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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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Paeg 2 ash a trage rtcpeiu

t9a8/.0n-d1alt/1i2p:pj.trhn/0i1i6/6cwo3olSc4r/9)(e6fgw7s0-we

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kamilia20  mdhcplalayiho ?attisi?cp +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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isrnyeHyptievist —iiinmdsnmxeuepot ypet II/IIV ivesesiintyrthpy anitcore to nvtorimaennle nti.gnae asuesC pnsay,ed o,cghu chets tistshg,ne .ahdheeca enOtf eens in mrfsrea nda eohst espxdeo to rid.bs eRlrbsieev in eyarl gsates fi tissmuul si dvioad.e

s'tI a tpey fo iteiscvretr ungl sieased.

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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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yWh the htreo wreans icscheo 'arent torecrc

A - Not an yahatcianlpc ornceait nmilya edu ot hncciytiro (spiotnonmcu fo o,sy wchih ahs igcoeplntyros that eoppel aym have glieeaslr )aostrwd

B - toN hmaats dzr(htariaceec by eomr cateu esdpeois fo ,nrcotcsicnthoonirbo ghinewz)e

D - nemaiA (6B, 9,B ),21B ro ambye a ayrpulmno isolmbem deu to B9 ro 2B1 cdefyicien -&;-tg tedeevla nyesitmocheo elvesl &;t--g ooimthsrbs g&;--t D?TV

E - uynmlaorP nrht;axa Teh emit eucors oduwl be umch omre ac,ute dna lowdu soal tepnres htiw otmmypss fo -ifeukll yo.stpmsm Rdaip ahdet oto

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 +3  upvote downvote
submitted by ∗monoloco(155)
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Tihs npiatte is excgipneneri tintiysvryheipse enmiutsinpo ofrm het aetraepk.s I swa nihkngit M. uAmiv whne I edtelesc paaersket -- I hknit ym oicgl asw dewlaf vngie eht fecicsips fo eth ta'tseinp o.yrst

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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woH wludo oyu onkw htta it 'sitn oolw osesrtr asdiees?

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cienfuegos  FA 2081 317: nnatioahil of rpseso eslad to u-flekil ospmmsyt htat pseosgrr icyqkul ot ,vfere npalyoumr rgmoherea,h asiesnitimtid adn hos,ck hitw gagimin bilosspy gnwhsio inwedde iitnmeasmdu +10


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 +0  upvote downvote
submitted by ∗endochondral1(24)
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cnigdarco ot uldorw phyteynivitseisr supeoiimnnt si ued to dtus and ttah wsa osal an ot..n.oip.

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amarousis  os tis' tiildfyene tusd utb hte fsiiepcc ypte fo sdtu aws het msot aoptintrm ni htis u.tqseion eth fcat ttah tyhe nomietden het irbsd is .mnrtiatop eht tuysd bosok uoldw sauce ti ubt hte drbi dsut si rome tpmraonti --. +
charcot_bouchard  vpitiysryntHiees nePunimiots - Oaingrc tuds (liek mdlyo oiPmyu noehinacss) - griIacnno nt uenods ephl ehre gtuhoh cbaseue tbho lliw snertpe iwht msae stricteevir glun edasesi i r.tupice ktnih nisce duts ni lrriayb atnre rnheeit oanrcig ro inrincaog dna aosl u tond ees naym larsniiabr htiw ulng iasesde utb brid nrpwoehis is fysaiecpillc dioeenntm as asuce fo PH see.disa +


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 +0  upvote downvote
submitted by ∗beeip(141)
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I losa saw itgnnkhi .M umaiv eeh,r utb ptyevsriyiniehst nsoipmiutne semse to fti tiwh teh elraungiortualrc e.nachgs

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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owh do we wokn aerekpsat asuce tviynheiyspser ipsnminueto

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smc213  81AF 756.p rbid tr-e-sugxo;p&e NHS nemisuptnoi tesi(cvrreti unlg )idsseae adn 1AF8 p412. ntroasgmauolu d:ssseaei ifgnore i&lH-raN;tmaetSg- .miintenospu I ahd to kema esnse of ti insec I ditn'd nkwo it saw NHS nimieptonsu ta fsi.tr +5


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 +0  upvote downvote
submitted by ∗breis(56)
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tsasPitcsoi oess(mmtei ldecla srhsootini or rtapor eadiess ro otrrap eve)fr is an toninicfe fo teh nugl aie)n(mpnou sadcue by the mtaciebur hhCdaaoyliplm a()alidhmyC iptscit.a

Sings and egp fomrvtcssu:.eyhmo, lualusy touiwth hcum sd aa.regehem a uhc..emcsphhll ahs.hect sce sonss ptae.rnhi of teorhersb a. torht.a

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charcot_bouchard  tedaUp no my verp moencmt : eYs htis si ott.assicsip ont ryeyesisnvititph tunop.simnie woH od u now?k yecLyhtopm and nsPereec fo amauGrnol - persoens ot urllalreitanc aoa Ndymhl.iwc SH anc alos sauce olose ruogamlna oto and teh lincialc utircep litsl ermo ookl keli Yo HSu okwn thaw ......... kcuf tsih euqs +2
shemle  eeHr Pt. otde'ns veah f!vree +9
shakakaka  ngtcNioasnae rmaungao,l tcpyah ycmtpylchio ilontiif,ntar adn osrbsiif are esen in evryniesipitHtys pisnoetimnu , aocgncidr to owUrld . +

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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