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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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eeohwrN eahv I eebn bela to infd hyw hte lehl siht si a .nhtig

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yotsubato  stI ont in FA, ec,kSthy or ahmtao,P ro U owr.dl I wnke ti tnsaw ceacnr ucaeesb its ielabrtl.a And ibtseaDe eadm no sesne ot .em oS I tusj etrhw dnwo ruDg feeftc adn lwkdea yaa.w +10
breis  ^eam^s^ +
feliperamirez  The only elspobis lenpxtaoani I hkitn is that seh was edurn a K anigrps irc,dietu ushc as aornitnpcoleos wch(ih udolw adle ot )camgonisytea. +
chandlerbas  uoy adh me ta ist not ni ecshkty ); +3
j44n  i tughoth HNT ucenidd mypte alsel wolud aeusc hits ecsubae eyht ogt yept II bduae.etis So fi uyo ndee a rop rezab nureht llhero 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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nGaljo dha a euclert taht ieotedmnn that fI" a nietapt ash rgeahrtaacl,o vrewei vyree urgd h'ryete aikngt cinse yanm usdrg useac ragrheolaa"t.c

Teh onyl hntgi of soeblspi nealverce in shit esmQ-t is tath she saekt a oeamidt,cni errheotef teh anwrse fo ugr"d ctfefe" is hte mtos kliyle aonsre fro ehr lgaor.atearhc

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hungrybox  I llsti tnhik ihts ionqestu is etrpty B.S tuB vginha deusitd esom ,eomr I tikhn 'tsi esls SB hant I llogyiinar ht.htgou amtPhao sgvie teh terhe jmaor uessac fo arheatrgaocl sa ppnlei nuitiomsl,ta tpocloranmia fo rnreiaot u,iityatpr nda dugsr es(e 1.61 - tesraB t.hooaPygl) Onyl dgur tcffee is na wsanre eihocc for isth ns.qeouti +9
hungrybox  oT ptu htneora wya - efboer yuo yrt ot og hthgrou vreey nwersa ceci,ho kgaisn osyfrelu d"ulwo sith scaeu elthca"aga?orr dIsaet,n aks oseu,flry aW"ht rea eth sascue fo g"ahractoa?rle gdnciorcA ot Dr. atrSta, eyht rea nlipp"e lisu,tniomat olcatiarnomp fo artroine ir,tuytaip adn "ursdg. +3
hungrybox  hTe usntiqoe 'tnesod ays gyhiatnn htat wloud potin you adtorw lepnip ,unitamsltoi leki it" lony seesm ot arppea wehn she tsup no a s/hatpsryli .psto"/r/srcnteus It lsao kamse no nimoent fo obmielpatr nlssdnibe (ihhwc wolud intpo oyu ot na enriatro ytiiratup rto,)mu os yuo can erul out poaicmralot.n The nloy iotopn eflt is grdu fteec.f +2
drdoom  roxhunyb’sg full mtnoemc bwl)oe( eeh:r henonse/03m7atmm#/pbx2:e4/m0a19erntw/ss0c/.b +1



 +14  upvote downvote
submitted by strugglebus(189)
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As na ed 8,1i0:001t eolpep eporedrt to aveh deis fetcesf enhw igtank dtr.zodgcinh oylhrieAoHoma m,teh 52 epolpe ).00(%2 haev rBtesa rgsaehdic

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neonem  I tikhn hte sbte ayw to searnw sthi oqnsetui was yb rsspcoe of an.nltiiiome +1
sympathetikey  a'Tths msoe histlulb l ol +9
karljeon  aahH I eladeiitnm het nsreaw yb sreopsc of itoileni.man +25
medschul  I nmeietilda tadizhsie by eoscpsr of aliotnmiien :( +3
medstudent65  tShi I aliiemdnte edstiahiz eaebcsu of onmeiiinalt wten ithw HNT iknhgtin enacnartrlii dbeel etfecnigf the turiiptay +2



 +3  upvote downvote
submitted by fkstpashls(23)
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Pssreoc fo iemiatonlin is eht oynl wya ot gte htsi rsanew otuhtiw aStvan lvseel of ,tiumas sa smeo etibwo aingewr dcuheor who eotwr teh siuqonet bpabylor ha.s

Cnrcae si uateanrlil sotmal lla eth ,tmie MD oednt's emka eness fro yan esnoar, NHT lesfit ndl'tuow saceu ykmli b,sboo dna stam cslle ngaetlgrudain no'stde aekm mkyli sbobo .eirteh oS, dan seuceab namy sgrdu can avhe imykl bobs,o uye'or lfte hwit dgur sceftef yb sprcoes of itiimnoa.enl

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djinn  I ndot ikhnt the urota aws a a.tsvna oAsl I ktnih si higrt cocspesr ot hnitk cer""can acn be tbairllea nda aganmntli ubt hte "urgd" atht ecsusa sith tsni T.CH hTsi esuitqon si bad tiwt.nre +1
hungrybox  doigrccAn to otm,Phaa larrahetacog si NOT daitsaeosc tihw ccenra reev (ees .161 - aebtrs oglpyt)oh.a +
djeffs1  icncoadrg to l'sesugsubrtg rbnseum sti emor kyliel ot eb /bl rancce hant .aihts.izde. +



 +2  upvote downvote
submitted by niboonsh(409)
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" retOh sslecsa fo aeoidmtcsin thta aesuc hcrroliepenmiapyta ecludin es,iptasnedntasr peetrnniehsavtiy tsgean, nda rsdgu ttah raincese loweb .moiytlit tnmrriiaHpoypleaec duaecs by isociedtman si commyonl osmiay,tmtcp iaucsgn caerol,trhaga nsrtlumea dsi,tncarbeu adn .nteepmico It si oamtItnpr ot eunrse that etyliaroimenchprap ni an udInilvida nettpia is due to dmiicontae adn otn ot a rculturtas ieonls in teh ayuhy/arpilihtiomcattp ;arae sith nac eb emlopaiccshd yb ()1 ntpgopsi eth oeniiacdmt rpoiaemrlyt ot tredinmee rweehht nopialcrt levels uetnrr to l,nomar (2) nhiiscwtg ot a eimoitacdn htat odes ton cseau lciamnphrtyaoriepe "

t.8.iwit6s0h5/b:dpu91.vm4hg//.nlcmwpe/nnbw2o

eed"dNs-nodoe-petnn edis etsfcef — uothhlAg sl-woode prhteya seesm ot iemzinmi teh iaebclmot nmoccltisaopi cinuedd yb a tdaeihiz ro li-datzehiike eurid,cti it may otn eraisceslyn nimietael rohte sedi .fscetef sA na eplexm,a sa amyn sa 52 nretcpe fo nem rteeadt wiht 52 dyga/m of orllhanciohetd oldvepe a lcneeid ni uexsal ntfunoci ][4.3 eSelp susidcrebant can asol or,ucc picarlyarltu fi the peatitn is no a uwmoi-sldo deit ].34[ How htees smoplber cruoc si ont "woknn.

siooe5tiar-rz23nt/ps5mir:tdhs-inpdnsrnteimu-i9tcu0awot#stt9uyepifyi/-eothi.aoc.esn8eehHtws-ia-np-plwte0c/td-te-e/whas2n

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 +2  upvote downvote
submitted by hungrybox(1277)
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amotaPh evsgi eht rheet jmora usscea fo trlgacarhoae as nleppi tnmtus,ailoi rtnapoimolac fo raentroi rta,piuiyt adn srgdu se(e 11.6 - Basrte o.golaP)hyt nlOy ugrd ceftfe is an nwrsae iechoc rfo htis tnseuoqi.

oT tup rtnahoe ywa - erbofe you try ot og hourght vyree rseanw ,eoicch aknsig rleousyf wlu"od htis euacs gtoaea"crlhar? I,neatsd ask ur,efslyo Wh"ta era teh asecus of "r?aloetraghca iconcgdrA to r.D tatSra, heyt era pneipl" ,natliosmtiu cotnmraoaipl fo ntrerioa pari,tutyi dna g.d"sru

heT qsoitneu s'detno say atnhginy htta ouwld potni uoy rawdot pplnie tsot,mniuila ekli i"t lyon seems to areapp hewn hse tpsu on a /ilshrtapys p/crssse"ot†tru.n/ So uoy cna rlue tuo pelnpi n.oamttuisli

tI salo mkesa on innmoet fo rtembliopa nselsdnib (whihc lwodu ntopi yuo ot an rniratoe apytiuitr )um,otr so ouy anc uelr out nlocoiaatrm.p The yonl tioonp fetl is rdgu eef.fct


Iev' nerev ense ntngaihy keli shit no a qiueonts utb I semaus teh BENM uldwo ordw it in mseo celtuovond ywa keli h.tat


I aliiytlni twroe itsh sa a muocn,besmt but I flee ielk ti eeesrdsv tsi wno mnemtc.o I wsa erevn lleyar adiseisft ihtw nay of hte lxaponetinsa for hsit obple,rm dna I ainlfyl dviaerr at eon ttah seakm hte msto nesse ot e.m

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hungrybox  O,h adn ebed,ssi npepli aisunitomlt dan prtcmaaoonil 'arten veen sewrnas oll +
drdoom  ysse[tm e]ramil uroy ctonacu sah nbee upgeard:d RAFTMO NNIJA +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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ezidasihT ereduc FGR ;t-&g dRucede ancelrace fo lcpitrnoa t-&g; lieohypmpratecain ;&t-g dsrea.cghi

toN srue owh rrcteco taht is, but eidas omrf nrccae negbi ,lilruaaent I owuld csiastaoe hgih anclitopr ihtw loss fo omdaepin deiid/tobrinhneicu raeecnlca of loancrpti lfseti.

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 +1  upvote downvote
submitted by sam1(22)
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dzhiesaTi acn cseau utcea trisiittnael prith,nesi a rmof of lanre rfla.ieu tohtiuW eht anlre rticxoene fo cnar,ilotp it nac libdu pu in eth resmu nda trelsu in aatoarregh.cl

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coccidioinmytitties  aeluSx nynotdsicuf ed[rsei sbdea = liodb]i anc be edu ot udgr edis cfsfete siseteieryhnptanv[], epr frtsi da.i :toiindE ga8 0:P2e1 net1:i c5oS5 Phry,cesP itsdsA1' cenrneido tocsne:i esicsvx"ee asnomtu fo colrtnpai disacateso wiht db↓oili 2].34[ s Thi esog trgoeteh thiw our xsuale nsnudfoticy hiwt "iyrs.veeietpshatnn" n ylO algloic ytnssheis I cna khint :fo ehi adzti = ↑rclitpano = l↓bidoi + ghla.terarcao tI woldu lsoa make nesse sceni ew rea dlagine itwh na dexecpet to eb amop-ssaltenpou lefmae il[mk otrdnocupi oudlw ehav to eb ued to enxoseguo sgr]u.ue Doc otin ym lrutcee tosen and udfno teh onfig:olwl aelbs-crtbeok and eaiihsdtz caues auelsx Ifyotidu.nsnc alos klie s'sm1a naelt.noxiap re'We rhcigaen ee,rh btu its hte ebts I nca do. +
g8427  aoyM icilcn sowsh arcel or ydolob lnpeip acsihgdre sa sdie fteacf of i.eThaszdi Btu dosetn staet lkymi hrsdieag.c +



 +1  upvote downvote
submitted by namira(39)
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sobieslP :etxlannopai

If het tp is niatkg a itdahzei hihc(w si K ldee)ig,tpn it gthmi heav alos been givne iwth a K pagrsin grdu cuhs as otspnnaleico.ri

apcnSoloriinte sah nroceodoliicng sfctefe usch as mcgesnaiotya and gheoatlarcar.

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sugaplum  I nhtki you codlu olny aemk hsit pusanotsmi if tyhe aisd taeptin" is no rasnddta thn t"x btu nseci teyh aveg het naem tczh, olduw tno be iraf ot umsesa eyht ear laso ngitka tinol.isceroapn I etwn iwth sproces of onianmltiei no ihts one. nvEe chkdcee ecassc c'miiesned dgru aervdse eectff oliorealhf.ca.rge.part ont tdseli orf ztch +2



 +0  upvote downvote
submitted by j44n(141)
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iPssboel acuess of ateahocrgalr l:dceinu aco,isndtMei hsuc as ecrtina eadvseits, nitsent,rsaasepd sopishycinactt dan high ooldb esprrseu .sgdru iiodOp e.su lbHrea mspt,neseplu hcus sa ,fnlnee aisen ro eekrguenf sdee

^ mofr hte oyam ..n.cc.ili ashpesim no teh NHT urdsg

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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dgiT&ea;iht=z ;pytraeg=aehi&mclc Oxnoxtiy (qG eoldcpu t;g-inrteo&p rinc a2=g&)t;C+ ppinel esdirgcha

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arkanaftus  tnOyocxi will ton korw no bretsa rnsuteigl on iymkl gchirdesa if teh dlsnag eewr ton epedar"p"r yb .cnoaiptlr ts'I klie ignrty to seqeuze tmpey oobllan - ghnotni egos tuo. +1



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