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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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eNeowrh have I enbe leab ot fndi why eth llhe tsih si a gt.hni

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yotsubato  Its tno in ,AF cytehk,S ro ta,hamPo ro U wrdol. I kewn it sawtn ancecr euascbe tsi e.btaalril ndA iestDbae adme on eesns ot em. oS I tjsu trehw dwno uDgr ffetec dna wdelak ywaa. +10
breis  ^^sm^ae +
feliperamirez  heT nylo sspbeiol ntxinalpoea I kthni is ttah she aws dneru a K sirpang tcd,iriue such sa rcopnetasoonli hwch(i lwudo adel to scamgtn.i)yoae +
chandlerbas  uyo had me ta tis nto ni tkcshye ); +3
j44n  i outhtgh HTN ucednid emypt eslla oduwl useac shit cebeaus ythe tgo epyt II debaeiut.s oS fi uyo eden a pro azber hnuter eolrlh 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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njGoal hda a cteurle taht enndeotim atth "If a iaepttn has gr,rhaalectoa wreiev reevy gudr ee'rhty niktga nices amyn ugdrs ecusa er"hgarocaat.l

eTh onyl nhigt fo spboesli eneclrvae in tihs Qst-em si htta hse skeat a e,idoinmtac frerohete the wnares fo "ugdr te"efcf si hte msot illyke sonaer for rhe .gecraaoahrlt

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hungrybox  I ltlis thkni tsih eqstioun is epyrtt .BS tBu ivnahg udedtsi osme ,mero I htink 'ist slse BS ntah I niagrlyiol hgu.ttoh mhatoPa ivegs the ethre jraom casesu of oceraltagrha sa lpnipe msi,tltounia aipacltonorm fo eairrnto iyitrupa,t and udgsr ese( 6.11 - aBerts oo.Pag)htyl lnyO rugd eteffc is an wneasr ccoieh for hsit ouent.sqi +9
hungrybox  To utp taonerh awy - fboere ouy tyr ot og htuhogr reyve naresw ,cciheo gkinsa rlosfeyu du"wol siht caseu eta?hag"arcrlo ts,nedaI ska ol,efysru tW"ha era eht causes of taler?rhacao"g dgAricocn to r.D rSaa,tt tehy era epinlp" aoilnsimtt,u lratcnapomio fo ortairne tut,riyapi adn "dgrsu. +3
hungrybox  Teh oquenist t'deson yas naytihgn taht duowl ponti uoy dotwra pilpne initousm,lta ielk t"i noyl esmse to rpapea nehw seh psut on a rhilpsyas/t ./tsrsprce/tnu"os tI also ksmae on toinmne of aeliorpbmt edsslibnn chi(hw owuld topni oyu ot an rotrenai tritipauy ut),rom so ouy anc leru uot cltr.naoiapmo heT ynol ntopoi felt si udrg efcfte. +2
drdoom  brnyguxsho’ lufl mtcneom w)bl(eo :eerh 0/21xn7r/tsnc3m.ph/bnt/a4mbme/e0a0wsme#:eo9s +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As na ,0te01 d1i0:8 lpepoe rodetper to aveh sied cstfeef hwen tgnaik Hczen airo.odtodygmhlhiorA eh,tm 25 pelpoe 2()00%. evha aerBts iasrgdehc

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neonem  I hnkit the tseb way to nearws hist soenquit was by spoersc of imi.alntione +1
sympathetikey  h'Ttas omse utblsilh l lo +9
karljeon  Hhaa I ediltienma the sneawr by cpserso of .otmniniaeil +25
medschul  I dmeanlieit tisiadzhe yb spcesro of eioitianlmn :( +3
medstudent65  ihSt I eetimdialn hisdetazi usebeca of niaitloemin twne htiw TNH inkitghn nectlaniiarr bdeel ftegniefc the tyiauript +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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Pssecor fo imaitioennl is hte lnoy yaw to gte hsti wsaenr oiuwtth aaSvnt lsevel of tim,aus sa oems eibotw gawnire hcouder who roetw hte qunestio abryoplb s.ha

ercnaC is erluaialnt omstla lla eht me,ti DM tdes'on akme seesn rof nay oensra, NHT isftel tlnu'dow cesua limky bbsoo, dan tsma lecsl aanltgduegnir den'sot kaem yimkl osbbo .ieetrh ,So adn ecseuba aynm sdrgu cna ahve lkyim obso,b eu'yro tfel ihtw grdu ceseftf by escprso of inotmln.eiia

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djinn  I ndto khtin hte uarot wsa a tav.ans osAl I tinkh is ritgh resocscp ot nikth arecn""c can be biarltael and liaatnnmg btu eth ""rdgu taht ecussa this sitn CT.H hTis seunoiqt si dba i.ntertw +1
hungrybox  codgArinc to ,tPahmao orahlaegtarc is NTO sesacoiadt wthi reancc ever es(e 611. - tserba al.yhoto)gp +
djeffs1  dngaricoc to lusrts'egbsgu ubsnrem tsi eorm iyekll ot be l/b craenc tnah ds.hie..ziat +


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 +2  upvote downvote
submitted by niboonsh(409)
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" reOht scaslse of dmaenotiisc htta secau eaacmhpieyorrtinlp ldncuei sentdtnaraip,sse etreenvaiipstnyh g,nesat and rsudg ttha ricneeas owlbe oy.ttmlii oaatilnepipycrmerH sacdue yb neadmitcsio is noloymmc ,tsmpaoimyct agscinu aaeratlcgoh,r latuernms acb,irsnetdu nad neepicotm. tI is mnprIotat ot unsere ahtt pcoaamnlerpiyerhit ni an invIauddli ateiptn is eud to demtinoaic dna nto ot a sluarrcutt oensli in eht tpriiautlacyypthhiao/m ;raea stih can be epdmaoccshil by ()1 spgoitnp the ciotadnime yeirlaopmrt to rnteemeid htewerh cilrntoap slleev turern ot ,noamlr )2( isgtnicwh to a atociednim tath sdoe ton suace yepeimaoptacrnirhl "

lm/.p5:w.vtpniu/h84o6n1ewthgm2wdsb.ni9/.c/0b

edn-opdNen-"ednsteo dsei cfestfe — gohlhtuA doe-sowl taehrpy emsse ot mizminei hte lbcomaiet conmplaisitco cdudine yb a zehiadti or -tezdikiilhea etcd,irui it aym otn lascisrenye aimtineel treoh dsie este.fcf sA na xeme,alp as nmya as 52 ertncpe of enm drattee tihw 25 dyagm/ of neltldirahocho eodelvp a lneiced ni usaexl unitoncf [4.]3 elepS ebrnusiscadt can losa corc,u taauyrlrlcpi fi eth eatitpn is on a sudwoloi-m itde ]3[4. oHw tshee epsmrolb oucrc si ton o.nk"wn

er9l9iteoeoae:/-tdtap3nii5syoswiwtto/d-5htts22u#aect--chimpi8ii.n.Hrte-w/imnhhznsnnfwneursaespedse-paspoc-uti0t0-t-t/yr

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 +2  upvote downvote
submitted by hungrybox(1277)
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Ptaahom gvsei teh etreh aojrm ssueca of hogeataarrcl as plpein nuito,lmsita cpaoiomrnalt of oiterarn ap,tiiyutr nda gsudr se(e 16.1 - eatrBs g.ayPo)loht lynO rdug tffcee si na wnraes iecoch for this oi.nsetqu

oT tup artheno way - erfbeo uoy rty ot og rtghhuo yvere raewsn ,eichoc giksan ulsofery ud"lwo iths aseuc raagt"o?haelcr dInaest, ask lfe,rousy thW"a era hte ssauce of recohr?tal"aga igcnocdrA ot .Dr arStta, tehy ear n"leppi naoi,uslittm rnoiotcmlaap of ireraont ap,iryitut dan "urds.g

hTe oiqnetus eonts'd ays yngntiah hatt luwod ption oyu twador npelip ittosnula,mi eikl it" olyn essme ot pperaa hwen esh supt no a tlhpris/ays ss/p†s/rctnt.orue" oS oyu anc eulr uot ipenpl ulot.inmstia

It loas masek no ntmonie of bealprmoti dsnbnlsei (hhicw lowud pnito uyo to na intearro tarityupi mtu,r)o so oyu can ulre uot mcor.ionatalp hTe lyon onitpo eltf is rgdu efecf.t


evI' vreen enes nhgntyia leki iths no a utosnqie ubt I amseus het BNEM wuldo rdow ti ni oesm cuvoedntlo ywa eilk aht.t


I lylitiina eortw hits as a ,tosbcuemnm but I eefl keli ti deresesv tis onw o.metcnm I swa vnere elryla isdfstaie hwti any of the napesloanxti rof isth lpoem,br and I fliyaln eirdvra at oen ahtt smeka the smot senes to e.m

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hungrybox  ,hO dan ei,sebds pneilp ntoisumtlai nad olcomtpirana retna' evne swnsrae llo +
drdoom  ssy[etm e]amirl oyru ntucaco sha bnee ddau:ergp FMOATR NINAJ +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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hidTzasei rceedu GFR ;-tg& ddeReuc acacenler fo inclarpot t;&-g itpeynemhiolpacar ;gt-& ac.gdihser

otN ersu who ctrcore thta ,si tbu eadis rfom cenarc ibgen tienl,ruala I wluod tsecisaoa ighh toaircnlp wthi lsso of nempadoi otuibeini/dedihnrc alrenecac of otpilnacr lfites.

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 +1  upvote downvote
submitted by sam1(22)
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eihsizdaT acn easuc atcue ttrlienitais iein,htsrp a rmfo fo laren u.airlfe Woutthi eth rneal erconietx of pl,carnoti ti can dilbu up in het esmur adn rtluse in cag.aeorlarth

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coccidioinmytitties  auxSel fsnitudnocy erei[sd absde = lbio]id anc eb deu ot durg sdie stcfeef npveeei]arthi,styns[ pre irtsf .ida E:oitdin g2e1 Pa80: 5S1n5:eco it ec,srPh Py sAs'1dti nreiecond t:nsocei ei"sxvesce tnsomua fo artnioplc stciaadoes ihwt bilod↓i ]423[. iTs h oges egotrteh with uro ulesax usdnioytcnf hiwt pene.tei"tiyanvrss"h Onl y calolgi hysnetiss I cna ihtnk of: htaedizi = alpotcri↑n = idoil↓b + .athrraagcelo tI wuold olsa kmae neses nesic ew era elndiag ithw an eeepxcdt to eb pnoosuteml-apsa leefma mk[il npoirocutd dlwou evha to eb ued to sxnueoego csoD. euru]g noit my lurteec oesnt adn ndfou hte i:llngoowf ctl-bskoearbe and siieazdth uceas exusal inycodI fsn.tu soal ikel ams'1s ltnpaanoxie. erWe' hcniaerg h,ere utb sit het estb I nca .od +
g8427  aMyo clciin hswso rleca or ylodob plinpe cshidreag as dise actffe fo sizeiT.had tuB nedsot setat yimkl s.dreachgi +


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submitted by namira(39)
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ePissobl apixenao:nlt

fI the pt is itgnak a azidithe i(hhwc si K etgi,ple)nd it mgith eavh asol bene vnige twih a K gsrniap udrg hcus as tnsilapn.coioer

nieciporlonatS hsa nilecnoidcoorg fscefet uhcs as iasygaetmcon adn rcoaath.gealr

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sugaplum  I ihntk oyu udloc ylon eakm tish taousmnspi fi yeht iads na"piett is on drstndaa nht "tx btu iescn hyet evga teh mnae thc,z dolwu ont eb afir ot uamess hety rea asol gakint ntaersoopclnii. I tenw thiw sspceor of aioniiemltn on tsih neo. E evn eckhdce acssce cesdenim'i gdru edvesar cffete fctg.a.earorerhllioap. ton desitl rfo zcht +2


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 +0  upvote downvote
submitted by j44n(141)
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bioslPes causse fo glhtrcaraoae :enliduc ocai,tneMdsi chsu as cnaiert ai,tseevds edisstnept,asanr ccatiisoynstph adn ighh bodol ereusprs dru.gs pidiOo .sue lbaerH es,ltpsmupne cush as ,fnenle ansei ro efnerkgeu eeds

^ ofmr het oyam c.l..ciin. eismphas no teh HTN rdgsu

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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&;=gaheziditT pay&cimecehl;ga=tr noxtiyOx Gq( cduolpe -itp&ogte;rn cnri 2&at)+=;Cg enpilp deisagcrh

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arkanaftus  tixcOnyo wlli ont kowr no stbear eturlings no ilykm cisehdgar fi eth gsnlda ewer tno aepdeprr"" yb cniprao.lt tI's ilek trying to qesuzee peytm oloalnb - ingtonh esog u.ot +1


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