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NBME 21 Answers

nbme21/Block 1/Question#12 (reveal difficulty score)
A 25-year-old nulligravid woman comes to the ...
Endometrial hyperplasia ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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submitted by โˆ—mcl(670)
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OPCS si sieacaotsd hiwt mrnbalao ntporcoudi of esx tridse,so unncldgii fysotidcnnu of renotseg nodiocurpt adn .ptengreosero yCnrilcloha etedlave lsevel fo sotregne nca uaces ndmtelioaer yiahra.elpsp


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meningitis  yWh tins ti ertdso?imiesno ulodC oneemso hlpe me tou on ti?sh +2
meningitis  rSyo,r I saw cusgiofnn wthi hhiger ksri rfo ermatelindo macinco.ra +1
vi_capsule  Eesgtnor si sbslinpreeo ofr ciylaclc neldibeg dan pain siecdsaoat wiht sosimeteridno neech oipnertgs si a metettnar aym.tdilo But setonreg tnsi a kris rafcot orf idomnotierEs.s rtReah reetsh aorreegdtr l,owf ctmaipaetl anftsnmitoaorr cte ihetsore ear porsnelbies for nosedtmsi.ioer +1
sympathetikey  fTw yuo etg so wnthor ffo by a rtcuiep htat you dn'ot eard het itsqonue lrrpoype. +34
hyperfukus  nsegitii@mn ikd fi u lltis acer oll utb wlasya og kbac to eieoientdm=ocpsotrics nilameodetr tsueis isuoetd of hte reuuts so oyu nac reul it tou ncesi sdneicera rnsegeot dowlu secau uyo ot vhae edwonser nsoeiediormst or a tcehikr noe tub otn nca ees het supmlc fo het siloflelc in eth sovriae if oyu loko epsru lseco os htat naolg wiht eht aonrsenitetp eakts ouy ot OPCS dna tmneaiy uyo tond' vahe a ybab ro ysta in teh rpveoftairlei ogthe(easesprn esahp) yuo etg deltaneoimr ;t-pnfetryelm-aipo-lreyo;il&&tpal-ir-giustathga raocicnam +2
lovebug  AF 190,2 paeg 613 +1
lovebug  erthO aersnw eH)gsiM sdremyon : idatr fo )1 ianovar afroim,b )2 ts,ceais 3) elaulrp snffi.uoe โ€œlnulPigโ€ sioantnes ni ogrin. FA 9,021 pg 362 +1
xw1984  Istn' ntipoo G, aetiLayomom i,teru desaticsoa ihwt hhig nrsgtoee ?level erP FA 0,022 diobfir is teonsegr sneie.ivts +2
ownersucks  @xw8914 ossrg mgaei dwlou wsho etulilpm heldrwo seassm +1

I feel the clearest way to understand this question/answer hasn't been stated yet. Recall that the cysts in PCOS are unruptured follicles. If follicles don't rupture, you won't have corpus lutea, which won't secrete progesterone and therefore menstruation won't occur. This leads to unopposed estrogen and disruption of the menstrual cycle, which can cause endometrial hyperplasia.

+20/- pg32(218)

The patient here is obese and has hirsutism. Her androgens are converted to estrogens in peripheral fat, causing hyperestrogenism.

The exact reason for increased androgens in PCOS is unclear, but it involves an increased LH:FSH ratio. Relative decrease in FSH inhibits estradiol synthesis in granulose cells and favors androgen production in theca cells.

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submitted by โˆ—pparalpha(93)
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ocmatsCioinpl fo OP:SC

uCscrvoaraalid seetnv

Tpye 2 desetbai llutmesi

aondmritEel nccearaplsyhrpei=a

cseaIednr cmaisareirg erat

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