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Retired 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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 +3  upvote downvote
submitted by โˆ—mcl(671)
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CPOS is sasidoetac twhi mabarlon toducproni fo xes det,ossir ninciglud ucsdinfotny fo gnortees dootrunicp dna trpeso.gornee icolyhnCarl vleeeatd elvles fo ogerntes acn eacus mdatlerneoi .aipahyelrps

tnltic/h59/isCpbe7nciPvlMr.mw3sg.1oht/:a/m9.c/9./pwnw

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meningitis  Why tnsi it tsneresmoi?iod ulCdo msonoee ephl em out no t?hsi +2
meningitis  rS,yor I swa sgnconfiu wthi hhgeir rsik fro aoemnlrietd arincm.oca +1
vi_capsule  Egsorten si eibnpsorsel ofr alylccci niegdlbe dan niap tisaecados hwit tsdioisoenrme neche rgnpstioe si a rematentt .atimodyl But seonterg ints a irks otcarf for modrnt.Eoiseis heatRr etrseh reegrradto ,lfwo eapamtctli ftmanrsanoirot cet eiheorst rea essnebprloi fro md.istoernseoi +1
sympathetikey  Twf uoy etg os othwnr off yb a rteipcu atth yuo dno't read hte qneotius eppol.ryr +34
hyperfukus  tnmgiiens@i dik if u sillt crae oll but wslaay go kbca ot sicotpsoemndeictioe=r omlaeenitrd eustis dsoueit fo eth usutre so you nac ruel ti uot seicn icseraend toeregns oluwd ceusa yuo to hvae eonsdwre isdienmtrosoe or a critekh eon but nto duyyeir.t..loc nca see the smulpc of eht oicfellls ni teh airsoev if oyu lkoo presu lcseo so taht anlgo twih eth tntapsneiroe easkt ouy ot POCS nad iytanme you tdno' veah a abby or ytsa in het lerrfepatioiv opgseetr(eshna )pesha yuo teg lernamiodet agr-lfintlle&ota&pu-ityphp--;tr-;yaeoiamlrietsg incraoamc +2
lovebug  FA 20,19 eagp 163 +1
lovebug  erthO ranwes gMH)ise dmonesyr : iart d of )1 nivarao iabfr,mo )2 ces,asit 3) rpaelul osf.fueni โ€œPnilugโ€l onasntesi in rog.ni FA 0,219 gp 362 +1
xw1984  ts'nI iptono ,G Lammtioeyao u,teir adoiaestcs whit hghi eegotrns ell?ve erP FA 2002, bordifi is rngtosee vstnisie.e +2
ownersucks  8x1@94w gross iagem lowud ohsw mupteill dewhrol emssas +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.



 +0  upvote downvote
submitted by โˆ—pparalpha(93)
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poasiilncCtmo fo CSP:O

vCadsorarcliau nsetve

yTep 2 absedite ltslmieu

iaemtronlEd ercacnpiprsey=hlaa

ecsdInare rargicsamie ater

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