nlaxpanoeit I itknh si tath hse saw neurd a K irsgnap iie,curdt csuh sa ocnosipoenlrat hciw(h woudl dale to t)ay.nosiamegc +
chandlerbas  ouy had em ta sit nto ni yhesckt ;) +3
j44n  i hoguhtt NTH deniduc pyetm asell owdlu uaesc hist ueesabc hety otg pyte II iuestd.eab oS fi uoy need a orp zbera htnrue lelohr ta 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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lnaGoj ahd a eulcret ttah otniendme htat I"f a nepatti ahs ,taogrchelraa ewirev yevre rdug ryhe'te gitnka csnie yamn rsgud ecsau lraergah"act.o

eTh lyon ihtng of oesbplis nleecerav in htsi s-metQ si ahtt hes satke a nmcedo,tiia heoerftre hte wnares of dugr" ft"efec si the otsm eyilkl enraso rfo her ra.htogcraela

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hungrybox  I ltsil ithkn htis qusoinet is epyrtt .BS Btu ngivha edtidus meso ,reom I ikthn 'tsi sesl BS nath I lriylgniao uttghh.o oamtaPh seivg het erteh jraom scesua of oarlgtreahca as lnpiep aotismlutn,i mtircopnolaa of eraitron tryut,iipa dan udrgs (see 11.6 - tBreas lyoag.)ohPt nOly dgur fefcte is na asnewr ceohci for hits tsnuoeq.i +9
hungrybox  oT tup eahotnr yaw - oebefr ouy ytr ot og tgrhuho eevry rwaens cihoec, giaskn lurosyef woudl" this usaec "tge?crohalaar da,Iestn sak reufslyo, "htWa era teh suacse of hgra"ote?lrcaa Ainrogccd ot rD. ,rattSa hety era iplen"p msa,nuiitotl lanrotomcapi fo ireroant autip,iytr nda "u.drsg +3
hungrybox  heT neuqsiot tne'ods say tannihgy ttah ldwuo iotnp uoy rdotaw ippenl sot,iimulnta keil i"t nylo sesme ot perpaa nhwe seh ptsu no a y/prshistal trrtusesn/"/.scpo It losa akmes no iomnent of miobelprat niesbsdnl ch(iwh wduol onitp you to an eairnotr iitartpuy u)m,otr so you acn uerl uto .ilcpnaatrmoo heT lyon ntoopi etfl is grdu fefcet. +2
drdoom  ghryxn’sobu flul mncmeto ob)wle( e:hre arsp/me/01n#0mw74e/.9m2:mx3btb/eschaot0nsne/ +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As an , 18t0i1ed:00 epoepl peetrord to have deis efeftcs henw gitnak omaoHercAidryhgdihon zto.l ,ethm 25 poelpe 0.()0%2 haev tsaerB gchseaidr

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neonem  I tkhin eth bset awy to snaerw ihts nqtiseuo saw by csropse fo to.ilieainnm +1
sympathetikey  Tshat' oesm ilhbults ol l +9
karljeon  aaHh I ladimeeitn the awenrs by srpoesc fo l.anentimoii +25
medschul  I tldeeiinma itehzisad by epcosrs fo mnlotieiain (: +3
medstudent65  iSht I ndleamitie zihdseiat ecaeusb of etiilmniaon enwt with NHT htinngki erctilaainnr eblde etgffceni eth yiutrtaip +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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Pesrocs fo oeimlaitnin si eht nloy yaw ot egt this neswar itouhwt naSavt vleesl fo t,amuis sa meso iewbot ianrewg cedrouh owh wtore hte eutinqso bpbalyor as.h

rceaCn si tlaeulanir sotmla lla the etm,i DM nsotde' kmae snsee rfo yna saoner, NHT tsilfe oud'nwtl scaeu kmyli ,obsbo dna astm eclsl iedugtrlganna tds'one emak liymk boosb eeir.ht o,S dna ecuasbe naym usgdr anc hvae mylki bb,oso uyoe'r etlf itwh gdur efctefs by peoscrs of ia.eiinlnotm

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djinn  I ontd itnkh eht oartu was a taasn.v sAlo I iktnh si rhgit orcpsesc ot htkni rc""ncae acn eb atelrlbia and manitalng tbu the ""grdu htat asceus hits tsin H.TC shTi seouqtni si adb .rwtient +1
hungrybox  dngrioccA to ,aoaPthm aharrtgecaol si ONT ascoeatdsi iwht naccre ever ees( 1.61 - etsrba .toaolhpyg) +
djeffs1  cranicgod to lggssueurs'bt mnsreub tsi eomr keliyl to eb b/l cnreca ahnt sziiet..ha.d +


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 +2  upvote downvote
submitted by niboonsh(409)
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" tehOr slcaess of oeidnsmctia htat eacus lyiaaoreiepcmrntph lunecid nnsesd,etiprtaas ervhnnipeaietsyt ngeat,s and rgsdu thta iaerencs ewlbo tit.oylim Herpnpeialirmatoyc udecas by asidmcteino si ylomonmc p,tyomstamci acsnigu aocrarget,alh umlrnseat eiucda,sbtrn nad t.inpecome It si otnrmapIt to srunee that pcaeryiineltmrhpao ni an dnvliuiIda atienpt si ued to oemitadcni nad nto to a usrtraulct nlesoi ni the ytmchayiauilrtopaiht/p arae; hits can eb haecodcmpisl by )(1 otgppisn het oiimdncate pyimoertlar to nedterime teehwrh alporcnit lvesle untrre ot an,rlmo )(2 twnhgisic ot a otiinmceda thta esod not uasce riecteyraohalppmni "

..swgbwt.ei4:/pvpwtd1/c/hbn0mn9l.oiu6582mn/h

ed-dnN"-nsetnepodeo eids efstcfe — htohuglA lo-dweos herpaty ssmee to emmiznii the olmeitacb ccmlnpisooiat cednuid yb a ahtediiz ro hiiktieed-azl edtiiu,cr it mya tno eiycalersns tmnliaeei reoth esdi ffst.ece sA na exlmpae, sa namy as 25 prtncee fo enm eadtret itwh 52 m/gyda of tlechnridlaooh edoeplv a ceindle in easuxl tncfuoin .43[] peelS tnsscrbaidue anc osla roc,uc lctplryriaua fi hte ptnetai is on a oi-wuolsmd diet ]4.3[ oHw eseth olrembsp ccoru si ont "ok.nwn

wu3hyened.iws-hi/tsHzhi-sel-dsi/#.pcutidrihsfacp-peaoar9witsom-tetmopa0n/r5:ne8-nrotcteoiip2-s2net0a5w-tet-n/itnt9suyet

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 +2  upvote downvote
submitted by hungrybox(1277)
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haPomta isgev teh hteer jmora sueasc fo crargataohle as neippl inmaltos,iut mnltapaoirco of anrtiero atpiuyit,r adn dugsr s(ee .161 - rBtsae ly.ha)Pogot yOln dgur efcfet si na rsenwa cehoci fro isth ieuoqt.sn

To tpu henarto awy - efbero yuo ytr to og otghuhr every arnwse ochi,ce gnaski solfuyre "oluwd shit ueasc acr?aralohgt"e Ie,nadst aks yr,fesulo Wta"h are the ssueac fo oaa"rlgrath?ce godincrAc to .rD ,rSaatt htey rea p"ilpne am,otnituisl ptrcnoiamlao of atenriro tyriat,iup adn gdsu"r.

The eostqnui n'tsdeo asy igtyhann atht udolw oipnt yuo rtdawo pnlipe olii,namtsut ekli it" oynl msees ot ppraea hnew she ptsu no a /ysaplhtrsi "prs./rs/stect†onu oS you cna urle uto einlpp til.uoasntmi

It oals kmsea no tmenino fo mieaplotbr idnbeslns w(hhci wdlou nipot oyu to an rraeoint ptriituya )toum,r so uyo cna rule tou r.cmitooanlap The olny tnoipo etfl si ugdr e.fcetf


I've eevnr nese thagniny ekli sthi no a noiestqu btu I ssmeau eht BMNE wodul ordw ti ni soem oeldnovtuc yaw leki atth.


I lilintiay eortw shti sa a t,cnsembmuo utb I lefe ilke ti sedvsere tis nwo ec.otmnm I swa nevre aelylr aetssdifi hwti yan of eth ntixapnlasoe fro tihs lrb,pmeo adn I ynllifa edirvar at oen tath kmaes eht mtos esnse ot .em

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hungrybox  hO, and eisbd,se lipenp inasuolttim and mnopalractio e'tanr nvee anwssre llo +
drdoom  s[smyte mlair]e yruo utcoacn ahs enbe gepudd:ar MOAFRT NJANI +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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eiazidhsT erudec FRG tg-&; uddRcee neacarecl fo patciroln ;&g-t ntmelaapopyhiirec g;-t& cg.esahrid

tNo urse hwo rtcecro atht ,is tub eiasd ofmr eacncr iengb aitlnlaure, I odwul eaiscsota hihg litcprnao ithw ssol of minpoade teiniibdecnhdoi/ru acaeneclr fo tirocnapl ftile.s

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 +1  upvote downvote
submitted by sam1(22)
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szTidhiea nca eacsu eucta eaiilnstirtt ,siihetnpr a omfr of lnear f.laurei huWitot hte arlne xecnretoi of apcor,ntli it nca bliud pu in hte esrmu adn urelts in cregh.oaaltar

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coccidioinmytitties  Sexalu nfosdiycutn edr[ise baesd = blio]di acn be eud ot ugdr deis tfseecf ne,athyinrtis]epsve[ epr sfirt .adi : toEiidn 8g 1P2a:0e ctS 5:ie51no , chesPryP si1As'dt erdencoin st:necoi ies"csxvee nmstoua of ctoilarnp tcosaiadse ithw li↓biod .23[]4 Th is soge etorehtg tiwh uor ulsaxe ynnctfisoud iwth rven."hn"sasipyiteet O lyn ocglial ysshnsite I can hkitn of: ht ideiza = ptrliaocn↑ = ↓ibilod + caotrhle.gara It oduwl laos emak esens isecn we ear ligdnae iwht na epxeedtc ot be tom-psupnlaeaso mlaefe [mkli udoncipotr udwlo vhae to be edu ot xusneogoe or]suD .eucg nito my ctreleu oestn nda unfdo het no:lilgwfo kel-bbtaserco dan hstzdaiei eausc easlxu c.Iy fntunisdo saol lkie s'1sam axnait.opnel We'er gnarceih h,ere but tsi the bets I nca .do +
g8427  yMoa iclcni swohs crale or bdoloy nppiel adhsegrci sa eisd cfeatf of dhiz.Tsiae uBt soedtn eatts ilkym sgrh.ediac +


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 +1  upvote downvote
submitted by namira(39)
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osisbPel :lotpxaanine

If eth pt is itkang a zihaedit iwch(h si K tgpl,e)dnie ti ihmtg eahv losa eben ngvie whit a K nisarpg grdu hcus as eonniptsrlo.ica

trilocenponaSi sah orndlcinoiegco ftfecse uchs sa yseigaoamctn nad cea.orrlahagt

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sugaplum  I ikhtn yuo udclo lony akme siht tnpomssiau fi yhte idsa nta"tiep si on nasatrdd hnt x"t utb sicen ehyt avge hte anme zh,tc dwuol not eb iafr ot museas yhte era laos tngkai alrnopsn.icoeit I netw thiw eporcss fo iieninmotal no iths neo. vneE kdeehcc csseac ind'mceesi drug easredv etffce ralthoo.f.creilerpag.a not distle rfo htcz +2


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 +0  upvote downvote
submitted by j44n(141)
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oilbssPe secuas of lcergroahaat ec:lidnu ae,oMsitncdi hcsu sa nceirat eeisa,vdts apeeartsndtin,ss siaotiynchstpc nad hghi blood spurseer s.grud dOioip ues. rHaleb mtenulpsspe, cshu as n,elefn iasne ro eknurgfee esde

^ rmfo the amyo icl..i.nc. aehmsisp on teh HNT srudg

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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it=z&hTa;iedg reitplmh;&egyca=ca Oxxntoyi (qG ldpeouc entrt;ogi&-p ircn t;)2=C+ag& plpine acegidrhs

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arkanaftus  tynocOix lwli ton rwok no aebtsr eslngruti on iyklm isahcergd if het agndls erew not depa"pr"er by ntiopr.acl t'sI lkie trginy ot queesez eytpm nlaolob - nghnoti gseo t.uo +1


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