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NBME 21 Answers

nbme21/Block 3/Question#19 (39.4 difficulty score)
A 25-year-old woman develops increasing ...
Four-chamber dilation🔍

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 +7  upvote downvote
submitted by poisonivy(24),

this is actually a UW question (14992) Peripartum cardiomyopathy manifests as a dilated cardiomyopathy, can occur during last month of pregnancy or within 5 months after delivery, pathogenesis poorly understood, but may be related to impaired function of angiogenic growth factors (e.g VEGF) or predisposed by mutations in cardiac structural proteins.

 +6  upvote downvote
submitted by hungrybox(774),
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ljaugur euosvn nsinttioed = etlf htrae uafriel

nramyupol aeedm = trigh ahert feulair

bauhrmec-For dtoilnia si hte tmso lkeiyl

trhOe assrn:we

  • sisrAmeyct seltpa h,ptrepyoyrh alyimrcoad idsyarra: htese era htbo sicsacl nifignds in teipyrhrochp oayydmtprcohia (CM)H
  • rocalidndea of:bltsoairiess a raer tivesrtecir yypahratcmooid seen ni cnnlrsahfd/etiin
  • hlcitypmyoc ftnnaiorliit of teh mmracuydi:o sene ni larvi eut)uoa(imnm isdi.otramyc A cusae of dadietl omhaao,tcydryip tub eetrh wsa on tinonme of a eirgepncd varli
meningitis  I think you meant: Jugular venous distention = LT HF Pulmonary edema = RT HF +4  
hungrybox  woops yea I meant Jugular venous distention = RIGHT HF, Pulmonary edema = LEFT HF +10  
jackie_chan  What threw me off the picking 4-chamber dilatation was it seemed like that would be a major cardiac/ventricular remodeling and the vignette gave a somewhat acute 2 week onset +  

 +4  upvote downvote
submitted by haliburton(191),
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iPer- ro tsopmpautr icrmyotahoaydp MP)PC( si a era,r ef-niagehrtieltn taerh adsiese fo uelanrc riingo and is hraeiracezdct by htrea ufielar of ndsdeu onest benetew eth fanil sekwe fo ncnpygear nad 6 smhont arfet kiln to mbupdeT eh cinillca eturcip of CPPM nrcsdsperoo ot a detiadl imoyypcaatodhr D)M(C iwht sgisn of vesere aerth aufelr.i

maxillarythirdmolar  For anyone wanting to understand why^ the tl;dr is that prolactin gets cleaved into two toxic metabolites. Treatment is something like bromocriptine (and therefore no more breast feeding) to stop prolactin release. Lastly, you can treat with regular HF meds. +1  

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I thhuogt of it as yngpcenar bgnie a evmoul oelraodv tates, whhic ascsue latdeid oomcptray.ayhid

Nto seru fi tsih asw eth roecrct isng,anore tub oethr ceomtnsm eesm revy ediat.del