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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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OCSP si etidsasoca hwti maalbrno ncitpoodur of xes d,sioestr uinindclg soncytuinfd fo tsnroeeg dtornoupci nda oseger.optnre lCyoihrlnca vdeeteal elelsv fo egstonre cna asuec oeridlenatm apph.eiylasr

cC/t/9bcislans/wptl.79/nhm9Mcv.iem//rPwh:p35tgi1..own

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meningitis  hyW ntis ti r?eedistinooms oduCl semnoeo pehl em out on ?hist +2
meningitis  ,ryroS I wsa sgufconin hiwt hhregi kirs for imoetarledn aa.ncrocim +1
vi_capsule  erognEts is selbepnsrio rof lcaclcyi neegldbi dan apni tcdasosaei whti sieiotnmsdroe ecneh enpisotrg si a tenamrett i.ytalmdo tuB gtsoeren tisn a rksi rofcat rof oEo.mnrissited hReatr sreteh edroterrag wfl,o ampcetltia snitaraonfrtmo tce eoeistrh are opissrenbel orf ionretise.dmso +1
sympathetikey  Tfw you tge so nrwhto ffo yb a eirtcup thta yuo 'tdon drae het nsuoiteq p.rpelyor +34
hyperfukus  @miietngnis kid if u lislt care lol utb alawsy go cbak ot tdsncoiecsmiopetio=er dlreenoatmi stsuei editsou of teh tsuuer so uyo nac erul it uot cnesi cdrneesai oresgetn wdulo eacsu oyu ot heav nrwseeod roeosimisendt ro a eitkhrc one tbu ont ed.or.y.tiuycl nca see eht ulcpsm of eht illcfoles in teh reaosiv fi uyo kolo pusre cesol os htta lngoa ihtw teh aninotpeerst aktes uoy ot PCSO dna antmeyi ouy nodt' aveh a aybb ro tsya ni teh apteioevilfrr p(hgtseosernae )ehpsa ouy egt amtornileed iiyaaefrpepalrlpiso-olygret&tahgiu-;-;tnm&tt--l nmoccaair +2
lovebug  FA 2091, pgea 163 +1
lovebug  rehOt nsreaw eMs)Hig srnmeody : ar tid of )1 aoiarnv mifb,oar 2) c,stsaei )3 erlplau uffon.sei โ€œniโ€uPlgl oseitsann in inor.g FA 10,92 pg 326 +1
xw1984  t'nIs topino G, ayioaLmemot tiu,re ctidaeossa ithw ihhg erogestn e?vlel erP FA 0220, bofdrii is oegrtnse sentis.iev +2
ownersucks  981x@4w sgsro gmiae odluw oswh peuiltlm welordh masess +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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cCsionomtpial of C:SOP

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esndacIer iarsemragci ater

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