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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

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 +36  upvote downvote
submitted by masonkingcobra(408)
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eagP 2 hsa a ategr iueprct

1fer01li20w3/61-e/)ca(./79s.4Stt6oic9a-prdh/608tiwo/jnnlw:pg

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kamilia20  yaohmpliahcld i??stcptia +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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sieyivernsyHpitt mseiiutxiomenpd—n yept /IIVII nyvieirttpyiehss nacorite ot oeernalntmivn tn.giane aesusC ,dnayeps uohgc, hscte ,tsgehtnis ca.eeahdh etOfn nsee ni femsrar dan othse depxeos ot bd.rsi ireblvseRe ni raely sasetg if susmitul si ieavd.od

s'tI a ptye of eitcveritsr ungl .sdeasei

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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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Wyh hte ohret srwena hecocsi rat'en errtcco

A - Not an ypclnacihata enrcatio amiyln deu ot ccithyorni noip(stocmnu fo ,yos hhicw ahs oiotngrpycsel hatt pepelo may aevh aeeigrsll ot)rawds

B - Nto htasam (icreaczrhadte yb mero aucet oeseipsd fo nobooccisrnniort,cth w)znihgee

D - aenAmi B(6, ,9B ,2B1) or bmaey a yrmlpnoua bmomlise eud to 9B or 2B1 denieyfcci ;t--g& tedveael hiceotyomesn elvels gt-;&- mobhosrtsi --&tg; T?VD

E - uornmlyPa anrhta;x heT item reuocs dwolu be umch orem ,uatec and wludo olas rtpense hwit tomsspmy fo l-fkeiul ps.ytomsm Rdiap etahd too

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 +3  upvote downvote
submitted by monoloco(155)
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sThi eptaitn si eicnxreneipg snehipsiteryyvti spinunieotm rfmo eth r.kspaaete I aws hkntniig M. uiAmv hnwe I eetlsdec ratkpeeas -- I inhkt my locgi aws weflda ginve teh siecicfps fo the tnept'sia r.styo

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 +1  upvote downvote
submitted by imnotarobotbut(184)
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owH udowl ouy onwk that it t'isn olwo rsrtsoe esa?isde

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cienfuegos  AF 1280 3:17 hnliataino of sspoer lesda to -luiflke potysmms ttah gopresrs kycqlui ot f,vree olrapnumy eegarho,mrh miiietsntsaid dna co,khs thiw gmngaii lpiobssy soihngw wenedid timmuisdaen +10



 +0  upvote downvote
submitted by endochondral1(24)
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ncgrdicoa ot ldoruw tyirypvesinstihe umpnioitens si eud to tsud and atht asw alos an ...o.tpoin

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amarousis  os it's eeifditynl dstu ubt eht ifciecsp eytp fo sdtu aws eth otsm mttpaionr in itsh qsot.eniu eht atcf ttha eyht enmoeidtn het sbird si o.npratmti eth ytdus kobos wludo ecasu ti tub hte irdb udst is oemr nmaitotrp -.- +
charcot_bouchard  neieHpryvtiyitss Puntsineomi - igOncra tuds (ikle ymold hoinemnoaPsci su)y - inargIcon detn uons eplh rhee hotguh sebaecu thob llwi ptrnsee hiwt same iicvrttrsee lgnu sdseaie ripeticu. nhitk senci sdut in ylibrra anetr eenirth cnoagri ro orinagnic nad osla u ntod see nmya brsrailnai whti lnug aseside tbu dbir swepohrni si ilpcsaefilcy eoendmitn as asecu fo HP es.aesid +



 +0  upvote downvote
submitted by beeip(141)
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I saol saw nniikhgt .M amuiv e,her but ihtiryintsevpesy itnspneouim sseme to fti whti the ulrerrugciloanta .esgacnh

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 +0  upvote downvote
submitted by endochondral1(24)
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who do ew ownk prkaeeats sucae yierpevhsityns tesnmionipu

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smc213  8A1F 75.p6 ribd rxep-o-eu&stg; SHN tonmipiunse treecitv(ris ngul i)esdsae adn 1F8A 4.p12 mlnrutaugoaso aeidsses: oergifn e;tNr-lim-atH&aSg intnsipu.oem I ahd ot ekma ensse of it isnec I td'idn nwko it swa HNS nuisnetipom ta .ifsrt +5



 +0  upvote downvote
submitted by breis(56)
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sstoasPtici seomi(etsm cllade ohoisrnsit or toparr ideessa or ratorp ev)ref si an nteicfoni of the ngul in)(opmeanu acsued yb eht uarebtmic maodhCllaiyph dym)Cali(ah aitpitcs.

iSgns dna r.ut,g hmveo:mpe cofsys uaullsy hoiuttw mhcu dlpseruaa e hce ..ehlmahcmh.gs t.cseca eshh sp.hsstnoanr ie fo aterhr.esbo ahttor.

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charcot_bouchard  ptUead no ym prve omcmnte : seY iths is ttoaiipsssc. tno rispyithsevinety nmitue.oisnp owH od u nwok? tcohemypyL adn escrPeen of lGmanaour - rpnseeso ot luecitrnallra hwoi aNymc.lad HS can lsoa ausec olsoe auonargml oot dna teh lccilani rutecip tslli orem oolk eikl ouHSY okwn thwa ......... ckfu ihts uesq +2
shemle  Heer Pt. ost'dne heva e!vfer +9
shakakaka  gnNntiaaecos rom,ganula pyacht yliyptcmhco noiiilrtn,fat and sorsfiib era ense ni siireHspteiytnvy unipmetonis , ocrcgniad ot ordwUl . +

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