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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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weorhNe vaeh I neeb lbea ot ndif why eht elhl htis is a nhti.g

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yotsubato  tsI ont ni ,AF hctk,eSy or ,aPtmaoh or U rlw.do I enkw ti sntaw neracc saebeuc tis trbliale.a And seDaetib dmea on neses ot .em oS I ujst therw down gurD cfetef nda ldweak ywaa. +10
breis  s^ae^m^ +
feliperamirez  The nlyo oplbseis tnpoxaeanil I hnitk si ttha hes asw nurde a K aigpsrn uditc,rie suhc sa ancnilosoopetr hhcwi( dlwuo dlea ot y.ma)catengois +
chandlerbas  yuo hda em ta ist otn in hctseyk ); +3
j44n  i thugtho HTN dcueidn mytep seall udlwo ecaus ihst ebecasu yeht tgo eypt II au.seeditb So fi you edne a rpo reabz netruh leorlh at me. +

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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oGnjla had a lcterue atht oetnniemd atth fI" a ptaietn ahs aclare,orahgt ewievr veery dgru ehr'tye tgkian since amny usrgd esauc ata"eoc.arlgrh

heT olny ginht of iopblsse evanelecr in isht ms-teQ si atth she tseak a mitndcoae,i oeerrheft eth rewsna of udrg" te"ffce si eht smot iklely sonrea rof ehr l.roaatercgha

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hungrybox  I tslil iktnh thsi qenousti si ttpeyr SB. uBt ghnvia tdesudi mose roe,m I hitnk sti' elss BS nhat I yiillnroga thhot.ug atoahPm evigs eth hteer mojar cusaes of hareracatlgo sa pplein tstunimiaol, nramctpoloia fo rienarot ip,rtiuaty dan sdgru (ese 161. - sertBa .P)lathoogy nyOl gdru ctffee is na neswar ecicho ofr sthi oieunts.q +9
hungrybox  oT utp oenrtah yaw - eoefbr uyo ryt ot og urohght ryvee erswna coi,che niskag uorefsly "uwlod isth aceus ?orathecagral" eadsn,tI ask syrleo,fu hat"W are eth csesau fo tcagl?hrera"oa cginAorcd ot rD. Sr,ttaa hety ear enp"ipl tlni,mutaiso tcioormanpla of itaornre tr,iiuypat nad g.d"sru +3
hungrybox  The siuqetno e'sntod say ynainght atht wodlu onipt ouy tradow pnielp tmaous,ntili ekli "ti nloy emess to rpepaa enhw seh tups on a stiapyhrsl/ /r"sp.ns/rtstcoue tI alos asmek no tminoen of mrpebaloti sblidenns (chiwh ldwuo notip oyu to an raeoitnr traitupyi tmuo,)r os yuo cna ruel out caonlrit.mopa eTh olyn noiotp eltf si drgu eftcf.e +2
drdoom  uxbrgsh’yon full tmcneom eolb()w rh:ee 0srexn7s/semtmme/#/n402pt1hwaa/3o.be/:0bnm9c +1


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 +14  upvote downvote
submitted by ∗strugglebus(189)
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As an 0:,it0e0 d118 eoppel teprdoer to vhae side ftfcees wenh naiktg imrcoo.nilHdAgryodzoht eah te,mh 25 eolppe (.%20)0 ahev rstaBe dhsgraeci

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neonem  I nhikt eth bets awy ot narswe stih uqtesoin asw yb pesrcso of eimnnolii.at +1
sympathetikey  asth'T omes lsubtlhi ol l +9
karljeon  Haah I ltianmdiee teh raensw yb rpcosse of .mnaitleioin +25
medschul  I aeielmnidt hitadszie yb coessrp of oinlteimain (: +3
medstudent65  tiSh I maeiliednt sdthzaiie euacbes fo tmnloiiaine went ithw THN kingnith iieacanrrtnl beled egecfnift het irptutyia +2


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 +3  upvote downvote
submitted by ∗fkstpashls(23)
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csProes fo lmioiaennti is het nylo wya to etg sthi aeswnr hwuoitt navSat ellvse of m,tsaiu sa moes bwoite inearwg eodcrhu how rowte eth oitenqus yarbpolb ash.

nreacC si liluaaenrt sotlma all eth eimt, MD o'tsned kmae eessn rof any ,oneras HNT efsitl utwl'don ucesa kymli s,bboo dan smat clels airgdlneagunt so'tnde meak yilkm bsobo ri.htee ,So nad auecsbe mayn sgurd anc ehva mkiyl ,boosb 'ueroy tfel hiwt durg ceeftsf by oscresp of aniltmoiine.

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djinn  I dnto itkhn eht ratou aws a vtsa.an soAl I nitkh si ihgrt rcscsope ot kniht cnrac""e anc eb lbialreta dan tgaimnaln utb teh urgd"" ttha ascuse tshi snit .THC Thsi eustqoin si adb .wentrit +1
hungrybox  rcdAignoc to ,maPaoht ceartgolaahr is TON tsedcoaisa tihw encacr vere (ees 11.6 - bsreat gh.o)opaylt +
djeffs1  cndrciaog to slugesrb'usgt nbruems sit reom lykeil ot eb l/b rncaec nhat .zsa.thid.ei +


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 +2  upvote downvote
submitted by ∗niboonsh(409)
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" hreOt scselsa of intaoisdcme atht cause ptecnmroapilairhey delcinu tndsirt,eaanspse ttvaisiyeprneenh t,ngaes dna sgrdu ttah sencerai ebwol lyiimt.to aoipcirHrmepntalye caueds yb icnmotsidea is onyocmml imatptos,ymc sgcuina roaaagtlehcr, munlsreta sdatbnuei,cr nad meo.npitec tI si tIntpoarm to seuern htat iamernrcehltaypoip in an aIldudivni epnitta si edu to icnmdietao dan nto ot a uurlscrtat esolni in teh /iltuhhtiatmrpapayioyc r;aea sthi acn eb smeiolcdhcpa yb (1) ipongspt het naetmoidci atomryrpile to ertdenmie ehetrwh tlropcnia lvlsee utrnre to r,nomal (2) tchingiws ot a niiodceatm ahtt deos not saeuc acanrtepiylpeihmro "

0/e/nd/mibpiv15.p6lbwnmgc.8us.w/49w2:.hontth

opdeddNo-t"eenn-ens sdie ftfseec — Algohuth sood-lew tyaherp sesem to mmiieinz the imblaeotc oloiinmapcstc dnidceu yb a dhazteii or itladz-ekhiei tiier,cud ti mya nto ilrscnseeya mtelneiai hetro ised .sctfefe sA na mepae,xl as yanm sa 52 recntpe fo men eteartd thiw 25 mgda/y of dahllhocrenoit evldope a denliec in usealx nofciunt .[43] lSpee uesinatbscrd nca lsoa orc,uc talcualiyrrp if het eintatp is no a oilmds-uow dtie ].43[ woH hsete eolbrspm ccuor si not n.wk"no

dniiretsti#/etw5ar0yci-ohm-cHwdwain2e-enae--iseetrousu5e/oydtn0thwif8att3h/i./-nieupo-stnznpott99prsppl-mse-aittcs.sh:2

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 +2  upvote downvote
submitted by ∗hungrybox(1277)
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aaoPhtm isveg the eerth oarjm sscuea fo hrogclatarae sa pnipel ,nsiulimatto oipmrcatnoal of aonetrir ttypui,rai dna srudg es(e .611 - reBsta oa).Plhyotg lnyO gurd tcfeef is na rawesn icchoe ofr isth .utoiqnes

oT tpu rntaeho wya - ebefor you tyr ot go oturhgh ervey eraswn cochie, ksiang lerysuof ldou"w htis cusae "ca?aatolhegrr et,Idnsa ask s,elofyru hatW" era eth seaucs of ch?gltraaor"ea rodAncgic ot .rD arttaS, hyte ear ipnepl" nitostum,ial orocplaamtni of ireonrta ta,yirptiu and du"gr.s

ehT otiusneq ste'odn ays anyhignt hatt dlwuo ntpio ouy rtdowa pepiln ,uiionamlstt elki it" nyol smees ot rpapae wehn hes ptsu no a syph/tslria /.tt/rscur†"ssonep So uyo anc rule tou nplepi lausiit.tmno

It also kemsa no otinmen fo bmperiltao dinlnbses icw(hh wdlou ipont ouy to na nareirto tiriutpya otumr), os you can leru uot aal.oromtcnpi ehT only ionopt telf si urgd ect.eff

†'evI nrvee enes haygnnit klei shit no a ntesquio tbu I mauess het BMNE wlduo wodr ti ni oesm ocvdnoeult way ikel tah.t

I iainliylt toerw thsi sa a nsotc,mbmue utb I efel ekli it sedeevsr tsi won .mceonmt I asw rnvee ralley idsasetfi tihw nya fo hte exipostannla ofr hsti po,mbelr nda I ynlflia dreivra ta neo ahtt kasme het tmos eenss to e.m

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hungrybox  h,O and bd,eseis ipplen tnuloistmia adn rlmopaonaict e'rant evne neasrws lol +
drdoom  esys[mt ei]mlar uryo tnacuco ahs eben rgd:deuap MTOFAR JINNA +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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haTiidzes dcueer RFG ;t&g- cduedeR elceacarn fo nicprtoal g;-t& aeiynptcroiplhmae &g;-t idcrgse.ha

oNt user how eorcctr htat si, tub saide ofrm ncraec bgnie tlur,lnieaa I oduwl tascisoae ghih pcloirnat tiwh olss of maodinep orndiib/ueihcidnte lacarncee of rnplioatc f.etlis

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 +1  upvote downvote
submitted by ∗sam1(22)
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zasThieid nca ceaus ucaet siietitlrnat hit,renisp a rmof fo elanr rlaei.fu htutioW the nrael cxtieoenr fo rpltcaoin, it can dbuil up in eht rsmue and lsutre in rhoraa.gatecl

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coccidioinmytitties  elSaux sunfycitndo [eerdis ebdas = lobdii] nca be due to dugr ieds fecesft ptte,e]eisa[nnsvryhi erp rsift a.di i:ndot Ei eaP 1820:g 5n itSe1co5: Pr,chesyP 1sstAi'd ncironeed csnote:i svxseieec" otumsna of arpctilon oeasaiscdt ihtw ilbdo↓i 3[42.] hTi s sego tthrgeeo tiwh our esxalu itfynosnucd htiw t"hyeirpitne"es.nvas O ynl gacillo yniehssts I can inhtk f:o ztae diih = cp↑atrilon = ilbdi↓o + r.telraohcaag It dulwo lsoa mkea seens icnse we rea iaelngd thwi an ectpedxe to eb ap-ltopnaoemssu aefeml mikl[ rinooducpt ulwdo evha ot be deu ot ooneeugxs csougu.]re D tnoi ym ruceelt osetn and dofnu teh ollf:iwnog a-crkebblesto dna aztdiehsi euacs xlaeus s.otydnIucf ni osla klei sm'as1 itaplxnn.oea e'reW hcriagen ,eerh tub sit eht etbs I nac od. +
g8427  oMay icicln sowsh ecarl or lbooyd pnilep gdraesich as ised fcatef of sidiT.ehza uBt soentd tsaet ykilm hridscaeg. +


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 +1  upvote downvote
submitted by ∗namira(39)
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slePsibo aialoxnep:nt

fI eth pt is iagntk a aziheidt hc(wih si K e)l,dtepnig ti ithgm ehva osla nebe givne thwi a K aisnrpg drgu ushc sa itlaprcsneoon.i

cioprniolenSat ash onciigocleondr tfcsfee uchs sa sytioagcemna nad acgletrrahao.

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sugaplum  I kthni ouy ucodl ylon meka ihst sismnuaotp if ehty idsa t"eptnai is no raaddtns thn "tx utb csein htey eavg eth eamn ,cthz wloud ont eb ifar ot usasme eyth are sloa kntgai oone.nscrtilipa I etnw htwi scoesrp fo ntiinoelami no hist one. eE nv ckhdcee esscca mci'eidnse dugr sdvaere fcfeet eif..lra.lreoaarctohpg tno detlsi rof thcz +2


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 +0  upvote downvote
submitted by ∗j44n(141)
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sbilsoeP eusacs fo eogaclhtarar lcd:uine Monic,aidets chsu sa neciatr ves,distea eastassnpider,tn pssthaiiccoynt dna hhgi odlob ruessrep su.rdg Odiopi use. lrbeaH ms,eeplnptsu schu as n,efeln eansi ro ueegrfnek edse

^ rmof het moya .lc.cin.i. imsapehs no the NTH durgs

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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a=gii;dzehtT& gctpmc&y=hi;leeaar yixnxoOt Gq( educlop op;gr-ei&ntt ncri a;=)&gC+t2 neplpi adsierhgc

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arkanaftus  txyoOinc llwi ton wrko on atsreb nlurgites on klmyi deihgscra fi teh anlsgd rwee ont de"rpr"pea by n.rpaticol st'I leik tniyrg to zqeeuse mtyep lloanob - gnihton osge to.u +1


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