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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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rhoeNwe evha I eneb bela ot ifdn hwy teh lleh sthi si a ign.ht

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yotsubato  tIs otn ni A,F ehS,cykt or Phta,aom ro U dwrlo. I ekwn it stanw raencc ubsaeec sti bai.aetlrl dnA asibetDe aemd on enses to .em oS I ujts twrhe dwon Durg feceft and lkwead yaw.a +10
breis  s^^ema^ +
feliperamirez  heT lnyo sblosipe aeoxnlipant I thnki is hatt hes aws endru a K sairnpg dcrit,eiu hscu as scnalnopoertoi (icwhh olduw dael to ga)os.emtyainc +
chandlerbas  oyu had me at its nto ni yekhsct ); +3
j44n  i tuthogh TNH deuidcn ymtpe elasl odluw acsue this eubcaes tyeh otg type II idt.eaubes So fi yuo dene a por rabze enhurt ohller at m.e +

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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joGnla ahd a cetulre ttha tinoednme taht f"I a etatpin hsa raahcegta,rlo eivrwe yerev ugdr 'tyehre knaitg iecns amny srugd suaec hlaroa"ategcr.

hTe olyn thgin of silpsobe lraeecnve ni shti es-tmQ is htta she tsake a amntd,ceioi ertehfero the asernw of "grud "efctfe is hte smto elkyil sernoa for hre grleta.cohara

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hungrybox  I illts tnikh tshi siuotqen is etpyrt SB. tuB vinhga ieutsdd soem om,re I tnihk 'ist slse SB nhta I ygllrnoiia hugt.toh hamPtao igesv het erthe rjamo uassce of laacgrearhot as eilnpp mosiautlt,in tarcpomnloai of oraretni ritapytiu, adn srgud e(se .116 - rBeats holtogy)a.P Oyln dgru fceeft is na nwersa ciehoc ofr tsih ten.siouq +9
hungrybox  oT utp thoenar wya - obefre uyo rty ot og htghoru reeyv nrweas ,echico igsnak yolsferu dl"uow sthi sceau roec"a?htlagra s,aetIdn ksa foesyr,lu t"hWa are eth scaeus fo "othraaagc?erl ccAridngo ot Dr. at,rSta hyet aer elnip"p tusia,mtloni proanmacitol of riaetonr uyrttip,ia dna s"drug. +3
hungrybox  eTh usionqet dns'eot ysa iyngnaht tath uldow npoti oyu rdtawo pepinl amtonitslu,i keil "it noly sseme to ppaare hnew ehs pust no a ah/ssylrtpi sunse/.tso"/rpctr It alos emask no eimotnn fo imbrloaept ssnndlibe c(hihw wuold opnit oyu ot na raointer ytpaituir ruom),t os yuo acn ruel tuo la.rpoocmatin Teh nlyo ntpioo left si gdru teefcf. +2
drdoom  rxghbu’ynos lflu enmcomt o(bw)el er:he e3s9s/re:sn0b#m./m/no/emth/4abpmxe7atc10n20w +1


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 +14  upvote downvote
submitted by strugglebus(189)
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sA na ,e000 8itd11: eleppo rrpodete to have sdie esfectf hewn gtikna rncayh .AgHizooeidmhltodor e,mht 25 oppele ().200% veha easBrt rigedacsh

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neonem  I tkihn eht steb yaw ot aswern tish ietsquon asw by esocrps of oi.itmeailnn +1
sympathetikey  hsT'ta oems usihtbll l l o +9
karljeon  aHah I emnetiadli het asnewr by ocspres fo ieain.ointml +25
medschul  I idemalntie izdsehtai yb sporcse fo oaliitmnein :( +3
medstudent65  tihS I tniedealmi ziiseadth beasceu fo nmiieointal wetn wiht HNT hinnikgt ricenaarltni edlbe feinfgtce het ptiartiyu +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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orsecsP of niotiilmena si the lnyo awy ot get hsit esnwra wouttih vSaant esvlel of ,tsumia as oesm iotebw eigwnar rdeuoch who wetro teh qnuitoes byplbaor sha.

Cercna si launaleirt mtoasl lal teh iemt, MD otns'de akem ssnee ofr nya saone,r NHT esitlf dlu'notw uecas ikmyl oosb,b dan tmas eclls edrngutaalign 'sdneto meak milky bboos e.etrhi S,o nda esuacbe namy drgus can ehav mylik ,oobsb yoe'ur eftl hwti durg sfctefe by csroeps fo .matnnieioil

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djinn  I tndo thikn het aurto swa a ntsv.aa lsoA I tnikh is grith sscporec to htkin cre"a"cn acn be allbtaeir nad aaingnmlt ubt teh "rg"ud thta ssceua sith ints CTH. hisT otqsieun is bda nitwr.et +1
hungrybox  rdiccoAng ot ,tmhoaPa rahlotcgarae is TNO sascitoaed wiht rcneac erve (see 6.11 - beatrs )p.ylgaotoh +
djeffs1  odarcginc to bug'sgturless rmesnbu its more leilyk to eb l/b anrcce anht dth.zisa.e.i +


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 +2  upvote downvote
submitted by niboonsh(409)
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" tOhre sceslas of steimiodcan hatt suace rtoayaremnpiliehpc udneicl rsnspsetde,iaant eerpntsaeivhtiyn an,gets and sgdru thta eacrnies wloeb tmi.olyti miylnritHecpreaopa asecdu yb dnmtcsoiiae si cynmomlo mmotti,pscay sgucina elahocrga,atr lsntemaru dat,iuesrncb and mnitp.oece tI si notaprmtI to snreeu ttha aatpoeilrhcyirenpm in na Iudadliivn ntiepat si eud to diancimoet nad tno to a utucrsarlt lsenio in teh ipiumithharpyy/cottaal a;rea thsi anc eb hopsclcedima yb )1( pgtosnip het emoadiinct traimyleorp ot ieeemdtrn hretehw ontcrlpai lvesle nterur ot lrm,ano (2) wgcinhtis to a tiedomcain thta edso ont csuea atepihpmcriarelony "

v2m/:p.tcb/n.9w4ne61sthiiml0/.p/ugnb8wdo.w5h

ndsdeno-npee-"eoNdt dies etfefsc — tolghhuA olesw-od rhaetyp seems to imnmziie hte milcbotae pioasnocilmct ndedicu yb a zhaiitde ro tk-ihzleiaeid cuiet,rdi it aym tno aeseynrslci nmetealii rothe sdie fcefste. As an ,xlapeme sa mnay sa 25 tecenrp of nem eadertt wtih 25 maygd/ of hdlreontaolhci evpledo a nilecde ni easxul tcnunfoi 4].3[ peSel istnaduebrcs anc osla ucc,or rulyltcaiarp if the aipntte is on a olwdmou-si dtei 4]3[. Hwo shete pbelsmro curoc is otn "n.nkow

woepiit/aei-euiesefo5thin-y:n0m2nctsat-/niehtm./0hitl-nrr3earywsnszipitdocwhwsi-ae-#srp98dce95t2not/ttudspp-oeH-at.st-u

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 +2  upvote downvote
submitted by hungrybox(1277)
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taamoPh iegvs hte eehrt ojrma suasce fo ocearrlhatga sa pnlpie ntliis,utmao iromacolapnt of ntireoar trp,yaitiu nda srgud ees( .116 - raeBst hg.talyPo)o nylO udrg eftfec si an eawrns hcoeic ofr sthi nueitsqo.

oT upt reohtan ywa - feerbo uyo ytr to og tghruoh vyere rsnwae hieco,c iknags rslfeuyo lud"wo sthi eucas ahetrca?"ogrla Inedsa,t ask oeuslfry, t"hWa are hte auescs fo acltoh?ar"grae rdoicAcng ot .rD aSt,rat teyh aer leppin" tsuo,iltnima lmciraotanop fo erntiora aiptriyut, nda "sgurd.

eTh itqunseo ensot'd say nnygihat hatt woldu iptno ouy wtrdoa enlppi tlun,iimatso ikle "ti nlyo esmes to aprepa ewnh ehs pust on a tpi/yrslhsa n/espr/osc."utrts† oS ouy nac rlue uto nippel lianot.usimt

tI also makes no ninoetm of pimarbolet ssledibnn iw(chh duowl point you ot an reoiatnr tyairpiut t,)moru so yuo acn urle tuo ooimtcl.apnar eTh oyln tpnooi elft is dugr f.cefte


e'Iv eenvr esen ginhtnya ikel isht no a eosuintq tbu I smuaes teh EMBN ulwdo wodr ti ni msoe tluvoenodc ywa lkie tath.


I lnliiitay weotr tshi as a tomb,csnmue ubt I feel liek it sreedesv ist won moctnme. I aws renve yrlela tadfseiis thwi any fo teh nasoxtnlapie ofr isht l,obemrp dna I nlyfail viarred at eon htta mskae the smto eness ot e.m

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hungrybox  hO, nad deisbe,s eilppn lnumotiisat dan ilcptanomroa aet'nr eevn wrassen llo +
drdoom  me[tssy mrl]iea ouyr ucconat has eebn dguedap:r FMORAT INNJA +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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zihaTsdei rdeuce FGR g;&t- eReddcu leearncca of pactirlno &tg;- trlpanpoceihaiemy t-;g& sd.ghceria

Nto ersu woh ecrcotr that is, tub ieasd omrf anercc bneig ilel,uaanrt I uwlod aaseiocst high torciapnl ithw slso fo mnadoipe itidb/ehrinincoeud lerncaeca fo ntlroapci elfs.ti

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 +1  upvote downvote
submitted by sam1(22)
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idThazsie nca cusae utcae irittatensli hinitreps, a mrof of ralen ar.iulfe htioWtu het nrale xorcitene of ,citnaporl ti acn iludb pu in teh mresu dan ulters ni aarhrgtce.alo

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coccidioinmytitties  uelaSx suotdfnnicy ed[sire adbse = loid]bi nca be edu to rdgu eids eftcsef e[,]teivapnissyhntre per tsifr .iad E:iindo t 1e :g80P2a niS5:e5oct 1 P yrPech,s Ais's1td endniorec snetcoi: exisse"vce tsouman fo ptnaclori aeiacsosdt thwi ↓bdoiil 342][. Th si sgeo erhotgte htiw ruo lsuxea iycdtnnfsuo wthi e.avi"itnps"ternhyes y Oln loaigcl sinhssyet I acn nkiht of: ztdieaih = i↑tncolarp = oi↓bild + aegracolhtr.a It ulwod loas ekma neses cesin ew rae dignela twhi an txeedpec ot be saoopelpmaunts- eeaflm lk[mi cpoidrntuo owudl hvea ot be ued to eonxguoes ] .euuoDcrgs onit ym ulrecet netos dan odufn the of:inwlogl esbb-oratelck dna ethaiizds uecas exlsau dusyo .cntIinf sola elik a'm1ss to.lapeiannx 'Weer geacirhn e,reh tbu ist the sebt I nac .od +
g8427  yoaM inccil wshos lrcea or odyolb neppli rdehsigca sa dies efcatf of sh.zdiiTae Btu setond tstea lyimk riaes.dcgh +


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 +1  upvote downvote
submitted by namira(39)
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esboslPi naxpo:taenli

If eht tp is ntigka a etidihaz (chhiw is K ,depln)geit ti ghimt veah olsa neeb iegnv itwh a K gaiprsn ugrd such as iaecnro.opnilts

ailroSnepiontc ash ndloocrnieigoc cfesfet husc sa iamoncaeygst dna leagatc.ahrro

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sugaplum  I nkhti ouy clduo nloy maek shit mopsusiant if heyt iads nat"eitp si no tadransd hnt x"t utb escin tehy vage hte maen thcz, wolud ton eb afri to uaesms tehy are aosl ikgtan cresiailn.poton I tewn hwit pcsesor of lotniienmai no ihts ne.o Eve n chkcede csseac cmdeisin'e udrg eraveds ecefft igapfactr.heo.l.reaorl not lstdie fro chzt +2


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 +0  upvote downvote
submitted by j44n(141)
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Plisboes scuase of haltreorcgaa :lnicued n,cioseMatdi hcus sa nieatcr tasdsvie,e npssarsitaent,ed acsopychsiintt nad gihh oobdl rrespeus r.gsdu diiOpo .esu alrHeb splnpet,muse schu sa enn,lef aesin ro enuregefk dees

^ rfmo het oaym ili.cc..n. sspaiemh on eht TNH usgdr

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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=hi&dztaiT;ge &maaycegcie;lpr=th xyOontxi (Gq ploeudc -te;pn&gorti cnri C)2ta=;g&+ nppile haecsgrid

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arkanaftus  xyciontO iwll ton wokr on taresb grltsineu no milyk icgserahd fi teh gldnsa reew nto pdrpea""re yb tp.orlinac It's kile iytnrg ot eqesezu meypt oonball - tohgnin oseg otu. +1


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