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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 hsa a regta eiptrcu

91iS3a-/w1h60jp0d2/0/tacwt4(.7/ei6nrc6eso)-l/l.18fnp9wog:rit

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kamilia20  ydplliohhcmaa iatpist?c? +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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iHytntriyvsiepse imtminepixsnuoe—d tpey IVIII/ vrinitpiseehytsy atenciro ot nlnmiorventae negnti.a easuCs sanydpe, gohu,c tehcs htit,snegs hcae.heda tfneO eens ni fesamrr and otehs exosedp ot irdb.s resRlbieve in ylera etgsas fi mutuliss is evaddio.

st'I a pety of crtietrisev nlug ds.eseia

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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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yWh het treho esnawr ehcsico r'ante rcrtceo

A - tNo na hpitaanlccya eortaicn animly eud ot tiocrncyhi p(unocniotms of yso, ihchw ahs yconsrlgpeoti ttah ppoeel yma vahe lireagsel stodrwa)

B - oNt atshma itehccdar(zrea by eomr eatcu iseeopds of hc,nobcottcooiinsrnr eenhwgiz)

D - Aimnea B(,6 ,9B 1B2), or baeym a upyrolamn lsmimoeb ued to B9 or 1B2 idecenyifc tg-;-& ldeaetev cnimoosheyte eleslv tg-;-& bmshoiotsr -g;&-t DTV?

E - namPlyour n;aahrtx heT miet srocue dlouw eb hcum rmeo aue,ct dan duwlo olas strneep hiwt mopmstys of leukfli- sm.oypstm adiRp daeht too

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 +3  upvote downvote
submitted by monoloco(155)
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shiT itpntae is xcgeerennpii ryynstiesipeviht tsinnepiomu rfmo eht ktpea.aers I aws nngiikht .M vuAim hnew I cteeesld ksaeptaer -- I ihktn my golci saw aedwlf neigv hte pesfcscii of the a'tsetnpi yr.tso

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 +1  upvote downvote
submitted by imnotarobotbut(184)
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woH odulw you wokn atth it 'stni oowl esrsort d?seisae

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cienfuegos  FA 1280 7:13 ilnanohtai fo poress ladse ot lkl-iufe mtsmsyop ahtt ssrpeorg qlicuky to fevre, ulyrmonpa ahegermrh,o idseniiittmas dna och,sk itwh mniiagg pbysilso ihogsnw dwneide emdanistumi +10



 +0  upvote downvote
submitted by endochondral1(24)
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caorncgid ot ldurow ythitireyspenvsi oneiitnmpsu is ude ot udst nda htat asw soal an .oi..ntp.o

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amarousis  os t'si nyltfediie tsud tbu eht cpsciief ptey fo utds aws eth tmos taromptin ni shit onqes.uit hte tacf atth yhet edoeitmnn eht idrsb si npmtroa.it eth dsyut obkos wduol uesac it utb eth ibrd stdu si orme mrotaintp -.- +
charcot_bouchard  ipnsiyeHytrtesvi itsmneuinoP - Oicngra sudt elik( dlymo uecaPohnyi)inosms - norInicag ndesuont pelh ehre tghohu ubeecsa tboh iwll ntseepr hitw msea vrctsierite lgnu sasiede ireuictp. htink sceni dtus in lrbiary ntrae rnehiet niocgra ro ngaoicnir adn olsa u dnot ese anym iarnrsbila hiwt lgun aseside tub irbd wrnieoshp si afiiceplycsl neomniedt sa cueas of HP ias.dsee +



 +0  upvote downvote
submitted by beeip(141)
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I sola swa inhigktn M. ivuam ,eerh tub iivepyhteinyrsst tuonimispen seesm ot tfi whit the ollactrgrauiuern nae.gchs

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 +0  upvote downvote
submitted by endochondral1(24)
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owh od we kown prtesakae uasec prseyeiyitvhns ponnusimeti

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smc213  F1A8 5.p67 drib x-;ets-&uogpre HSN enonuitspmi tteser(ivcri glun e)iesasd and A1F8 21p.4 luatsonrmuoag ssid:esea iernfgo trH&--itaeSN;amlg .seuiinonptm I hda ot akme eessn fo ti cines I ind'dt know it saw HNS pinieumtnos ta .tifsr +5



 +0  upvote downvote
submitted by breis(56)
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tiaotsiscPs (mseioetsm aleldc ohsstoirin ro raotrp sadesie or otrrpa )ferve is an eiofnctni fo hte ngul ioauem(nn)p dasuce yb het aciretmub miloahhaylpdC mia()hlyCda ti.aticps

sSngi nad vhegest:y ,ocm or.mpusf ysllauu whiutot hmuc ucp ecma.lmhde sshleahehar. g. htce assch.e sh.naies postnr of rboretesh .a r.httoa

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charcot_bouchard  Upadte no my vrep mncoetm : eYs hits is aptsistc.ois ont vyhiprtesneysiti .tpnsmiinoeu oHw do u knw?o toyyLemhcp and sePrence fo nouamarlG - rpossnee to ualnlecltrira y.wi ahclmdaoN HS cna oasl uceas osloe ngrmlouaa too dan eth ilcicnal cuipret slitl remo olko lkei uoYSH wkno whta ......... fkuc siht useq +2
shemle  Here .Pt ntes'do evah ver!ef +9
shakakaka  tsgaacnnNieo lguamn,aro yathcp hoypytmcicl t,riliitfnnao nad srsofibi rea nese in iirytenityssveHp tniosenpmui , ironacdgc ot ldrUwo . +

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