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Retired NBME 20 Answers

nbme20/Block 1/Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect 🔍 / 📺 / 🌳 / 📖
tags: pharm

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 +25  upvote downvote
submitted by strugglebus(189)
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woheNer ehav I been leab ot indf yhw the elhl htis is a t.nghi

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yotsubato  stI tno in ,FA ,ctyekhS or oaP,thma ro U dr.lwo I ekwn it anwts rcneac ecabeus ist itl.aerabl nAd bsDteeia emda no seens to .em oS I tsju twher odwn ruDg ctfeef nad ekldaw y.waa +10
breis  s^a^e^m +
feliperamirez  The noly lesospbi ntixaapnelo I ktihn si ahtt hse aws denru a K pginsra iietcdr,u uhcs as oiarlnesotnpco ih(chw wldou dael to mioacsgyt)an.e +
chandlerbas  you dah me ta tsi not ni htcseky ); +3
j44n  i ghtothu HNT ucdnied mpyet slela owlud asecu htis ecuasbe heyt gto tpye II duetea.bis So fi yuo ende a rop breaz ruehnt eholrl ta me. +

https://www.mayoclinicproceedings.org/article/S0025-6196(11)61587-5/pdf#:~:text=Other%20classes%20of%20medications%20that,dis%2D%20turbance%2C%20and%20impotence.

if you want to save your time and not read an 8 page research article like I did heres the summary

Other classes of medications that cause hyperprolactinemia include antidepressants, antihypertensive agents, and drugs that in- crease bowel motility. Hyperprolactinemia caused by medications is commonly symptomatic, causing galactorrhea, menstrual dis- turbance, and impotence.

+1/- j44n(141)


 +21  upvote downvote
submitted by hello(429)
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aGjonl ahd a reucetl ttha enetmdnio htta "If a etpaint has ,rreoagclaaht iwrvee verye drug 'eyreht tagnik eicns yamn dgrus ecsua lac.rhaeotga"r

eTh oyln ngthi fo elospibs careelnev ni iths s-Qmte is ttah ehs akset a ,niitmaocde reothefer eht wesrna of grud" t"efefc is teh most elkliy searon ofr ehr atrho.lgraaec

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hungrybox  I sltli htikn tsih toniqesu is yttrpe .SB uBt hivagn tiddeus smoe roe,m I nhikt t'si slse SB ahnt I linilroagy hottgu.h oamtPha vsieg teh rheet jaomr uaescs of aacoerhrtagl as lpepni omanttui,sil rnamlpoctiao fo rtarnioe aiittpyu,r dna gsudr (see .116 - Bsrtae )ol.Pygatoh lOyn urgd efctfe si na earwns cohiec orf shit inuo.seqt +9
hungrybox  To tpu ntareoh awy - febero yuo yrt to og ourhgth eervy nerwas hicoce, sngaki uesforyl wuold" sthi aucse alac"atergoh?r Ine,tasd ask eo,ryfuls htaW" rea eth auescs of aor"alg?hcetra rdocAcgni to rD. raSat,t yteh rea neppl"i otnsatilum,i painotarlmco fo itronera tpy,uiarit nda .gd"sur +3
hungrybox  Teh iqnotsue tne'osd sya ynianthg htta wdulo oitnp ouy wroatd ppilne ,uatimotilns leik t"i lyno sseem ot aaeprp wnhe esh tusp on a rtshl/siyap tusnes./tr/p"oscr tI alos maesk on onniemt fo piterolmab lnsebinds (hhciw dulwo noipt yuo to na aitorner ttiypurai ),mortu os ouy can leru uto laionapo.mtcr hTe ynol tnoiop ftle is urgd tc.effe +2
drdoom  o’bsungryhx ullf tomcnem )b(wloe :reeh npbc2n39s1m/rbm/e./e//4hexm7sa0a:m#0es0twtno +1



 +14  upvote downvote
submitted by strugglebus(189)
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sA na 8 1,e0td0i:01 eeppol otrepder to haev seid cefefts ewnh itnkag zAonomieyodiagrthhHcodl.r mt,eh 52 ppeelo 0(0)%.2 vaeh sBeart rcadeighs

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neonem  I ikthn teh etbs wya ot reansw itsh qnsiueto wsa by cprsose fo .iiiontamenl +1
sympathetikey  athsT' omes uslhibtl o l l +9
karljeon  aHha I ntlidimeae eth nsrwea yb srocpse fo nnti.eaimilo +25
medschul  I itadmneile zthidsiea by opecrss fo oniniilaemt :( +3
medstudent65  Shti I eltaminedi shaeiitzd aeeusbc of noaemiintil etnw tihw HNT itnhinkg natrlriicean elebd geitncffe teh ttpiryuai +2



 +3  upvote downvote
submitted by fkstpashls(23)
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roPsecs of aitominelni is the nylo wya ot gte hits enwsar toitwhu anatvS svlele fo atui,sm sa seom tiwboe aegwinr uhrcode ohw woert eth nutiqeso byoplrab sh.a

rnecaC is uaeritanll alomts lla hte m,eit MD etd'son ekam sesne ofr ayn aenso,r NTH setfli l'dtowun seuca kylim ,oobsb dan mtas elslc atgdnliaergun etdnso' keam kilym osbob teehri. So, nad ecsbeua myna grusd anc eahv milyk o,sbob yeo'ur ltef itwh dgur fsecfet yb sposcer of mliioi.naten

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djinn  I otdn tinkh the ratou swa a aa.tvns lsoA I nhtik si gitrh cscoersp ot khtni c"ncaer" anc eb blteraila dna mgtainnal ubt teh ud"rg" tath cesasu hits nsit .HCT ihTs sioqetun is abd nri.wtte +1
hungrybox  ccoArigdn ot mh,Ptaoa agrahoretlac is OTN ectiaodass ihtw aecnrc vere ee(s .611 - strbea po.lao)thyg +
djeffs1  icaognrcd to es'urbtugsslg brsmune sti roem elkyli to eb l/b ecrnca thna .th.ide.szai +



 +2  upvote downvote
submitted by niboonsh(409)
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" Otehr sasselc of imdcoiasetn atth sueca realtappemonhriicy luicned arptsisdesnaten, nepieetyvhinasrt etgns,a dan dsgru atht siecenra lebow yimito.lt rcnHrpmeeyiaitaopl ausdce by itnciasmode is olcmomyn cmpt,imytsao gansicu ecagrrohalta, eusmlnart atdsbenr,uci nda etpoie.cnm tI is pntamorIt to rsuene tath ipoaiehrnyamtclrpe in na idvandiulI neptati is edu to deictinoma nad nto to a cruatltsur onlies ni het tciyoahmypipalttiah/ru ar;ae htsi nca eb sdphaieclmoc yb (1) nsgoiptp het imdncitaoe atyorimplre ot netrdmeie rewhthe litorcanp svlele erturn to rlno,am ()2 nwhtscigi ot a tmnodceiai ttah deos tno csuae perirlctyoamnahpei "

5nobm/82n9.6wu1.ltgip/40pcsw/.bh.nh/vdetim:w

epoeetnne-o-ddNdsn" edis steffce — lgAhutho esoodw-l arteyhp semse to iemiznmi eth limbcateo nioosaimpcctl uedcind yb a ithzedai or kthe-aeiidizl udeirit,c it aym nto seieslracyn mieltanei htroe dise fe.ftesc sA na mpaxl,ee as nyma sa 52 ectpren of nme dtaetre iwht 52 myg/ad of iarhelthoncold veoledp a cleiedn in lauesx ctifnuno .4][3 elpSe esatcirbdnus cna aosl ,ccoru lyurlpitcara if the taepnti is on a io-wmoduls eidt [4].3 wHo tshee bompeslr orucc si not ko.nw"n

airen9i-siwiascoiniarfenscnw0/c/tt9pu3-e-yssh-/zoteu.-dtrmn0s8iipseoy#-hnmh2a.H-5os/poep:w2tetipretudtetitnhwta5t--ldet

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 +2  upvote downvote
submitted by hungrybox(1277)
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ahPmoat vseig het herte omjra usasec fo ealtaorracgh as npeilp iaotnl,msitu nlomcapaorit fo rinaotre tiur,tiayp nda rsdgu se(e 1.16 - Besrat h.oot)yPagl nlOy dugr tffcee si an aersnw ohecci rfo tsih oqeusitn.

To tup ahotnre way - beefor uoy try to go hhtrogu ryeev anrews ihecco, ngkias sfeloury "uwdol tihs csuae ltarr"ac?hgaeo n,edIsta aks ry,sofelu "haWt era the cuaess fo tgaaal?oc"rher onAcicrdg ot r.D ,rtaSat eyth era elp"npi mtuatli,nios iamooptcrnal fo onertair yat,irpuit nda "grsu.d

The osutqine onestd' ays atyhignn tath doluw itpon uyo owtdar penpil iutomstialn, ikle it" lnoy sesem ot parpea hewn she tpsu no a ityp/salrhs "t/†ecsnorsrp/sut. oS ouy cna rleu uto ielnpp smnitoaut.il

It osla esmka on onntiem fo prbemiatol dbseslnin h(cwih ldouw piton oyu ot na tarenori urpaitiyt mr)ot,u os you cna erlu otu apmotorl.anci Teh nloy ontopi eflt si rugd .ftfcee


ve'I reven enes nngytiha eikl sthi no a ueintqos but I msuesa the MENB wudol wdor ti ni mseo noctouvedl ywa ilke .ahtt


I iatlnylii etorw stih as a mmbs,eotnuc utb I feel kile it erdevsse tis onw ntm.ecom I swa vener rylela sfsetadii hiwt nay of hte oneatpalsxin rof htsi bpmlro,e adn I ilalynf vrireda at eon thta kasem the tsom seens ot e.m

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hungrybox  ,hO dna bseis,ed linppe tlaisuintom dan amtolipnroca eatnr' evne ssrwena lol +
drdoom  [emsyts ialmr]e yuor nocautc sha been egdur:apd ARFMTO IJNNA +1

One more thing: Pathoma specifically says cancer is NOT a cause of galactorrhea.

So the people who are saying you can rule out cancer because it's bilateral are completely wrong. You rule out cancer because it doesn't cause galactorrhea.

Besides, breast cancer can be bilateral. Bilateral breast cancer is almost always invasive lobular carcinoma.

This is analogous to serous cystadenocarcinoma. Bilateral ovarian cancer is almost always serous cystadenocarcinoma.

Idk how this "breast cancer can't be bilateral" myth started propagating.

+9/- hungrybox(1277)


 +2  upvote downvote
submitted by dave_(3)
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ieisazhTd credue RGF gt-;& udcedRe alaecnrec of oliptcanr ;&-tg iarpcimhyopetalne ;t-&g sdchg.eari

Nto esru how ceocrtr taht i,s utb idase rfom rccane bigne intll,uaear I wuold sositcaea hhig opnaicrlt whit ossl fo ednipaom inibuoeeddc/nirhti encaclear fo apoticrnl s.eiflt

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 +1  upvote downvote
submitted by sam1(22)
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iTidhaesz anc aescu teuca nistilatitre iinpesrh,t a from of renla lf.euair uWhtiot hte enrla toieernxc fo ,nrtiapolc it cna idblu up ni hte smeur and urtles in .troragahlcae

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coccidioinmytitties  uSlexa uoidcyntnsf sre[eid bseda = ibol]di nac eb eud ot rgud dise cefseft ytp,v]sasrneit[ineeh rpe itrsf ai.d d iEnito: :e g81a20P :5ei1ntSo5 c Pcye, Prsh sd'iAts1 neeinorcd :nietosc ivs"xsceee mtasonu fo raoncilpt dsaieatocs with i↓obdil .3[]42 sihT sgoe oethgret hiwt uor xulase nnuoiyscfdt wtih hiantye"i.nsvetep"sr lOy n cglialo yihssetsn I can knith fo: edtiaizh = crlotapn↑i = di↓blio + laraocerthg.a It lwuod slao kema esnse enisc we are dinegla hwit na peedcext ot eb t-eopsmanlsupao fmalee ml[ki dutoonircp uoldw hvea ot eb ued to ugoeseoxn gD ]eruocs.u oitn my eulrcte esotn and dfuno eht lo:lfgiwno staecbo-rbkel and tzihsaeid seacu xlsuae ycnitfdsoIn.u losa lkie 'm1ssa onaxnep.lati W'ree cainhegr ,ehre tub its eht tesb I nca .do +
g8427  Myoa icnlic woshs arlce ro blydoo lepnpi iherscdag sa eids cetffa of easThdiiz. But sodent setta kilmy ga.dshicre +



 +1  upvote downvote
submitted by namira(39)
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lPsbeiso iex:lapntoan

fI het tp is ngtaki a iaedzhit h(whic si K edte,lgin)p it tihgm vaeh soal enbe ignev ihtw a K isprgna dgur hsuc as snirpiooatl.enc

ceiorSalnnpito sah ilcngncieooodr cetfefs cshu sa nmtegaiscyoa dan tclaorrag.hea

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sugaplum  I tikhn you duclo loyn kame isth snuamsptio if yhet iads tt"ainpe si no dsdatnra tnh t"x ubt ecisn yhte egav teh aenm zt,hc udlow otn be afir to mueass htye ear olsa knatgi lcaiotnpniore.s I tenw iwth srcespo of oatinneliim no stih .oen nve E dceckeh csscae iensdiem'c urdg serdeva efefct .geerlih.talropaoca.rf ont diselt ofr thcz +2



 +0  upvote downvote
submitted by j44n(141)
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eosisblP cseaus fo ghraoeltcraa n:ulceid itecdsiM,ano cush sa ctnirae saevei,dst t,anrpesndsesita iaphottcsyisnc adn hhgi bldoo rsrpuese .gdrsu iopdOi .esu balHer l,tsnesppeum such as eennfl, isena or geknueerf sede

^ rmfo teh moya ..i.lni.cc ihempsas on het TNH usrdg

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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T&ti=dizhg;ae hrme&iealc;=pyactg Oytnxxoi q(G dlcuope &pnetg;oir-t cnir 2+)Cta=g&; epnpil eiadghcrs

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arkanaftus  oxtyOnic lwli ton wokr no etrsab sltngieur on iylkm arghicsed fi hte asngdl ewer not dpp"ra"ree yb i.portlcan stI' eilk ygritn ot eqzuese tepym bollona - inhnotg sgeo uo.t +1



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