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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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submitted by โˆ—mcl(671)
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POCS is odssatieca wthi rnbolama roiocnptud fo xse ssoedr,ti cilnndgiu cdyonfusnit of srotneeg pdnoouitcr dan oeoprgsrtne.e llCcyiharno eavtldee vleesl fo nreoetsg nac cuaes damelotinre .ayhepilsrpa

.im/lac3hwitl9t.7psn.9gP1sM//mwhvb/e9rCc:/.ti/5cpwnon

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meningitis  Why nist ti ssnoorimeei?td Cdulo oeoenms lhep em tuo on sthi? +2
meningitis  yrrS,o I aws gunifncos wiht higher irsk orf lerematodni c.amcaroni +1
vi_capsule  noerEtsg is elosbrienps ofr lycclaic iebgdlne nad inap ioeasdscta tihw edrnmsosoitie ehcne pitrnesog si a nerettatm omld.iyat uBt ergosetn itsn a risk acrtfo ofr odtisesoEin.mr thraeR eehtsr gatrrdereo fol,w cmaiattpel soiorafamntrtn cte oserieht aer pssbneilreo fro ensoorsiitmde. +1
sympathetikey  wTf uoy tge so tohwrn fof yb a ruecipt thta you tod'n eadr teh eouqntis .eryprolp +34
hyperfukus  @gmsiinetin dik if u itlsl rcae lol but ylaasw og abkc to teiospd=iorieeomstcnc tornleadime teuiss stdioeu fo het teursu os uoy can leur it tuo nscei eredcsnai nsetgore ludow scuea uyo to vahe denewros eonressmtoidi or a etrckih oen but not .lreyct.iu.oyd anc ese hte mlspuc of het lisolflce in eht viorsea if you lkoo ruspe lseoc so atht oganl ihtw teh isptnotarene askte uyo ot CPOS adn nmeaiyt you dno't vaeh a ybab ro asyt in het evpirerifalot phtsoesanerg(e p)shae oyu tge emtdnloriea sotray-aimeili;tgoarpe-y-pa--fre<lgnil&tpth;u omcaaircn +2
lovebug  AF 2901, pega 136 +1
lovebug  rhteO nesawr gs)HiMe merysnod : dtair fo 1) naraovi ,baoimrf 2) ,tsaices )3 leprual isof.nufe nuโ€œiPgโ€ll atoisenns ni rgno.i AF 9210, pg 236 +1
xw1984  I'snt onitop ,G omaaoyteimL ,uteir diacosetas twhi ighh eogsrten l?veel erP AF 0202, odibfri si neotegsr nvstiee.is +2
ownersucks  xw419@8 ssrog agemi udolw swoh lpteumli dlroehw assems +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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aiooslitpnmcC of SOC:P

oauiracdarCslv envets

Tpye 2 atdesbei siluetlm

traonmliEde ecnacrahia=lprpeys

aerdcesIn cmraiieagsr trea

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