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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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howeerN heav I enbe bael to infd why het lehl tish is a .gnith

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yotsubato  tIs otn ni A,F ckyhet,S or hotaPam, or U dlor.w I ewkn ti stwan nccaer eesubac its i.raeabllt Adn Dieabste edam no ssene to .em oS I jstu wrhte nwod rDgu fetfec nda dwalek aw.ya +10
breis  ^m^as^e +
feliperamirez  eTh loyn sislboep pnilaxetano I hintk si hatt she saw nrued a K inrpsag ireudtci, usch as rsitooaeolcnnp hhc(wi woudl elad to n)tisaa.omygec +
chandlerbas  ouy had em at its nto in ecshtyk ;) +3
j44n  i gouhtth NTH cdnudie ptemy alels uoldw ueasc htis easbecu eyht ogt ypte II di.bseeuat So if oyu ndee a por rzeba uetnrh hlroel at .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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Gajonl had a erectul thta nnoimedte ttha If" a tiapent ash tcahrlgara,oe vreiew ryeve rgud yh'rtee ktngai seicn myna rusgd secua "coltraaarg.eh

The lyon hgint fo bosiselp ceernalev in isht mQts-e is ttah hes seatk a ,iciaoentdm roefteehr het wrsnae of urgd" fe"ftec is eht tosm kleyli ersona fro ehr ola.aartehrcg

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hungrybox  I itsll kthin htis inostqeu is rettpy BS. utB vaignh sidetud omes ,mroe I itknh 'tsi elss BS tnah I riiyllgona tohu.thg aaPhtom segvi eht hrete mrjao esscau of aalhactrgeor as ieplnp l,anostumiit moralipctnao fo rearoitn ,ttiyaupir nad srdgu s(ee 1.61 - taeBrs oP)tay.gohl lnyO dgru eftefc is an awsner ceohic rfo sthi stionu.eq +9
hungrybox  To ptu eontrah yaw - ferboe uoy ryt to og ohthgru yever sarewn icecoh, aisgkn userflyo wudl"o tihs saceu "acrgraoalet?h s,ntaIed ksa leoufys,r ht"aW era het sauesc of ta"?ghaalorecr Ancigodcr to r.D ttra,aS ythe aer e"pipln moitiuasl,tn ooinlpatamrc of ienrrato upiryta,ti nda d.urg"s +3
hungrybox  eTh siutoeqn n'tdeos sya natnihgy atht wduol opnti yuo daorwt linpep oiatmluisnt, keli "ti noyl smsee ot eapapr when esh pstu no a tshysi/rlap /"sp.nosr/rcutste It losa ekmsa no onimtne of lrpeatmobi bilndsens hhi(cw louwd tonip you to na iertanro iruattiyp rto)um, so oyu anc leru otu acrtaop.oniml hTe oyln nptioo lfte is rdgu tefe.fc +2
drdoom  ysh’rnoguxb lulf mmtocen ble)w(o rehe: 7nesee/eta#/wt9bmmnbp:0401amsoh/2xs//m0n3cr. +1



 +14  upvote downvote
submitted by strugglebus(189)
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sA an d01,801t:0e i loppee reopertd to haev side cftfees nhwe akigtn ootgAlnymzehdcrioHr.a dhoi hmet, 25 leppeo 0%0(.)2 have taseBr adsircghe

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neonem  I tknhi het etsb wya ot wnares htsi etisuqon swa by seocrps of o.itliaennim +1
sympathetikey  'stTha oesm ishutllb oll +9
karljeon  aaHh I teinidlame het wnares yb sopcesr of alt.ioimnine +25
medschul  I tinlemdaie azeithids by pocesrs fo inlinatmoie (: +3
medstudent65  thiS I etadmniiel eatishdiz easecub fo ntaienmoiil ntew hwit NHT hgntkini etaarclninir ldbee eicffnteg teh iuyttirpa +2



 +3  upvote downvote
submitted by fkstpashls(23)
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oscersP of nioatielmin is eth onyl yaw ot get hsit esarnw ohttwui ntSaav ellsve of uatmis, sa soem wbotei eingwar rochdeu hwo wtroe teh ueqtiosn labopybr .has

Ccnare is ialruelatn altmos all the ,item DM otedn's maek nsees orf nay norsa,e TNH iltfes otnld'uw euacs ylimk osbb,o nda msta elscl nuaniagrelgtd nsted'o meka kyilm obbos t.rehie S,o adn bsceeau myna srgdu nca evah ikmyl bobo,s rueo'y eflt htwi rudg tsfecef by csroeps fo nemtnl.aiioi

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djinn  I nodt hnkit het traou wsa a nsa.avt lsoA I itnkh is ightr cscspreo ot iknht "arnc"ce anc eb irlataelb and ganlnmati tbu eht r"u"gd ahtt escuas siht sitn TCH. sThi niqsetuo is adb nr.tetwi +1
hungrybox  cAgrniocd to tohPma,a oclrgeaharat si ONT cdaiosstae thwi raeccn erev ee(s 11.6 - absrte o)oayhpl.tg +
djeffs1  nagcrcoid to ugg'erusstsbl seurmnb tis more elilky ot be /bl carcen nhta d.sztii.hea. +



 +2  upvote downvote
submitted by niboonsh(409)
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" rOteh ecsssla fo sidntacomie atth auecs meipyhcaorplantrei cudlein nertsaassed,pitn yieipnasnvrehett snat,eg dna dgsur that nrcaeesi elbwo yiltio.mt eiaeappmoyritnclrH duaesc by itanmicesdo si mcoyonml atsomtiycp,m usaginc otaglacaerh,r lstranmeu e,rtbuanscid dna p.itoecnme It is mtotrIpan to uneres hatt alpheecoiirmntayrp in an vnaddlIiui pinaett si eud to otiaicnmed adn not ot a lctruartus onleis in het imcohtua/tprptayhiaily ar;ea tshi can eb lcopechaismd by )1( tsnoipgp the cotiniamde prremoyliat to tdieremen theerwh aorpncilt vllees uertrn ot oa,rnml ()2 hgnsctiwi to a oicntadime htat odse nto ueacs neathopracmeiyilpr "

n.dgmo/bne.vn0:hslw2t.pcipm8.i4/w96th5w/1b/u

--ede"oepNnnsendtdo sedi feseftc — tAhlgohu -oldoews hapyrte esems to iimemzin eht eomtabicl ailicotnompsc ncieddu by a zteidiah or izt-iiehaedlk tcdir,eui it yma nto lesnarscyei lneietami rheto ieds c.ffeets As na lapem,ex as many sa 52 tnpecre of nem eredtat whti 25 /dyamg of iallhdtroeohnc ovpelde a neelidc in ulaesx ifcunton [].43 Spele dearbistuscn nac losa r,cuco yalprltciaru fi the tpetnia is on a uld-wmsooi deit ]3.4[ How ethes oembprls cruoc is tno nw"onk.

ciweimus0di/wz.a3o-cniy22sre-0ootpitt-hnasu-iaeeaeopeulteHh5/pptf-ais:rotrh8intt-reit--ttn.tywdde9is59/-swm/nesptcnhns#

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 +2  upvote downvote
submitted by hungrybox(1277)
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mPahato vsegi eth herte morja susace of aalhrgaetocr as pnlipe ,intaslotium clopanirtoam of noiretra ipuay,ttri and ugdsr (ees 1.16 - tearBs ghl.Poota)y Only rudg tcefef is an reawns ecoich rof siht siuno.teq

To upt teanohr way - eefbor uoy yrt to go hroutgh vyeer nsaerw heiocc, kingas eyrosflu ol"wdu tshi saeuc ragcaleto?ra"h tasnI,de ksa freuo,yls a"Wht ear the esuasc of a"aorrch?eglta ngArdicoc to D.r atrtSa, ehyt are pl"epin moin,sutital miartoloapcn of orienatr riyiptu,at dna gsu"d.r

eTh iesunqot 'dntsoe ysa anignyth ahtt dwluo itnop oyu watrod ilnepp tsntiuao,ilm lkei it" lnoy esmes ot praepa ehwn hes upts on a /hyitlrasps rou/ns.tse/r"p†cts oS uoy nca lrue tuo ilepnp tstlmouniai.

It sloa kmeas on onitmne of prlaitmoeb eibssldnn ic(whh lwuod ponit yuo to an tionrear tyiiatpur trmo,u) os uoy cna lrue uot atlcprooiam.n heT lnoy oitnop lfte is ugrd ef.fcet


eI'v evner snee nghatiyn kiel this on a nuqotesi btu I amuess eht ENBM oudlw dowr ti ni moes otdovlencu way eikl att.h


I linltyaii eortw htsi sa a nobt,mcseum but I efel lkei ti ersvdese its now emm.otnc I aws vneer earyll asdtiiesf wthi yan of eth xtonpesianal rfo stih ebrlmp,o dan I nflaily reradiv at neo atht kemas teh otms sense to me.

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hungrybox  h,O and edesb,is ipenpl litiuontmsa adn tinromoclpaa e'tran eevn eassrnw oll +
drdoom  [estyms ei]raml uryo tcnacuo ahs bene ag:rdedup FRMOAT NNAJI +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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szheidaTi dreuce GRF g;t-& eduedRc areclcaen fo oarlcpint &g-t; ocneyrtmiaeipaphl -;> aidh.crgse

otN ures hwo rccrote htta is, btu esdia morf erccan neibg lau,elrinta I ulwdo seoscaati ihhg caripntol htiw ossl of omdpanei toenbunid/idechiri cncaarlee fo aticopnlr lsfit.e

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 +1  upvote downvote
submitted by sam1(22)
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hezisiadT nca eusca actue rtlttisneaii itr,seihnp a morf fo earln afiur.le oWtuiht het nrela oitrenexc of n,riopctla ti acn idlub pu in eth srume dna eltsru ni rag.reacltaho

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coccidioinmytitties  uealSx ftnnduicyos diseer[ abdse = ldib]oi can eb deu ot grdu idse fecetfs rpsnvhnstae][e,ytiie epr iftrs .adi it:no diE 0: aPge182 5S5oic: n1te c ryh,ePPs A'1idsts ndcnrieeo so:neict svie"xsece tumsoan of rlpncaito atciasesod ihtw ↓ilobid .[]234 sTih sgeo gohtreet with our aexlus fcinnyotdus wthi "pra.stehtvyes"iinen nO yl gclaoil thsisseyn I can ihntk of: d eatiizh = potlria↑cn = boidil↓ + orrgetal.acah It ouldw also emak seesn icsne we ear ideglna twih na eexpdtec to eb maepnol-osaptus emalef ikml[ itndoopcur wulod eahv to eb eud ot exsugeoon orusc]guDe . inot my letruec oesnt nad dounf teh noillogf:w -crlkobasbete nda dtheizias uasce asxeul I.cd touinsfny lsoa keil 'asm1s oanaxni.tpel er'eW ngarheic rhe,e utb sit teh tebs I nca d.o +
g8427  oyaM iclnic wshos clear or oblody npipel hicgsdare sa sdie efaftc of izihaeT.ds tBu sdonte atset lkiym egisard.ch +



 +1  upvote downvote
submitted by namira(39)
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iesslobP :leixtopanan

If hte pt si tagnik a taizhdei h(icwh si K ngip,eelt)d it hgtmi vhea osal ebne gvien ihwt a K psainrg urgd usch as aliooe.sniptrnc

Slepcontiniora hsa indiroogcnloce efsfcet cuhs sa eitsonaaygcm adn e.htrgarcaalo

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sugaplum  I khtin uoy locud loyn meak shit pismutsaon fi yeth iads t"teaipn si on antadrds hnt "xt tbu ecsin etyh vage eht mena t,chz louwd otn be arfi ot maseus ehty rea aslo aiktgn eonsictripla.on I twen wiht esocrps of lanmneiioit no tihs n.oe ve En hkceedc sescca ism'eecidn drgu vdseare fetfce e.rcaprofaah.gielo.rtl ton lseitd orf zthc +2



 +0  upvote downvote
submitted by j44n(141)
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bliessPo csasue fo thlcaregoraa eiunl:dc iesdanctio,M shuc sa iaetrcn ees,tavisd rsn,tpasdsaeeint ctihtsscaynipo adn ghih dbool rserspue rdu.sg diipOo sue. leHabr eppmlse,ustn csuh sa nfnlee, ianse ro knufeeegr dsee

^ from teh omay .iic.n.cl. ihespsam no eth HTN drsug

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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T&;=giazdetih pg&meal=h;rietacyc xnOyitxo G(q cpdeulo pioet-;&rgnt ricn g2&)C+ta;= lieppn grhisaedc

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arkanaftus  xyOntcio liwl not wokr on tresab eiusglrtn no milyk gairdhsce if het lgnsad weer ton rp"pae"der by otanlipc.r st'I lkie rtnigy ot zseueqe meypt bonalol - ogthinn soge uto. +1



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