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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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Nworhee hvae I been able ot dnif yhw hte lelh isth si a tnihg.

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yotsubato  tIs ton in ,FA ,hktSecy ro atmoPha, or U wdr.lo I kwne it stwan ancerc cbueesa tsi a.tberllai ndA ebaDeits aemd on eessn to em. So I jtsu wethr dwno Drug tfcfee dna adkwel aawy. +10
breis  s^a^me^ +
feliperamirez  hTe onyl splbsoei xtonieapaln I ithnk is htta ehs wsa durne a K srpgian icie,udrt ucsh as oproanilcstone wihhc( would dlae ot ctnem.s)gaiyao +
chandlerbas  oyu ahd me ta sti ton ni secthky ); +3
j44n  i ohugtth TNH idneucd etymp alesl wolud scaue tshi esbceau yhte got eytp II ebedsaiut. So if you dnee a rop aerzb ertunh ehllro 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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onaGlj hda a ertecul ttah nedteiomn that "If a eantpit sha aethacl,ragor eeivrw eervy drug 'hrytee ngitka icens mayn gudsr uaesc tcalraegoa".rh

ehT yoln tnhgi fo pbosesil ervealnce ni hist -mQtes si htat hse seatk a neidctim,oa treofehre hte anwser fo g"dru eff"tce si teh otsm yikell oreans ofr reh aoa.lcgehatrr

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hungrybox  I ltils hnkti thsi qnoueits si teprty .SB tBu haigvn itddsue meso ,more I ihtkn 'sit less BS atnh I rnoglyiial htguo.ht oathmaP egisv het heert aromj escasu of rtaceahrlaog as piplen mslti,uiatno rtlcpaimnooa of artrnieo y,apiitrut adn rsgud ee(s 161. - etBsar hPlago)oyt. ynOl rgdu cfefet si na aswenr ccoeih rfo hist oeu.ntqis +9
hungrybox  To upt traeohn wya - feoreb uyo ryt to og ohthrug yerve ewasrn ecoic,h gasnik yulrfsoe l"dowu tsih aescu eg"atohrc?lara seInta,d kas ol,efysur hta"W aer eth asseuc fo h?rtcragalea"o ocigrcnAd to Dr. rStt,aa heyt are pipln"e losutami,tni nlotaomcraip of roaritne upr,ityati dna rg"uds. +3
hungrybox  eTh ontqsuie n'steod yas gthianny ttha duwlo ioptn uoy dtarwo pelpin uims,alntoti ielk "ti noly esesm ot apepra nweh esh psut no a hsias/rltpy ".rrssttsp/nce/uo tI loas maeks on tmonnei fo imoartpebl bnselidns hihcw( ldouw inopt ouy to na oreritna trpiytaiu to,urm) so oyu acn ulre uot ota.loaipnmcr The nyol ontoip ltef is dgru fetc.fe +2
drdoom  gsbr’unohxy ufll etmonmc )wlb(oe he:er o07xt/9e#aee/n/ms/s.hws0m/a01pm:cn2mtb43erbn +1


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 +14  upvote downvote
submitted by strugglebus(189)
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sA na te,01 10:d8i0 eeoplp eetrpdor to vhea ides ftfcese enhw kigtan zoroharom.chdHtinl oAgidey tmeh, 52 pelepo (.)%002 vhae saBert ihgacsedr

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neonem  I tinkh eht tbse way ot sewanr hsti qisnoetu aws yb esrpsoc fo naimlioite.n +1
sympathetikey  aTsth' esom iultlbsh l lo +9
karljeon  haaH I telnamieid teh nwears by ocsspre fo otiinmiealn. +25
medschul  I diinteelma hdstiezia yb epsrcos fo nneaiiilmot :( +3
medstudent65  Shti I dnaeetiilm zhdsaeiit ebcaeus fo lnamitoeiin ewnt htwi NTH thkningi einlaitancrr eldbe gtfifeecn eht titipruya +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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socsPer fo enioaiitnml si het lnoy ayw to tge ihst swearn ihotutw atvSna lvlese of i,smuta as msoe webito eargwni urcdheo hwo ewotr het iesotqun aybprbol .ahs

acCren is inllteraau msalto lal eth em,ti MD t'dsoen akem ssene orf yna rsno,ea NHT leitfs d'lwtuno ecasu miylk b,osob nad stma lcsel daegrgtauniln n'edtos emak ikyml bboso .hrteei S,o nad cebeasu namy sgdru anc ehav ilykm ,bsobo 'rueyo flte whit rdug esefcft by seporcs of ii.milonetan

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djinn  I otnd ntkhi het oratu wsa a antvsa. olsA I thkin is rgiht essrcpoc to intkh arec"cn" acn eb arialeltb nda laiatnngm utb hte r"dug" htta cuases siht stni TCH. ihsT qnsioetu is abd i.wttner +1
hungrybox  Anocirdgc ot ,Patoahm aaagcrtelhor is NOT sdastcaioe ihtw cenarc eevr e(se 1.16 - easrbt ologpt.)hya +
djeffs1  ancgrodic ot lsuegstb'ugsr usmebrn tsi rmoe leyilk ot eb b/l crcean tahn .ihs.eidt.za +


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 +2  upvote downvote
submitted by niboonsh(409)
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" etOrh csslaes fo sotcemndiai tath acesu lnhcieoapramyeirpt cilneud taeaprs,etinsnsd teanpvnrsyieheit en,tasg dna gdrus ttah seirnaec bowle i.mlttioy meeiHcotaanpylpirr sdceau yb ceionstamdi si mcnyomol map,syotmcit isaugcn lae,gartcohar lmntusrea usaedcib,trn dna eoimtnpe.c tI is ttpnmIrao to neseru atth alnotpyiarphricmee in an ilIindavdu itpante is eud ot comineidat nad ont ot a casulrttru nosile ni the ilt/raptaomyachupthyii eaar; siht nac eb hmadsepolicc by ()1 pniotpgs het mtecdionai iltreyparmo to medetneir ehtwrhe lipcnaotr leselv rerunt to ona,rlm ()2 hiniwgstc to a ieimactodn htta esdo not ceaus cymloipearienarthp "

ul:.g4e./nt9db0p/hvm.8nwh/msbi/w.62i5pcnow1t

-osep-tdNeo"dnnened sied eescfft — hhAguolt ods-owel yrhptea essem to eznmmiii het lmtcabeoi cipsmnlotiaoc nciuedd yb a etzahidi ro -thlekdiaeizi dueiirtc, ti amy otn cnyalsreies elaiinmet eohtr deis fefsetc. sA na pam,leex sa amyn as 52 tcerpne fo nme ardtete iwht 52 /amydg of lnatidoehhlroc eopvdel a indecel in lsxaeu ntofuicn ]43[. eelSp snrcdtuisbae nac asol cc,uro lactualiyrrp if teh ietpant si no a sidolwum-o edit .[43] oHw ehest mseroplb ccrou is ton nownk".

et8sd.t#rlii02ctc--a9w/-ti/etnptpstuepn/-t5sm9irrihesi-ztedc:dennsh-tpw-eisaohimsa-o5hontntnwfep2u-eo3y0iuiy/oH.saawetr

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 +2  upvote downvote
submitted by hungrybox(1277)
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ohaamtP egivs eht rehet aormj asuesc fo corhlagtraae sa lnpepi ltnuis,tmoia aooitprcnmla fo etnorair itiuptayr, dna usrgd se(e 161. - Btaser latohgyPo). nOyl urgd ceftef si an nwaers ceocih ofr ihts euti.nqos

To ptu neahotr ywa - feerbo you tyr ot og ugohhtr vreey saenwr ,hcecoi kagins usfryole odu"wl hsit aseuc gaa?lroe"rchta taId,ens ksa euysf,olr h"tWa rea teh ucsesa fo ehrlarg?acota" condgirAc to r.D aS,trat tyhe aer enppli" mttilau,osin aocalinotmpr fo aiorertn raui,tipty dan "sud.rg

heT ioueqnst tesndo' ays yaihnntg atth dlouw tpnio uyo daowrt ipepln inatm,utosil klie i"t ynol msese to rpapea hnew ehs tpsu no a yarltphsis/ r†s"pr./euotcsts/n oS ouy nac rlue uto lpneip ai.lsuionmtt

It aols meksa on moetnin of lerpoabtmi dlinssneb i(hhcw udlow nitop uoy to na rtoiaern irauyitpt mtor),u os oyu anc uelr tuo lp.tmaanorcoi hTe onyl itoopn etlf is urgd .eftecf


'Iev nreve esne thngniya elik tsih no a soniueqt utb I ssmaeu teh ENMB owlud odwr it ni moes dovoltnecu wya eilk that.


I yaiilntli eowrt ihts as a tumosnbc,em ubt I elef klie it vseedser sit own .otcmmen I saw evern yerall sfdetisia htiw nya fo teh olitxsaenapn orf htis lre,ompb nad I ilnlyaf rderavi ta eon atht smaek eth most seesn to .me

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hungrybox  Oh, nad e,ebsdsi plnipe sttoaiuinlm nad opncaotairlm r'tnea eenv srwasne llo +
drdoom  tse[sym aerli]m oyur toncuca sha nebe u:pdderag MAFORT JINAN +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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ehzTsidai duceer FRG &t;-g cRdedeu naealeccr fo clpironat -t;&g reemchynolpiiapta t-;&g rie.cghasd

toN esru who rctreoc tath is, btu esaid fomr ecncra negib iltarun,lea I wludo tcasesaoi ihgh notplairc twih loss of mnpdeiao unticibri/dhineoed celrnaeca of atlnicpor isl.fet

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 +1  upvote downvote
submitted by sam1(22)
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Tzdahiise cna ceuas teuca iitltneartis rtp,ieishn a rmof of rlean lafeiur. Wtthuoi the eranl cnretoiex fo rc,potnila it can iludb up ni teh rmsue adn ueltsr in a.ocrgehtalar

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coccidioinmytitties  Sauxle sycuodintnf e[edisr debsa = l]idoib cna be deu ot grud sied ffceste tsnseepnea]v,y[hriti rep fstir di.a oi:d tinE P2ega:108 e5c1oniSt:5 ePhr,Ps yc sti'dA1s dionrence icnt:soe "vsisxeeec nuoamst fo ntlirocpa stdceasioa hwit ↓ilbodi [.]342 isT h egso gehttoer ihtw uro saeulx syuntcfinod thiw "yehnva"tsesineptr.i ln Oy llgaoci ssyistneh I can hinkt o:f aiihtdz e = nplr↑octai = obiild↓ + geohara.rlcta It owdlu lsoa amek neses sicne ew era lgenida hitw an exdcepte to eb omltapao-npsseu aemelf kil[m dtunicoopr owuld ahev to eb ude to egsuoxone ucurDg eo]s. noti my leeurtc netso nda odufn eth :onlwlfogi bteb-lrckseao dan tihzsadei eucsa uaselx cyIoin.usndtf laso leki s1ams' nleatx.opnia 'eerW argncieh r,hee but sti teh bset I nac .do +
g8427  yaoM cnicli shswo arlce or dbyloo eilnpp eisgdcrah as ieds tfcafe of iazT.heids uBt detson tsaet imkyl .resigdhac +


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 +1  upvote downvote
submitted by namira(39)
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ilsbPose ixeanlotp:na

If eht pt si kangit a ieadziht (whhic si K nlpi,)gdtee ti gmhit avhe oasl ebne ievng hiwt a K nrsigap rudg chsu sa eoot.ilircaspnn

leiocniantSrpo sah iligocdncooner cfsefte hcus sa aogneymsaict and rrothae.aagcl

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sugaplum  I hnitk you cdoul oynl make stih usnpostaim fi htey sdia ant"ipet si on sadardnt thn tx" utb cesin hety agev hte aenm hctz, oulwd ont eb raif to sausem tyeh are also naiktg ocai.lnnsiterpo I tewn iwht spscreo of aiteiinlnom no tish en.o Enev kedcche sasecc ndsmciiee' drgu sdevrae ffecet fcero.arlegahira.t.olp ont sdelit orf hztc +2


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 +0  upvote downvote
submitted by j44n(141)
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sPsbloie ausces fo laraacethgro elcn:idu tsMaonciide, hcsu as atreinc tesd,vaesi ,prdesesastninat pnctiisacoysht and hgih oldob espuerrs r.sdgu Oipiod .esu bHelar ,slpemsntuep such as nnlefe, nasei ro ekeugefrn sede

^ ormf hte aoym c.n.i.lci. ssiemahp no the NHT gdusr

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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ihi=&edtga;zT aetypcr;aih&e=glmc ixxtOnoy (qG doplecu rttpn-ieo;&g crin &=)Cg+;t2a elinpp ahgidcers

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arkanaftus  yicoxtOn liwl nto rwko no srbtae tlrnseuig no klymi rsgdehiac fi eht naglsd erwe not pdaeper"r" yb r.tanilocp 'stI elki itrnyg to zueeesq tpyme lnaobol - ntoihng gose uo.t +1


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