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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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aPge 2 sah a tgaer petrciu

/3rel10dfthi:-66-ija.i12pl1n6w9(gt)r/nwoe4op/0c0tcSsw/98./7a

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kamilia20  caoyhmdlhplai iticp?sa?t +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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siyrpesvteiyHnti sinnotpmii—edxemu type IIVII/ erpneihvitystsiy citonera to onntrlevenima inta.egn Ceusas apdy,nse hgcou, cseth e,ssigtnht dehaceha. tefOn nese ni rarfsme adn tohes sdxpeeo to sdrib. Rrbveeisle ni yelra taesgs if isusmltu is .ieddvao

Ist' a type of ettviesricr lnug dasies.e

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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 hte htore ewarns ccoshie 'taern crrocet

A - toN an aynactiaclhp cnieaort mlynai deu ot tnyiricohc op(soncnuimt fo ys,o cwihh ash gspyctrlonoie htat epepol mya aveh egaillrse dtworas)

B - toN hasamt eatcrdrh(eczia yb meor uceta dspsoeei of noccroitosni,nhtocrb ewenhgzi)

D - emAain B,(6 ,B9 1,B2) or bamye a prunamoly obeimsml eud to B9 ro 21B efcyeciidn -&;t-g taedvele eemcyhonotis llevse -t&-;g tobsrshmoi -&-;tg ?VTD

E - almnruPoy ranhxat; eTh imte oercus oudwl be mchu eorm uatec, and olwud laos esnptre ihtw ssmtoymp fo e-lifukl smmy.otps adiRp dahet oot

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 +3  upvote downvote
submitted by ∗monoloco(155)
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This aetintp si neeicngrpxie ryhnvystisieitep notuenpismi frmo eth ask.ertpae I asw kgihnnti M. Auvmi nwhe I leeetcsd aapeekstr -- I inhtk ym olgci was dwlefa negiv hte sspeciicf of eht e'saiptnt ystor.

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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woH loudw you onkw ttha ti 'snit oowl stsoerr ?easiesd

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cienfuegos  FA 1820 3:17 laiohatinn fo ospers dsela to llfuei-k mpysmost ahtt psrgesro klyuqic to ve,fre urmoyanlp h,orragemhe medaiitisistn nad c,khos ihtw giamign boslypis wngisho dneiwed anidsetimmu +10


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 +0  upvote downvote
submitted by ∗endochondral1(24)
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aorccidgn ot rwoudl eyynseivttihsrpi numiptoeins si ude ot tsud nad tath asw aosl na oi...tpno.

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amarousis  so tsi' iyedftelin ustd utb het icpfisce ypet fo tsud aws the tosm intotrmap in sthi sui.oqnte the afct ahtt eyht nmointeed the irdsb is taroitn.mp hte ysdtu sokob luodw cseau ti utb eht idbr tsdu is rome tmtoraipn .-- +
charcot_bouchard  Hevtseinytripsyi ePimuotnins - Ocargni udts liek( lmyod Pc oaiisymnsunh)eo - grnaiIcno teduns no ephl erhe outhgh sabceue tbho iwll snretep twih emas isevtritecr lngu eiadess iriu. tcep kithn iencs dtus ni larriby rtaen eithren nirgoac ro nonicgira and also u tdno ese mnya nrlairbais twih lngu edaises tbu ibdr opwhrsnei si ielcyfpalcis ontidenme sa asecu of PH e.daisse +


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 +0  upvote downvote
submitted by ∗beeip(141)
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I lsoa swa knnthiig M. mvuai r,ehe btu nryshitipetvieys upmtonseini meess to tfi htwi the laiagoclruntuerr encsa.hg

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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hwo od ew onkw kaeetarsp esauc itsvirepenhysy puetinmonsi

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smc213  F1A8 .756p rbid -ruex-o&et;gsp NSH nipetmnuosi ve(iricrttse glnu e)asesdi nad 1A8F 41.2p tsmalguornauo eeassdsi: efogirn atreH;itN--maSl&g esomtn.iipnu I had to meka seesn fo ti scine I tdd'ni nkwo ti was NHS iiemtnnuosp at sfr.it +5


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 +0  upvote downvote
submitted by ∗breis(56)
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ctsPisiatos memsto(eis eadllc hoisstnior or oratrp esdesai ro roratp frve)e is na tineinofc fo eht nugl )p(onaunemi csuaed yb eht miuerbcat iCdahoalpymlh (h)ilydamaC sttcii.pa

Sngis adn vo uhrpefsyec,ms:mtg. o uyalslu uhwitto cmuh sc.su.em er.aeahedmhlhg ha plc stsh hcea.ce o.tesirnsnhps a of hasebo.e rtr .htatro

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charcot_bouchard  tUadpe on my evrp tcnmmoe : sYe isht si css.iiotpats otn tivtseiersnyihpy msieptuo.nni How od u wo?nk theympLyco adn sncPeere of unolGarma - esonrpes to allatrnruelic Nyd.hmcwla oia HS anc olas uaces soole aognmural oto dna eht lncaiilc icetupr llsit meor olok ielk Huo SY kwon twah ......... uckf iths qsue +2
shemle  reeH Pt. dtne'so ehav reefv! +9
shakakaka  ingNaecsanot nroulag,ma tpahcy tlcyioymchp ,trtnioaifnil and bsfrsiio rea nsee in risieviyHeyttnps siinemotpun , cdrignaco to wrdolU . +

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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