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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(670)
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CPOS si aesdcatiso tihw lmnarbao ndirctupoo fo sxe sds,irote ndcnuiilg ycnftndusio of gostener cdoruntpoi nda n.eegtrrpooes lcahriyonlC vadelete evlesl fo eotngsre nac ueacs amneirdeotl eisalapr.yhp

/iMCmlm/Psblnpp9g9t/o.cws1h/ce.3/wh:/aiv5n..cintr79tw

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meningitis  Why stni ti oriinst?eosmed uoCld ooseenm ehlp me tuo no s?tih +2
meningitis  ryS,or I aws usninofcg hwit ihgrhe rski fro mtoaenidrel ca.oaimcrn +1
vi_capsule  roseEtgn si obslepirsen rfo ailcccyl egnblide dna naip idtcaessoa iwth stormnesidoei ehnec ngiproets si a nmrtettea amodly.ti uBt osertegn tnsi a kirs ofartc fro etmEdoosiinrs. tRehar tershe trageerord f,low tciteapalm nfitsntaoramro tec heoersti ear espelbisnor ofr riitee.dmsnoos +1
sympathetikey  Twf uoy tge so wtonhr off by a ctpreui htta yuo tno'd eadr het etousinq rryppelo. +34
hyperfukus  tnimgiei@sn kdi fi u lltis erac llo tbu swyaal go ckba to seoiireseoicd=mptcotn rnoiedlatme sitsue otisude fo teh suuter os ouy cna elru it tuo seinc aierendcs rotgense uwdol caeus ouy ot hvae esdnoerw esoinotdmrsei or a ketchri oen utb ton iy.udt.yceo.rl cna ese eht splumc fo hte floseicll ni teh iroevas fi uoy olko prues sceol so thta anolg wthi eth nensiartepot kteas uyo to SOPC nad yteamni uoy 'dotn ehva a bbay ro stya in hte iotapivlfreer oshraneepe(sgt ape)hs oyu tge tdilnomerae y-;ltmataiialro-fl-i&rptauhrigeop-ptlt;&eeygns- ccnmiroaa +2
lovebug  FA 012,9 pega 316 +1
lovebug  hterO erawns HgM)eis reysnmdo : itrad of 1) vniraoa ,mrobfai 2) c,esitas )3 uallrpe fenuofi.s โ€lguPlโ€œin tosnseian ni irno.g FA 092,1 gp 326 +1
xw1984  s'ntI oonpti G, amaioLtoyem etiu,r stoeasaicd hwit hhig gsotener ee?llv ePr FA 20,20 riiofdb is goetsern intie.ssev +2
ownersucks  48w@x91 sgrso emiag ldouw owsh tlpumiel wldhoer ssesma +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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oiotpsCalncmi of COS:P

dlrcavsoaiuCar vtsnee

ypeT 2 tiaedebs itlemlus

iaortemlndE arccneral=iseahpyp

cdIneaser rgismareaci tare

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