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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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eNheowr vhea I eebn labe to dnif wyh the lehl hist si a tgh.ni

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yotsubato  stI nto ni F,A yehctkS, ro omP,taah or U .lword I nekw ti snatw enracc casubee ist il.trlaeab dnA etbDseai mead on eness to e.m So I jstu hrwet odwn urgD efftce dan wlkaed aayw. +10
breis  s^^^ema +
feliperamirez  hTe oyln pslosbei niaetoxnalp I nthki si hatt seh saw dreun a K pirngsa tud,eicri usch sa ncratoeliosonp ih(cwh doulw aled ot nm)yo.aatsgeic +
chandlerbas  ouy dah em at its ton in tcyeskh ;) +3
j44n  i gothuth NHT dducein etmpy selal oludw scuea ihts eeubcsa yhte ogt eypt II .sbieadtue So fi uoy edne a pro azber treuhn hleorl ta 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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Gnljoa dha a uelrect taht eenotdimn ttah If" a pattien hsa aralrhog,tcea eiervw eevyr dgur hytee'r ntiakg sniec nyam rudsg saecu a"g.lahrcteora

eTh onyl ntghi of iboselps raenecevl ni htsi seQt-m is atth she tksae a aionied,mtc etrefroeh eth wsrean fo rgud" e"tfecf si teh smto kielyl rsonae fro ehr hrlotcraagae.

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hungrybox  I lslit nkith htsi oitueqns si tpeytr .BS uBt ianghv teisdud mose mor,e I nhkit i'ts sesl SB tahn I gylniraiol ot.uhght aPmhtao vsgie teh herte jarmo eusacs fo lahagacotrer sa lipenp sotnumatiil, itmanoprocla of netaroir ,ipuyatrit nda rusgd se(e 1.16 - eraBts P.otg)hayol Only grdu fefetc si na anrwes iehcco fro siht i.ueonsqt +9
hungrybox  To put narteho way - eoerbf uyo ytr to og uogrhth yrvee nawrse ccieo,h iagkns eruolysf udl"wo sith aeusc aegrlarct?ho"a nadIet,s ask ofr,elusy hWa"t aer eht ecassu of hr?r"tagaaeclo rAdigcocn ot .rD aatSr,t tyeh rae lp"eipn isoial,tnutm martnlpooiac fo ertronai ai,ttruyip adn rug."ds +3
hungrybox  Teh utonisqe s'endot ays thinangy atth dwulo ptino yuo raodtw ipenlp t,maiilonust liek ti" oyln seems to aparep ewhn hse tpsu on a lsaiystrph/ s"nso/pecu/.strtr tI sola eakms no netoimn of prlmtibaoe lbdsesnin hchi(w dulwo poitn uoy to an eratorin yarttipiu ,rmou)t so uoy nca reul out pnc.amtoliora eTh noyl topino telf is udgr f.cftee +2
drdoom  hg’nxrsobuy fllu tmnoecm ow(el)b re:eh th/4/w:msbm70c9em1s.#tnao//m/pbra00ee2n3xsen +1


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 +14  upvote downvote
submitted by strugglebus(189)
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sA an it, d00e118:0 ppeole otreerdp to aevh desi cseetff wneh ngakti rtoidloyzhH mndocAoierh.ag ,htme 52 pepleo %(0).02 veah areBst csredigha

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neonem  I ithnk het esbt ywa to nresaw sith tqunoies was yb ecrosps of ilnnt.moeaii +1
sympathetikey  st'haT mseo ulhlibts oll +9
karljeon  haHa I latdeineim het rsanwe by crospse of nal.oetmniii +25
medschul  I idemtlneai edszaihti yb sscoerp of ieoiantimnl (: +3
medstudent65  Shti I mnadiileet dsiizthea easebuc fo niieaimntlo went with NTH hiikgtnn cealniiatrrn ldbee ffentegci teh ypitturia +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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cerPsos fo inmaielitno si eht oyln wya to get hits rnswae twuoith tnavSa sellve fo ,ausmti as esom betiwo rnaegiw orhedcu owh orwte het senqouti aypoblbr .sha

anecrC si atlrinluae stalmo lal teh ,itme DM onds'te mkea sesen rof nay oa,snre NHT fetsil 'tdluwon saceu ylmik o,bsbo nda tsam llesc gntdurlneagia 'oestnd kame mlyki obsob ert.ihe S,o and ebuseca naym grusd can vahe kimyl bosb,o oyr'ue tefl wiht grdu ctfesef by scopers of limai.ietonn

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djinn  I ndto nhkit hte toura asw a tvna.as losA I ikhtn si irhtg psscoerc to tinkh a"cecrn" nac be batreiall nda antmiglan ubt het u"d"rg thta ceassu stih itsn T.CH shTi uoitseqn si bda ttwenr.i +1
hungrybox  dnriAcgco to otPhmaa, oraaaelrtghc si TNO adecastsoi whit ecnrca ever (ees 16.1 - btersa loptgy)aho. +
djeffs1  gcianocdr to surt'ggslesbu embnurs tis moer kelyli ot eb b/l eanrcc naht a.isih.ze.td +


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 +2  upvote downvote
submitted by niboonsh(409)
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" eOhtr sslseca fo iacitsmnoed that uasce rimihaayneorltppec ndculie srandsaepis,tent ainepievynhtstre ,snegat nda dursg taht aiscnree eolwb ttimi.loy mpHiaorcyinateprel cseaud by ieamnoscitd is lnooymmc t,mmsioytcpa cinagsu agahr,latoecr rnasutlme snabur,itecd dna .cmpoietne It is tmnIotpar to esunre thta lnharpcroteeymipai ni an nvdidaIuli nitapte is due ot onctemiiad nda ton ot a tasrtcluur oslnie ni hte apoaatitiyi/hurplycmht a;are shit acn eb apdhlcicemso by 1)( gpitnpos teh temoaiidnc tmrpiorayle ot eeintmdre ehtrewh ioltarpcn lelesv nreurt ot ano,mlr (2) ntsciigwh ot a odecnitmia ttha deso not ceaus pimoyiteahcrnpreal "

tgb//.n0d.5/6b4h.mtwcp1uwinlnh:sem2w/9.8ivpo

dsonodpet-deN"-nene sdie sftcfee — guhAltoh osdl-eow yehatpr semse to ziinemmi eht tbiomleac lctioopicsnam cuinded by a zedhatii or -kiizaledhiet dirteuci, it yma ton lesirsncyea niteeilma eotrh ised fsfee.ct As na mleep,ax as mnya sa 52 pneecrt fo emn detarte ihtw 52 ya/dgm of oliardhlctoehn pevolde a ceniedl ni lexsau tconuifn [43]. eeSlp udercbtnissa cna lsoa courc, lparcailurty if teh teitapn si on a ooismuwdl- ited 3.4[] woH teehs srolmpeb orcuc si otn "n.ownk

awer-a-c3pa:tit-scn0m9ip/hn-2hoeiorohcwae/dstiuzens-mtu5.-oaeetsei8syttft5#tnepdnp0lwodti9i/pyts-2n.irwrn/iies--heHtuts

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 +2  upvote downvote
submitted by hungrybox(1277)
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hatPamo ivges hte rteeh moarj ueascs fo rortehgaacal sa peplni toln,mtusiia opilacntrmao fo ornairte rpuya,titi dna dsgur s(ee .161 - esBtar oyhP)g.loat lnyO rugd fcfeet si na wrnsae eiocch orf shit .tsuiqnoe

oT upt hnreota ywa - fbroee oyu tyr to og hgrouth yerve arswen ,chcieo nkgsai yofeslur owuld" hsit useac ga"craeol?ahtr teaIsnd, ska eo,fsuryl ht"Wa rae hte suecas fo eraaghc?toal"r rnocdigcA to rD. aSrat,t tyeh ear n"eplpi isamnoutit,l iaocnotramlp fo niroatre iar,ittyup dna udrg"s.

ehT enuqotis 'teosdn ays htygiann ttah odlwu onipt you toarwd epplin i,iatlumotsn leki t"i ylno sseme to rapape nwhe hse pust on a lh/ytrssapi rtpsct/u"†sensr/o. oS uyo anc urle uot npielp s.lntiumiota

It aslo mkase on omeintn of eproalmibt bislnnesd i(chhw wduol ptoni you ot na eatrnoir tyuitripa )ourt,m so uyo anc lure tuo man.pooalrtic heT nyol nioopt etfl si drug fc.teef


'eIv ervne ense nnyigaht iekl thsi no a oiseuntq ubt I ssauem teh NBEM ulowd orwd it in omes ndetoclvou ayw klie at.th


I ilynlaiti etrow hist sa a mseu,obnmtc utb I fele kile ti rveseesd ist own .otmncme I asw rvene ylrale desaistfi tihw nay fo hte oanptelnsxai for tihs m,pblroe nda I allfyin vridaer ta neo atth smkea the sotm nsees to m.e

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hungrybox  ,hO nda ees,ibsd lnppie sinilaomttu dan lrcpaiatoonm n'tare eevn essarwn llo +
drdoom  ystse[m ale]rmi uyro aunoctc ahs nebe p:ddaureg FOMRAT AJINN +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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aeizsThid recdue RFG t;&-g dceeRud ernclcaae of tlripacon &;t-g ioicmarypepnelath -g;&t drsicegha.

Nto suer hwo rtccero tath s,i ubt ideas mofr caernc eginb t,rilaunale I dulow tcseaiaos hgih lcitnorpa whit sols fo doeipman rhdnd/ciiuenebitoi earcanlce fo pircntalo .esflti

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 +1  upvote downvote
submitted by sam1(22)
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zeTiiadsh nca seauc aceut ilnireiasttt eisihnpt,r a form fo ranle faluei.r Wtohitu eht elanr trexnicoe fo taco,rnpil it anc udibl pu ni eth uesmr dan ulrset ni hrraagtceola.

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coccidioinmytitties  xSeaul dftnicynuos iedre[s sbaed = bliodi] acn be edu ot gdur idse sfetcef tvserenyain[,ipet]sh epr frsti i.da dniEo t:i g1 a:082eP ec551tS ion: rhy,PcPs e tAsd1'si noneeicrd sietcno: esexsivce" tunsamo of acinotlrp oticsseada hitw l↓boidi ][432. Thsi seog hgoetter twhi uor axelus fndtcsoiynu ihtw .eaies"pvrnhsieyt"tn ylOn aliolgc thsnyssie I nca nhitk f:o tazid ehi = cio↑rplnat = oii↓dbl + ero.laarcthag tI uowld osla keam esens siecn we era gdeilan hitw an exteepcd ot be atupme-sonsolap emfale limk[ idupcrntoo dwolu avhe to be edu ot onogesexu g]er.Duocus nito my cteulre setno dna udfon eht ioo:wglfnl -krobcsetblea nad ahzditsei cesua alusex cIi.snydnt fou alos leki sma's1 laxeoi.nntpa eWre' cnhigaer ,here utb tis eht sebt I acn o.d +
g8427  oaMy cciiln whsos laecr ro oldyob epplni ghricsead as iesd cfeatf of hizeidsa.T Btu sdntoe tesat ykmli hscadgre.i +


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 +1  upvote downvote
submitted by namira(39)
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sioslPeb pxnloeaa:itn

fI eth pt is aikgtn a iheitzad (wihch is K lnpd)ge,eit ti tighm evha slao been vegni ithw a K nirpgas rudg ushc as ri.spanceolniot

npneSrlctiioao ash lnoiccoiorndge ctffese csuh as neiaocymsatg and haleaao.crrgt

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sugaplum  I hktin you ulcod nylo kmea htis psmoutasin fi hyte aids eapttni" si no tasnddra nht "xt utb scien htey eagv hte amne zc,th dluwo tno eb rfia ot ssuame tehy ear salo tkanig en.incoltsiaorp I wnte with rpscoes of teiaoinimnl no isth e.on Env e eedkcch ccssea idiseme'cn rgud eerasvd eefftc pcl.aireog.tea.rolfarh otn esdtli rof czht +2


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 +0  upvote downvote
submitted by j44n(141)
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solibesP cuessa of teaalhragroc uidel:cn ,aeMciosntid csuh sa intarce aievtd,ess isnape,erdtssant shnisatoccptyi and ghhi dolbo esrrsepu g.durs poiOid .use lbrHea n,eetsplpmsu hcsu as fnelen, naesi ro reugnfeke eesd

^ romf teh maoy i..i.ccl.n mpsaeshi no het HNT grdsu

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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=i;tg&azhTedi ah;m&pciegy=lceatr txnoiOxy (Gq pceduol iepr-;tgot&n irnc 2;Cg&ta+)= pipenl ihacergsd

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arkanaftus  ocxiOnty illw not krwo on ebsrat erniuslgt on limky regasdcih if teh snadgl rewe otn erdpp"ra"e yb ntlproc.ai I'ts elki ginyrt to qzeeuse mpyet obalnol - otnnigh ogse ou.t +1


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