need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
🔑login 🔒register ⋅ ☎️contact ⋅ leaderboard links youtube ⋅ ⛳membership alerts tags ⋅ 📊scores 🔮score predictor
search for anything ⋅ score predictor (“predict me!”)

You must be logged in to vote!
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

 Login (or register) to see more


 +36  upvote downvote
submitted by ∗masonkingcobra(408)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

agPe 2 sha a tager eurcpit

//a-i/4(w)1g:3f6ra16cjt.-ls10p/wtwri8Snh79n0ic2/0.d6o9epoetl

unscramble the site ⋅ become a member ⋅ $279$49
kamilia20  yimpdhaclohla iasti??ctp +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)

You must be logged in to vote!

 +9  upvote downvote
submitted by ∗hayayah(1212)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

piHsiinyevyterst midsutpi—oeixmnne eytp IVIII/ tyeeripyntvssihi nitcoear ot nmalovrieennt .atgenin eaCssu enps,day uocgh, cseht gt,hitness heeda.cah ntOef esne in frmsrea adn sheto edpsoxe ot br.dsi eivbserleR ni lyera getsas fi tusiusml is ddvae.io

Its' a eypt of trcreiitsev ulgn .aissdee

unscramble the site ⋅ become a member ⋅ $279$49

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)

You must be logged in to vote!

 +6  upvote downvote
submitted by ∗neovanilla(57)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

Why the rehot ewrasn csieohc eant'r trcocre

A - otN na itnccalyhapa neaitcor yianlm deu ot tocyrhiinc uicsptoon(nm fo so,y hcwih has gtplsrncyooie ttha lepeop yam hvea sreallige sdo)rwat

B - Nto ashamt cet(ierhracdza by meor etuca ssepoedi fo onrc,booctntsnhoriic hegew)niz

D - ianmeA 6,B( B,9 1,B2) ro meyab a poraynmlu ilobmems ued to B9 or B21 feiecyicnd ;--> aedeeltv otiyncoesmhe eellvs --t;g& ismhortbos g-t&;- VDT?

E - rnuyPalom rtn;xaha ehT mite suocre oudwl be hcmu rome ae,utc and lduwo lsao tprnees thiw ymspostm fo fkuie-ll .msysotmp dpaiR tedha oot

unscramble the site ⋅ become a member ⋅ $279$49


You must be logged in to vote!

 +3  upvote downvote
submitted by ∗monoloco(155)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

hsTi ttaenip si xcinnreiepeg syeptrtihevsniiy iteosinpnmu rofm eht kreeap.tsa I swa ignkhint M. mvuAi enwh I clteseed tkraepesa -- I khitn my cgloi wsa dfealw veing het ccisepsif of the nt'itsepa ro.yst

unscramble the site ⋅ become a member ⋅ $279$49


You must be logged in to vote!

 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

woH dulwo you wnok taht it n'sit wloo srerost dsaeie?s

unscramble the site ⋅ become a member ⋅ $279$49
cienfuegos  FA 8201 7:31 iotahnlnai of opssre dseal to filkl-eu ssopymmt ttha osrprges qklycui ot fe,erv lynauormp ehramg,hreo tssiiadnitemi nda sko,ch hwit nimaggi boslpisy nhwoigs dewdien idnstamueim +10


You must be logged in to vote!

 +0  upvote downvote
submitted by ∗endochondral1(24)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

odngrccia ot uowdlr tpsyevyhsiiterin optisniuenm is ude to dust dan ttha saw aols an oo..it.p.n

unscramble the site ⋅ become a member ⋅ $279$49
amarousis  os 'ist dnteilyfei sudt btu hte iicfpces pyet fo dstu saw het omst ritompatn ni tshi tnqi.soue the ftac hatt etyh ndnmeeoit het rdbsi is at.rtnpomi eth stuyd osbok wdoul asceu it tub eht idrb dsut si mero noaittpmr .-- +
charcot_bouchard  syitstierHpeviyn sietPoinmun - Ognrica tuds (lkie dolym nn ie)soiPsoycumha - agIincron eonunsdt lehp eehr huothg beseacu bhto lilw erpsetn ithw sema tretsiciver lnug siasede itriuep. c khtni iecsn dtus ni yblrari ntaer trnihee nogciar or noaigrcin dan osal u tnod ees many rbisnlaria twih gnlu daeeiss utb ribd rewhonips is fcclasiepyli noietdemn sa useac of HP i.sasdee +


You must be logged in to vote!

 +0  upvote downvote
submitted by ∗beeip(141)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

I laso asw itignnhk M. mvaiu e,reh utb ttpssyeynvhiiire siinmptneou sseme to fti hwit the iruurageronacllt hcs.ange

unscramble the site ⋅ become a member ⋅ $279$49


You must be logged in to vote!

 +0  upvote downvote
submitted by ∗endochondral1(24)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

hwo do ew kown satarepek aceus tipriysevehsyn tiusmnpneio

unscramble the site ⋅ become a member ⋅ $279$49
smc213  8FA1 7p5.6 irbd xrgo;ues-&ep-t SNH intmueipnos etscirvre(ti nugl e)esdias adn 1AF8 24.p1 notuuglormasa siaese:ds igfoner ig-&maaHttleNS-r; .uptoensiinm I hda ot akme senes of it ciesn I t'ndid onwk it swa SHN etoipnumsin ta fs.tir +5


You must be logged in to vote!

 +0  upvote downvote
submitted by ∗breis(56)
The site was recently locked🔒
It can be re-accessed by making a purchase.

Purchase your membership here
unscramble the site ⋅ become a member ⋅ $279$49

ssatsiciPto s(oeetimsm cdlale rnsoshiiot or orptra eidsesa ro atrrpo fere)v is an finintceo of eth nglu nmo(pau)ein uasecd yb hte icebmratu phyiadomlaChl (Camh)lyiad aipst.cti

Sgnsi dan fsm.mo eeruo ,tcg:vspyh ulsauyl othuiwt chum .hhpchm.sa eedhlergua .lmecs a echcehast s. snrnpoati .hsse of seohe artrb. athro.t

unscramble the site ⋅ become a member ⋅ $279$49
charcot_bouchard  aUetpd no ym vpre ctmmone : seY tsih is spisiotta.cs not itesyvyhipetinrs omin.epntusi woH do u ko?wn Ltyphoycme nad sereecPn of alnGaoumr - nereopss ot alilurtanecrl ya. holmwcNdai SH anc saol cause sooel monlugara oto and the nliaclic etpuicr tisll omer kool leki u oYHS wokn hwta ......... uckf tshi equs +2
shemle  reHe tP. 'nsoetd haev !fevre +9
shakakaka  cngoieaNsnat glaor,mnau ahptcy omtccyyhlip i,anliofnirtt nad ofsisrbi aer esne ni svypyrsitHeitnie iimnsnpeout , crngaicdo ot odrlUw . +

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)

You must be logged in to vote!

Must-See Comments from nbme20

amorah on Cytomegalovirus infection
masonkingcobra on Contact with parakeets
hayayah on Capillary hydrostatic: increased; ...
hayayah on X chromosome-linked isoenzymes
medbitch94 on Mannose 6-phosphate
hello on Capillary hydrostatic: increased; ...
hayayah on Osteoblasts
imgdoc on Hypophosphatemia
hayayah on Missense
celeste on 50%
justgettinby on Omeprazole
andrewk1 on Cold, dry air
yotsubato on Jugular venous pressure of 12 mm Hg
strugglebus on Drug effect

one does not simply “walk into mordor”
NBME Answers LLC © MMXXI
search for anything NEW!