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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 diostcsaea wtih olramban roucdiontp fo exs tsiod,ers nginidulc fisndytcuno fo steonerg iodpncrotu dna rreonpts.eoge lhrloCcnaiy etevedla eellsv fo otsegner anc easuc alreenodimt e.aarslphipy

soclwmwi.C.3rwi9n./p7/ps/t9hnPvhba1i5t:te9mM/nclg/./c

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meningitis  hyW isnt ti eeomi?isotdsrn dulCo eoonmes ephl me out no ht?si +2
meningitis  S,rory I asw foucgnnsi itwh gherhi iskr for iednlrmoeta a.miocacrn +1
vi_capsule  toeEnsgr is lsepbesnior fro clicaylc nebgelid dan nipa cdeaisatso wtih oesdesnoiitrm enhce tgreinpos is a rtteantme .iymaldot tBu stegrnoe itns a iskr oartfc fro seiiErmdsot.on Rahret sereth rogreeatrd lwfo, tliapatmec tmrfsnoorntiaa etc esortieh aer iesnosepblr for r.eniostmoidse +1
sympathetikey  Tfw uyo teg os hwnotr off by a utcrpie that oyu 'odnt aerd eth nqiuteos y.eorplrp +34
hyperfukus  @iisnmneitg kdi fi u lilts ecar oll but laasyw og bcak ot pcenetiosoitco=irmsed rintmloeead suseit teodsiu fo eth usertu os uyo nca elru ti uto nicse sncraieed egresnto lowud saeuc ouy to vahe seerodwn trismedioneso or a hirekct neo tbu ton luoryetcy..di. cna ees hte mpslcu of het sofecilll ni teh iasrove fi yuo kolo eupsr oscel os ttah olagn htiw hte snneertoptia tkeas oyu ot COSP dna yenmtai uoy ontd' vaeh a abby or tsay in hte fiitveeparlor hseeerogn(taps pshe)a yuo get roeetnimadl iplt--omritgptgoeeaaf;ry&uihty-;llsrnalt--eaip& ianccarom +2
lovebug  FA 2,910 apeg 316 +1
lovebug  htrOe aesrnw gieHsM) rdeoymsn : ritd a of 1) nravioa i,brfoam )2 sstiace, 3) rueplla iusf.nfoe โ€œlโ€ilunPg iosnatnse ni o.nirg FA ,9021 pg 326 +1
xw1984  Isn't oipnot G, tmoaimoyaeL et,uir dotecaasis wthi ihhg etsgoren evll?e reP FA 2,002 friidbo is nstrgeoe iteisves.n +2
ownersucks  491xw@8 srsog aegim dowul shwo eluiptlm reodwlh ssasem +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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niatCcooispml fo CP:OS

cCuadvoaisrlra vesten

eypT 2 teibased slltiume

Ermtliedoan eacnrcahi=psryaelp

eIrsncead irmaesagrci aret

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