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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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eaPg 2 ash a tgear peuirtc

o)wi1w1r/t60pjdl20.iwhi/71a0t8fa-e69/cS:.otsp4l-n6//e3(9ngcr

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kamilia20  hmyhlloadapci tii??cptsa +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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sitrHivytipeesny piisod—inumenmtxe etpy VII/II ispivyesnhriyett ranoitce to ionemvntnlera n.netaig sauCse s,pneayd ,uchog esthc gh,setstni ehadchae. fOnet eens ni farsmer dna sohet esedxop ot rsbi.d Rvierslbee in eyalr ssgate if ilsumsut is iv.edado

Is't a ptye of etrvtresici lgun sie.esad

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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 oerth awsren esiocch a'rten ertorcc

A - toN na nalpaccayhti trnioaec nmlyai due ot nicitrcyoh ntounop(imcs of s,oy chhiw ahs tosplyceirnog hatt lpeope aym ehav eglrialse swordt)a

B - Nto aathms (rcazceedrihat by reom ctuae ospeesdi of ccnnsciiorthtbnrooo, ewi)hezgn

D - naiAme ,6(B B,9 2B)1, ro eyamb a nolyuramp mbilsoem due ot B9 or 21B dfyeniccei -;t&g- eeavetld yotheioemncs sleevl -;t&g- isbohrstmo t-g-;& DVT?

E - myaoPrnlu txhnar;a The tmei scuoer udowl be much meor tuc,ae nda owdlu saol enretsp hwit smysotpm of fuil-lek tyopssmm. Ripda etadh oot

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 +3  upvote downvote
submitted by ∗monoloco(155)
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Tshi iantpet si necpxrgneeii rssniietevhyptiy iimunspenot fmor the .tpeearkas I swa hnkigint M. mvAui when I setlecde aeakpsert -- I hntki ym colig was dwleaf gievn the ipsccseif fo the 'inteatsp tsory.

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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owH dwolu uoy owkn atht it is'nt lowo rtoessr aseis?ed

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cienfuegos  AF 1820 1:37 inlnaaioht of peross aelsd to leklif-u ysspmmot htat gprseors lyicukq ot free,v yompaunlr rore,mehagh diimstitisena nad okhsc, with aggiimn isypolbs inowgsh dweiden tainsemdumi +10


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 +0  upvote downvote
submitted by ∗endochondral1(24)
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gcircadon ot rwldou nystpyetrvhiiies nositupnime is eud ot tusd dna tath wsa loas an npooit....

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amarousis  so its' inlfedytei stdu utb hte ciipecsf pyet fo sudt wsa hte stom ttanoimrp in hsti qstie.uon the atcf ahtt htey iennedotm eht idrsb si amtp.intro teh sdytu skoob wloud eacsu it but teh rdib sudt is reom tmiratpon .-- +
charcot_bouchard  psysrntHieitievy ueoPninsmit - ingraOc dtus (keli lymdo hcueaP)noimyn sios - cngIinora sonndu et hlpe reeh hhogut baeuecs bhto wlli etpsrne hitw esma rtcsiertvie glun dissaee cteiiu r.p ktnhi neisc dtsu ni lrbayri netar ehtenri iroagnc ro ocnignair adn laos u dnto see amyn bsrinlaira iwht nlgu dasiese utb ridb esiprwnoh is cfaiyeispllc emnotndei sa seuca fo PH ide.ssae +


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 +0  upvote downvote
submitted by ∗beeip(141)
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I loas was inhgtink M. uiavm h,ere ubt tirysiietvshnepy niumiepsotn seesm ot tif wtih teh unaoceirrllrguta cahs.eng

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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who od we nkow aetrkapes eusac trvsepisyyiehn emstnpuoini

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smc213  18AF p.675 drib r--psuog;te&ex NHS noipueimnts et(rristveic ugln si)eeads dna 8AF1 .14p2 mguuroosatnla :edasssie grfneio r-Saga&;lmti-HetN po.niseimutn I ahd ot eamk seesn of it sncie I idtd'n wkon ti asw SNH umonenisipt at rs.tif +5


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 +0  upvote downvote
submitted by ∗breis(56)
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tiPsstaisoc ssme(ieomt acledl sroiintohs or prrtoa esieasd or aoprrt e)vrfe si na einfnioct of teh gnul inpmneu(o)a duasec yb teh acuemrbti aylmhdpCoilah ildC(hma)ya itsacp.it

gsnSi dan hm:vpgt,soru myose. efc luslyua ttihwou ucmh ..eaehsur slhdh ahmc.lm gpaeec hasestc ech. pasenstrohi. sn of boh tae.rrse toaht.r

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charcot_bouchard  teadUp no my vepr mnmcoet : sYe hist si i.toscspiast nto epihnvtriteysysi oesmipn.nuti wHo do u owkn? cLtpmyyeoh nad ePnsecer fo lmuGnraoa - ssponree to rclaualtnlire yoNd mialhwc.a HS nca oals csaue loseo aoarmngul oto dan eht nalicilc preicut iltls erom ookl kile SYuoH wkon thaw ......... fcku tish equs +2
shemle  eHre tP. eodns't vhea !revef +9
shakakaka  nceNnaiogtas g,nrlouaam typahc ohlycmtyipc t,nfilintroia and bsfriosi era esne ni Heprntytisveyiis oiiuetspnnm , aocdnicrg to rdUlwo . +

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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