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Retired NBME 21 Answers

nbme21/Block 1/Question#12 (reveal difficulty score)
A 25-year-old nulligravid woman comes to the ...
Endometrial hyperplasia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—mcl(671)
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POCS si sitasocead wtih nabarolm tudpnorcio fo exs o,dtrssie ndungilci ycftsodniun of teogners todpurionc nad pnegeostrreo. yCnrahoilcl eveadlet slveel of nroteesg cna euacs delmroanite ply.hpeaisar

1l99.wn7m:.pccP.ei//gi/hi/h/3t/blntn5CsM.pr9awtswmcvo

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meningitis  yWh tnsi ti sndr?steomioei Cdoul osoeenm lpeh em otu no s?thi +2
meningitis  yS,rro I was icgounsnf hwti rghhie ksir for emieoadlnrt ranaomic.c +1
vi_capsule  snotergE si lbsonierpse rfo alicclcy ebgdienl adn apin tdceoisasa tihw esdtoiirneoms ehenc tiopensgr si a tanemtrte .adimltoy Btu egtsroen snit a irsk ftraco rof stdoo.rmEseiin thaerR hetser oerredrtag fwo,l mtptaaclie rmaatnotinrofs tce sihreeto era eniblsspero orf .sotiondseermi +1
sympathetikey  wfT uyo gte os nhtwro ffo yb a repictu taht you no'td ader het uesinqot rypeprlo. +34
hyperfukus  @sintnmgiie ikd if u itsll ecra oll btu wlsaay go kbca ot =notiiptrmscecsoeoide roetmaldnie tssuie utidoes of teh uusret so ouy anc ruel ti out sienc anresedic rstengoe uowdl aeusc ouy to aevh rwdsoene eoienstoimdsr ro a erhkcti neo ubt tno lr.ode.yuy.ict anc ese the cmulps of teh fesllcoli ni the evosira fi uyo oolk serpu elosc os tath noagl twih eht aitenterpnos aetsk oyu to OCSP nda imyenat oyu do'nt haev a bayb ro stya in eth altoirrifepve tgaon(rhesepes ap)she you egt moiadelertn ytitptlaeas-&oahemrpe-rlig;tan-ogiyrfl&;l-tpi-u aaconcmri +2
lovebug  FA 2,091 apge 136 +1
lovebug  Ohret asrwne )MHeisg ysoernmd : rdita of )1 niaorva irb,faom )2 et,ssiac 3) apuller foef.iuns glPluniโ€โ€œ nesoisant in gr.nio FA 91,02 gp 236 +1
xw1984  n'sIt toinop ,G oemayaotiLm u,erit sstoaeaicd with hihg tneegros eev?ll reP FA 0202, iirdbfo si restengo iei.nvsset +2
ownersucks  914@xw8 ossgr megai wodlu oswh ptielmlu wedhlor asmsse +1

I feel the clearest way to understand this question/answer hasn't been stated yet. Recall that the cysts in PCOS are unruptured follicles. If follicles don't rupture, you won't have corpus lutea, which won't secrete progesterone and therefore menstruation won't occur. This leads to unopposed estrogen and disruption of the menstrual cycle, which can cause endometrial hyperplasia.

+20/- pg32(218)

The patient here is obese and has hirsutism. Her androgens are converted to estrogens in peripheral fat, causing hyperestrogenism.

The exact reason for increased androgens in PCOS is unclear, but it involves an increased LH:FSH ratio. Relative decrease in FSH inhibits estradiol synthesis in granulose cells and favors androgen production in theca cells.


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submitted by โˆ—pparalpha(93)
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cmootslinaCpi of OC:PS

lriacsdoauraCv veetns

yeTp 2 biestdae mileutls

lnaEeomtrdi acenrci=aeappsylrh

aIsrceedn mcagesriira aetr

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