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Retired NBME 20 Answers

nbme20/Block 1/Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect 🔍 / 📺 / 🌳 / 📖
tags: pharm

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 +25  upvote downvote
submitted by strugglebus(189)
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eworNeh veha I enbe bale ot dinf ywh eth lleh isht is a ightn.

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yotsubato  Ist ont ni A,F hk,cSety or aoa,Pthm ro U rldo.w I wkne it wstan rccnae sbuceea sti raible.tal dAn tsiDeeba mdae no ensse ot me. So I ujst rehtw ndow ruDg tcffee and lawdek aa.yw +10
breis  a^^m^se +
feliperamirez  ehT nlyo slpesibo laninxepaot I knhit si that she was udenr a K gspinra cieturd,i chsu as elaspooniorntc ciwh(h ulwdo elda to m)gye.sacnitao +
chandlerbas  ouy adh em at ist not ni etykchs ;) +3
j44n  i huhgott THN ddnuiec empyt lasle dwlou sueca tihs euscbea yteh tog yept II usideeab.t oS if you dene a opr rzaeb nerthu rehllo at e.m +

https://www.mayoclinicproceedings.org/article/S0025-6196(11)61587-5/pdf#:~:text=Other%20classes%20of%20medications%20that,dis%2D%20turbance%2C%20and%20impotence.

if you want to save your time and not read an 8 page research article like I did heres the summary

Other classes of medications that cause hyperprolactinemia include antidepressants, antihypertensive agents, and drugs that in- crease bowel motility. Hyperprolactinemia caused by medications is commonly symptomatic, causing galactorrhea, menstrual dis- turbance, and impotence.

+1/- j44n(141)

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 +21  upvote downvote
submitted by hello(429)
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aonGjl ahd a uretcel ahtt ineeotdmn ttha "fI a ieattpn ahs earlgar,htoca eirewv reyve gdur hteyer' aingtk necis mnay sugdr uesca a"olatarh.cegr

eTh ynol hintg fo poeslibs evcarelne in shti s-Qmte is thta hse teksa a m,tneoiacdi reeorefht eth wnsera fo rgu"d "ecetff si hte tmos iyklle snroea ofr ehr ehoaar.trgalc

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hungrybox  I tllsi ktihn tihs inoqeuts si etrtyp S.B But hvanig uiedstd smoe oem,r I hnkti sti' ssel BS tahn I lnliairoyg uoht.ght amaoPht evgis hte hrtee orjam secsau of ctreolgrhaaa as pnilpe tioinustm,la rpoctinolmaa of tairnreo urtiya,ipt nad gdrsu (see 161. - eBastr glho)t.yaoP nlOy durg ftfeec is an nasrew iccoeh orf ihts et.uoqnsi +9
hungrybox  oT utp ahrento ayw - eebfor uyo ryt to go rhhugot reevy wensra ocche,i aksgin ueyrflso ulo"dw stih eucsa a"ahaetl?ocgrr anIs,edt sak ,oeuyrsfl a"thW are the cssuea of hearol?trcaa"g cAnricdog to .Dr atSar,t etyh are i"penpl oiulntasi,tm acplonoaitmr fo iraoentr tiuptray,i dan s.dgr"u +3
hungrybox  The tneqsoui eo'ndst say inhtngay ttha lwodu ptoin oyu wtroad pepiln uamtsnitlo,i keli "ti noly esmse to aerppa ehnw ehs tups on a ts/slpyriah osunsprtr/c"s.e/t tI oasl maesk no tnneiom fo ptmlaroibe edsninbsl hchwi( oduwl oitpn uoy to na etarnrio yairtptui ,)routm so you anc ulre otu nlaoai.mtprco Teh lyon ionpot elft si rudg eftfce. +2
drdoom  goh’syurbnx ullf omcenmt (lew)ob r:hee tm0a.:o7c4n2mshp/m/#extew9a/e/3snr0b/e1s0nbm +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As na ei108,: 1dt00 ppeoel tdrrpoee ot hvea edis fseectf hewn gtaink ozcdHotilo.hdyraihrAgnoem emth, 52 peeopl 00%.(2) eahv saertB hcrsigead

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neonem  I nhkit teh sbet ayw ot snraew hsit toesuqin swa yb osspecr of tei.nioainml +1
sympathetikey  'thasT smoe htibulls l lo +9
karljeon  aaHh I anmldtieie het rwanes yb eocrssp of inneolitaim. +25
medschul  I tildameein hszedtiai by esocprs fo meinloiatin (: +3
medstudent65  Sith I letmedaini tahsiiezd acsbeeu of nimoelitnia ewnt whti THN ikntgihn inrceiraaltn deebl etegcnfif teh yuraptiti +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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scroPes fo lnietoimnai si the ylon way ot gte ihts aswern woithut Stvnaa lsleve of m,austi as omes eiwtob reiwgna rdouehc ohw woret the qoetnsui blyobpra s.ha

nrCcea is raiauntlle somtla lla eht mtei, MD tn'dseo meka snees rof yna e,asnro THN ftilse 'tounwld ceasu ilkym s,boob dna stam lcsel dtienuraaggnl toend's keam yilmk bbsoo erhti.e ,So nda ebesuac mayn grdus nca aehv lmiky bbos,o 'uyroe felt tihw rgud fesectf by scepros fo oliiaetnnmi.

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djinn  I tndo nitkh eth rauot aws a .taavsn sloA I knith si ithrg scpersco ot htnki "rc"neca nac eb btieaarll adn gtlnmanai tub teh rgd""u that seaucs hist tnis H.CT siTh isutenoq is dba ntiewrt. +1
hungrybox  cicAnogdr ot ,toaPham hracraetoalg si TON oitcedasas wiht eccrna vree (ees .116 - ebastr h.ta)poloyg +
djeffs1  rcignocad ot gseluustrsb'g uenrmbs sit rmoe lilkye ot be lb/ rccane tnah he.zai.isdt. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" tOehr ssceasl fo osidtcamnie ahtt uaesc pmiyenaoraelhrcpti ulndeic datestsnipesna,r enhptiretvnayise sean,tg dna srdug that eranisce belwo .mtiotlyi onpaeyapriclimetrH educsa yb csdneiiaomt is oynlmcom tpitcmams,yo iugcsna alr,tcaegohra rntsumael rne,cutdibsa dan ptoeice.nm It is tmatponIr to nseuer ttha iaacpyereiphlntorm in na vlIdudinai pittena si edu to aicndmiteo dna otn ot a usralrutct lneosi in het tra/uahtilcoyppaimihty r;aea tshi anc eb idocapmhescl yb 1)( ipgtsnop eth amnodietic atoelpyirrm to eeidrenmt ehrtwhe nlpacitro slevle eruntr ot l,anorm 2)( hwgnciits ot a iomntaidce atht eosd nto uaesc rayapnhpcemtelroii "

:tm0nwwh19in4uvot.m/b8e2dgl///c.nsb.hpiw6p.5

d-te"dsoe-deenNnnop ieds etscfef — toghAuhl oo-dselw eahytrp meess to imzimnei eth meicabtlo mnsitccopaoli dduicen yb a atzehiid or leiiaik-zethd ectdruii, ti aym ont ereacslinsy ieamintel thore ieds .esetffc As an la,xempe sa aynm as 52 eneptcr of nme ttrdeae whti 52 ygd/am fo eorcltnidhloah pvloeed a lnceide in suaelx funoctin .[3]4 pSlee bessdanirtuc nac aols c,ruoc aarryilcptlu if the netipat si no a -dmuiwsool idte 3][.4 wHo sthee rosemlpb cruoc si otn .w"nokn

oi#2fsihntspH-uhteieewiust-eii-r-ntet0m0tsa8miccnire/.ap9e9ti5o:ten/a-runa-sl-hr3n-z/wptt.ip/entdytwe5cw2tsda-hdooospys

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 +2  upvote downvote
submitted by hungrybox(1277)
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hPtoaam vsgie het rehet omjar saucse fo hatcareaolrg sa nplpei asiomnttlui, oircmlpaanot of ertianor iapt,yuirt dna dusrg (ese 161. - aertBs Ply.hoagto) yOln gdur tefecf si na awresn icohec rfo sith .uisetonq

To ptu hartoen wya - feoebr ouy yrt ot og uhtgrho ryeve rewnas cech,io isngka yrfseuol wul"do hsit sceua ht?oraaae"gclr a,ndItes ask y,lferuso h"atW are eth esacsu fo rrhc?leatgoaa" dingcroAc to .Dr Sa,trat htey rea npe"pli msiiluotta,n ntpoairmloac of tarerion yuipitar,t nda s"r.dug

ehT qeisotun tsdno'e yas thinyagn ahtt uodlw onpit oyu dwtoar pinlpe tiis,natomul leki "ti lyno smsee to ppraae wehn ehs psut on a hylsasip/tr sos.rp/tetrscun/†" So ouy nac rlue tuo ilnppe i.utmilsaont

It lsoa aeskm on omitnne of epblomtari dilessbnn w(ichh udlow itpon uoy to an ertnaroi taripyiut rmo)u,t so oyu can uerl tuo moptn.raailco ehT yonl noptio ftle is dugr t.eecff


evI' rneev sene ayhnnitg liek sith no a iquetosn ubt I aumses hte EBMN owudl dowr ti ni msoe tolevocudn ayw klie t.tah


I linlitayi wreot siht as a nm,boetumcs tbu I lefe klie ti sesvdeer sit now nc.temmo I asw evnre alrely fstaidsie ihwt nya of the xentolaapins rof tsih rboe,mlp nad I ailflyn eirrdva ta eno that saemk hte ostm esens to .me

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hungrybox  O,h nda ebisde,s ippeln otmsluinati dna ianptmcolaro t'eran eenv saerwsn lol +
drdoom  stmsy[e irl]ema uyor tnucoac sah ebne eapdgudr: AOFRTM ANNJI +1

One more thing: Pathoma specifically says cancer is NOT a cause of galactorrhea.

So the people who are saying you can rule out cancer because it's bilateral are completely wrong. You rule out cancer because it doesn't cause galactorrhea.

Besides, breast cancer can be bilateral. Bilateral breast cancer is almost always invasive lobular carcinoma.

This is analogous to serous cystadenocarcinoma. Bilateral ovarian cancer is almost always serous cystadenocarcinoma.

Idk how this "breast cancer can't be bilateral" myth started propagating.

+9/- hungrybox(1277)

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 +2  upvote downvote
submitted by dave_(3)
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siizahTed ceured GFR g;&t- edcdeuR canrcaele of lcotnapri >-; oplinehipaecayrmt t-g;& eid.raghsc

Nto ures owh ccorret htat ,si ubt edasi rfmo aneccr igbne illa,raneut I lwodu aoassicte ighh aiponlrtc hwti olss of anoepdmi didneiiin/tuhecbor eaelrnacc of rniaopctl si.tefl

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 +1  upvote downvote
submitted by sam1(22)
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iheszadTi cna sucae ceuat aelitntitris iphstrein, a ofrm fo erlan frluae.i tuhtoWi teh lerna rxcoietne fo acr,pitonl it acn udlib up ni the seumr and rueslt ni .oaaetalgrrch

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coccidioinmytitties  Sxelau cyofndtsinu edrie[s bedas = ]dbiiol acn be deu to gurd eisd efcfest e]sysptiv[heirntn,ea erp ifrts aid. n :iEtiod eg2a8P0:1 1i c5neo:S5t ePchy Ps,r 1Assd'it ocdnriene oitecn:s evs"ecisxe tounsma fo cnilpaort iasdoetcsa whit oiild↓b ]43.[2 s iTh oegs oetethrg wiht uor sxelau uoinctsdnfy hwti ryetnvns".h"iepiaste nly O cloigal stynhssei I acn nkthi o:f adith ize = ran↑cliotp = di↓loib + atgahacerl.or tI luodw losa meak sesen iscen ew era dgainle tiwh an epeexdct ot eb tops-noaalpemsu emafel mlki[ cpntiruodo wudol evah ot be ued to ogoseeuxn r].gcouesDu otin ym lcuerte entos dan nfuod eth gifw:ollno tbekbcao-lers nad iadzteihs ucsae xaules iyd.fc Itnnuos asol ilek '1amss .nilapnotxea ere'W ncgrieha he,er tbu tsi teh tsbe I anc od. +
g8427  aMyo icnilc swhos racle ro lydobo ppline gsrhacied sa deis tffcea of Tiiasdhz.e tuB toesnd teats mkiyl .hsgedcrai +


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 +1  upvote downvote
submitted by namira(39)
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elsbisoP nptalnxa:eoi

If teh tp is nkiatg a etdaizhi hwh(ci si K ,geeldpint) it mgtih ahve lsao eben evngi whti a K isrpgna ugrd shuc as csnrtino.opeali

npSoiloraicent sha ordocnleincgio eeffcts hsuc sa atmneagscoiy and acgarho.relat

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sugaplum  I htnki oyu oducl olyn kaem tihs snimspauto fi they idas "naettpi si on dasarntd htn "xt tub ciens hyte egav eht amne hc,zt dwuol nto eb fira to semsau ethy ear aosl aktgin .lnaiosnirpotec I tewn hitw cersosp of ialtnieionm on hsit n.oe nvEe kcdhece cecass ieecdm'nis gdru avdeesr ffeetc oalelep.iar.rotcrfahg. ton dletis rfo chtz +2


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 +0  upvote downvote
submitted by j44n(141)
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bseoslPi uescsa of hglracteraoa edcnl:ui iad,ioesctnM hsuc as aicentr a,vesdites taapres,tsndinse nshpiyatcostci dna ghhi dbloo sseuperr udgr.s oiiOdp .seu earblH msptupnsl,ee shuc sa nlef,en einsa ro ekgnuefre edes

^ mrfo eht ayom cli.c...ni psmaeish no hte HNT rgdsu

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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hietzi=;Tagd& &rm;=thiyepcglaeac Oitxonyx (qG ucldepo ongeptt&-ir; nirc t+=&2;)Cga nieppl ecisrahdg

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arkanaftus  oxnyOict llwi not wkro no sbreat nlusirgte no iymkl eigsdcarh fi eht danlgs rwee ont ard"eer"pp by oial.ntcrp 'stI elki rintyg to qesuzee mptye blnoaol - gtnoihn seog u.ot +1


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