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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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OSCP si ioaseatcsd hiwt mrboalan iocturodpn of sxe ,isrstdeo uninldcig toicnynsfud fo reosnetg opuincdrot and oepne.rsgroet hyoCllacrin vdlteeae elvles of sogtrnee anc eucsa dtreliaomne rphpsaie.lya

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meningitis  hWy itns ti ems?sdiioetnro loCdu mnoeoes ehpl me tou no this? +2
meningitis  oSryr, I aws icnugofsn iwht erhhgi riks for tmdanoeilre ncamraoc.i +1
vi_capsule  srnetEgo si bspilrosene rof clyclica eildnbge dna pnai sasaidtcoe hiwt tesiiemndorso enche osgintpre si a tmaeerttn mao.dtliy tBu energsot stin a srki crotaf rof etsdromis.nEio atRreh estreh arterregdo owfl, liamactetp aiotrftnmnarso cte oersithe era psiebnlrose rfo eoriisdn.emtso +1
sympathetikey  Tfw yuo get os rhntow ffo by a peutcir htat yuo do'tn dear the enuqsiot ylerppr.o +34
hyperfukus  @iigsnntime kdi fi u lsitl crea lol tbu aayswl go ckab ot orstcc=eemiodintoespi nalmoeeitdr essitu ieduost of the teusur so you acn elru it tuo cisne narcedies esrgotne uwodl csuae uyo ot aevh nesweodr teireonimdsso ro a khtecri neo tub not .eycd.lo.itury nac see teh mlpscu fo hte esllciolf in hte ieavors if oyu kool repsu olesc so ahtt onlag thiw het raniotnspete skeat uyo to PSCO dan yitemna oyu 'tnod vhea a bbay ro tsay in teh evriforeailpt erteaphgos(ens pash)e oyu gte rmliodanete a-ryripu-gti;tlnom-a;phiole-tte&igtlpralfyesa-& iocaanrcm +2
lovebug  AF 09,12 page 613 +1
lovebug  trOeh rwensa )egMsHi rnsmdyeo : tdair of 1) raaovin mr,aofbi )2 stse,cia 3) ulpalre .oensffui igโ€œPulnlโ€ onnatsies in .irngo AF ,1290 gp 236 +1
xw1984  ts'In pnoiot ,G iemLatoyamo ,eutri codtsseiaa thwi hghi sntegore lve?el rPe FA 22,00 ridoibf is onretgse einsive.ts +2
ownersucks  4x@1w98 sgosr emiag uwodl sohw letlumpi wdheolr ssmase +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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ltpoCmaiiocns fo OSCP:

rsoaicvluaCadr esvnet

epyT 2 eadsetbi tlesmliu

timolnaEder caercnipyrs=lephaa

nascdreIe iriagrcmsea erta

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