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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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herwoeN eahv I been laeb ot fdin hwy eht hlel ihts si a hintg.

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yotsubato  Its otn ni AF, ,tekShcy or otaPh,ma or U dorwl. I wnke it tswan ncaecr uceesba tsi arat.ielbl dnA eaDbiste emda no esesn to m.e So I ujts wethr nwod rDug eetcff dna wdaekl wyaa. +10
breis  asm^^^e +
feliperamirez  ehT lyon lospisbe ailtnaepnxo I think si atth seh aws neudr a K nrpsgia iudcetr,i husc sa tcalrpnosnoioe which( luwod elad ot gcmasnayo)ei.t +
chandlerbas  uoy ahd em ta tsi nto in hyetcks ;) +3
j44n  i thgthuo THN dncdeui teypm lslae wudol uecsa hsti beseauc ethy gto etpy II bes.idutae So if uoy dene a rop zearb utnehr hrello 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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lGonaj dha a uecrtel tath noenmteid atht fI" a tnpaite sha aalgocrth,rea vwiere eeyvr rgud 'tehyer gankit nseic mnya dsrgu uasce .ratalhe"ogacr

heT olyn nhtig of iebplsos aeevncelr in ihst smeQt- si thta esh teask a aedimtnic,o ehtrerefo hte wnares fo "durg tcf"efe is teh msot yleikl sarnoe ofr ehr caraeag.hortl

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hungrybox  I lslit tnikh hist nutqeois si etprty SB. But anvghi tudsdei emso r,ome I hktni it's ssle BS anth I nrigoayill o.tthugh aPthoma sgiev eht heret rojma eassuc fo taeracahrolg sa penpli ttiiamsl,onu pmnctiraloao of eanrrtoi iityuar,pt dan rugds se(e 16.1 - tsearB aoyltP.gho) yOnl rgud fcetef si na wearns iechoc ofr sith qten.iuso +9
hungrybox  To put thenroa ywa - roebfe ouy yrt to go oguhrht yerve wnresa cio,ceh ganksi ylfeorsu u"lwdo sith uasec tca"areol?rhga tInased, aks ylrous,fe atWh" ear the auescs of cet?aagrhrla"o dgicrcAno ot .Dr aaS,rtt htye ear pnep"li niuamtlio,st tnplaooacimr of rianetro tai,utriyp and dus"rg. +3
hungrybox  hTe equsiont d'oents yas iagnhynt hatt ldouw inpto yuo tarwod nplipe touatiimns,l like "it ylon esmes ot aapepr ewnh hes ptsu on a il/rhtpsays ctse"prs.nr/tsu/o It laos kmeas no inmeotn of bproeilmta slsenbind w(ihch owdul tnoip yuo ot na orrntiea tiarytiup ),urtom so ouy nca rleu tou pran.mlaooict ehT lyon pnooit lfet si gdru e.cfetf +2
drdoom  xugnhyor’bs lflu tmmonec o)wbe(l eeh:r 3t0e4bsmm2bexe0n/1mtac/#r0w/en9pa//7smho.:sn +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As an e1d,:00i081 t ppolee prdortee ot vhea edsi ctfseef wehn nagkit h notoag.ymcriddrhoHAezlio m,hte 25 epleop %00.(2) veha Braste eshdgarci

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neonem  I nkiht teh ebst ayw ot newsar sith tnquioes was by ropsces fo tmin.ileonia +1
sympathetikey  a'Tths eosm blilhsut lo l +9
karljeon  aHha I diimtaenle het wresan by oespcsr of l.niemoiinta +25
medschul  I aleenmiitd hsdteiiza by ocresps fo itnnemlaiio (: +3
medstudent65  tSih I telmdnaeii deitaihsz ebucsea fo tnlimioenia ewtn wtih NHT gninithk rrniilaeacnt lbeed fteengifc eth tptuiiyra +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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csPoers fo mietnalinio si hte ylon ayw to get sthi aserwn oituhwt Snvata sveell fo mui,sta sa eoms eiobtw gewrina rduhoce ohw wotre the ntuqeiso aopyblrb .hsa

rcneCa si ruetlinlaa tsoaml lla teh ,meti DM se'ntod ekam seesn rof nay oeasn,r HTN fsltie wudlnt'o ausce ilymk sbboo, dna mtas ellcs nlatiggunaerd toe'snd emak kmyli osbbo ieh.ret S,o nda busceae ynma rgsdu can haev ilykm b,bsoo o'yreu lfet ihwt ugdr cftseef yb rsospce of o.meintiinal

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djinn  I odnt inhtk teh atoru wsa a .aatvsn osAl I khnti si rhtgi espsrcco ot ithnk "race"nc acn be etaliblra nad iaanmnltg btu eth d"rug" ahtt cusaes shti nsit T.HC sTih oesitqun si bad ttweni.r +1
hungrybox  dgccAonri ot Pamo,tah aceaarrhltgo si ONT soedctsaia iwht recnac rvee es(e 611. - artsbe ltyo)ahpg.o +
djeffs1  ngiardcco ot ulg'gsrtebsus numrbes sti oerm ylkile ot eb bl/ ccnaer anth ..ehidtsiza. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" thOer ssacesl fo eiisodcntam thta eusac pihaceiepaorynlrmt ldecinu sttsa,sindepenar etinihreneptavsy at,gsne adn dusgr that ieanescr owebl tmoityil. caayermorpinleHtip scudea by tndaimocise si nocymlom a,momiystpct sucagin l,eraathcogar emsrnuatl bts,arduienc nda epomitce.n It is pItmtoarn ot rensue ttha araehitinyclppmero in na idlInavidu natptie is ude to tinciadmoe nad ton ot a srtlcuruat enlsoi in teh hat/tuiycoppthmlyaairi e;raa stih acn be icchspoedmla yb )(1 nsgppiot teh ieaoncidtm eolrirtamyp ot dnmiteere wretheh ctopnaril lvlese reutrn to rlon,ma )2( wcgisniht to a cmnaoieidt ahtt edos otn esacu elmoeychnipirratap "

bs/pm0vhn.eg1t/h.8m2l.w4wcu/ni9/nbitwp6od:.5

s"eodd-neNnpned-ote dsie teffsce — tulohAhg w-oledso hepraty seesm ot niiimezm eht timecbola oncclsmatiipo cddineu yb a eadiihtz or lhazeki-diiet tid,iecru it mya tno erlyicansse inmlietae herto eisd c.tsfeef As na pee,alxm sa nyam sa 25 tprecne of men ertteda tihw 52 ay/dgm fo airdhtnceolohl eledopv a eiecdnl ni ulasxe ctofinnu ]3.[4 lpeSe dbrteacssnui cna sola crc,ou luaytpriarlc fi teh tanietp is on a wooildm-us etdi [.]34 owH htees brlosmpe rcouc is nto nkw.no"

utie..etnhsf-lp3/-/nt2ien:tatyas5rss-nht-eria95swisdp-/eeta-#dpdy-0Hwennhto0-8wiocumstecauew2te9iimropniso/tt-chiportzi

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 +2  upvote downvote
submitted by hungrybox(1277)
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tahomPa gesiv eth rtehe mjaro cseasu of aolacehgartr sa inpepl oiitalnmt,us tolrmaiocnpa of oeianrrt y,rupatiit and gdurs e(se 1.61 - treBas ).haoolPytg Oynl dgur ffceet is na nrwsae iheocc for tsih o.tnsique

oT tup tahnoer yaw - ebfero uyo try ot go ruhhtog yvere renasw ociche, knsiag lesfyour uwl"od ihts csaue rlo"hag?acraet des,natI ksa fsyel,rou hat"W era teh ecussa of "?acateahorgrl gcAinrdoc to .Dr raStat, etyh era lepipn" tlinmsiuoa,t roalmnptcaoi of etarinro up,iitraty adn ds".rgu

eTh qtnieuos det'nso asy ganhnyit taht louwd optin ouy wodatr peilnp iiltamsontu, leki ti" ylno emess ot parape hewn seh stpu on a /ysptalrsih tsr/s/.n"c†tsurope oS ouy nca rleu out peipln otiains.ltum

It lsao smkea on menoint of preotblami ssnildbne cw(hih loudw pinot you to an ntrireao tuiiatryp ,)turmo so ouy cna rule tou rocpaitmnaol. Teh lony oponit flte is gurd cf.tfee


e'vI evner snee nitgyhna leik stih no a tquensio but I amusse hte BMNE uowdl rdwo ti ni some uodnoectlv wya klei tt.ah


I ialyitiln erwot hist sa a mnecu,tsmbo ubt I eefl klie ti redessve sti now mote.cnm I swa reenv elalry aitssfdie htiw ayn of hte oxeainnpaslt for this br,eolmp dan I niaylfl raervid at noe htat emska eht smto nssee to m.e

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hungrybox  h,O and ibedes,s penpli lamusniitto dna rmiaolcaoptn trean' eenv assrwen oll +
drdoom  mt[yses ei]alrm yuor unaccto ahs eben ud:grdepa MATRFO AJNIN +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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aTsidehzi dceeur RFG &g;-t cRueded crclneaae of rplioactn -;tg& hpneatiaecpolyirm ;tg&- hace.drigs

tNo ruse who oecrcrt htat ,is tub daeis ofmr ceranc bneig rtinal,aleu I uldwo eastsioac gihh pcaoitrnl itwh olss of oaipmnde iicddib/oeinruneht lercaacen fo arlonpcti estl.if

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 +1  upvote downvote
submitted by sam1(22)
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ieaszhTid can sceua tauec airstlttinie hin,iertps a mrof fo arlne fauri.le tohWiut the neral cenerxoti of cao,tprnil it acn idubl pu ni the erusm nda sutelr in glc.atraahreo

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coccidioinmytitties  Salxue dnoutsycfin siee[dr seadb = b]ildoi acn be ued ot urdg eisd ftfeesc ynh[stie]ren,isvpeta pre srift dai. :dtnio iE eP 821ga:0 tin5o1cS:e 5 cr, heyPPs i1dAt'ss encrdnioe onsitec: seieevs"xc sumtoan of croailtnp aadceosist whit l↓obidi 342.][ is hT egos ttgoeehr whti ruo axsuel ufsnyncoidt ithw trsi"nstv"yheneapei. Oynl golilca sshsetiny I nac ktinh o:f hditizea = o↑acrltpin = lidbi↓o + celrat.agharo It ludwo lsao eamk ensse iensc ew ear ilgnaed tiwh an eecdptxe ot be mosost-auneappl mleaef ikm[l onuotdricp oludw ehav ot eb ude to eexgounos gsec]. uoDru onit ym erletcu tsone adn noufd the nfgloowli: tocelsb-rabek dna hiizeatsd uesca ulesax i uytnd.Icofsn osla ekli ma1'ss annaext.opil Wr'ee ehncgair h,ere utb its hte sbte I nac o.d +
g8427  aoMy inccil oshsw caelr ro ybodol peinlp iaserdgch as iesd fatecf of .siedaTzih uBt odnste ttase ykmli a.shcgdrei +


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 +1  upvote downvote
submitted by namira(39)
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Pssloibe ln:apxnoiaet

fI eth tp is ngatik a aetiizdh hhwc(i is K plgtedien,) it hgtmi aevh oals eebn vgein wiht a K ansripg rugd chus sa plno.oaeinircst

lertnoSipanoic hsa ogdoclnriiocne ecsffet hcus sa nmatsicgaoey and raoarclgt.eha

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sugaplum  I nikth uyo ocldu nyol amke tsih unmtpssiao if eyht isda tapeti"n is no rtnaadsd thn "tx tub iescn heyt aevg teh enam ,tchz uwlod not be fria ot asusme teyh ear oals ikgatn lrcineoai.otnsp I ewnt hiwt oerscsp of tilnomniiea on htis .oen Enve kcedech casecs siemendi'c gdur earevds ffceet a.erragrfhcil.l.aopeto ton itesld rof ctzh +2


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 +0  upvote downvote
submitted by j44n(141)
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soiblPes sacesu fo eoatrhlacrga diuecn:l cdnsite,oMia scuh sa taciern ,desetsvai pntsrdsai,easnet phocntatisiscy nda hihg lbood eusserrp ds.gur poidOi u.se rleaHb npsup,esltme schu as enen,fl esina ro geenrkfeu eesd

^ mrof eth aomy i..lc.ci.n ipsmeash no eth HNT rdgus

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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aTitze&d=ihg; =hlre;igt&yaacpecm otinxyxO (Gq clpoude o&er;tp-itgn nirc a;>C)+2= eplpin iharecsdg

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arkanaftus  oOcyinxt lwil nto kowr no sabtre ntgiresul no mkliy arischedg if the nlgdsa rwee not e""rdpepra by crnoiltap. t'Is lkie yrgtin to eseuzqe eptym nalolob - hgtonni oges o.tu +1


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