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Retired NBME 20 Answers

nbme20/Block 4/Question#21 (reveal difficulty score)
A 47-year-old woman comes to the physician ...
Contact with parakeets 🔍 / 📺 / 🌳 / 📖
tags: pulm

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 +36  upvote downvote
submitted by ∗masonkingcobra(408)
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ageP 2 has a ategr ptrieuc

a01o0()6:hi3rrwweflnpi8a-sct12n/-64pg9w/ect/ji96.t.od07//S1l

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kamilia20  dyomlhpchaial aii??ptstc +1

FA 2019 P. 661 Hypersensitivity Pneumonitis is a mixed type III/IV hypersensitivity reaction to an antigen in the environment. Commonly seen in farmers and people exposed to birds. Presents with Dyspnea, Cough, Chest tightness, headache. It is reversible in the early stages if the allergen is removed.

+7/- lilyo(94)

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 +9  upvote downvote
submitted by ∗hayayah(1212)
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inHrvtspiyiteyes onxntpimeuesdimi— etpy I/VIII ipsvtnyhseriiyet aotnceri ot noeermnntlaiv nai.gnet uCaess yp,asedn huo,cg tcseh t,egstishn eaae.hchd nOfet sene in amfrsre dan steoh sdxeeop to rib.sd eersvelRib in rlyae sstage fi uumtilss si div.odae

t'sI a ytep of rcestirtiev lngu .eidseas

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A type of hypersensitivity pneumonitis associated with animal exposure is bird fancier’s lung, in which the major antigens are proteins in avian serum, feces, and feathers, including bloom, the waxy powder coating them (18). Pigeons and parakeets, including budgerigars (a type of parakeet), are the birds most commonly implicated, but poultry, finches, doves, canaries, and other birds also have caused the disease. Exposure to live birds is not necessary to produce hypersensitivity pneumonitis: the illness has resulted from using feather pillows and duvets (19), being exposed to a wreath made from the feathers of a dead pet bird (20), and laundering a pigeon keeper’s overalls (21). Other examples of animal proteins that are known to have caused the disease when inhaled include proteins from the dust of mollusk shells used to make buttons (22) and from animal fur used in garment manufacture

https://pubs.rsna.org/doi/full/10.1148/rg.297095707

+7/- alexp1101(11)

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 +6  upvote downvote
submitted by ∗neovanilla(57)
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yhW het ehotr wrnsae ceiscoh ae'nrt rccerot

A - tNo na athalypnccia acertnoi myinal edu to ocitcinhyr sniuo(mnoptc fo soy, ciwhh ash ginpyslrtecoo atht pelpoe yam aehv arsleileg ota)dsrw

B - tNo tahmsa iazccterhrda(e yb meor ucate soipesde fo chnnotor,obtrscconii geinwhze)

D - ienmaA 6B(, B9, ,1B2) or aebym a pnloamruy bmlmoies ude ot B9 or 2B1 denyfiiecc -g&;-t edelatve itooecnemsyh leelsv ;-gt-& osrmbtohis -g-t&; V?TD

E - Pylruonma rnt;xhaa eTh meti eursoc udowl eb hcmu orem aetc,u adn ulowd osal eptesrn htwi soptmmys fo e-llikfu somt.mspy Radpi hetda oot

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 +3  upvote downvote
submitted by ∗monoloco(155)
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sTih netptai is igrnpiecexne yheintvprtesiysi sienupiotmn ofrm the pee.taraks I aws nkghtini M. uAmvi hewn I tleeedsc eepkatrsa -- I tinkh ym ilcog aws lwaefd vgnei teh scfiepcis of the ea'psittn sty.or

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 +1  upvote downvote
submitted by ∗imnotarobotbut(184)
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Hwo dwlou uyo onkw taht it i'snt lwoo storrse isa?dsee

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cienfuegos  FA 0281 :731 inonhaital of esspor desla ot -kllieuf psmtsmoy ttha psgoesrr ilqkcyu ot ,fvere ouynrplma omhe,grarhe nsiaiisttdemi nad ,skhoc twhi maggnii plyissob hwonsig iwddeen amusdinmtei +10


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 +0  upvote downvote
submitted by ∗endochondral1(24)
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dgicncaor ot wuldor stpiythnriesievy sentmuipnio si ude to usdt dna hatt wsa losa na .on.t.o.pi

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amarousis  so tis' ndieytfiel utds ubt eht pccefsii pety of tsud saw hte mtos ornapimtt in htis iune.qots eht fcat htat ehyt teodinmen eht sdibr is a.ipotrmnt hte tusdy bkoos ulwod cueas ti but teh ridb stud is emor tanimortp .-- +
charcot_bouchard  titsvpeyrnHyieis ismetnPuino - ingOacr utds (ekli ylmod ssanimcnooehyiu P) - nanigIroc uondtnse lpeh eher uhohgt beecaus hobt lwil etnrspe hiwt maes eivsrrctiet ungl essdiae .ruetipic khtni iecns udts ni ilraryb rnaet iernhet gnraoci or rinaocngi dna laos u odnt ese myan narabsilir hwit lngu eassdie but bdri wresonhip si lysapifcclei ndtoenmei as uasce of PH .deassei +


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 +0  upvote downvote
submitted by ∗beeip(141)
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I salo aws tghinnik .M auimv ehe,r tub yiiersiyhsttvpne eponmsutiin mssee ot fti twhi teh tugecrorrianallu eghcasn.

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 +0  upvote downvote
submitted by ∗endochondral1(24)
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who od we wonk eetapasrk uscae nyrvteseipsihy iptsineunmo

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smc213  FA18 .5p67 dbir r-geup&;o-xest HSN tneipoumsin srirce(evitt nlug )seiaesd dna F18A .1p42 roulgtsmnauao deea:siss ifogenr Hlma&Sir--etNag;t .pietuinnmos I hda ot aekm eenss fo ti ecins I i'nddt nokw ti was NSH ousimitnnep ta .trfsi +5


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 +0  upvote downvote
submitted by ∗breis(56)
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saistsitPco stoismem(e dllcea hitsnooirs or oaptrr saiseed or raprot vref)e is na ntnoifeci of het unlg enamin(opu) cadseu yb teh aicrmbtue lalohhmCiydpa a)mhCaliy(d ticit.psa

igSsn dan .,:eeh ycomfogrtvmpuss lulauys ohuitwt cuhm muh.aere.ms ahl ahcdce. hgespl sae s.echcht tr.snhpsanioes of oteahr sbr.e rhatot.

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charcot_bouchard  pedtaU on ym repv cntmeom : seY isth si itsac.osptis otn pierntysteiiyshv noinpetism.u oHw od u wok?n cyohpLtyme nda nePcrese fo aaumonlrG - esorsnep ot aunrtlaelclri my i.aNcahdwlo SH cna loas esuca oselo lragoumna oto nda eth calclnii cpertui illst eorm olko eilk HuYSo nowk twha ......... cukf this uqse +2
shemle  Hree t.P doet'ns hvae f!veer +9
shakakaka  caNsnaiotgen lagrmno,ua thcpay yytmpciholc frio,tnianlti dna srbsiifo are esen in nepHyyivsstretii ntnsipomeui , ocgnacrid ot wordlU . +

https://pubmed.ncbi.nlm.nih.gov/7569404/#:~:text=The%20inflammation%20is%20often%20followed,than%20in%20women%20and%20children.

you get granulomas in both

+1/- j44n(141)

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