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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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eoehrwN evah I bnee ebal ot nfdi hyw eht hlel isht si a g.nhti

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yotsubato  Its otn in ,AF hckSet,y or Paohtma, ro U wrdo.l I wnek ti atwsn necacr eeaubcs its b.lriatlea And teDsbiae amde no sseen to me. oS I jtsu rehtw ownd rgDu fetefc nda keadwl aa.yw +10
breis  ^e^sm^a +
feliperamirez  Teh loyn osspelbi oelaninxatp I inhtk si atth seh swa druen a K ripangs dciti,reu ushc sa eonisrplotnoac (ihhwc udwlo edla to gsoaimc.)yetna +
chandlerbas  you ahd me at sit not ni stykceh ;) +3
j44n  i thutgoh THN cuneddi yeptm laesl uldwo usaec iths aesubce yteh got ptye II .seieutadb oS if uoy nede a por erazb hrneut lreohl 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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lojnaG hda a teucrle tath otmndeien htta fI" a ttpeain ahs ae,clgrhoatar ireevw reeyv dgru erht'ey tikagn secin amyn srugd scuea letgarhao."car

heT oynl nhgti of ibopsels nleevaerc in tsih Qsemt- si htta esh tksea a ieadn,toicm eferhorte eth arnwes fo rgd"u t"fefce is the sotm kleiyl reaosn ofr reh alrhraa.tcoeg

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hungrybox  I llsit ntkhi htsi uenqstio si ettrpy B.S uBt hagnvi disudte esom omr,e I khint ist' lsse SB htan I iiagoylnrl h.httguo otPhaam evigs eth theer jroam suscae of lecgrhaaraot as eippnl aoimistultn, alocaoripnmt of iaronert ri,tyaptui dna sgudr ee(s .161 - traeBs P)ol.htagyo ylOn durg effetc is na seanwr ociech rof thsi .oenutqsi +9
hungrybox  To upt aenrtho wya - bfreoe yuo rty ot go touhrhg rveye wserna eicco,h skiang osurylef "ldwuo hits cuase aer"chagtl?aro s,taeInd sak efosylr,u aWth" aer hte csesua of ghl?acortaae"r Aigocdcrn ot rD. tSraa,t eyth are p"neilp tnm,siialuot caoanpitmrlo fo itorrean rat,iytpui dan srg".ud +3
hungrybox  eTh suiotqne tode'ns sya tinyhnga ttha lwoud iontp you wdrtao ppinel lttosu,iainm ielk ti" yonl esmse ot aaeprp hwen hse tspu on a ilyrts/asph crrst.usots"n/e/p It sloa mseak on tinonme fo tmrpbeloia ndebnilss hh(cwi dluwo ption ouy to na teranoir yrpttiuia )ru,tom so ouy nac reul out irnaoctlopa.m Teh noyl notopi tfle is dgru tff.eec +2
drdoom  xbg’yronhus lflu oemmntc lebwo)( hee:r nesent4.03b/n01oae7:xsrs0pmh2memc/a#wm9b/t// +1


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 +14  upvote downvote
submitted by strugglebus(189)
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sA na ,0d 110i0e:8t elopep edretopr to ehva esid ftfeecs henw itagkn oyrnHoidcetorhg. Ahlomdaiz teh,m 52 elppoe .%0()20 aevh tserBa cieahgdrs

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neonem  I tikhn hte bset yaw ot rswaen tish esoiutqn wsa yb sserpoc of .oinelianmit +1
sympathetikey  st'haT esmo bsihtull llo +9
karljeon  aaHh I lmiaediten hte ersnwa yb essproc of itaenmnloii. +25
medschul  I eidlimnate idsiteazh yb spcoesr of nolimiaietn :( +3
medstudent65  ihSt I inteaidlem asdhztiei ucbseea of eiilnimaont nwte twih NTH nitkihgn ricrlnteniaa eblde fgecinfte hte iptuiyrat +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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cPserso of anmiioilnet is het ylno ywa to teg stih newras wioutht Saavtn eevlsl of uaistm, sa eoms eobiwt iwgaern udreoch who etwor teh uteonqis prbaobly .has

nrecCa si ullrntaaei satmol lla eth mte,i DM 'dosent make essne rof yna ,oaerns NTH lstfie ulntdw'o aceus imkly obbs,o nda asmt llcse gdngranlieuat sdtone' keam kmyil bsobo reht.ie o,S dna beueasc mayn dsrug acn heva ilkym ,bsboo y'euro tfle hwti urgd cfteesf by poessrc of mal.inteioni

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djinn  I ontd knhit the uraot aws a s.atnva Aols I thkin si htgri ccerosps ot ithnk crc"nea" acn be ealtrbali nda anntimlag utb hte dru"g" ttha uaessc tihs tisn H.TC Tsih snuotqei si bda .wintert +1
hungrybox  Anrdcoigc to Pmatoh,a arraloaehcgt is ONT cdstosaeai whti raccen eevr see( 116. - baerst a.thyg)ploo +
djeffs1  gdinocarc ot gusbgsu'slret umrnseb tsi mreo ykilel to be b/l arcecn thna aizhs..ited. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" ehrOt lsscaes of dsceoinmati atth acues pieplytincmrahoear dlecuin eastsinderapn,st rnhttvyeeenpaiis ,getnas dna gusdr that ancierse eowbl timylot.i plnHoereyipracaitm acedus by nimtcoeaids is moncyoml tmicmytoasp, siacugn cahatlrae,rog runtesmla idt,saubcern nda etopn.cime tI si Irnmtotpa to sreneu thta aiiaeetyhrrmlocppn ni na nviIddulai tanitpe si due ot neocmdiait nad ton ot a tultrrscua ensoli ni eth ytohcapituptrlm/hiyiaa a;era tihs cna eb ocipchmsalde by (1) opsintpg teh etcimioadn olermatypir to rtimndeee rhethwe parnotilc slevle rtreun to al,onmr )(2 ntiiwcgsh to a tecnoamdii htat sedo nto esuca rmipcatipleoyanreh "

m//ug0iwt.li/.sbwh.evph:6.wtn5on8np9d4b/m21c

tdee-enNdenonsod-p" sdie ftfeesc — luthgoAh wsodel-o retpyah seems ot iiezmnim eth eblmotaic picaoisnoclmt dedcnui by a taeiidhz ro te-zkaihdilie ,uctiierd it yma ton eyscelrnsia litmeenai rohet sdie ec.ffste As an em,palxe sa amny as 52 rencept fo nem teadrte twih 25 a/dygm of llcnroihahdoet eldpevo a indleec ni eluasx nfociutn 3.[]4 epSel iadenurcbsts cna laos c,ucro rluaiclarypt fi hte ettinap si no a lsdouwi-om etid 34[]. wHo tehse mbelspor ccruo si not .nwko"n

iihz29iee82-ta-etapced9s0dfensi3at-uths-tssH/topt-e5m-itwadirht-is/nis-:w5eyepiw/y-.0u#lntnrconrtenp.rooioaps/ncttemuhw

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 +2  upvote downvote
submitted by hungrybox(1277)
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aPtomha sevig eht hteer rajmo ceassu of aalgtcraehro sa lepipn ottasilmi,un ipramnctaool fo ntioarer atptryui,i dna srdug see( 611. - eatBrs ohly.to)gaP yOnl udgr fecfte si na awesrn ciohce fro hits qiets.uno

To ptu toehanr awy - eefrbo yuo ytr ot go thogruh rvyee ranswe coieh,c sginak sfloryeu "louwd ihts usace ahrgreato"ca?l t,dInsea kas fe,yrsluo h"tWa aer eth cauess fo acaharl"oge?rt ciondcgrA ot .rD tS,aart hety ear le"pnpi stlumiitnao, oortinpmlcaa of erritoan aptyui,tir nda gs".dru

Teh tosnequi d'entos asy iatygnnh tath uodwl ipotn uyo daowrt ppeiln tisi,mntualo iekl i"t yoln sseem ot eaparp hewn she tups on a aips/trhlys †cr./rtsps"en/suot So you cna lure uto leppni s.miutoiltan

It lsoa amkes on meinnto of trpameiobl dbneinsls wichh( olwdu tinop oyu ot na rarotine puitayrti o,trum) so uoy cna eurl tuo moctapnra.ilo Teh olny tonpio etfl si dugr ecet.ff


v'eI erven eens ghtynani kiel htis no a uoeinqts btu I sesuam hte NMBE wlodu word it ni meso dcletnouvo ywa like h.tta


I iiinyatll rtweo tihs sa a ,somtceubnm tbu I fele keli ti drsveese sti own .ncemtom I saw venre llraey datiessif whti nya fo eth eaanloinxtps orf hits mebrplo, dna I iyllfan eavridr ta eno atth esamk hte sotm esnes ot em.

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hungrybox  h,O nad isebs,ed ineplp laoiiutnstm adn riatamcoplon tarne' enve swersan oll +
drdoom  eystsm[ iam]lre yruo utoccan ash eebn aug:edprd RFTOAM NAIJN +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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saTiehidz eucder FGR -;t&g decdueR eaclcrnae of icolrpatn t;g&- rcpeyleinhamtpoia ;&g-t i.hcresagd

Not erus ohw ceorrct hatt i,s ubt desia mrof crcnea ibnge ianlla,teur I luwdo stacaoesi ihgh oilpracnt iwth sols fo neomadip hnbiudder/eciioint eccelaarn fo nictrlapo ls.ietf

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 +1  upvote downvote
submitted by sam1(22)
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dhaeizisT nca esuca eutca tntiistlreai pntehisi,r a orfm of ealnr fau.eril htitouW het nlear cenoeixrt of irontp,acl ti anc liudb pu in eth remsu dan tuersl in agclrtao.erah

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coccidioinmytitties  laeSux nsuiytcdfno siree[d edbas = ]ilbiod anc be edu to grdu dsie sftceef ]eiepesnah,vtr[tsnyi per tsfir dai. tEodi in: 8P12a:ge 0 5:oni1ce5 tS ,cPeyhPrs At1'sdsi inorecedn ncieo:ts esseixcv"e antoums of ntiloprca issoaatecd ithw liid↓ob 432[]. i hsT eosg rttheoeg ihwt ruo luaexs fynctdionus with v.het"saeitniepsrn"y nOy l oclalgi syseshnti I can ntikh o:f ieh tadzi = apnt↑ocilr = bldiio↓ + .choaalreartg It odulw sola maek esens ecins we are dganeli hiwt na dxeecpet to eb alepsunta-osomp mlfaee mlki[ ucrintodpo dlouw aehv ot eb eud to goeusneox u]ouDscg r.e noit my uretelc nstoe nad dufno eth ogwfilonl: ealobektr-cbs adn hzteisdia eusac xlaseu tnudoifs.Iy nc laos lkie sm'1as inaepaol.xtn eW're negicrah erh,e btu sit eht setb I acn .od +
g8427  yoaM iinclc wohss ecarl ro oyoldb leippn irdshaceg as seid taffec of hsid.azeiT Btu ntodse atset imkyl isdh.eagrc +


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 +1  upvote downvote
submitted by namira(39)
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sPoliseb ltpo:nnaeaix

If eth tp is ngtaik a dziiehta ih(wch si K pgdine)etl, ti htmig ahve saol been enivg with a K gpsrain rgud chsu as c.inetproilanso

rpatSniilneoco ash cnglonordoieci esffetc chus sa yaiemoscnatg nad .hoaglratecra

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sugaplum  I nkiht oyu odcul ynlo aekm sith uatompssin if yteh adis eia"ttnp is on nasdtard nth "tx ubt nisec thye gvae eht mane ,zthc dwuol ton be aifr to sueasm teyh rae lsoa inktag elrntcn.isapoio I netw wtih orpcess fo niomtliniea on itsh one. E nve kchceed ascces sncei'demi rdgu rvdasee effcte oepf.lalr.arao.hirgetc ont setlid orf chzt +2


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 +0  upvote downvote
submitted by j44n(141)
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iblePsos aucses fo hraalgoatcre nluie:cd sMeoidt,anic hcus as aricnet aeistsdve, drpsetse,naatnsi intcyatsicsohp nad ghih blodo eprresus gsr.ud Opidio eus. arelbH lemp,npssute csuh sa ,elnnfe neais or urgkefene dese

^ morf eth oyam ..ic.n.cli issaemhp on teh NHT rdgsu

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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dgi&zT;=hiate &ahecglr=piamety;c nitxoxyO (qG lcedpuo nttgroip&;-e cinr )g2=t&+Ca; ppenli irsedchga

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arkanaftus  yxOocint illw otn korw on esabtr gstnuierl on ikyml srihgedca fi eth nsldga rewe otn erapd"pre" yb cil.tranpo s'tI ilek ynrigt ot ezeqeus tmyep looalnb - tognnhi sego .tuo +1


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