NBME 20 Contact with parakeets (NBME Answers)

Retired NBME 20 Answers

nbme20/Block 4/Question#21 (reveal difficulty score)
A 47-year-old woman comes to the physician ...
Contact with parakeets 🔍 / 📺 / 🌳 / 📖
tags: pulm

+36 upvote downvote
submitted by ∗masonkingcobra(408)

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egPa 2 sha a gaetr rtieucp

7-l9rn40w1awctfa6-)6Stojcr/s/0peoi:d21h6.83lgi9//10w.te(ip/n

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kamilia20 hhiaolacmydpl ?tis?itpca +1

FA 2019 P. 661 Hypersensitivity Pneumonitis is a mixed type III/IV hypersensitivity reaction to an antigen in the environment. Commonly seen in farmers and people exposed to birds. Presents with Dyspnea, Cough, Chest tightness, headache. It is reversible in the early stages if the allergen is removed.

+7/- lilyo(94)

+9 upvote downvote
submitted by ∗hayayah(1212)

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spyHeiivsyinrtte tmie—isnpoenmixud ptye II/IIV pysrsttieveiihyn triocane to tnennvameroil ae.gtnin saseuC s,ednapy ucgh,o ehstc stthgni,se hac.eeadh ftOne enes in mrseafr adn etosh eepxsdo ot d.sibr Rebveirlse ni layer gsstae if iulsstum si viedd.oa

st'I a pyte fo iesveirtrtc ungl esisdea.

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A type of hypersensitivity pneumonitis associated with animal exposure is bird fancier’s lung, in which the major antigens are proteins in avian serum, feces, and feathers, including bloom, the waxy powder coating them (18). Pigeons and parakeets, including budgerigars (a type of parakeet), are the birds most commonly implicated, but poultry, finches, doves, canaries, and other birds also have caused the disease. Exposure to live birds is not necessary to produce hypersensitivity pneumonitis: the illness has resulted from using feather pillows and duvets (19), being exposed to a wreath made from the feathers of a dead pet bird (20), and laundering a pigeon keeper’s overalls (21). Other examples of animal proteins that are known to have caused the disease when inhaled include proteins from the dust of mollusk shells used to make buttons (22) and from animal fur used in garment manufacture

https://pubs.rsna.org/doi/full/10.1148/rg.297095707

+7/- alexp1101(11)

+6 upvote downvote
submitted by ∗neovanilla(57)

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yWh het ehotr nwsera socchie nare't ecrrotc

A - oNt na npltaachiyca notecair inymal deu ot rihnctycio onm(inoctsup of yso, hicwh sha tlyineogocspr hatt epeolp amy hvea eeglrilsa wsot)rda

B - Nto thmaas radatih(cezcre by roem tuaec eoesdspi of or,boconicinrhcstotn )nezwgieh

D - inmaAe B,6( 9B, 21B), ro bmaye a yunoralpm liomemsb eud ot B9 or 1B2 iyeneifccd -&t;g- eveetdla tiscnmeooehy sveell --;gt& oomsbshrti ;g-&-t ?TDV

E - lroymnPau xhrt;ana eTh iemt cusero udolw eb cmhu reom auec,t nad wludo olas nreptse ihwt ssmmotyp fo flil-eku o.tmymsps dipRa tehad oot

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+3 upvote downvote
submitted by ∗monoloco(155)

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iTsh ipnetta is epexiiencngr iyretshvynetpisi tmpoisinenu rmfo eth ksraapete. I aws gkihnnit M. uAimv ewhn I lsdtecee saatpkere -- I tknhi my oglci swa ldwfea vnieg hte fsciecips of eht istpat'ne oy.rst

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+1 upvote downvote
submitted by ∗imnotarobotbut(184)

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Hwo udolw oyu onwk ahtt it i'stn owlo rsoerst asdeei?s

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cienfuegos FA 0182 1:37 innaltoaih fo sresop sldae to u-eilkfl ymspotsm thta rpegosrs kiculqy ot fre,ev lprnouyam ,hahoegrerm antmtdissiiie and h,scko ihwt iagngmi oyibsspl nsihwog diwnede nsitdimmuea +10

+0 upvote downvote
submitted by ∗endochondral1(24)

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oracdicgn ot wrdolu rtpiyevsynhseiit nsemuoiitnp is ued ot udst and htta was lsao an .p..ito.on

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amarousis so s'it fiielntdey dust ubt eth iccfipse ypet fo dsut aws the osmt mnpirtota in htsi uien.otqs teh tacf taht ethy dotiemnen teh ribds si .marttnipo teh ydtsu koosb oudlw sauce it utb eht bdir dtsu is oerm rpioantmt .-- +

charcot_bouchard epsniHtretysiyvi iiustPnenmo - agcOirn stdu elki( dlmyo siPusoymhea)cnnio - noIgrainc tn esunod elph eerh uhgoth eubcase hbto will epesntr tihw msae cvrettieisr nlgu eeadiss te .ipcuri tnikh iecsn tdus ni iyrlbar rtnae ihrtnee ocgrnia or cgniirnao dna osla u dotn ees nmya asrribianl itwh nugl daieses utb rbdi preisnwoh si leclsipcfyia tendomine as acseu of PH isd.seae +

+0 upvote downvote
submitted by ∗beeip(141)

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I osal aws ithkginn .M iumav ee,rh tub sstpieirytinhvey niunseiptom esmse ot tif ihtw eht ouucrilnraeaglrt nghsc.ae

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+0 upvote downvote
submitted by ∗endochondral1(24)

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how do we nkow tkaaespre secua yinrhepessyivt sopteiiunmn

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smc213 A81F 576.p ridb pox-&u;getes-r SNH omsnituienp itcrsevti(er ulng esie)sda adn 81FA p.412 oarutnlousamg e:idssesa oinegfr ;SatlN-itae&gHrm- iunemtspoin. I dah to eamk esens fo it isenc I din'td wnko ti was SNH nismtpuoeni at frits. +5

+0 upvote downvote
submitted by ∗breis(56)

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ssaisPiottc messtoi(me dalcel rsnsoihoit ro otrrpa ssideae or rproat )eefrv is an ncenitofi of the glnu )(nmpioenau seudac by eht amirctbue pldihmlaahoCy )dCimya(lah a.pititcs

singS dan ro oy pfs:she,mcutvmeg. sllyauu httiuwo chmu aaelrsdem.pchs m ..hheeuhglac eshccshte .a nstsaprioes .nh fo t .ereaobshr th.tora

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charcot_bouchard apteUd no my erpv comtemn : seY sith si stti.spacosi tno ivrytipyeshsntei nonimpetsiu. wHo od u ?wonk eyptcLhomy dan Pesnecre of almorGnau - ssepnoer ot elularctailrn Ncdaimh lw.oay SH anc oasl ecaus osoel aormnglua oto dan eth aicllnci uciterp ltlis emro ookl leki o YSHu konw ahwt ......... kfuc sthi eqsu +2

shemle eerH P.t odes'nt aehv efrev! +9

shakakaka Niogasenacnt aml,garuon hatypc tcpyhlimcoy foiriatnl,tin dna isfriosb rae esen ni pvtnyisyrtHieesi snpnimoteiu , cdacnorgi to lUdrwo . +

https://pubmed.ncbi.nlm.nih.gov/7569404/#:~:text=The%20inflammation%20is%20often%20followed,than%20in%20women%20and%20children.

you get granulomas in both

+1/- j44n(141)

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