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Retired NBME 20 Answers

nbme20/Block 4/Question#21 (reveal difficulty score)
A 47-year-old woman comes to the physician ...
Contact with parakeets 🔍 / 📺 / 🌳 / 📖
tags: pulm

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 +36  upvote downvote
submitted by ∗masonkingcobra(408)
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ePag 2 ash a ragte cputrei

whS(9-c7rltwo10j-:gp4d6.a9et/1p0e.w0/iio/nasnt8rc2/6lf/)1i36

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kamilia20  ldhcaypialomh ??atiipsct +1

FA 2019 P. 661 Hypersensitivity Pneumonitis is a mixed type III/IV hypersensitivity reaction to an antigen in the environment. Commonly seen in farmers and people exposed to birds. Presents with Dyspnea, Cough, Chest tightness, headache. It is reversible in the early stages if the allergen is removed.

+7/- lilyo(94)

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 +9  upvote downvote
submitted by ∗hayayah(1212)
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steiivsiHtypyenr msodinuenpeitx—mi ptey V/IIII tnyesryeivhitips ntaeicor ot naeeroinltmvn eintgan. ueCass dp,nysae ,cuohg chtse ,gstestnhi ahd.ahcee Ofetn eesn ni arfrems adn htose odsepex ot .isdbr bereRilesv ni rlyea sgesat if smitulus is .iedadov

stI' a tpey of rrcvsetteii ulng dseisea.

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A type of hypersensitivity pneumonitis associated with animal exposure is bird fancier’s lung, in which the major antigens are proteins in avian serum, feces, and feathers, including bloom, the waxy powder coating them (18). Pigeons and parakeets, including budgerigars (a type of parakeet), are the birds most commonly implicated, but poultry, finches, doves, canaries, and other birds also have caused the disease. Exposure to live birds is not necessary to produce hypersensitivity pneumonitis: the illness has resulted from using feather pillows and duvets (19), being exposed to a wreath made from the feathers of a dead pet bird (20), and laundering a pigeon keeper’s overalls (21). Other examples of animal proteins that are known to have caused the disease when inhaled include proteins from the dust of mollusk shells used to make buttons (22) and from animal fur used in garment manufacture

https://pubs.rsna.org/doi/full/10.1148/rg.297095707

+7/- alexp1101(11)

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 +6  upvote downvote
submitted by ∗neovanilla(57)
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Why the ehrot asnrew cioshce e'rtan trcroec

A - Nto an iaaclytnapch catieorn imalny due ot tincciyroh n(omcntioups fo y,os chwih sah esginoptrcoly thta oeeppl mya eahv lgerisael atwor)sd

B - oNt atsmha zacda(hrtcreie by emro ctuea diseeops of ccro,ithonbnstoonrci ihgee)zwn

D - nimAea 6B(, ,9B )2B1, ro eaymb a nlauopymr seibolmm deu ot B9 or 21B fyideiecnc -;tg&- lvedeeta motneysichoe esllev tg;&-- ohtrsiosmb -&;gt- ?TVD

E - Prolnymua hrtaxna; hTe etim ecsuor wdoul eb mcuh omre tu,eac dan udlow sloa enesrtp htiw sstopymm of -leiufkl tosymp.ms Ripda hetda too

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 +3  upvote downvote
submitted by ∗monoloco(155)
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sihT aetpnti is xigeneipncre eeyiiritsyhtsvnp tmspunieion mofr het kaset.apre I was iithngnk M. uvAim wenh I celseedt peaeskrat -- I thkni my cilog saw afedwl ivgen hte ecipscfsi fo eht tit'sanep tsoyr.

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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woH uwdlo you onkw ttha it in'ts lowo rsrtoes sa?sedei

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cienfuegos  FA 0821 :137 tlaianhnio of ssopre adels ot ill-eukf spsmyomt that rposegsr qyiluck ot frev,e pmulyaron heoame,grrh ansiitsdeitmi nad kos,ch hwit mgagini ypbiolss ogihwsn nweeidd tadimmeiuns +10


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 +0  upvote downvote
submitted by ∗endochondral1(24)
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oangcrcid ot wrloud niietprysyietvhs tmsuneniopi is deu to usdt nad hatt was aols an po.int.o..

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amarousis  os its' teydifleni sdtu utb het fiscpeci epyt of dust aws eht mots mtritaonp ni thsi eqiotsun. the fact tath they ontmenide eth rsbdi is itmr.naotp hte tsydu okosb dwuol useac ti btu hte drib utsd is ermo irptmaton -.- +
charcot_bouchard  tsyinieHpisetrvy neiiPusotmn - Ogrnaic dust leki( ymold eh camn)onoPyisusi - oiIgrnacn nnes udto plhe heer htuhgo buescae hbto wlil eserpnt ihwt smea esrietitcvr nlug isdaese ructie.pi ntkih scein usdt ni abrrliy eratn iehrtne oniarcg ro nagniorci and aols u ontd ees anym bsnirlriaa wthi lugn eiessda utb ridb rsowipenh si laeycfpisilc odnniemet as cesau fo HP eeasd.si +


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 +0  upvote downvote
submitted by ∗beeip(141)
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I saol saw iithngnk .M imvua ,here but nstieyspvehiyrit nosumtiipen esmse to tif thiw teh oaritulgelrnaucr gn.hacse

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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woh do ew knwo trekapsea acsue ythieypvrisesn opnimsueitn

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smc213  18FA 756p. bdri e;exs--r&tupog NHS imosuntpein (itrisecvret ngul aes)sedi dan A8F1 2p41. matnoalsuuogr dissseea: igerofn &-aNH-;aitmtlgeSr uinoe.impsnt I had to kame nsese of it ceisn I 'ddtin nowk ti aws SNH pusminoneti ta t.rfis +5


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 +0  upvote downvote
submitted by ∗breis(56)
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itsitoscsPa osemi(mtes cellad hososnitri or ptaror dsieeas ro ptrora rfv)ee si na oinceitnf fo hte nugl apmouei)nn( aeudsc by the uetbcmari mohdlhaiCyapl dChamai()yl pcitsi.at

giSns nda e.htmsvy: peufmg,cosor allsuyu iuhtwot chmu eemehml esc..luh.gcrhspaa hda he.stache sc eshtsiop.nr sna fo treorh.b aes rhto.ta

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charcot_bouchard  daeUpt no ym prve mcmonte : seY itsh si ioss.taitcsp nto pvsthiiyeyintesr nsmuioe.tnip woH do u kon?w etcyopyLhm nda ceseenrP fo luanoamGr - oepssnre to ucarrlnletlai Nyhodl.maa ciw SH anc osla cusea lsooe lmogaanur too nad eth cicailnl upitrce ltlis eorm kool klie oYuSH wkon htwa ......... kufc tish uqse +2
shemle  rHee P.t dotsen' hvae efe!vr +9
shakakaka  tigesnncNaoa nogaramlu, pathcy iccytompyhl ilnfrioiattn, and iirsbofs era snee ni yyptienviesHsirt nispnemotui , nicgaodcr ot Uwdrlo . +

https://pubmed.ncbi.nlm.nih.gov/7569404/#:~:text=The%20inflammation%20is%20often%20followed,than%20in%20women%20and%20children.

you get granulomas in both

+1/- j44n(141)

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