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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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erwNohe heav I bene leba to fidn why het lelh shti is a hngi.t

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yotsubato  Its tno ni ,AF ,tkhecyS ro hatmo,Pa ro U dowlr. I wken ti satnw rcnaec ecuseba sti lirlat.eab ndA bitsaDee edam on eness ot .em oS I ujts hrewt dwon rgDu eceftf adn lewdka wa.ya +10
breis  sa^^^em +
feliperamirez  The ylno isspeobl ineanploaxt I itknh si that esh saw udern a K isgnapr eutcirdi, cuhs as osircoepotnnla cihwh( odluw lead to emicagnsyt)oa. +
chandlerbas  yuo had em ta sit tno in shktyce ); +3
j44n  i otthhug THN uicednd mtyep ealsl duowl sueac hits bcaesue ythe gto eypt II .diseeabtu oS if uyo ened a rpo erzab heutnr eorlhl at m.e +

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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jGonal ahd a ltueecr hatt mdnnteieo atth f"I a teptnai hsa ahoegrcarla,t revewi yerve grdu yet'reh tkniag enics amny sgrdu seuca o"h.garaarectl

Teh oynl gihtn fo lesobpsi crnleveea ni shit es-mQt si ttha esh astke a oidancm,iet orfherete eht newsar fo rg"ud feec"tf is hte otms llkeiy nreosa rfo erh alagrothcre.a

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hungrybox  I lilst ihntk hist itqoensu is teyptr SB. Btu vgihan isedtud osme eo,mr I knthi t'is slse BS htna I anyiliogrl tguhoth. Ptaohma svige hte tehre jamro sausec of gtlarhcaaero as ippnel mtonaiilts,u icomalnaotpr of onretira uytaiip,rt nda dsrgu e(es 61.1 - Braste .)Pothlaoyg lynO dgru tecffe si na rnawse ecoihc rof tshi t.snqeuio +9
hungrybox  oT tup onrtahe ywa - rfbeeo uyo ryt ot og hotrugh yevre enswar he,coic gsikna fuoylers douw"l htis ecusa rr?atohgalca"e ea,dstnI sak lfouysr,e Wath" rea the cssaue fo a?aerahgcotr"l ngoiccrAd ot D.r raa,Stt heyt rae pli"enp sumit,taoinl apmtilocanro fo onerarti ,yriittupa dna "sgru.d +3
hungrybox  Teh oqisenut dotsen' ysa ntigyahn atth odwlu iotpn uyo owatdr enppil stilm,nuoait iekl "ti onyl emses ot epaapr henw ehs tpus on a psyta/rishl r/ouectnsrp/.ts"s It osla smeak on imtneno of olribampet elsdsbnni i(cwhh lwuod ntpoi ouy to na ronteair tyiiartpu o,mr)tu so you can erul tuo alotmpo.nciar Teh noly nooipt tefl is urdg f.tcefe +2
drdoom  nr’osbgxuyh lufl ecommtn b(weol) r:eeh ch/:#.s/as/2emnmnwmt0s90x/1e7tnpbrema/34bo0e +1



 +14  upvote downvote
submitted by strugglebus(189)
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As an d00 18i:10t,e elpepo portdere ot veah desi scteffe when tgnika i .noeaylrrdoidthmhcgoozHA emth, 25 leoppe 2%)0.(0 ehva rtaesB acdsgrihe

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neonem  I tknhi eht tbse awy ot wnsrae this etqnouis saw by crposse of itnieonmai.l +1
sympathetikey  'stTah meos lhisbltu lo l +9
karljeon  aHah I teideinlam het narsew by osecsrp fo inonlma.iite +25
medschul  I neldetmaii tdziihsea yb psercso fo oinmtiilnea :( +3
medstudent65  Shit I aimnidlete tdihieasz esbeauc fo netinlioima tewn htwi TNH gitikhnn aeatrlnricin ldbee fieefgtcn the iairtutpy +2



 +3  upvote downvote
submitted by fkstpashls(23)
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socePsr of eintomliain si teh noly ywa to etg tish newsar hitotuw aStvan levsle fo isa,mtu as esom etobwi eanigwr rdhuoec who wreot teh isnqoute bolrpbay h.sa

Crncea is auatillner ostmla all hte mt,ie DM t'eosdn emak esens rfo nay osrnea, HNT iftlse wltdn'uo cseau lykmi so,bob dan tams eclsl iranegtnladug t'onesd aemk liymk osobb teirhe. o,S nad esuceab mnay rdusg can aevh lymik oo,bbs 'erouy etfl whti grud cfsefte by spcoser fo tinoml.ineai

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djinn  I odtn tkihn teh ouatr wsa a v.ntasa slAo I nitkh is irght oprcessc to iknht rcac""en acn eb alaletbir adn ntmlainag btu hte gd""ru htta csaeus tish ntsi C.TH siTh sotneuqi si dba .inetwrt +1
hungrybox  Aodccgrin ot to,aPham hactlragraeo si ONT eadatcssio iwth racenc ever see( 611. - ratesb t)opahgol.y +
djeffs1  anoircgdc ot rs'ugssubetgl ebrmnsu tsi moer yillke to be /lb rncace anht hdieiz.a.st. +



 +2  upvote downvote
submitted by niboonsh(409)
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" Orthe ceslass fo diitsemnoac htat ueacs proyapletaiecimrnh ildcneu aept,iassnredstn seeryveithitnanp ,entgas adn sudrg atht eeicsran lobwe .iytomitl cyipmrrenaHaletpio eudacs yb oseditnmaic is ncooymml psmt,yacoimt uangcsi ahlcro,egtraa trneualms ad,buiestrcn nda pnieme.oct tI is oarntIpmt to rneeus thta nmhplroipriyaacete in an addniulIvi nttapei si due to ticanmodei dna not to a ctsauurtrl onseil ni teh iathtaopmyiciahrupt/yl a;ear isth nac eb pmodlcechsai by ()1 optgnips teh itniocdema iarloeyptrm to merinteed whthere oacpitnlr slveel tunrer to lno,rma )(2 itgwcsnhi ot a amicitoedn ahtt sdeo nto uesac elpcmoaehiyrnaript "

t/iu../hnimoescmgd5nwwp90n/b6/:48..bw1hlt2pv

ed-"ododpNeetnesnn- sedi efefstc — hAotlhgu dow-esol eartyhp sesem ot izimnmie the ceiatomlb oistnclcmaopi dceudin yb a etadihiz ro ztelka-ihedii ,teduiric ti yma nto lsysaicreen eenamliit toher esdi cetfse.f sA na ,xamlepe sa ymna as 52 prtneec fo nem eetdtar hitw 25 /mgyad fo oeiactnhodhllr vpdoele a ldnecei ni suaexl onicftun ]3[.4 lpeSe sidbuescnrta acn laso oc,cru irluapcayrtl fi het nipttea si no a smdl-iuwoo etdi ][43. How eehts melsprob uccro si not nwo.n"k

:mosm-#r-yn9ae2sHiwtrttndieaopu.itteias9nenaw-pio/ehcoeti5-floi-nruiwy-s5stctn0wrh-2./ts/i-ahpstznitdppeee-0u3t/sdthc8e

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 +2  upvote downvote
submitted by hungrybox(1277)
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tahmPoa igves hte eterh mojra uscaes fo erlotrgaacha as ilpepn ionti,tuamls tnaoplrcimao fo raitneor i,aypuittr adn rgdus (ese 61.1 - estraB aohol.)yPtg ynlO drgu etfcfe si an seawnr cicohe rof thsi utsq.onie

oT upt atnoreh way - feerbo yuo ryt to go uhhtorg eryve earwsn oh,icec sgakni urolyefs ou"dwl this ucaes aragelohc"a?tr atIn,esd ask oeyslfr,u ah"Wt ear teh casesu of crlraoha"etga? nigcdrAoc to .Dr tSar,ta they rae iepn"pl tntiu,omalsi nliraatcmoop of nearotir truypia,ti nda drsug".

eTh oqeinstu entods' ays ginynaht thta dowul tnoip ouy wodtar penpli noiui,attsml keli it" ylno meess ot ppeara ewnh hes ustp on a yssrp/tlhai turrpts†.c"ne/sso/ So you acn urel uto neppil istitomualn.

It osla esmak no ntmione fo alretmpboi sbisennld chi(wh dlwuo niotp yuo ot an rtionare iparutiyt rtmo,u) os uyo nca rlue tou .iptacaomnrol hTe ynol oopitn eltf si rudg .efftec


v'Ie rneve nsee nghytian ikel isth no a siunteqo btu I semasu teh NMBE wdluo owrd ti in eoms ectvundloo awy ekil .thta


I niiiltlay rotwe hsit sa a mut,nbsmoce utb I efle ilke it eesvdsre sit wno mc.metno I swa revne erlayl istiesdfa htwi nay of het onaltnxpasie fro siht b,mpreol dna I ailnlfy iderrav ta neo tath skmae the tsom nsees to em.

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hungrybox  h,O nda dssb,eei niplpe oliatsuimtn adn oapirtlmcnoa enr'at nvee raseswn oll +
drdoom  ys[tesm a]rliem uory ucntaco sah eenb gaepurdd: ORMFAT NNIAJ +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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zdaihTsie uecdre FRG g&-;t eucdedR ercnlacea of otnlcipra ;-tg& eatiipocynrlpehma -t;g& ca.irgshed

tNo seur ohw ertocrc atht ,si tbu edisa mfro eracnc gneib tr,aiealunl I owudl easoiacts ihgh ocpatlnir htiw osls of anmoeidp iieuieionbntrch/dd aercenalc of rociltpna fi.ltes

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 +1  upvote downvote
submitted by sam1(22)
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deziTsiha nac usaec teacu irntsttlaiei hi,tepinsr a rofm fo erlna re.uflai Wttuhoi the aernl xctroneei fo aprtnol,ci it can liubd up ni the usmer nad trselu in tr.lcraoahega

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coccidioinmytitties  eluxSa ytunsfcodni sred[ei sabed = bi]loid anc eb ude to drgu eids cetesff seeh]nnp[ytesiivtar, epr trsfi dia. di:iEnto 02aP1e g:8 t 1c:einoS55 PrP hsecy, s1iAdt's cednoerin etsn:ioc v"eceissxe mnotasu fo iaoptcnrl actiaoessd wtih ↓ibdoli 2].34[ Tihs oegs eghrotet whti uor euslax disnyntofcu iwth h"e"pety.itsninseavr On ly cglaiol hssnstyie I acn kithn :fo izh etadi = itlpnrca↑o = l↓oidib + rtalcrehoa.ag It uwodl also keam sesne neics we are egliand hwti na etpeedcx to be neutlmsppa-soao meflea mkl[i otrinoupcd olwud ahve to eb due ot snueexogo cgoru.]eDu s ntio my lutreec notse dna fnuod eth i:wlngoflo blke-rbatoecs nda tezidshia uaecs xealsu c Iiyt.nndsofu losa lkei 'sasm1 nlpaxna.teoi er'eW anihgerc he,er but tis het tbes I nca o.d +
g8427  oayM lcciin wohss lrace ro ydoolb elippn resihgacd sa iesd ftefac of dhTiezs.ai utB tsendo satte kyilm d.scaigehr +



 +1  upvote downvote
submitted by namira(39)
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oslsbiPe txlponn:aiae

If eht tp si iagntk a ziidetah (whhic si K pn,lidegt)e it hgtim eahv laos enbe eivgn wtih a K pginars rdgu chus sa ciinntproe.asol

rinnScoiaetpol sah cinlocginordeo fecstef hscu sa oamitsnceayg dan ra.aecohrlgta

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sugaplum  I itknh you ludco lnoy kmea this mouaitsspn if htey idsa nttpa"ei si on addnrtsa hnt "tx tub escni ethy vage eht mnae zhct, ludwo not be iafr ot asseum they rea saol kngait e.noritcnpalios I twen iwth ssoercp fo nienilaitmo no hist .eno nve E hcdkece scscea msnciiede' gudr vaeders ftfeec g.heacraeo.r.polilafrt ton lietds fro cthz +2



 +0  upvote downvote
submitted by j44n(141)
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lsoibseP ucsesa fo grohacatrael ncie:udl Mnio,dcistea shuc as tirncae vtdeises,a rsietn,sadesptna hcitntsaciypos nad ihgh oodbl esrpruse gus.dr idOpoi s.ue elHarb snspepu,tlem chus as feenln, neais ro nefrgeeuk esed

^ mfor hte yoam i.cic.ln.. phseasmi on the HTN durgs

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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diegTztiha;&= le=mcr&hytac;gpaie xOiytxon Gq( cepdluo -;ogtin&prte crin gtC=&;+)2a lnippe gridasech

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arkanaftus  xictyonO will tno rkow on sbaert ilngrtseu no ilykm chrgesdai fi hte alnsdg weer tno aepd"rerp" by tiaonrplc. I'ts kiel ygintr ot eezques ytpme nbolloa - nohnigt sgeo .out +1



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