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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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submitted by โˆ—mcl(671)
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CPOS si saioaetsdc htwi balarmon oniodurpct of sex t,dioessr dinnilugc tincfsunody fo eroensgt uopncoirtd dan rp.erteosgneo Ccnalyhroil eetvadle vselel of gtnreeos nca usace ritoemlaedn asp.leapiyhr

/Mbngonihtsrcctwt3lmc9i.h:.w//.nvpCm/w.9a/Pe/sil79p51

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meningitis  Wyh itns it i?srdoinemoest dCoul nmosoee pehl me uot on ish?t +2
meningitis  ror,yS I aws nsfnicuog wthi gehrih kisr rfo edmnliaerot roinc.maca +1
vi_capsule  rotsEneg is eopsreslnib for liylccca negledbi nda inap sdtcaisaeo iwht dioiesrntmseo enhec sperngoti is a attneretm tima.oldy Btu egertnso nsti a ksir crotfa rfo rosnimi.Etdsoe aeRthr hetres retdaregro f,low tmlapaceti atnorfrisnotam tec roehsite rae epsorslenbi orf rtois.mosdeein +1
sympathetikey  fTw uoy get so towrhn off by a cripetu htat uyo ntd'o dear eht uqeitnso .ropeplyr +34
hyperfukus  gini@inemst kid fi u itlsl erac lol tub alwyas go bcak ot moc=ciisrepeedtinoots dlemoairnet eitssu tdoeisu fo het uetusr so you nca ulre it uot scnie ecedranis nsgetero dwlou sauce you ot aevh snowreed dsesooimtrine or a ctehikr neo but ont yordu.ci..tley can see eht mulcsp fo het flelsicol ni the sviaore if yuo okol eusrp esclo so htta gnalo hitw eth titpeosrenan eskta uoy ot POCS adn mntiyea oyu nt'do veah a bbay or syat ni eht vaelefiiroprt repnasehos(tge e)ahsp you gte laedimetorn i&pgaorept;yspel-th-l-mao;ayl-tigfrt&uneal-iirt acmroncai +2
lovebug  AF ,1029 geap 136 +1
lovebug  rehtO nrsawe iH)Mseg nyorsdme : ad rit fo )1 oiraavn i,bmfaro 2) etis,asc )3 rlealpu nfsf.ueio ilgPโ€œnuโ€l seiasnnto ni rgon.i AF 0,129 pg 236 +1
xw1984  ntI's oiptno G, iaoLmeaoytm euir,t ieasosdcta htwi hghi gtrseeon lvlee? erP FA 202,0 odbirfi si tesrogen t.sesnivei +2
ownersucks  @81x4w9 gross amgie oldwu show umtpeill edlhrow ssemsa +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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pmCnocsalitoi fo C:PSO

vlsuriaadrcoCa esevtn

epyT 2 dbaesiet tulislme

naeEitdolrm eacrncasprepily=ah

dcIesrean igieasramrc reta

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