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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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hNrowee ahev I bnee eabl to nfid wyh hte llhe hist is a nihgt.

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yotsubato  sIt nto in FA, cShe,kyt ro oahmtP,a ro U rold.w I nkwe it wtsna cencar eaeucsb sti liatar.bel Adn Dsibaete dmea on ensse to m.e oS I jtsu twrhe ndwo gruD ctefef dna ldewka a.ywa +10
breis  m^^ea^s +
feliperamirez  heT olyn isbselpo alentipaxon I ihtnk is ahtt hes wsa duren a K sgprina eituric,d husc as nrialposooecnt (hcwhi odlwu elad to aea.tycnis)gom +
chandlerbas  oyu ahd me ta tis not ni yschtek ); +3
j44n  i hohtugt HTN ddeucni ytmpe salel uodlw ecusa shti ecebsau eyht tgo etpy II a.bteiduse oS fi uoy edne a orp beraz hrntue lolerh at m.e +

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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nljaGo ahd a eetulcr ttha oeidmetnn taht I"f a tentpai has lgotrh,ecaaar wveire evrye gdru ryehe't nagkti ncsei nmay ugdrs uesac tog.lrrhc"eaaa

hTe noly hnitg fo olbpsesi elacenrve in itsh metQ-s si htat hes sktae a iaoe,cdnmti reotrehfe het nwaser of ud"gr cfe"eft si hte mtos ykliel osrnea for reh oth.alraergac

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hungrybox  I lslit tknih isth noeiqtus is retpyt B.S But hgnvia edidust mseo rm,eo I nitkh 'ist essl BS atnh I rayinliogl hot.hutg oaPtmah sevig the terhe rjoam uacses of corergaltaah as leipnp su,ilttmniao tmooicnlapra fo etronari ,yttiaipru adn ursdg e(es 16.1 - rsBeta yP.tol)hgoa ylnO gdru fetefc is an nswrae hicoce rof tihs qi.onuets +9
hungrybox  To upt norehat wya - freebo ouy rty ot go uoghtrh verey rewsan ehcoic, kisang freloyus u"owdl itsh uesac orlaecrga?"hat a,ntdesI ksa e,uflroys h"atW rea eht aucess fo rtoarhge?ac"la cidgrnocA to .rD rtS,taa yhet ear nep"lip att,oiinlusm irpmooantalc fo iarntreo iyi,uraptt and .drsgu" +3
hungrybox  hTe uteoqsin o'tsnde say inghtany atth wdluo tnpio ouy aowdrt npplei lsuntm,iotai kile ti" nyol sesem ot parape ehwn she tpus no a lh/psratsiy .srto"nsput/r/sce tI saol smkea on nmienot of trobilmpea dsblsinne hcih(w ouldw topni uoy ot na trroiean tpauityri )mu,ort os you cna rlue uot ionloaa.ptmcr heT nylo ntioop tlfe is urgd tfefec. +2
drdoom  gshx’nbyruo llfu ocmemtn eb)ow(l r:ehe mse1at/b/me:cm7.t/resn3p0e/abh0/s4wnx2#0n9mo +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As na 0et0d1i:8 01, eloepp oredeptr to ehva ised ecfftse nehw nigakt onid.igroyhd tAholezacmoHr e,tmh 25 eopepl 00.2()% heva tBaesr aceigdhsr

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neonem  I khitn hte tbes awy to newrsa ihst tnqseoiu aws by ocerssp fo loieannit.mi +1
sympathetikey  h'aTts meso hilutlsb l ol +9
karljeon  haHa I mleineidat eht ewnasr yb sprcseo of meiaotinnil. +25
medschul  I idmiteenal tishidzea yb scpeosr of ilnionamiet (: +3
medstudent65  ihSt I nilietemda teisizdha ceaseub fo naliniotiem netw iwht TNH nhitnigk eitirnraancl bleed tigefefcn the iutrpyait +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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erPoscs of itmnoaieinl si teh ylno ayw to gte shit sanewr htuiotw atSvan llesev fo tui,sam sa moes weboit rageinw uocrhde owh owret het neistqou rpaoblyb has.

Ccenar is areultinla saomlt lal the t,iem MD td'sneo aekm esnes fro nya nserao, THN leifts dwutnol' cause iylkm osbbo, nda mast clsel irgldagtaennu es'ndot make iymkl bobso ehit.re oS, dan bueesca ynma sdgur anc veah ikmyl s,bboo 'ryueo etlf ihwt gudr ffeects by eosprcs fo nntaom.liiei

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djinn  I dnot hiktn eht taruo wsa a astva.n lsAo I itknh si tirhg secspocr ot tkinh "nc"acer acn eb ilatraebl and ainnlgamt tub het gr"du" thta ssuace stih isnt HT.C iTsh ntuiesqo si bad .titwrne +1
hungrybox  dinAorgcc to Ptaom,ha eogacarlatrh si TNO sdsetcaoai whti recacn rvee s(ee 611. - btsare athl)oo.pgy +
djeffs1  cgndorcai to lgtrbgsusseu' mrbuesn ist mreo keylli ot eb l/b ecnacr tnah h.zies..taid +


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 +2  upvote downvote
submitted by niboonsh(409)
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" hrOte sesascl fo edcisniaomt htta scuea neiyhperiaartpolmc dnlueic teaspnnriss,edta ytnestenveihrpai gteas,n and srdgu atht eseainrc wbole itm.oliyt raiepyorepHniclamt decaus by nacmsetdiio is ymcomlon caots,mtpyim gcausin catga,rlerhao smanreutl es,arbdntciu dna epemi.ncot It is rpatntoIm ot eesnur that ealecnhprtamiiyrop in an naiiluvddI tpteian is ude to mntiedaoci dna otn to a uaurrtlstc sniole in eht /myiyattoihirtcpaphlua ra;ae sthi cna be cladhoicsepm yb 1() gointpsp eht imaiondect eyplmtoairr to eretdinme hrwhete toparlicn elslve nrrteu ot ,orlnma (2) ticsngihw ot a ieinmcotad that oeds not ceasu hirpecmoanaeitpryl "

ep5mnth/pwi/inb96tmo.svbl.hgd.//n14u:wcw280.

doe-eNn-epsdenod"nt side esfcetf — glAtohuh d-eoolws htrapye ssmee ot imimiezn eth iobtacelm aliiscmocpnot nidudce by a aizediht or zdialetehkii- ,eutirdic it aym ont yelscniaesr lamneteii horet ieds te.cffes As an mxepla,e sa nyam as 52 recpnet fo enm tedraet thiw 25 dm/gay fo drlocnatlhieho deloepv a eenlcdi ni eauxls ifncuotn ].3[4 lpSee sediuscnrbat nac sloa ,orcuc cltlauayirpr if the tnpteai is on a wdmoilosu- etid ].[34 oHw ethse roplmbes ccuor is nto .okw"nn

-stupn0:8s-ta/smhc.i/eiestsiiwrhdyu-e9trwnotooee2y-3edf-ttcrn9/t2Hl5ia/e0smd-is5nttaptta-peppsweiziwtc.niernun#-ioahho-

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 +2  upvote downvote
submitted by hungrybox(1277)
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htamaoP veigs the ereht mroaj aecssu fo cahgartrelao as inppel tislit,muano aocortiamnpl of rteanrio ttyr,auipi nda rdusg es(e .161 - rseatB P.)tgyolhoa lyOn drgu feefct is an answer cioehc for iths etu.noqsi

oT upt roatnhe way - feoerb ouy rty ot og guohrth evrye rwnaes i,ohecc aikgns luyesrof o"wudl stih saecu ocrrlatagae"?h ,entdasI ska lyers,uof h"tWa ear het cseuas of cartrgaal"?eoh noAgdcric ot rD. a,rattS teyh rea "eippln nmstliai,out ainomlacoprt fo otaeinrr taupitri,y adn ".drsgu

heT onesiqut tnd'seo say tignahny ttah ludwo piont you rwdota iplnpe tilioumats,n elik "it ylno sseme to prapae hwne seh upts on a hysi/tpalsr †rsst/c.ps"rnto/ue oS you nac uelr uot plneip ittounamisl.

tI alos aksme no intnemo fo boprlitaem nnsebslid wichh( owdlu oipnt you ot na eartniro ytuapitir rutm,)o os oyu can uelr tuo rca.ntmloioap heT ylno npioot lfet si drug e.ftcfe


'eIv eenvr sene atygninh like hsti on a iqouetsn btu I mauess the BNME luwod rodw it in mseo cludovonte ywa eilk .atht


I ilatliiyn torwe hist sa a ubnmtm,osec btu I efle elki it esdsrvee sti wno tmeomcn. I saw rveen elrayl asfiietds thwi yna fo eht iatlxoansenp rof htsi ,opembrl nda I aiflnyl vdeairr at eno atth kamse hte otms eessn ot em.

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hungrybox  ,Oh dna e,seisbd plpeni lsnumotiait dna pratmclionao tae'rn neve sewansr lol +
drdoom  ss[etmy lriem]a your ouctnca ahs ebne pud:gader TMRAFO JAINN +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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zTeidhias cedeur RGF -;gt& eueRcdd aneaecrlc fo ronicaplt ;-t&g rpalenpoiahymctei t-g&; rdhecia.gs

Nto erus owh occterr htta ,si tub esaid rmfo rcanec ngbie eiuaartl,nl I woldu ssctaeioa hihg aolrncpti wtih ssol of napioedm hutibddoinencre/ii crlcaaene fo nraiptlco tflies.

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 +1  upvote downvote
submitted by sam1(22)
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zsiihdeTa nca acuse etacu lntretiitasi ieihtn,psr a romf of relan .luefari iouhttW het naerl ecxietorn of ,ncltapori ti acn dubil up in hte seurm dan ultrse ni aaolachrerg.t

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coccidioinmytitties  laeuxS oifsyudtnnc erse[id baesd = oi]dlbi cna eb ude ot rdgu esid ftceesf i,stipa]n[etsehenrvy pre fitrs dia. Ei:i ntdo P0g a:12e8 i15tc e:S5on ePrhy,sc P sd1sAt'i ocredenin esinotc: seeicvxes" nsmuoat fo tpcnilroa tsiedscoaa hiwt biodli↓ [3.4]2 i Ths esog reotgeth itwh our easxlu tdfsouncyni htwi ninhe."svt"tyraieesp nOly lgaciol etinhysss I nca kinth o:f t dzehiai = itaronl↑cp = ioi↓bld + aagh.tareorlc It oudlw aols eamk neses eicns ew rae eginald wthi na tdcepexe to be puaoean-pmtlsos faelem mli[k oipotucdrn udlow evah to be deu ot euxosgeon sugr.D ceu]o noti my ruelect esotn dan fdnuo teh giw:folnol eboakctebrsl- nda iiazdseht aecus luaxes uI.inydtsofc n olas elki s1msa' ine.alxanpot eW'er rhnaecig hr,ee tbu tis het ebst I cna .do +
g8427  Mayo incicl whsos ecalr or olybdo peplni hsareicgd as esdi eafcft fo s.aheidiTz But neotds tetsa kymli cie.dsghra +


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 +1  upvote downvote
submitted by namira(39)
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blPiosse eaixlaotnn:p

If eht pt si gitakn a izatdihe w(ihch is K dingele,pt) ti gmith evah olas eben ngvei hwit a K ranspgi dugr suhc sa triopli.asnceon

Sonritoecinlpa sah igccnnoilooder esfefct uhsc sa ceaoytsimnag nad ortgaa.lacher

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sugaplum  I tihnk uyo dcluo onyl make hist uanisstpmo if eyth dsai aentt"ip is on antrdads htn xt" tbu csnie tyeh eavg teh eman ,tczh wlduo ont be rafi to susmae etyh ear laos aintkg aenonipilsrco.t I tnwe tihw pcssero fo einmlaintoi no thsi .eno n Eev ceheckd sacsce imdee'icsn rdug rvaeesd fetecf laarce.toir.fpgr.oheal nto etdsli for thcz +2


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 +0  upvote downvote
submitted by j44n(141)
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lbiPesso saecsu of aeatarrcolgh iecndu:l dnaticsei,Mo ucsh as airnetc ade,veists a,nisnttrpsdease piasythotsincc adn ghih lobdo eesrrspu ur.sdg Odipio s.eu Hrbale n,tuesplmpes such as ne,flne enias ro neeugrfke dese

^ form the yoam ...cl.cini hipamsse no eht NHT udrsg

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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i&T;=izetgadh ;ltmer=yigeaahc&cp iyxtnOox qG( pocldeu re-o&itt;pgn rcin &+g=)a;2tC pinlpe ahdcesirg

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arkanaftus  otOcyixn lwil otn wrok on rsebta sruetlnig on ymkli idgasrech if eht dgalsn erew ton pd"ep"earr by ioprt.ancl I'ts kile giyntr to zueqese emytp nloaobl - nognith geso uot. +1


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