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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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 +3  upvote downvote
submitted by โˆ—mcl(671)
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PSOC is asseiaotcd tiwh mnbaolra utpdoconir fo xse dseiro,st duninligc yfconutidsn fo rsgtneeo oruditnpoc nda segrrpenoeto. rlohiyncaCl elvedeta evslel fo esntegro nac scuae mleaireodtn eayilpar.phs

.apl9.e7Pnim/wMhgot.t3c/wwt/vbcnpin/hscC/1i/5.9m:9rls

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meningitis  yWh nsit it ootsi?misedrne Clodu nmoeseo hple me uot no ?hist +2
meningitis  rS,yor I asw fnnsoguci ithw ehhirg kris rfo rdonialtmee acocr.nima +1
vi_capsule  onsEertg is inseoprelbs fro cycicall ngleibde and niap eaotaisscd hwti romoetdnesiis ehcen igenoptrs si a tttmrneae yoamildt. Btu nroesetg isnt a sikr ocrfat for dtoosiesmn.irE Rrehta thsree eagrrtdero fw,ol etatclpmai omaafintronsrt etc etehoirs era rosienbsple ofr o.srmieidnstoe +1
sympathetikey  fwT oyu egt so ohtwnr ffo yb a eitpcru htat uyo o'tnd eard hte ousiqent poy.lrrpe +34
hyperfukus  s@nnmgietii kid fi u tsill crea lol tub swlyaa og kbca ot t=cstipomdsonioceeeri daitoelremn ustsei detsuio fo teh uretsu so yuo anc erlu it otu iencs aenrdeics etrosgne uowld auecs yuo ot vhea nsdoreew odomsenisrtei or a ritcehk neo but nto de.yrtlo.iucy. nac see eht plmusc of teh slofeicll in teh vieaosr fi ouy ookl eursp csole so thta logan whti teh oestpearnnti asket oyu ot OCPS and yteniam uoy 'nodt evah a bbya or ayst in hte elirvifortpea ohape(tsngeers eas)ph uoy gte tiomdlnaeer i;otrai-eurti;hapyog&milanftt-t-perla-gey&-spll ioamccran +2
lovebug  AF 0291, gaep 163 +1
lovebug  Otrhe eswnra )eHMgsi medrsony : rtd ia fo )1 ainoarv iamborf, )2 sci,eats )3 rplluea ioun.sfef gPlโ€uโ€œiln asieosntn ni igr.on FA 9102, pg 632 +1
xw1984  nt'Is ootpni ,G yomLeoatami tir,eu oetscsaida tihw hihg renoetgs lvlee? erP FA 0,220 idbrfoi is trnegsoe n.sviieets +2
ownersucks  18wx@49 sgsor agmei oldwu ohsw pmutilel odhelrw esssam +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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lpnCmtcoiaiso of C:POS

lsoadcraivaruC tenves

eypT 2 aesbdtei mteiusll

nteadiErmol carcenayhpeplsr=ia

reansdeIc seaiircrgma eart

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