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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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wheoNre aveh I nbee ebla to difn hwy hte lhel ihts is a gi.tnh

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yotsubato  Its ont in A,F eStcy,kh ro o,aPthma ro U l.drow I wnek ti tasnw ccnare sebceua sti lreaabli.t ndA aseteDib deam no sesne to .me So I sjut htewr ownd ugrD tcffee dna ledwka .wyaa +10
breis  emsa^^^ +
feliperamirez  hTe lyon spisleob ainlxoapten I inhkt is hatt ehs saw neudr a K psnraig ,tdiceiru ushc as lortnpsieoacon h(cwih lwodu ldae to ntimsy)g.oaeca +
chandlerbas  yuo hda em ta tis nto in thkcsye ); +3
j44n  i ghtothu HNT udincde ypetm alles oulwd ecsau tshi eebasuc htey gto etyp II tusdiaeb.e So if uyo dnee a orp breza nrhuet lorhle ta .em +

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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Gljoan dah a etluecr that nndmoetei atht fI" a atipnte sha areraola,gcht rievwe revye rdgu rytee'h taikng icnse aynm rugsd suace e"octhl.aaagrr

hTe olny ghitn fo sespibol lnreeaecv in htis sme-Qt is thta hse skate a moteicn,dia orfreeeht hte snwera fo gudr" ef"ftce si eth omst leikly rsnoea orf hre lr.gctaaheora

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hungrybox  I ltisl kthni hsit tseuqoni is yrptte BS. But hgavni udisedt some eo,rm I tnhki ts'i sesl SB tahn I aoilnyilrg gthuhto. oamPtah geivs the teher rmoja sesuca of rceorlaagtha sa ipplne aitnlmus,oti rlncamapoito fo toearnri iatyitrup, dna ugdsr se(e 16.1 - treBsa tyho.Po)gla Oyln rdgu tffece si an wsnear ceocih orf iths io.sutqen +9
hungrybox  oT upt enhtora yaw - reefbo ouy yrt to go ogrthhu veery swerna ecio,hc iasgkn lfysoeur "lwdou ihst ceuas crh"roegatla?a datesnI, ask syeu,ofrl "hWta are eht easusc fo cgearol?aar"ht rcciAdgon to Dr. Strat,a heyt era pilnpe" smloutntaii, coamitlnaorp fo raneirto ia,ytrutip dan .gdsu"r +3
hungrybox  heT estqnuoi esdno't ays ytagihnn ttha owldu ptnio ouy dtraow pnelpi l,anioimutst lkei i"t noyl esesm to aaerpp hwen hes tpsu on a ihparts/yls sre/c.tstu/nro"ps tI osal mksea on oeinmtn of obptielrma dbiselnsn hcwhi( odwlu niopt yuo to an aoeinrrt iaipurtyt uto)m,r so you acn ruel uto oroml.pctiaan Teh yonl ptinoo lfte is gdur ffetc.e +2
drdoom  bogrhsnxy’u ullf nmteomc )be(wol ehr:e te:0e#xbcm/o9ens//sn30p72be0.ms//1rnwmtmha4a +1



 +14  upvote downvote
submitted by strugglebus(189)
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As na ei,8d:10t00 1 elpope rdrpteeo ot ehav dise scffeet wenh nkgita iA.gHo rcmlrdhhtzoaonoydei hmte, 52 ppeole .)002%( ehav rBetas eadrhgcis

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neonem  I itnhk eth sbte yaw ot raewsn sith otusniqe wsa by percsso of .inaetomilin +1
sympathetikey  a'tshT seom ibsltlhu lol +9
karljeon  ahaH I eailndmiet the arsenw yb scerosp of meoliii.nant +25
medschul  I aleeiidntm zietidsha by ecorpss fo aiinmtenlio (: +3
medstudent65  tihS I daitmleien eihaszdti eucesab fo lmniiatnoei newt ihtw THN nginhtik ncriltreania ebdel ngitcfefe the yttuirpia +2



 +3  upvote downvote
submitted by fkstpashls(23)
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seoscPr fo innmaeioitl si eth lyno awy to etg hist reasnw tuthiow atavnS ellevs of i,atums as some iotweb gneiarw edorhcu hwo wroet teh utsnqeoi oapbrybl h.sa

aCcnre is riuaanletl olstma lal the im,te MD dosten' kmea nssee for ayn rseoan, HTN slfeti luw'dnot scaeu ylkim bsoob, dna mast lscle rlinegngaadut soednt' kmea milyk osbob .tireeh ,So dan ceueasb namy gdrus can evah imkly oo,bsb r'ouey tlef hiwt drug steeffc by oescpsr fo ilnm.ieaoitn

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djinn  I ondt tnkih het ruaot wsa a .nvstaa sloA I khtni is ghtir sceocrps to nkith c"ean"cr nca eb ibelarlta and gmaanlint ubt hte r"dug" ttha sasuec shit inst H.TC sThi stoquien is abd ti.newrt +1
hungrybox  nAccgdoir ot tamah,oP caraorlgaeth is NOT tsicdsaoea wtih cacren erev ees( .161 - sertab yaho)tglo.p +
djeffs1  acgdioncr to 'sglrssutbegu senbmru tis rmeo lkilye to eb /bl rcecna tahn ita..edihzs. +



 +2  upvote downvote
submitted by niboonsh(409)
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" htreO secssla fo smidcteaino htat acues erntyimrepacaolhpi uldncei dsensnase,iatptr ievnttierpsehayn naetgs, adn durgs ttha rcianees weobl tmil.oiyt ltycemirnrpiHeaapo eaucsd by sdtnmoiaeic si moynmocl mmsttpoay,ic cugsain hrgaleroat,ca meralutns acutbdns,rie nda e.neicotmp It si mptaontrI to sureen ahtt aprmatnoleiircyehp ni an iaddnlviuI neittap si ued ot incdiaemot and nto to a rctualutsr eonisl in the iytttcralpouaphhya/iim aare; tshi nca be icpaesocdmhl by (1) tspginpo het tiidenoamc trmpeoliary ot tredeeimn heehtrw ptlcianro vselle rntuer ot nmlo,ra ()2 tigiwnchs ot a econiimdta ttah deos nto sceua eianpcoeilmatyhrrp "

mn2.s/6eguthp:/5hb./n.ww14vil9o.bmwtpcn/8id0

dnoddoneee-tN"nesp- dsei cseetff — htulAgho s-wodelo patryeh esesm to iziiemnm teh oeamitlcb octolpciamnis cendiud by a iazhetid or thaeildiki-ez uiteirc,d it aym ont yeinlarssce atlmeniie toehr esid cteffes. sA na pleam,ex as nmay sa 52 neectpr fo emn ettdaer ihwt 52 m/yagd fo neotlhraichdlo vepdleo a lnceeid ni asulxe onncufti [3].4 Sepel cnieusdbastr acn losa cro,uc aritrulpcyla fi het teptani is on a uodwsim-ol ietd [34]. woH sethe eolmbprs cocur si otn won."nk

eytwh25swrtt/p-i9-ueth-8Hsi3zeteora5a-ieipscihi.e9i2msopidontfe0lnonitp-ptwet-c/ot#-naanus:/0itde-dt-euh/tnmsn.aswcrrsy

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 +2  upvote downvote
submitted by hungrybox(1277)
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amohPat ivseg teh there amjor secusa fo torgahleraac as npelip n,iutsaiomtl lamaitrponoc fo ratoiner tratyiui,p dna rugsd ese( 61.1 - Bsraet tPlhyao)og. lOny ugrd ecteff si na arnews icecho fro hsti oitq.sune

oT put thaeron ywa - brfeeo uoy tyr to og ogthhru rveey rseanw hoicc,e iskgna osulrfye uowdl" isth eusac "raathg?elcaor neadsIt, kas l,osyreuf Wtha" rea teh eucsas fo ?graacloh"tare dciAnogcr to rD. tatSar, eyth rea enplp"i iiuantotlm,s aamopnirlotc fo irenaort ipurtay,it and "srug.d

Teh qiotsenu dtes'on asy nhtynagi hatt ulowd piotn ouy atdowr elnppi ,itmonstauli ikel t"i ynlo emess to apreap ewnh ehs ptsu on a pyailrts/hs rscs.†ort/e/s"upnt oS you can elru tuo plipne aoinlts.muti

tI saol kmase no teoimnn fo lmaieobptr dlniebssn w(ichh odwul tnpio ouy ot an rraoneit patryuiit )umt,or os uoy acn urle out .ctaiamnorlop The yoln ootnpi tefl si urgd .fectef


I'ev verne seen gaynhtni keli hsti on a iqnteuos tub I ssuaem hte MNEB luodw odwr it ni soem dvuoclenot awy ielk htat.


I laintyiil otwer siht as a tmomueb,csn but I leef ikel ti ersedevs tis nwo m.eomctn I swa eernv realyl ieatidsfs htiw any fo het nplnxaietaos orf hsti eplbom,r and I lilaynf ireadvr at neo thta seakm het tsom seesn to e.m

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hungrybox  hO, dan sseed,ib lipnpe itaoutnmlsi dna amcnarioplot 'artne enve esnrswa llo +
drdoom  ymesst[ ]aimler uroy couacnt hsa neeb dag:urped OAFMTR INNAJ +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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sihziaeTd erdecu RGF -g&t; deeRduc ncaealecr of picotalrn ;-&tg lpircameotayiphne g;t-& scaerg.hdi

Not user woh rceotrc taht ,si btu sdaei fomr cracen negbi leu,tainrla I udolw oesaastci ihgh irlntocap with lsso of nmapeido ini/cdtueieornbdhi ncaelarec of lrnptiaoc .iftles

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 +1  upvote downvote
submitted by sam1(22)
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sedziTahi can euasc etuca sttilitrenai ptinhiers, a form of rneal auilefr. tituWho eth anlre xcntoeeir of tc,lproina ti anc uldib up ni eth rsuem dna esutrl in haac.ralrgote

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coccidioinmytitties  uSaexl oyntdinfsuc dieser[ esdab = oid]lib anc eb ude to rgdu dsei eftfcse essea]n[t,nripehityv pre frsti ida. iido:nt E a20 1Pg:e8 S1ot:i5e5 nc yP sherc,P Aisds1't eondnirce n:istcoe vecis"eexs utoasnm of itlrpocan eaaitcdsso ihwt bido↓il ]24.3[ hsT i oegs ehgtrtoe iwht our axseul yiuosncntfd twhi "iinestnshepayr."tev l Oyn lgcoail shtysiesn I acn ikthn :fo dahz ieit = n↑ciralopt = id↓olbi + oagcr.lahrtea It odulw loas kaem esesn ensci ew era degailn tiwh na eetpcxde to be tma-asloppeosnu faleem [lkmi oopturncdi duwlo veah ot be ued to esgneooxu c]sgeor.Duu into my ureetlc tenos adn ufodn teh ifl:wlnogo kbb-stleroace dna dizshaeit uceas sxuael Itcyi snoudf.n sola elik 1sma's axtnl.iaoepn W'ree eahgincr r,ehe tub sit hte tesb I nac od. +
g8427  Mayo icinlc wssho lcear ro dobloy elnppi erschdgia as dies tacffe of .saidhzeTi But nstode satet ymlki ahsecdgi.r +



 +1  upvote downvote
submitted by namira(39)
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sePibsol t:naelpnxaio

If hte tp is gktain a zeatdihi iwhh(c is K eeitdp,l)ng it hmtgi evah laso been gniev itwh a K gapirsn gdur husc sa riceainlnt.opos

onletnSpcaorii ahs recilioocndnog tcsffee hucs sa cgoisaetnmya adn caeglara.htro

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sugaplum  I nhtki oyu ouldc nlyo meka isth tsnaomupis if yeth asid ptt"naei si no trsdaand nht x"t tub nices ehyt eavg eth anem tczh, olwud ont be afir ot aessmu htye rae aslo itnkag aloinocptsr.nie I tewn hwti srcepos fo aiotnmeinil no isht o.ne vne E kechecd cessac si'ceienmd rudg rsvdaee eftfec ieergoorarh..al.fclapt nto liedst orf zhtc +2



 +0  upvote downvote
submitted by j44n(141)
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ilebssPo csasue of argorhlaecta inl:decu soedtcan,iMi scuh sa anctrie avsedit,se dtptansiease,srn htyaictnsocpsi nda hhig obodl rsueresp udsr.g iioOpd su.e erlabH emluesntps,p hucs sa ,enlefn seian ro rueenekgf eesd

^ omfr eht omya .il.c.n.ic psshamei no eth HNT drgus

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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tgdh;=aiTeiz& =ry&cmi;eatpelghac toyOxixn qG( uepdcol p-t;or&inegt nicr ;+Ca2&)t=g peplin siaercghd

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arkanaftus  iyOntxco lliw nto rowk no sbrtea reitsnulg on mkyil idseachrg if the ngdals ewer not adeerpr""p yb aplr.toicn 'stI keli ingryt ot qseueez tmyep nbloaol - otingnh seog otu. +1



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