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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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PCOS si aeaidsctso ihwt brnmlaao cnouitdpro fo sex dioetrss, nligundci onundifcsyt fo oeetrsgn ptoonirucd adn pngoserrtoe.e ihoCnycllra vtedleae lelves fo eersgont nac ceaus ierealtmnod lapieprahs.y

/el/ih.Po.hc3atbgivsr1cn/m:59wt9.lp.pwm//sciwtnC/9n7M

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meningitis  Wyh nist it e?nodestsiorim oCdlu enoomse elph me tou no ish?t +2
meningitis  Syro,r I aws ginnofscu wiht rgihhe sikr ofr dmrelinotea acnmria.co +1
vi_capsule  ngteErso is eslibnrsope orf lylcacci ineldbge and anip tcadosasie ihtw odirsemontise cneeh rpsnigeot is a armeetttn ltod.mayi uBt rgeonste snit a skri actfor orf osrtesidnE.iom reathR ertehs doratergre fl,ow ttilcaapem sfroantonmtair etc rsteehio rea bslieneposr rof iirosnsede.mot +1
sympathetikey  fTw oyu teg so otrnwh off by a rpiutce ttha uyo ont'd read het snoitqeu prp.roely +34
hyperfukus  stnimni@ieg ikd if u sillt care llo utb swyaal og cbka to dnpt=coetmeiicsiroeso tmnerilaode tsieus uidotse fo hte rtuesu os oyu nac elur ti uto einsc denieracs tergneso ulwod useca uyo ot haev enowdres iooneeissrmtd or a tchkier eno btu otn tcoeul.i.y.ryd nca see hte pcuslm fo the eisllclof in eht arvieos if yuo look ersup elosc os that agnol htiw hte sartnepiteon setka yuo to SCOP dan miantey uyo ndo't hvea a bayb ro sayt ni eht eaevtrrofiilp (enrsotgphsaee has)pe uyo teg telreamindo ptlapfil-uit;yy&eohatgi;ri--rltlpmaa&neo-trge-s mciaarnco +2
lovebug  AF ,2910 epga 613 +1
lovebug  Otehr wrsaen M)igeHs edmosnry : d riat of 1) arivona bri,ofam 2) se,csait 3) uplealr ueo.nffsi gllnโ€œPโ€ui atnniseso in i.rngo FA 90,12 gp 362 +1
xw1984  tI'ns itnpoo ,G oeyimLoatam tuier, aesasdicot thiw gihh ogtseern evl?el Pre FA ,2200 briidfo si netgesor iivne.tsse +2
ownersucks  xw9@841 sgsro gimea dowul sowh tullpmei orwheld samess +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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aoispilonmCtc of CPS:O

Cascrurolaaidv seetvn

Tpye 2 bsedaite usteliml

metElraidno nrccaealrys=pepiha

eerascInd isarmagceri erat

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