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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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CPSO is tcdaeiasos hwti mlaanobr oroucpdint of xes eissodtr, ndgliicun donucfytsin fo roteesgn dotnouipcr dan r.ontergseepo llairycoCnh etedalev lsleve of notgrese cna ecsua nomdilearte hapyae.rlips

h.sm1C9/a/mn/w/:9lp9p7tlwtrc.sPtMn/bowi./ev.inih3cc5g

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meningitis  yWh stni ti rsi?neotsidome duClo onmosee elhp me uto no sh?it +2
meningitis  rrS,oy I swa cfsinnugo whti ehhgri rsik rof imlaeodrnet aonric.acm +1
vi_capsule  onsErget is lnisesreopb ofr clclcyai ldnbgiee nda inpa ecsaitsaod thiw rotedsminieso ehnec rpegtnsio si a eattetmnr lydima.ot tBu egresnto snti a kisr rtafco fro meioEdrstn.iso reRath rseeht rdrrgoeeta wl,fo etcmtiapal iataornonstfmr tec hesteori aer bnelroessip rof .mirinostoedse +1
sympathetikey  fTw you gte os tnrhwo off yb a ipeurtc thta ouy ntod' daer hte istnuqoe py.rprleo +34
hyperfukus  mninieti@sg ikd fi u ltils arce lol but lywasa go bkca ot cnmseicdeptootris=ieo oaemedlnirt useits istdeuo of eth tsreuu so yuo can ulre ti out eicns eednrcsai goretesn olduw cusae you ot eavh enswoder nieostoerimds or a hrkteci neo ubt not yyrtcoel..ud.i acn ese the lsmucp fo hte iofslelcl in eht vearosi fi uyo olko usepr oelcs so atht gloan ihwt eht iptonresntae takes uyo ot POSC dna iymtaen yuo o'dtn vaeh a ybab ro ayts ni the iliarveotperf ehgspa(eosertn esap)h oyu teg teadnlemiro lhp&ttlo-naaaysetrftrpme--uilg;a--p;eoigriy&lit aaoinrcmc +2
lovebug  FA ,2109 pgea 613 +1
lovebug  etOhr ewsanr egH)sMi nmdseroy : i atrd of 1) ivraona iromaf,b 2) acsetis, 3) rplauel eufio.fns Pgโ€inuโ€œll tnssaineo in riog.n AF ,0291 pg 623 +1
xw1984  ntI's toniop ,G mmioaoLaety tiue,r esicoasatd thwi ghhi rnsetoeg ele?lv rPe AF 0,022 iobfdri is gortnees nsiietvs.e +2
ownersucks  1w4x9@8 ogrss aiemg wolud owsh utipemll hwedrol aesmss +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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molcoptisaiCn fo CSPO:

oasvaualrdCcir esevtn

pTye 2 btesedia semltuil

darltEnimoe enccarieaplryap=sh

reaIncesd aeriimcgsra tera

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