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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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rweeohN avhe I ebne aelb ot dinf ywh het llhe shit si a hn.tgi

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yotsubato  tIs tno ni A,F k,ctehSy ro o,Pmhaat ro U .dwrlo I eknw ti swnta rancce eeaubsc tis i.abtlaerl And esateibD amed on snees to e.m oS I sujt rthwe nwdo guDr ceftef dna aedlwk ya.aw +10
breis  ^e^^mas +
feliperamirez  The ynol sopbslie nloxaitnepa I khtin si taht seh asw denur a K npirasg i,cutdrei hucs as acneoritlonosp ihwhc( louwd leda to nteyi.amsc)gao +
chandlerbas  uyo adh me at sit nto ni hesckyt ); +3
j44n  i thtuohg HTN ndicdeu mteyp saell lowdu eucas htis eaesbuc yhet otg tpey II ase.ubteid So fi oyu eden a rpo zerab tnreuh lrolhe ta me. +

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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Golajn dha a etrluce thta eiodnnmet ahtt "If a ettapin hsa et,rhaagacrol wrveie yvree rgud yr'heet ntaikg cesni anym usgdr ecsau hatcgl.ar"eaor

Teh ylon htign fo bssploei eelecarvn in itsh mtsQe- si tath ehs ekats a im,ioedanct efeterrho eth anwres of "udgr ff"ecet is teh mtso llyike srnoae rof reh rthcgraeoal.a

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hungrybox  I lslit nthik hsti oqestnui is ttpyer .SB uBt hvniga studeid smoe r,oem I hknit t'si ssel BS atnh I nralyligio httgo.uh aoPahtm evgsi eht heetr majro ssacue of raalhotgacer sa lepinp ilu,notismta altriomaconp of rnretoia pri,ttyaui adn gsrdu (see 1.61 - Btesar .thlyoPg)ao Olyn grud ceftef si an sarnew ocheic rof hsti uqns.oite +9
hungrybox  oT ptu ethaonr yaw - eorebf yuo try to og gouthhr eevyr nwasre hccieo, ksigan yorfelus "dwulo sith casue ?haargoat"cerl s,enIadt ksa sfyu,reol "htWa aer eht seusca of a"lcgraehro?at coigcrdAn ot r.D tStraa, yhte aer "pinple l,atiismontu crapoilntaom fo tanieorr pytia,ritu dna ru.ds"g +3
hungrybox  The ontiesuq 'esdtno yas anhiyngt thta ouwdl onpti uoy atrwod peipln isutmlaoni,t ilek it" ynlo sesme to eppaar nehw esh tpsu no a iapth/rlsys tsertssp./ncro"/u tI oasl kesma no onmtnei fo tplibaerom ensinslbd hihw(c wolud iotnp ouy to na iearrnot ptuiiyrta ,tr)mou so uyo nca lrue tuo .omacntiaorpl ehT yoln iopnot felt si rdgu tf.efec +2
drdoom  sgrnyo’hubx llfu momecnt lbo(e)w eehr: nenb:p/r#bsm7m3wsne9xeae/t0s/.cm0a2m/o1h40t/ +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As an d1ie01t 0:08, eeoppl oredptre ot ehva seid fftcees ewhn gktani oyn.gAcrrdzotHmoloiaheidh th,em 52 pepoel .(0)2%0 eavh terBsa crahiedgs

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neonem  I nkhit het btes yaw ot sawern shti iteunsqo swa by spcsreo of nenai.imoitl +1
sympathetikey  ts'Tah semo itslulbh llo +9
karljeon  ahHa I iaenlmetid teh nwsaer by ssporce of taiiinln.ome +25
medschul  I dmeiltniae iheaiztds by presocs of omiliaietnn :( +3
medstudent65  hSti I ineldemiat hzidtsaie acusbee fo enmiialinto etwn with HNT ninhgkti elniaantirrc dbele ifetgnefc eth trpiuayit +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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oecPssr fo ilnoatiemin is hte nyol yaw to egt hist wasnre woithut avntSa eellsv of sm,utia sa oems tobwie nriewag uocrehd owh wreto eth uonisqte baoblypr a.sh

ernaCc si irnalautle laomts lal teh iet,m DM eon'tds emak esesn fro yan osnare, TNH selfti lutdwon' cseua ymkli ,bobso and msat lcles ralugtnnieadg o'etsnd mkea kilmy oobbs etri.eh o,S nda bsecuae mnay dsgur nca heva iyklm osbo,b 'eoyur ftle hwit dgru efescft by spcsore of imnletoa.nii

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djinn  I dnot kinht teh aturo swa a atnvsa. lsoA I hintk is tigrh esocscpr ot tikhn "rncae"c acn be baiaelrtl dan tmalingan tbu eth "rudg" thta uescas ihst tisn T.HC shTi sontuieq is abd w.niertt +1
hungrybox  docnArgci to ,htomaaP aorralacghte si TON oiaascesdt tihw acrcne vree (ees 1.61 - tebras )gt.aopyohl +
djeffs1  nodcrgcai ot lrtu'eggsbssu ernbmus its erom eyllik to be b/l ercnac nhta hsii..zetda. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" Ohtre lceasss fo mtseodiaicn atth sceua ryripatopeianmehcl ilunced den,tptiaesanssr rneneyieavhttisp gsen,ta dan rgdus htta erinecas ewlob io.mtilyt apiecnropteayrlHim decaus by eodniciastm is cyomnolm ammpyitcos,t cauisgn lrarh,tagcaoe larsmutne at,usebnircd and eoneipc.tm tI si anItmptor to esernu ahtt nrtmlhpypirieacoae in an ilnvdidIua ipttena si due ot iadmitcnoe and not to a trutruscla esonil ni eht ly/uaimpocyttiarihpath a;rae htsi acn eb pescdaohlcim yb )1( giopnpts the imenacdiot rtealiomyrp to emindrete rtwheeh rolncptai llvese rnetru to malo,rn 2() ihisgncwt ot a dancmiitoe htat sdoe tno esuca lyertiirppmcnoheaa "

dic.u9b1g5nbt/6honh8wi/vwtlpnm.e:0sw..m2p/4/

sodnd-ndeoet-e"epNn sedi fetsfec — ghutohAl sweol-do ryehatp mssee ot iineimzm hte blomiaect pstilincaocmo cuenidd yb a ziedathi ro dkzieae-hitil cu,eitrdi it mya otn salncyseeir emtlaiine hroet esdi tffee.cs As na mee,plax sa mayn as 52 eentcpr of nme tdraeet wtih 52 ygm/da of eihatlndcroloh eplvdoe a ienlcde in slexua fctonuni [4.3] epelS rbecnusdsait anc oals croc,u aplluricraty if hte ntipaet si on a iw-lumodso teid 3[].4 owH teesh bmlpoers ucocr si nto onkwn."

tseepezh.--eycadid9#wse2oan5s-n8ts-tpHcu-pwi2ewnian/tlnef.s/i:c0te35or--i-wrtpn9nhtotdmepis-asrteii/uh/ht0amtituiryoots

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 +2  upvote downvote
submitted by hungrybox(1277)
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ahaPmto vsgei eth hteer rmjao ucessa fo hrrelcaaatgo as epnilp smnlitiot,au ainoltrpcaom fo aeirtnro ui,ipttyar nad rsdgu (ees 61.1 - tserBa .l)ohgotyPa yOnl dugr ftefec si an nrwsae oehicc fro shit ue.tonqis

To tpu roaenth ayw - fbroee ouy rty ot go thorhgu yveer awrens ioech,c gnsika erlosyfu dulo"w hits caseu rhatlaecorg"a? ,dnItaes kas sye,rlofu h"tWa era teh sucsae of rlrce?taagah"o Acnidrogc ot .rD atrtSa, hyte aer pnl"pei tilis,tnomua icrtanlamopo of rnteioar tyriiatup, adn ."drusg

hTe qoesunit ndtoe's ays ngayniht thta owlud ntpio you toadrw ppneli autnlo,mtisi liek "it nylo sseem to praape ehwn hes ptsu on a iassprht/yl /toerrc.†p"sns/tsu So oyu anc rlue uot nplpie imtlatsoniu.

tI olas msake on notenmi of aomlpretbi inssdenbl cihwh( lodwu otpin uoy to an rnorieta pttruaiyi uomt,)r so you can lure uot rolt.nimapoca ehT loyn tioopn ftel is durg .feeftc


eIv' eernv nese ayghtinn ekli isth no a oeiqutsn but I esmsau hte MNEB dolwu rwod it ni emos novdueoclt yaw keli ha.tt


I atiiilnyl wroet sith sa a ,bnmcuetoms tub I flee keli it rvedsese tis won nmecm.ot I aws renve yalrel eiiadstfs tiwh ayn fo teh pnlenaxoitsa fro isht emrpl,ob dan I nlaliyf revrdia ta eon htat kaesm eht msot senes ot m.e

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hungrybox  hO, nda ,edebiss pienpl titlonusiam adn caooinrtapml te'arn even esswran lol +
drdoom  tmyss[e liarem] uyor uccotan ash eben eg:rpudad RFTMOA JINNA +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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iazidTesh duerec GRF ;-&tg deceRdu caeacrenl fo lopatrnci &t;-g aecpetmhaiypinolr -t;g& gsreahdi.c

toN seru how tecorcr that is, but aiesd romf arccen ngebi ,elrtuaalin I oludw ioaastesc hghi nlrpacoit iwht loss fo damioenp nehdir/iutcieiodnb rclcaaene of pntioaclr le.tfsi

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 +1  upvote downvote
submitted by sam1(22)
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eszdiiTah can scuea auetc eititstnialr ithnesrip, a mrfo of elnar iau.felr uhtiWot the nealr xicteneor fo nlio,ctapr it can lubid pu ni hte murse nda esurlt in rhl.coaearagt

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coccidioinmytitties  aSulex focyistnnud [eirdse dabes = i]bdilo anc eb ude ot gurd seid fetsecf ,e[sntisetneya]pirhv erp tfisr ida. :oitE din :28e P1a0g eS 51c5onit: herPc,ysP dsis1'At nrencdieo sc:neiot "cesxesiev moaunst of oplnacitr eiscatsdao hwti ioi↓dbl 2[.]43 s Tih soeg rogehett htiw uro usleax ftcniuosdyn htiw tiennhs.v"tir"aeepsy O nyl ilagolc tnhyssise I acn kithn f:o a eiitdhz = tlrnpocai↑ = od↓iibl + rlgaaeo.tahrc It loudw aols emak ensse csnei ew rae eidangl ithw an tepedecx ot be teappoamolsuns- leafem l[kmi rotnpcuiod lduow hvea to be ued ot osegounex u s.]eDogcru oint my euletcr osnet dna fudon het iofwogll:n bkcoelterb-as dan itezsaihd cseua eusxla yidnI.ntfuosc also ekli 'ssm1a ne.aainlpxto 'reeW hcagenri ,erhe ubt tsi het bets I can o.d +
g8427  yaMo ilicnc oswhs lecar or odbloy ilnepp sehracgid as esid ecffat of zshTeaidi. utB osdnte taset lmyik hdgieasrc. +


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 +1  upvote downvote
submitted by namira(39)
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loebPiss oaalex:itnpn

If the tp is tgaink a eihazdit (cwhhi is K eelpgdt),in ti migth vhae slao been gievn with a K asgpinr urdg such as tlrnnaoscioep.i

npneciaiotlroS ash ciorcnendoilog sftecef shuc sa satongcaemyi adn l.raaocehratg

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sugaplum  I hntki uoy loudc ylno meka sith snsmtouipa if eyth dias "netitpa is no aarsdntd htn tx" but sneci hety gave het mean chzt, lowud nto be aifr ot euasms ethy rea aslo agitkn sprco.inoinltae I wtne hwti ssoecpr fo ialiineomnt on htis o.ne vn Ee heccedk sescca eicmdisen' udgr edrseva fefect fircatpreholl.o..garae ont deltis rfo czth +2


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 +0  upvote downvote
submitted by j44n(141)
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oiselPsb sesuac of roagrhlatcae enu:cidl antMdsoiei,c cush sa eaintrc vastee,sid ,ipaetsdrnsnaest icoyssahtpictn dan gihh lbdoo rupseres u.sdgr odiipO u.es lrebaH psmtelnueps, ucsh as eln,efn enisa ro fneekegur dsee

^ ofmr teh aymo .c.c.nl.ii iesphasm no the HTN dgurs

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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=;igtdh&ezTai cytcirla&aem;=ghpe yOnitoxx qG( peolucd tp;tg-enir&o ricn t=&C)2;+ga nelipp rhecisdga

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arkanaftus  ixyoctOn llwi not wkro no ratsbe tglirusen no myilk iagchesrd fi eht snladg erew nto ea"pd"rper yb piaclnro.t 'tsI ilek igtrny ot uzqeees pyetm lnoloab - htonnig oseg otu. +1


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