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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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ehwerNo heva I eben able to find yhw eht lhle this is a tnh.ig

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yotsubato  Ist not ni F,A c,Sthkye or Pomta,ah ro U d.wlor I wnek ti antws ernacc ceauesb ist artlal.bie nAd eiaDtsbe deam on ensse to em. So I stuj hrtwe nwod ugrD fefcet dna alekwd wa.ay +10
breis  ^s^ea^m +
feliperamirez  The ylno ssolbepi xaantolinpe I tkihn si htta hse asw reund a K iaspgrn iricu,tde husc sa lnonotcioaspre (hihcw udlwo leda to anytis)gaco.em +
chandlerbas  ouy dha me at ist tno in teyskch ;) +3
j44n  i hhogutt HNT deniucd mytpe sllae wodul easuc this sebeauc tyeh tgo eytp II s.aituedbe So if uyo dnee a opr rzeba rnethu olelrh at 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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Golnja dha a rctelue ttah eointnmde htta fI" a tiaentp ahs lhrga,taaocer wrveie ryvee rgud ereyht' gknati sienc naym surgd ecsua ocl.gtrraa"aeh

ehT olny ntigh fo losbpise areclnvee in tish msQ-et is atth hes satke a cidtnimoae, hrfotreee het nwreas of "ugrd "ceeftf si hte toms lyilek earnos fro her al.arcgaetrho

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hungrybox  I ltsil tihnk this niequtso si terpty SB. But nhvagi idetsud omse ,emro I itnkh ist' ssel SB hant I lingiaoyrl u.hothtg ahtaPom gesvi hte ehret ojram suesca fo eatrlchagrao as elpnpi tmaois,intlu rmntocoaplia of rtnoaier ,arpuytiti and dsurg ese( 611. - ratBse og)oalP.thy nylO grud eeftcf is an ensarw hicoce rof isht tqeiuons. +9
hungrybox  oT put ahetnro yaw - robeef ouy rty ot go hhruogt veery waesrn iceoh,c insgak ersfulyo "udowl shit scuae aertch"galo?ra tde,nsIa ska s,uelyfro t"ahW aer hte causes of tcelor"aa?garh Aocnigdcr to r.D S,trtaa etyh ear ilpepn" itm,luoaistn ocaonptlarmi fo notarier tpit,iryau nda d.grsu" +3
hungrybox  Teh qunoseti sode'nt sya ynitganh thta wdolu potin ouy orawtd nipepl ,mnioliuatst leik ti" nlyo semse to aperpa hnwe hes tsup on a istrpyhls/a tso."tcrpnur/sse/ tI aslo esmak no nemonit of eapblrmoit enbsilnsd hih(wc uldow ntoip you ot an itnaroer ruaiiptyt ,rtomu) so oyu nac elru otu atnpc.lriomoa eTh lony ontiop felt si rugd fecetf. +2
drdoom  sxunghroyb’ lulf metmonc w)eb(ol e:her s7p3./0ebwbx9setn:amm0rh/me1namcos4t2/n/0/#e +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As na 01t8 e:d00i1, eloppe redrtpoe ot vhae dise fscftee wehn tkaign dHAmehrihdt. ogzrnolcaooyi mt,eh 25 eplope %).020( vhae stBrea caegshdir

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neonem  I hiknt het tsbe ywa to anrsew shti stuioeqn was yb corssep fo nia.neitmloi +1
sympathetikey  thas'T meso busltlih ol l +9
karljeon  aHha I lideniteam eht rsaewn by cerosps fo .oletnminiia +25
medschul  I midenietla deaihszit yb oserscp of anlitoemnii (: +3
medstudent65  Stih I miladeetin diezihtas sebucae of iilimtaoenn enwt ithw HTN githnikn ialtnnriarce edlbe cetfnegfi eth rtyptuiia +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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rPscseo fo ltmnniiieao is teh noly wya to get sthi anerws tuwhito Snavta lveesl of st,maiu sa osme iwotbe eagiwnr hourecd hwo trewo teh inotsequ orylpbba hsa.

ercCna si entiuaarll otasml lal eht ,mtei DM dtesn'o amek nsees rof yan neos,ra THN ltfsie dnuol'tw useca lmkyi sboob, nad stma clsel rgennldtuaiga tndse'o eamk lmkiy sobbo ehi.ret ,oS and cbesaeu mnya usgdr can aevh ylkim b,oobs eoruy' left thiw ugrd esetcff yb secpors fo telmnnio.iia

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djinn  I todn knith teh ouatr wsa a a.tnvsa sloA I ntkih si girth scsropce ot kithn "recna"c acn eb tllaebair nad nnglaiatm btu teh "grdu" hatt uassec ihts ntis H.TC ishT enqtuiso is bad .eitwnrt +1
hungrybox  icngocAdr ot otPa,amh ehotraaarclg is ONT escstoiaad whti cnecra vere es(e .611 - eartbs lg.ahoyt)po +
djeffs1  oracdcing to ssurslbgetg'u nersubm tis eorm liekyl to eb lb/ ncerca atnh .ziateh..dsi +


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 +2  upvote downvote
submitted by niboonsh(409)
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" rethO sslseca of nsdtieoimca taht cesau aenirprcyphomtiael nliuced neeapst,irnsatds vtehneisayetrinp ,nesagt nad rsgud hatt cresneai bweol .tliitomy Hiepplatrnroacyime caeusd yb itsomnacdei is moloycmn aopy,csmmitt cugnisa racr,tlgaohea mlnsetuar bnisc,eadrtu and cnmptoiee. It is maIrtpotn to snerue ttah yrprhpaianmctleeio in na aidvnldiuI teapnti is edu ot itnoemicda nda otn to a urucsatltr isoenl in hte ucilaprihtaohmpayt/yti era;a tish nca eb eascomicdphl yb 1)( gpsnopit eth tacmeidnoi elmratyirpo ot iretedenm wthheer arlinoptc evesll rreutn ot mrno,al 2() ihgicstnw to a tcinimeaod ahtt does nto aescu repnayicimrloaepht "

io:edtnphwns.9nm4wi862.umlbthcvw51g//.//bp0.

deseeo"nted-podn-nN esdi etefcfs — lAhgouth -lewdsoo pyhtare semse to imizenmi teh etcbloaim conlsacimpoit uceindd by a theiaidz or iilidhek-teaz iiud,ecrt ti amy nto enrsieyscal mintaleei ohret eisd .sfectfe sA an e,leapxm as mnay as 25 peerctn of emn tredtea wiht 25 ydmga/ fo lnaloihtcdehor plvdeoe a deeclin in xluase tnofncui ]43[. epeSl asrdbuntesic can sola ,cucro aaillrctpuyr fi eth tpniaet is no a do-sowmuli tide .[34] oHw eetsh sbomlerp cruco is tno konwn".

twoe-ictr/iuwtiin92ssirhtne-Hiutnwptha-tt/hsarsc-/-uodeyossmfli.tzon8-n--p#2tema-ar0d5eepin0ncydtph:35eiio9peatw/ese.st

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 +2  upvote downvote
submitted by hungrybox(1277)
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hoatPma eigvs teh tehre jmrao seaucs fo gaehorlcrtaa sa ielppn mitstauo,nli toniclrmoapa of rieanort yapirtiut, dna sugrd e(se 11.6 - esatrB lya)gto.Poh Oyln urdg fefcet si na eawsnr occhie rfo shti tius.qone

oT ptu hetraon ayw - fbeero oyu ytr ot go hogutrh eeyvr arwsen ho,eicc kgsani uerlysfo lwuo"d shit uecsa a?r"rloceagtha adtse,In ask urfys,leo "atWh are het cessau of ?elhc"aragotar ogccnridA ot r.D ttrSaa, tyeh rea eplpn"i lsiutoaintm, oaiptmonalrc of irnrateo u,yartipti nad gdr.us"

The qnoiuest dson'et sya ntanigyh atht wodlu pinot oyu rtdoaw ppinle limoantius,t keil t"i nyol essem ot aarppe wnhe hse sptu no a /ltasirhsyp /ecotussrt/s.rp"†n oS yuo anc leur uto elnipp louiimtsat.n

tI sola eakms on ntnmeio of oraeimtblp lnbisndse whh(ic wodlu potin you to an eoranrit utpyraiit om),tru so you nca uelr otu ptroimaaconl. The loyn itonpo ltfe si ugrd tffce.e


'Iev renve nees yhngatni keli htis no a inoueqst btu I smsuae eth EMNB wluod dowr it in emos londotvecu way ilek t.tah


I itlniylia toerw tshi as a ,oneubsmmtc tub I elef elki ti eseersvd tsi wno .nmetmoc I was neerv lareyl asifisdet whit nay fo eth pslaxnioatne for hsit lmer,pbo dna I alnyfli evidarr ta oen ttah emsak teh tmso ssene to e.m

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hungrybox  ,hO nda ie,ebssd lenpip ilsuonmiatt nda lrptianmooac teran' eenv warssen lol +
drdoom  ems[tys ae]lrim your anocutc ash eneb ddpru:gae MOTRAF 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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saezdTihi cueerd FRG -t;g& eecRdud alrneccea fo anlorcitp ;g&-t emipyhlrnoacptaei &;-tg rh.segiadc

Not uers ohw etrorcc ahtt si, utb daeis fmor ncecra ibgen ,reianautll I lwduo aasosctei ghhi aocplrnit ihwt slos of depnmioa toieundic/hbdineir eanlcearc of cltoirnap ei.lsft

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 +1  upvote downvote
submitted by sam1(22)
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dhTaiesiz can cseua uetca itnistlteira isi,rhtnep a rmof fo alnre uefalr.i Wohtiut eth earnl ecnroxeit fo opalci,trn ti can ulbdi pu ni eth mreus dan tluesr in agoretrc.laah

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coccidioinmytitties  xulaSe fcydniotsun er[sdie bedas = ]bidilo anc eb deu ot udgr sedi sefetfc ,eiv[aenintsysperh]t per sritf ad.i tEi:nid o :e80Pa 2g1 e5S: 5i1ncto PPsh c,rey s'tidsA1 erincdoen e:isntco "sceevxsie nsoumat fo pniatclor aostaecdis whti l↓bidoi ].3[42 T ihs geso rettohge ihtw oru saelux yntuiocnfsd iwht s.eter"vpytn"aiesnih ln Oy gcliola sssihtyen I anc thikn :of hadizite = ↑ctonplira = liodib↓ + etralah.rcago tI dluwo lsoa mkea essne sicne we era iladeng tihw na texedcep to eb nsa-oelputmspao efemla [imlk todcopnriu uwldo evah to be due ot guoexnoes Dsueg]ruco . ntio ym rceetlu ontse nda ndufo hte wlfngolo:i sbkaerbceolt- adn sizdateih acesu elxaus ci.tnfydou sIn laos ielk ms1'as ilxeptaoa.nn 'Wree ranchegi ,ehre btu tis eht estb I nca .do +
g8427  oMya ilnicc shosw cearl ro dlyobo nlippe cidasgreh sa esdi ffacet fo .isaziThed Btu eotdsn attes ikyml hiacgsder. +


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 +1  upvote downvote
submitted by namira(39)
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ielssobP olaant:pnxie

fI the pt si tkinga a zahiited w(cihh si K idlnge,ept) it ithgm vhea aslo nebe vgeni htwi a K aprgsin rgud hsuc sa inotspcn.reoali

nirpocoSlatein sah gcdecilonorion festcef uhsc sa emsoantigcya nad gaarcrtlh.aoe

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sugaplum  I ktihn uoy cudol lnyo kmae hsti atsosinupm fi tehy dsia atnit"pe is no aastnddr thn "xt utb cinse yeth vgae het nema th,cz owldu tno be frai ot ssamue tyeh aer sola giknta insprtnoeliac.o I tenw with esoprcs of ionmteiinal on tsih o.en Enev chcekde csaces in'simdeec dgru areevds feftce rohagrite.r.allaecpof. otn dtseli rof zhtc +2


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 +0  upvote downvote
submitted by j44n(141)
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osieslbP sseacu fo oeaclagrhtra dlecinu: cn,saMdiieto usch sa etarnci tisdev,ase einr,nstastasdpe ahoycnispittsc dna ghih dlboo suprsere u.sdgr diopOi eus. lrbeHa mu,speeslpnt hscu sa ,lneenf asine or rkefeguen sdee

^ fmro het yoma ...nclcii. mpsaeshi on teh TNH sdgru

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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;ziaiehd&=gtT &hei;era=ymtcglcap iontOxxy Gq( epolduc p-;tr&genoit inrc g;+)ta2=&C epplin rehicgdsa

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arkanaftus  cxtOoiny lilw not rkwo no bseatr eunstrgli no mykil hsegdraci fi het dagsln erew not epr"dpea"r yb ctl.ropain sI't ikel rginty to zqeeuse tpyem blolnoa - tgonihn oges t.ou +1


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