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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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Peag 2 ash a tgera ucrtpei

t1ci1wh/(a91-wll8idw70af6/3/s2ooi06p/.nSntpr64r:9ee).j-c/tg0

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kamilia20  liaadhoyhpclm isttiac??p +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)


 +9  upvote downvote
submitted by hayayah(1212)
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setteiHpsinvryiy deixnuo—pinsmetmi pyte II/IVI tyeisvyhsintirep nteiroac ot maenvrenoltni tn.iange sasuCe sy,epadn oghcu, sehtc entihstg,s dhae.cahe tOenf nsee ni ermfras dan shoet eesdxpo to rds.ib veesRbirel in rlyea gtasse fi luitmssu is aed.dovi

It's a ypet fo vercttsreii ungl ssieae.d

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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)


 +6  upvote downvote
submitted by neovanilla(57)
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hyW teh toreh werans ihsoecc n'tear crceort

A - oNt na hyaplicctana eociartn lminya deu to chctriyoni mosinotpnu(c of ,yso hchwi hsa reitsnopocgly that leoepp amy veha rageeslil dwotas)r

B - tNo hamtsa taaricrcezdhe( by mroe cauet eesodsip of tctncoi,hbcosrnonroi ie)znwhge

D - mnAaie 6(,B ,B9 B2,)1 ro beaym a luromaynp lbomiems eud ot 9B ro 1B2 ecidfeiync t-g;&- vdlaetee cotnmyeehsoi sllvee -g;-&t ossrmobhti -gt&;- VT?D

E - yuPolrnam nrtax;ha Teh meti scerou doulw eb hcmu ermo cuea,t nad uwodl lsao neptrse hwti soyspmtm of l-feiluk mts.oymsp iadRp athde oot

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 +3  upvote downvote
submitted by monoloco(155)
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shiT itanpet is xnpgceeiirne eptryhnisveiisty inuptenmios mfor the aepkre.sat I wsa intinkgh M. uAimv ehwn I esedcelt etakpeasr -- I ikhnt ym gcilo aws edflaw iengv hte fecsicpis of teh atpnites' r.osyt

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 +1  upvote downvote
submitted by imnotarobotbut(184)
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Hwo wluod ouy wkon ahtt it sti'n lwoo tssrero ae?sisde

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cienfuegos  AF 0128 :371 tnilahoina fo rsepos dslea to lkufli-e tmsmspoy ahtt poesrrsg luyqcki ot erfev, aplrnmuyo eohamrh,egr dmnisieattiis nad hkosc, htiw gimgani plisysbo soigwhn iedwnde ideanumtsim +10



 +0  upvote downvote
submitted by endochondral1(24)
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coginradc ot ldrowu tsyrieyhetspiivn unitnieopms is edu ot tuds and htta saw oals na t.i.op..on

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amarousis  so is't edlefyntii usdt tub the pfciicse peyt of stdu asw the msot omptnrtai ni itsh utsnieo.q hte ftac thta yeht edeimtnon teh irbds is iptonmart. the suydt sobok dwoul sueac ti utb hte dirb usdt si rmoe tanmpirto .-- +
charcot_bouchard  vytipseeHisityrn ouinsimtnPe - Oaingcr dust eilk( lmody nPceioshmnuoya i)s - rgIincano ue nonstd lpeh eehr ugthho cubseae bhto will nperets whti seam rcrsiitteve ungl idsesae itcrp.ie u hinkt cnies usdt ni rayilbr rtaen ethirne acrnogi ro rnaoiincg adn laso u dont ese amny sarbirlnia whit lgun edeiass utb irdb serownpih si ycfliapcisle nemoetdin sa ecuas of PH adesis.e +



 +0  upvote downvote
submitted by beeip(141)
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I aslo was nhtiking M. iamvu ,eehr tbu yyptsiesnvhtriie nimeptnsiuo esems ot itf tiwh eht rguiaaulecrrltno ac.ehgsn

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 +0  upvote downvote
submitted by endochondral1(24)
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owh do we nwok eperakats uscea teshvyiyeprsin oueitinmnsp

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smc213  18FA 56.p7 ibdr u;-rx&eoe-gpst HNS imsnpnuiteo irscv(tetier ungl e)aesdis nad AF81 41.2p toulsouagrnam seeissa:d gofeinr l;t-aHriN-Sematg& .ueistimonnp I dah ot mkea nsese fo ti isnec I 'ditnd owkn ti was SHN tnsoenpiimu ta s.rift +5



 +0  upvote downvote
submitted by breis(56)
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csasiPitost tiessemom( llcade nsoisohtir ro rarpot sdieaes ro tprroa evefr) si na oiinnetfc fo eht lngu a(miepnun)o ceadus by eht tacimubre mpahyoliCldha )dayC(amhil p.tsticai

gniSs dna v,prm f.ysogmeco ts:hue uluyals twiohut cumh gsch..lealmercsh.a aeped muhh ae.hhseccts i oe.nsntphssar of rehbraet.s o .ahtrto

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charcot_bouchard  pUaetd on my prve etnmcmo : esY hits is tspssac.oiti nto ipehiyvsnttiryse epnsmntu.ioi woH od u wonk? Lcephtyomy dan ePesrenc fo nrluGamao - resenspo to rrelaluitlcan dlmwyaho a.Nci SH can laso esacu oleso ogmlauarn oto dan hte nccillia cprteui slitl mroe olko kiel uYoSH kwno htwa ......... kfcu tihs quse +2
shemle  erHe .tP dsneot' aehv rve!ef +9
shakakaka  iagNsaotcenn lruag,mona ytpcha yicmpclohyt ilnarntfioit, nad fisosbir rea nees in rissiyytteivenpH oneunisptim , cgonriadc to Urdolw . +

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