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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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SCPO is ascsideato thiw aaonbrml ntidoprcuo fo xse ,drssotie cdinlngui oncsyndtfui of oteergns ornpudtico adn teo.egrnepros hrllyncCiao eelavtde vlsele of tosnrgee can aucse amrleonteid plspryi.ahea

5/pclsht.917nl.3/oPw9t9Cmt.:hmeiMgn/./ciw/pncva/wribs

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meningitis  hWy isnt it ?rissdiomnteeo ouCld msneeoo pehl me uot on ?thsi +2
meningitis  oryr,S I saw ncfnusgoi tiwh iegrhh skri fro irneetmaold occira.amn +1
vi_capsule  Enotesrg si lsreosbnpei rof lcayccli bgildnee nda inap sodasiatce twhi edoimsesintor nhcee grtnpsoie si a nmteettra d.omitlya utB groetnes ntsi a irks cftoar orf .isomtnriEdseo etRahr rheset rrgodreeta owlf, latatmecip osrmaronttiafn etc rhteeosi rea relinoebsps fro dio.tsmneeosir +1
sympathetikey  Twf uyo gte so trohnw fof by a erticup ttah uyo dotn' eadr eth tnquieos pop.yrelr +34
hyperfukus  ngmiesin@it idk fi u iltsl reac lol but lasawy go acbk ot ioiotocseeptedsc=mirn ieemanrltod seiuts suoiedt fo hte useutr os yuo anc eurl it tou cnies deicasren srneoget owdul caseu you ot eavh neesordw tesmioeinsrod ro a trhecik eno btu ont uyel..i.rtycdo nac see het ulspmc fo eht ileloslfc ni eth raievos fi uyo oklo psuer ocels os that lonag wtih eth oaiertnstpne eatks yuo to OPSC dan myiatne ouy ntod' hvae a aybb or ysta ni eht iratleorfviep nreap(ehsogets epsa)h yuo get oetidlreanm itlm;&;-hileplrap-er-tsnfteotl-rypgiog&aayi-tua aianrcmoc +2
lovebug  AF 2190, pega 613 +1
lovebug  Otehr asernw es)iHMg smydreno : rdtai of )1 raoanvi iafbmr,o 2) ,isaestc )3 prleula seuo.inff nliโ€œPgโ€lu inaonetss ni on.rig AF 019,2 gp 236 +1
xw1984  s'tnI oponti ,G mimaetoaLoy ,ieurt sacadeotis wtih hhgi neresogt eell?v rPe FA 200,2 fodiirb is tergneso .sinetsevi +2
ownersucks  @x891w4 ssgor egmai ulwod wosh piellutm hrdolwe sesasm +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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ptimnoalsiCoc of CP:SO

dsclovaarirauC vtseen

Tpey 2 etasebid smtliule

Elrndeoamti accenrslypahe=pair

decrInsae risaiacmerg trae

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