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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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PCSO si sascteioda ihtw nbaamolr ropontucid of exs ite,ssord cindulngi tsondiunycf of goeernst dorcitoupn and srnoogete.pre Cihnyarocll dteavele elevls fo gernoest cna escau tnoeeirdmla riseylap.aph

cio/:m53ttl9cw.sChnn19Pwii/9.sh/tpc/e/l.v.7m/pabnwrMg

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meningitis  hyW stni ti i?serodsmetoni udCol neeooms phel me tou no t?sih +2
meningitis  r,oyrS I was nfscniogu iwht riehgh irsk for itlemnerdoa .crmaancio +1
vi_capsule  gnertEos si rosenpelisb fro cclicaly eebidlgn and pina odaeasstci wthi seedmtoriosni chene tnsprgioe si a eneartttm m.iodltay utB tgroeesn nist a srki taocrf orf im.issdtEoeonr rhteRa hteesr edrrageort owl,f aetmcapilt staomnitnfaror tce iehretso rea oesebslprin ofr inres.dmiesoot +1
sympathetikey  fwT oyu teg os ortnhw ffo by a tueircp taht uyo t'nod aedr hte nutesioq rppoer.ly +34
hyperfukus  gntinm@iies idk if u ltlsi reca oll btu ayslaw og cabk to scmpodii=oietenesctor onedtarilem uitses tiudeso of eth userut so oyu can eurl it uto encis nsiaceder gesrnote lwdou secau oyu to evah newrdeos iedosnosermti or a rthkcei eno utb otn c.oyd.eytlir.u acn see eht culmps fo eth sflolielc in eth ioaresv if you kloo urspe socel so ttha gnlao twhi the oneatpitrnes stake yuo ot SPCO dan natiyem you o'dtn ehav a yabb or tasy ni eht ipeloraitrevf r(ntpgheeseoas a)hesp yuo gte ionateledmr iryf-ripg&etrhmlaoolgluip;&ny-aetsitla-tae;p-t- ramiancco +2
lovebug  FA 2910, apeg 316 +1
lovebug  Otehr rwasne geHMsi) smndeoyr : tidra fo 1) avorina ofmi,abr )2 sseai,ct )3 aeulprl o.fsnufei โ€œnglโ€uiPl naiosnets ni nrog.i FA 0,912 gp 236 +1
xw1984  'Inst inpoto ,G emaoamLtyio rtie,u asodiceast hiwt hgih eretgson vee?ll reP AF ,0220 ibdiorf is ngsteore vi.tiensse +2
ownersucks  x1w4@89 ssorg mgeia lwudo owsh ilutlpme ledhorw ssaesm +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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lcainoiCpsomt fo OS:CP

doaacCrisralvu neevst

epTy 2 dasbeeit ullmiset

iaroEdtemln aernccplrha=pysiea

endscaIre cersgaarmii tera

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