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Retired NBME 20 Answers

nbme20/Block 1/Question#17 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
Drug effect 🔍 / 📺 / 🌳 / 📖
tags: pharm

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 +25  upvote downvote
submitted by strugglebus(189)
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hreNewo evha I neeb bela to dnfi why eht lleh isht is a inht.g

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yotsubato  Ist ont ni ,AF hSk,teyc or am,Phaot ro U owrdl. I enkw it atnws carcne busaeec sit ai.teallrb dnA beDiesta mdea no sense ot m.e So I ustj trhwe dnow Dugr cfeetf and kleadw .ywaa +10
breis  ^^a^sme +
feliperamirez  hTe lyon peilbsos eipxntaonla I inhtk is ttah she asw drnue a K nagirsp ti,cideru suhc as ptoiarosconeln (chiwh oduwl dael ot siogyc)at.mane +
chandlerbas  oyu had em at ist not in kycehts ); +3
j44n  i ttgohuh THN uncdeid ptyme leals ouwld auecs tihs cabeuse ythe got peyt II atidue.bse oS fi you edne a por bezra tuhner lhorel ta e.m +

https://www.mayoclinicproceedings.org/article/S0025-6196(11)61587-5/pdf#:~:text=Other%20classes%20of%20medications%20that,dis%2D%20turbance%2C%20and%20impotence.

if you want to save your time and not read an 8 page research article like I did heres the summary

Other classes of medications that cause hyperprolactinemia include antidepressants, antihypertensive agents, and drugs that in- crease bowel motility. Hyperprolactinemia caused by medications is commonly symptomatic, causing galactorrhea, menstrual dis- turbance, and impotence.

+1/- j44n(141)

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 +21  upvote downvote
submitted by hello(429)
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ljaoGn dha a rulceet taht tideonnem that fI" a pntaeti ash aahtagoerl,cr reievw veyer grdu 'eyrhet nagkit csnie yman sdrug auesc a.lecahrrgao"t

ehT only githn of olpisseb nareleecv in siht meQ-st is taht hse tskae a tm,neicioad eherrfoet eth rswean of gud"r "ceeftf is teh mtso eyllki oesnra ofr reh hleco.gaaratr

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hungrybox  I ltlsi thkni thsi soiuentq si trepty B.S But higavn diseutd moes rom,e I tiknh 'tis less SB naht I ygiriaonll ogutht.h ahmaPto iesgv hte rehte omjra sasuce fo eaortaahlgcr sa pnipel aisou,nimltt onticparmaol of rnriotae tritap,uiy adn rdgsu see( .116 - etsBra aPghtoylo.) Only dgru fetecf si an rsneaw icchoe fro sthi tsueoi.nq +9
hungrybox  oT ptu areohtn ayw - efrboe yuo yrt ot go ohruhgt ervye rswnae heccio, gsaink lyoerfus udolw" itsh acsue rort?eal"agcah aI,tdsen ksa r,seyfluo hat"W era teh sesacu fo rgarloch"eaat? roiAgcndc to Dr. ,traatS yeth rae ppen"il mt,oliinsatu ocainrplamot of erotrnia ,piutiaytr adn dr."sgu +3
hungrybox  ehT snotquie 'eodnst ays iyannthg hatt dwluo intop you trwdoa enpilp tli,asmiotun ilek "it ylno esmse to pareap wneh hse pstu on a s/lahyrstip et"rr/ostpu/c.ssn It aosl ekmsa no nnitome of aolbeipmrt slnbinesd hwic(h uwodl pitno oyu ot na atirorne iaiputtry tmrou,) so you cna ruel otu canrmipt.aloo The ynlo ntooip tfel is udgr et.ffce +2
drdoom  yrnsgb’hxou ullf mcontem olw)e(b erh:e 97/0nsa0mm1pr/n/ec#x/nmabe3t2ewte:0h4bmos.s/ +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As an i8:1td1e0 0,0 lpepeo petroedr to aveh dies fcefets nweh intakg ildrgioehcHmra.oAtyoon hdz ehtm, 25 pleoep 0.%02() veha rBstae geihrsdca

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neonem  I hkint hte ebts wya to rnaesw hsti osueiqtn asw by ecprsos of aenoit.mliin +1
sympathetikey  Tasht' oesm hbltsilu ll o +9
karljeon  aaHh I lnditiemae eth nsarew yb pcrosse of ilm.iaoninet +25
medschul  I mtinlaedie stzedhaii yb oeprcss of ntiolmneiia :( +3
medstudent65  ihSt I mndieeitla idazieths sbeuace of miiinltenao ntwe ihwt THN htniingk rlaenntciair beedl tcgffieen hte uriyiaptt +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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srcoesP of tniminaoeil si eth yoln ayw ot tge hsti awnesr twohitu aSnvat ellesv of smiuat, sa omes ibeotw iaewnrg eruhcod woh twreo eht netqosiu yrbalbop h.sa

neCrca si llaeurtnai stloma lla eth ,emti DM e'ontds emka enses rfo yan rnoa,es NTH sflite lon'dtwu eacsu kymli bsbo,o dna tmas sllce lnneiutgdraag 'eontsd kema ilkym obbso hetr.ei So, nad aesecbu yanm drsgu cna heav kymli sbo,bo ueyo'r eflt ithw gdru tcsffee yb sorepcs fo .imieolintna

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djinn  I tdno intkh hte tauro wsa a naatvs. Aols I itkhn is gtrhi ccseorps to tnkih r"ae"cnc nac eb ieltaralb nad matnanilg but the g""dur ttah ascseu sith tsin HT.C isTh inqosute si adb twe.irtn +1
hungrybox  oigcncrdA to taPhmo,a rgaaclroteah si TNO odaaicstse itwh eacnrc erev ee(s .116 - ebstra ogahl.oyt)p +
djeffs1  cdicorang ot guessg'lrustb nbsuemr tsi omer yiekll ot eb /lb nrccea ahnt e.aitdszhi.. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" Ohert aeslcss of esictndmaoi atth uaecs rppileiacmtrynoeah udnelic eetpisnsrsadtna, etnvrehanyiitesp ,segtan adn drgsu thta eanecirs welob oimtlti.y cypenptmaHriloirae cadues yb ceodstainmi si omocynlm ,atpictysmmo iscunag tlrac,aogaehr utrmnseal ebtcasiun,rd nda epinot.cem It is anttpmIor ot enreus ttha ahicaorenpmreipylt in na iailIuvndd itptnea is ude to imodiatcen adn ton to a turcruastl osieln in het hirpiyuatyp/hmaticolat a;are hsit can be plcheioamscd by 1)( sgniptop the ciindameot ayrmelioptr to dmneteire rehweth nlatcoirp eellsv rnrute ot ral,mon 2)( htcisiwng to a amntedoici ttah eods tno euacs iorlaapeycmtinerph "

.dw.4b1/hmwm//b.uin02in/cw:tolvtn.6s8hg9e5pp

-dp"noneostdNneede- eisd fcteesf — ugtohlAh se-dwool epyahtr semes to mezniimi eth boctemlai ocmnctasiolpi dicdnue by a ihtdzeia or eiiheidlz-akt iet,drcui it yma nto lnyicsseare eeiinatlm hoetr idse ftcfese. As an axp,emel sa anmy sa 52 peternc fo men tdtaere htwi 25 d/ygam fo hnrcthdlloeioa lepovde a celnedi in ulsaxe nicftnuo ]3.[4 pleeS nerbsustaidc nca olsa o,rccu ylcratipural if teh etapnit si on a idu-mooslw eitd 4[.3] owH sehet emrbopsl ocruc is ont onk"n.w

-a-#wn0tiiH-sitp:metrs8-dneiunstcipweutfmoeythezrtlpa2i-d/3on/n-te.shrupatoitn5t/iasir9-0ties5phh-ednoyc/aws-c.eo2twse9

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 +2  upvote downvote
submitted by hungrybox(1277)
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tPhaamo sigve teh trehe jmora ucasse of ctleaargraoh as pepinl ,talmiinotus tcpimaoonrla fo natroeri turtyp,iia nad rdusg ee(s .161 - etsBar h).aglyotoP ynlO gdur fecfte si na seranw ochiec fro tish t.qsnueio

To put erntaho way - eobfer yuo try ot og thrhgou eevry esnarw ,iochec igknas uorslyfe dw"luo tsih ausec a"agaerch?tlro ,ndstIae ask ue,yflors aWht" aer het ausecs of aocr"l?grethaa ginAcrcdo to r.D art,tSa tyeh aer "epnpli tiit,mlauons moaonaitrplc fo rieatrno ,ittiprayu dna ugd.r"s

hTe qesnoiut et'nsdo ays tnghinay htat owuld ntopi you wroadt eppnli imnlttsoa,iu keli t"i nyol eemss ot prapea enwh hse ustp on a aitrhs/pysl er/so†t.crps/u"tsn oS yuo cna eurl uto nelppi tsitaoi.numl

tI saol ekams on nomtine fo ebrlioapmt binsdlnes ic(hwh luodw pinto you to an rtniorae puyairitt muotr,) so ouy nac leru tuo i.lnpamtroaco The yoln oointp tefl si udrg e.cetff


vIe' nvere seen nhngtayi like htis no a soiuetqn ubt I mseasu eth NMBE louwd dwor it in seom dlovntcoeu way iekl .thta


I aillinyti reowt htsi as a u,nbsmometc btu I efle ikle it dvssreee tis won t.mmonec I swa rvene ellyar eiditsafs iwth yna of the aoialntnsxpe rfo tish mlrp,obe nda I lyalfin rivedar at one atth ekasm teh mots essen to m.e

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hungrybox  ,Oh nad ed,sibse ilenpp mittsoilaun adn amoorcipnlat r'neta even sneawsr lol +
drdoom  sme[yts ir]emal ruoy octnuca sah bnee p:uadrgde MTAFRO INNAJ +1

One more thing: Pathoma specifically says cancer is NOT a cause of galactorrhea.

So the people who are saying you can rule out cancer because it's bilateral are completely wrong. You rule out cancer because it doesn't cause galactorrhea.

Besides, breast cancer can be bilateral. Bilateral breast cancer is almost always invasive lobular carcinoma.

This is analogous to serous cystadenocarcinoma. Bilateral ovarian cancer is almost always serous cystadenocarcinoma.

Idk how this "breast cancer can't be bilateral" myth started propagating.

+9/- hungrybox(1277)

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 +2  upvote downvote
submitted by dave_(3)
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ehTdsiaiz ucrede FRG gt&;- eecdduR ceecnrlaa of lcrainpot t-g;& atecpyoimhrneialp ;tg-& .segachidr

tNo eusr woh rtrcceo hatt si, ubt aesdi frmo ceacrn nebig ela,iulatnr I ouldw teicaosas ghih ltpnircao ihwt lsos of npoidmea cdhidneurbinetio/i eecracnal of ranpctiol .etflsi

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 +1  upvote downvote
submitted by sam1(22)
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sziThdiea nca ecasu eatuc ttslniitiera stniep,irh a fomr fo leran rue.ailf Whtiotu eth alern nrxoeecit of lnitcorap, ti nac bulid pu in teh rseum adn lutrse ni aorelaa.hrcgt

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coccidioinmytitties  uSleax isnfycntudo e[eirsd ebsad = l]bodii nca eb due to urdg iesd estcfef s]ps,nihit[veretenya erp tisfr ida. ido E:nit 10e8a2:gP e5o1it :5cSn erPhyPs,c i'st1sdA necrideon sec:otin ceseevixs" uotmnsa fo rtnplcoai eacadsisto ihtw ibdol↓i [342]. shTi egso htetgroe hitw our elauxs tnndcsiofuy wtih e"i"rtiypsnh.ntevsea yOln lcaiogl esniyhsts I acn nkhit :fo t ieazidh = lnropt↑aic = biodil↓ + grraclh.oeaat tI dwolu osal kema neess ecisn ew ear lgaidne with na cedeexpt to be soapnlateoumsp- fmeale k[lmi nurodtcipo oldwu veha to eb ude ot ogxnsueeo oeu]Du.rcgs tion my tuecelr enots nda nfduo het nowf:gilol eolasc-ebbktr nda eitdhizsa secau uelxas isu.c nIyofdnt alos klie ms1'sa poi.laaxentn 'Weer rhnaceig rh,ee tub tsi het etsb I cna .do +
g8427  oyMa cilinc howss lrcae ro bdoylo plpien gihradces sa deis tfefca fo zhsiaie.dT uBt densto ttesa mkiyl chdagrs.ei +


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 +1  upvote downvote
submitted by namira(39)
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bselPsoi lia:xanptone

fI eht tp is ngtaik a aeziihtd whci(h si K p)tene,gdil ti mthgi avhe losa enbe vgnie whti a K igparns ugdr husc as ooienstrc.nlpai

rtnneloiioScap has cnloorodgnceii secefft chus sa aiycamsngote nad cegora.athalr

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sugaplum  I nhtki uyo uldoc only aemk ihst simnuptoas fi ythe aids ienta"tp si no sdadtnar hnt "xt utb nseic htye gaev eht mean h,czt oludw not eb irfa to sueasm yhte rea osal ikangt otce.nopiirsnal I wetn hwti rpescos fo aoneinitmil no stih n.eo nEve cckehed cacsse cismedni'e durg avderse ectfef coal.aporirta.hegl.efr not itleds orf czth +2


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 +0  upvote downvote
submitted by j44n(141)
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lbsPiose ussace fo tacgaraerloh ndieclu: istoniaMce,d chsu as irntaec asese,dtvi eia,sanptsrntsde paoicshstyintc dna hhig loobd uesrsrep g.udsr Odioip u.se lbeaHr um,sepenlstp hucs sa nfl,nee inase or ereeknguf eesd

^ rmfo the yaom ..ccil.n.i psiheams on the THN sgudr

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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aTh;di&zeg=it plcyt=h;mcaee&gira iotxOnyx q(G clpoedu i;gtt-&eoprn ncri +g;=)taC&2 lpienp icdhsgrea

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arkanaftus  iyocxtnO lwil nto okrw no etrasb untselgri on yilkm sgdrhaeci if the sndlag eewr ton d"rpeaerp" yb oticr.lpna sIt' klei ryntgi ot eeuqesz yetmp bolalon - ngotnih ogse .tuo +1


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