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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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Nheoerw haev I nbee bael to difn hyw the lleh htis si a n.higt

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yotsubato  Ist nto ni A,F ethck,Sy or h,maoPat or U owdl.r I nkwe it watsn anecrc uceesab its bellitraa. Adn Dbiesaet dame no ssnee ot me. oS I ujst erhwt owdn uDrg fctfee adn kdaelw aayw. +10
breis  em^s^^a +
feliperamirez  ehT nylo bslipoes pxtoannelai I think si ahtt hes swa rnedu a K aspginr ,riieudtc csuh sa roscennopialto icw(hh oluwd laed ot ycogsaimtae.)n +
chandlerbas  uyo had em ta sti ton ni kchtyse ); +3
j44n  i utohthg HTN eicdund eytpm elsal wdolu cesau itsh aubesec heyt gto eypt II .tiaesedub So if yuo edne a rop zaerb nrehtu ohlrel ta 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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Galnoj ahd a erueclt tath nteidmoen htta I"f a aetinpt has acrhatlaero,g evewri ervye ugdr 'eetyrh tngkai nisce mnay gruds saecu oraah.regclt"a

heT lyno tginh fo ieospsbl veerelnca in sthi mt-eQs si hatt hse steka a dcimetaion, oefeherrt the rawesn fo rd"gu f"tecef is the otms kyille rnoase orf her ohlarrtgeaa.c

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hungrybox  I tisll nthki this tqoieuns is ptyter .SB But ganhvi sedtiud oesm ore,m I hktni 'sit lsse SB anht I yrgliianol uog.thth haamPto iegvs hte ereth moarj eucass fo raalctgreoha sa lniepp antuli,mstio aploraimtonc of aoernirt tayrip,uti nad usdrg ees( 11.6 - atrsBe lh)oytoPg.a ylOn udrg fetcfe si na eswanr ciecoh rfo stih tenqouis. +9
hungrybox  oT ptu erahont ayw - rbefeo yuo rty to go tuhrohg ervey rwsean h,occei saikgn feorsylu odwl"u sthi ceasu a?hrclao"arteg Iet,dasn ask ylsrueof, "atWh rae the essuac of etgc"aol?harra Agocicndr ot Dr. t,raSta ythe era i"nppel tluntmaii,so rtncalmpooia of ointrrea rtiytpu,ia dna "sdr.gu +3
hungrybox  hTe eusoqtni eosdt'n ays nitanhyg atth dwoul tnpoi ouy rdawto pnipel liitstm,uaon ilke t"i nyol smees to pparae wehn hse stpu no a ph/ryltasis rns/u"tt.esp/osrc tI oasl saemk no otnnmie of pbtiaomelr snbldeins hwhi(c olwud potin ouy to an ernoatir yituprtai )urom,t so uoy nac elur uot n.rmacipatolo The noyl tpoino telf si grdu ffeetc. +2
drdoom  uohysg’bxrn fllu ctmemno bw)lo(e rehe: s:/.4tn0be91tx0/3spnsam/cmh0wb#/7emo/ean2emr +1


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 +14  upvote downvote
submitted by ∗strugglebus(189)
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sA na 0:,i1 08e1t0d peeopl rreoepdt ot vhae sied fetcefs nehw iagktn .igo thHiydAohecnoazdmlorr teh,m 52 leoepp .0%()02 hvae raetsB iedhcgras

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neonem  I khitn teh btse yaw to resanw isth teqinuos aws yb ecrspso fo i.etninlioam +1
sympathetikey  th'saT some shlluibt l lo +9
karljeon  aHah I nmedeailti hte rnseaw by epsscor of mniaent.iiol +25
medschul  I teiadnimel shaetidzi by erospcs fo mtienalonii :( +3
medstudent65  hiSt I elindiamet ietisazdh ebacseu of iiamenltoin wtne thiw NHT ikhngnit acitlinrarne bedel tfeinfcge het rypititua +2


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 +3  upvote downvote
submitted by ∗fkstpashls(23)
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oecsrPs of oaietnmliin is hte olny awy to get hsti naserw whotuit tvSnaa vesell of i,astmu sa smoe ebwtoi ieawgnr orhudec woh torwe eth sunietqo parbolyb a.hs

acCnre is lratluinea moltas lal the mtie, DM ntsd'oe mkea neses ofr yan aeo,srn NTH eflsit duotn'lw csuae mklyi ob,bso and smat clels anelggnduiatr stne'do make ykmli oobsb te.ihre o,S dan ebcsuea naym rsdgu nac avhe kmyil oso,bb oeryu' eftl iwht gudr escffet yb oecrpss of enotaimi.lni

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djinn  I odnt nkith eth aourt saw a anats.v slAo I knhti si hitgr ecsrpsoc ot nikht acec"r"n acn be lreibalat dna mlaiangnt ubt teh r""udg that saescu ihts nsti C.TH ishT teiusoqn si abd wetitnr. +1
hungrybox  crcidAngo to atm,hoPa eragrataolhc is NTO octssaedai hwti canrce eevr e(se 11.6 - ersbat pg)lohtyo.a +
djeffs1  ocrnagcid ot sbtglss'grueu nsmrbeu sit rome eiklly ot eb l/b cancer ahtn iei.hztd..sa +


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 +2  upvote downvote
submitted by ∗niboonsh(409)
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" hrteO cssaesl fo codmstieain ttah eusac poyetainirhmrlceap uecdlni sd,enrsseatitpan tphynaenirsveeti aetgn,s nad dgrsu htat ancesire eoblw ttmyo.ili etirplHipercoaaynm ecdusa by oisaedctnmi is omnycoml pcoiysmmtt,a nascgiu raoral,gtheca lmstraenu r,teasibducn and o.peemtcni tI is romaptInt ot eenurs thta amyerlrnopichpatie in na vdiaiudnIl eantipt is ued to ionedicmta dan ton to a rrtslcatuu inseol ni the iutiaipy/plathhmyctroa aear; tshi anc eb cdmselphoaic by 1)( pgtpsnoi hte coamieitdn mrtaproiley to ermdetien thherew ilpotacrn levsel nruter to a,nrlom (2) sightcinw ot a teaoimdinc htta deos otn esuac rimenlcpahoipeyatr "

.p8//bns0.om5d2.it.w4te/whmu9gb1:n/lwh6invcp

nndooeeN"e-d-ntsedp sedi scftfee — hAluogth wdsoole- hetayrp sesme to nziiiemm eht amilctbeo spioaloccntim dincedu yb a aiihedtz ro i-liehzdkatei tridic,ue it yam tno yienercasls enialmeti oerth sdei fs.fetec As na ,pemalex as yamn as 52 tcenrpe of emn aerdett ithw 52 gdma/y of lcthraonliodhe lveedop a inecdel in xasuel cnuntofi []3.4 eSlep ciesdausbrnt anc asol ucco,r urayltapcril if eht taepint is no a uosmo-lwdi iedt [3.]4 woH stehe emopbrls ccour si ton n.w"kno

nnn95p.etatwt0pzih#sed/ncHtii./9ateresntweh/oei-ytwnsiruhessaon5tptrtepd-mto/e-iwdtr-2-y-otiemcp3f-l8:acsiuioua0hs-si2-

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 +2  upvote downvote
submitted by ∗hungrybox(1277)
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aaPmtho eigvs teh ehter ojram eucass of aeoltcagahrr as ilpnpe tnslua,oimti nimocartopal of ietrrona ittau,iryp dan gdsur ees( 1.16 - atesrB )hoPyol.gat yOln ugdr feftec si na neswar eochic ofr ihts inqso.eut

oT utp ahrntoe ayw - feerob uyo ryt ot go hthuogr evrey nwsera hoci,ec gknsai seoyflur "ulowd htis uscea r"h?etlaagraco ,enIdats ska so,yfurle hWt"a rae het suseac of racehg"oaral?t nAcgrocid to rD. t,raSat hyet aer "lnpiep ,maoistitunl mrtcailpnoao fo neraitor a,uttyipri dan dsrg"u.

ehT siunqote otne'sd say ngtyhnai taht oudwl oitnp you dorawt plipne amtn,lutsioi kile i"t ylno msese to paprea henw ehs sutp no a hs/slatpiyr ts.s†"rtne//oscupr So yuo anc rule otu pilnep sttoulamii.n

tI loas mseka no nmnoite of aieblmrpto niblesnds hcih(w lwuod ntoip you to an oriteran riuyttapi oumt),r os uyo nca relu tuo ltmo.niacpora Teh ynlo optnio tlef is ugrd .ffteec

†veI' rvene nese naynthgi eikl hits no a tqounsie btu I musaes het EMNB oldwu owdr it in mose vcuoltenod ywa elik .hatt

I inilaylti rwtoe htsi sa a emscumntb,o tub I efel leki it revdsese its own ne.mtocm I asw eevnr ayller sftiaiesd ihwt any of eht siloaeaxnpnt rof hist roleb,mp adn I alnyifl arerdiv at eon ttha easkm eht toms nsese to .em

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hungrybox  ,hO dan dessib,e lipenp iittouamnls dan irlpoatmacno 'atner neev wraness oll +
drdoom  tysm[se ae]riml oryu antcocu hsa eneb dprad:uge AMORTF ANINJ +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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hedTiiazs cerued FRG g-&t; Rcdduee lrncaaece fo iarotcnlp -g;&t ncaayhepeolprtimi -&tg; reh.cgsadi

tNo sreu how rtocerc ahtt i,s utb ieasd mfro ecacnr enigb alnuaite,lr I doluw setiaoasc hhig potlicanr iwth slso of paedinom eecnii/obirhtidnud cclaaeenr of pancioltr ieltsf.

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 +1  upvote downvote
submitted by ∗sam1(22)
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siTedziha acn aeusc ctuae astriitletni prineist,h a mfro fo leran liau.fre thWiuto the anler xertencio fo p,anrtcoli it nac ubdil pu in hte ruesm nad truels ni teh.rrcagaalo

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coccidioinmytitties  uSaexl ncusfyitnod isdee[r absde = i]ldboi nac eb eud to rdgu ised cfftees hrtvssaei[n,n]etpeyi rep siftr .aid n:od iEti 8e 1:P20ga n15o tSe5:ic PyPrc ,she 'i1sAtsd niodrecen sio:tcen vxe"ssecie saountm fo atorclipn octaesdasi whit bi↓idlo 24.[]3 sT ih sego teortghe htiw uro lxsaeu yntisuocdfn iwht evpnaynsh"i.iteets"r y lOn lacgilo hinessyts I acn nkhti of: heid itza = a↑topcnilr = iibo↓ld + eaoalr.gcrhat It uwdol laos meak eessn encsi we ear egiadln ihwt an ceeetxpd to eb pm-pooleautnsas lafmee ikl[m uiprtdcono wdulo veah to be due ot exgoeunos suu.gDceo ]r otin my reuetcl etnos and funod eht glfoniow:l tceskera-blob adn hiiaezdts ecsau uexasl s.ytiucIfdno n saol lkei ssa'm1 iaoalxtnen.p eerW' rceihnag er,eh btu tis teh sbet I can .do +
g8427  oMya nicilc swsho ecrla ro oboyld pipnle ahesdcirg as isde ctffae fo eT.sidhzia uBt dsetno taste yilkm .sirehdagc +


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 +1  upvote downvote
submitted by ∗namira(39)
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olPsebsi :xinalotpaen

If hte pt si tkagin a hiizedta hhi(cw is K e)ield,ntgp it tihgm eahv aosl nebe egvni itwh a K raigsnp gdru hcsu as scato.plirninoe

tpceoilnSioanr ash iideoorncclgno ctfesfe chus sa aaismnoygcte dna aoarca.lrtghe

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sugaplum  I hinkt uyo coudl nloy kame sthi aupinostsm if htye dias npeitt"a si on snadadrt nht "xt btu iecns they agve teh enam ,zhct wdolu otn be arfi ot uemass eyht era oasl iangkt olnrcsipenao.it I ntew htwi cepsosr of ieinmtaloni on siht n.oe Eve n dhckcee csecsa ne'iidescm urdg rsedeav ftefce .irgafroclaroe..hlaetp otn eslidt ofr tchz +2


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 +0  upvote downvote
submitted by ∗j44n(141)
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bsiePlos ussaec fo rlgocaterhaa ud:ielcn andietocsiM, csuh sa naetrci esiaved,ts epainssetarndts, tpytaccssinioh dna ghhi doblo ussrrepe d.srug idipOo e.us blrHae pslpetes,unm hucs as nenlfe, ansei or eukfnegre eeds

^ mfor het yamo ciic..n..l smapesih no the TNH usrdg

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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zh=ia&;Tedtig ripg=lt&emayae;chc ixntyOox G(q uplcedo tn&pgir;eo-t nrci )+;t2a&gC= lppein raihgecds

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arkanaftus  tociOyxn llwi ton owkr no ebtars stelirnug on miykl hgaicserd if hte asdgln rwee not p"pe"derra by pto.riancl Its' like iytrng to euqeezs myept laoblon - tgnhino esgo t.uo +1


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