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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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erhwoeN aveh I eneb aelb to idnf ywh eht hlle ihst is a tin.gh

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yotsubato  stI tno ni A,F cyt,Skhe or aa,Phtom ro U .dlwor I kewn ti atsnw ernacc uescabe sit l.ilbatare nAd sbaDiete mead on ssnee ot m.e So I sjtu rwhet wdno Dugr cftefe dan klaewd a.ayw +10
breis  ^e^s^ma +
feliperamirez  The ylno psbleios tlaenxiopan I htkni is ahtt seh aws nerud a K rganisp i,utidcer hucs sa ncoospnleratoi ihhcw( luwdo elad to siatmgc)n.eoya +
chandlerbas  uyo ahd em ta tis ton in hksteyc ;) +3
j44n  i ohtghtu TNH cudneid ytpme aslel uldow eascu hsti esbcaue they otg epyt II etuabis.de So if uoy eend a rop aerbz retnuh ohelrl ta .em +

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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Glnjao hda a tlceure thta tnmdineeo htat "fI a itenapt hsa hrerlot,agaac wvriee yreve urdg thee'yr agiknt eiscn nmya rsgud esuca cargeloar"a.ht

The ylno tinhg fo ipssboel enevrceal ni htsi e-Qstm is atht esh tseka a eid,oictanm tefroeerh het srwane of rgud" "ctffee si het ostm eyllik asnore fro hre aleo.agcrrhat

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hungrybox  I lilts knhti itsh suoienqt is yreptt .SB utB inahgv dteudis meso rom,e I kihnt 'sti lsse BS hnta I iylalrongi hu.hgott tPoamha esgiv teh rtehe rjoma sucesa fo eartaohcrlag sa nleipp lot,atisumin iotmlnacrapo fo tnaeoirr irtpuit,ay adn rdsug ee(s 6.11 - eaBtsr yP.tg)oahol yOnl drgu etefcf si na anewsr ieohcc rof hits ne.iosqtu +9
hungrybox  To ptu etahorn wya - oeerbf you tyr ot go uthhogr vreey esanwr cehco,i skiang uroselyf dlwou" hsti asuce ar"cgahraeo?tl t,aesdIn aks oe,rlsyfu Wa"ht aer teh uescas fo rlahtcgoaa"er? nccidgAro ot Dr. taS,tra yhet aer nl"ippe nait,smltoiu oormtcnapail fo enrorati iptuya,rit dan "rsdgu. +3
hungrybox  hTe toieqnsu nso'etd asy inyntahg that uwold piont oyu wratod lpeipn usm,oittlina leki i"t nyol emsse ot apeapr hwne seh upst on a r/slyatihsp tptncer"ssr/uso./ tI aols ameks no tnmonie of aoemrlbtpi enisdnbls hci(wh wdluo tiopn oyu to an reitonar artutyipi ,utrom) so uyo cna erul uto ao.cmlrptnaio ehT lyno iponot etfl is ugrd efc.tef +2
drdoom  rubnygsox’h full oecnmtm lwo(be) h:eer 7/oetcn4ap/9e#m3tm.m1es0eam/sn0hb2/w0x/:rsnb +1


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 +14  upvote downvote
submitted by strugglebus(189)
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As na 1ti0081,0:ed oepepl podreret to ehav sied tfcfees hwen ntgika iAddmhHzoyi ngcelr.roootha m,het 25 epople .02%)0( vaeh traeBs hicaegsdr

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neonem  I nktih eth tebs ayw to nwaers hits tusqieon wsa yb escrosp fo mi.entainoil +1
sympathetikey  sth'Ta some ubslthil oll +9
karljeon  haaH I eimlatenid hte esnrwa by rcoesps of t.nneioiamli +25
medschul  I tnadiemeil itzehisad yb proecss fo toiainnleim :( +3
medstudent65  hSti I ndiialtmee ehaziistd ebucsae fo tinmanoieli netw iwth TNH inghintk erltnnciiara bdeel ftiefngec eht iyutrtpia +2


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 +3  upvote downvote
submitted by fkstpashls(23)
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oPcsesr fo iilmneatino is het yonl ayw to egt hsit rweans htowiut Sntava lselev fo tusami, as smoe bioetw warieng uhdrcoe woh oewtr het souineqt bbporaly .hsa

aCernc is utlneriala lmtaso lal the ite,m DM 'sndoet meak sseen ofr any soan,re HNT eitlfs l'wndtuo ecasu kmyil ,boosb nda atsm secll agnautegldrin eo'tsnd akme kmily osobb he.eitr So, adn cbeaeus mayn srdug can hvae yilmk o,bbso eoy'ur elft thwi urdg ctefefs yb csroesp of mati.ionlien

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djinn  I dnto knhti eth oarut asw a .svaatn oAls I nkhit is gitrh ssoccrpe ot nkiht r""cecan nca eb tiablreal and nilaanmgt utb teh u"rg"d hatt cesaus hits nist .CHT ihsT osqeunit is dab tit.wern +1
hungrybox  rconAdigc to mohaP,at agerhloctaar si ONT ssaceaodit htiw eacncr erev e(se 61.1 - ertbas pagto.h)ylo +
djeffs1  cigodcrna to bslsggreu'sut rusenbm sti emor ilelky ot eb bl/ cncaer than izas.tdihe.. +


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 +2  upvote downvote
submitted by niboonsh(409)
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" Ohert sasecsl of netaiocimds ttah ucaes ciereproilhtpyaamn inclued enaesrtiadpntss, pthrivaiseyntnee esng,ta nad gsudr ahtt iernecsa olwbe tmlyoi.ti ciptmipHnarlyoeaer uscaed yb tsimoceidna si mnloymco titmps,cyamo gnciuas o,ageahlcrrta ltruasnem euit,dsrnabc adn een.ptcoim It is tImatnorp to nersue ahtt piymonecpehatarlri in na ildnvauidI tanpeit is ued ot midoeancti adn ton to a urcturlats esolin ni the htmctotlpuarii/ayypiah ear;a sthi can eb leamdhpsccoi yb )(1 piotngsp hte iaeniocmdt mpiyorertla ot erdeemnit hetwehr oaiprlnct lelesv unrert to nrla,mo 2() wtishcnig to a dtoniimace htta esdo otn seuac tlormhipapieaerncy "

:0lpp6o.wg/bdvsmn4/ewnt95.8i.c2u1htwmibn/h/.

n-oNnteedsd"nde-ope sdie seftcef — ugolhtAh leosdo-w ethryap semes to minieimz teh maltboeci ioalniomcscpt nudeidc yb a etdhiiza ro daitiezi-lkhe e,icdurit ti yam ton erlyicnaess eetmiianl eotrh sied ef.efsct As na l,xeampe as nmya as 52 precten fo nem atdrtee htwi 52 m/aygd fo oeaidollrhthnc edpevol a eneicld ni eaxlsu cnfitonu ]3[4. eSlep trsibcsuenda nac oasl r,cuco ulcirrylpaat if eht ntipeat is no a -ioslodumw tdei 4]3[. wHo heset loersmbp courc is tno ".nknow

pso./tz3yis8-te-0nestnest-nttrt-slw5-mt#niii2.-h/cw:e5a-itamoiea/hhnhprisetri-wdy0eatepetp9ssnaeH9ofr2couiwduotpd-uc/in

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 +2  upvote downvote
submitted by hungrybox(1277)
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Phomaat gsiev teh etehr mojra usesac fo aacorthgrael sa lpipne itsuiomnalt, rcpomnalatoi fo ironeart pruit,aity and dusgr (see 611. - tsaerB ogP)ltyh.ao yOnl gurd ftfece si na sanerw ehicco fro hist o.isqentu

oT upt oeahnrt yaw - reebfo yuo ryt to go rohhutg vyere rwensa oce,hic nskiga eufolsry wdol"u itsh eacsu rtaechgr"laao? ,edtsaIn aks syfo,elru a"thW rea teh ecsuas of o?r"hrcalgatea dcirnAcgo to D.r ,aartSt hyte era l"ieppn notlitms,uai pcoaanolirtm of trarinoe utarpi,yti and dg."urs

hTe qnitueso stnoed' ysa aiyhntgn taht ldowu inopt you toawdr pnliep ilaout,mnsit ikel t"i lyon sesem ot rppaae nhew she puts no a r/syslathip /†n/storset"urcp.s So oyu cna leur tuo pnielp atiioutmls.n

It aols mkase on ntnmioe of miarlbtepo siendsnbl hcwhi( ouwdl otinp ouy ot na oriertna ritpyutia r,u)mot so oyu cna uler uot oa.laimoncrpt Teh onyl toopni elft is rudg fe.tefc


e'vI eenrv snee hygiatnn klie htsi no a ntiuoseq utb I eusmas eht MNEB wloud wrod it in smoe ctonedulov ywa leki that.


I lyniiaitl rowte hits sa a s,mboenmtuc tbu I fele elik ti vreesdse sti own n.omtmec I was nreve lylear sidftsaei twih ayn fo het ioensptnalax rof itsh lr,mpoeb and I yllinfa irvrade ta eno ttah askem eht tmso enses ot me.

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hungrybox  hO, and b,esdsie penpil umsitonaitl adn manaotoiclrp tr'ane evne rneswsa llo +
drdoom  essmy[t l]imera oyur tauccno has eebn ueragpdd: RFMAOT IANJN +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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izaTdsehi reeudc FRG ;g&-t eRedcud ceacrnela fo pnactoirl g;&-t oytimlapneriapech &;-gt rcigehad.s

tNo erus how orteccr atth s,i tbu esiad fmro cacren igenb l,trleaunai I wdlou aisoasetc ghhi clnotipra wiht olss fo pendomai nhond/biiutieceidr reaceclna of crntilpoa .seilft

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 +1  upvote downvote
submitted by sam1(22)
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asehTizdi can csuae eauct itisenritlta ep,tinrish a ormf of rlnae urf.iael htWuoti het elrna coterienx fo lac,trnopi it acn uldib up in the umser and rustel ni aaaerrtcghl.o

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coccidioinmytitties  eSlxau nndiosyctfu [erdesi aebds = bdlii]o cna eb ued to gdur esid cffetse aitreesh][nn,peiyvst erp tfisr .adi Ed:n iito 018e :2Pga S tc:ne5oi51 Ps,ecPr hy 1s'tisAd neoeidrcn ie:ocnts esesvxeic" uamonst fo ilorcptna aeitsocasd hitw l↓doibi .[43]2 ih Ts oseg trogheet wiht uro elsuxa dniutsyconf whti te"enhvi.pitssean"yr l nOy liolacg tehsssiny I nac tknih f:o iadizeth = ↑corltnpai = ↓dbioli + g.roearaalcht tI duowl olas kema eesns ceins ew ear dialneg twhi an excptdee ot be apltsumsop-eoan emalef ilmk[ oudcirpnto uwdol vaeh ot be ude ot unsgoeoxe ruuDg oec.]s tion my tcueerl ensot adn dfoun teh wio:lgonlf aerbtecko-bsl dan heszadtii asuce uexlsa unty dcn.iIsfo lsoa leik ss1'am tpiaalnx.oen eW'er ehrcgnia ,hree but ist teh tbes I acn .od +
g8427  yoaM inclic oshws arcle or byodlo nppiel ghdacrsie sa seid caffet of ediTihz.as Btu dtonse ttase likmy r.igadhcse +


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 +1  upvote downvote
submitted by namira(39)
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slPoebis ep:natxanlio

fI hte tp si tnkiag a eaidzith hih(cw is K ie,n)glptde ti htigm ehav sloa enbe envgi whit a K priagsn ugrd hscu sa nroiao.cipetlns

rpcteoSiiaolnn sah indeoriccnloog tfsfeec scuh as mnaagcyiseto adn raeor.hgtcala

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sugaplum  I iknth oyu culod ylno amke htis sospinmtua fi yhet sadi p"itatne si on astndrad nht xt" btu neisc yhte aevg eht mane htcz, duowl tno eb frai to essuma they era laos aingtk toeni.iprnlcaos I netw ihwt rcesspo fo tniioaeinml on shti one. ven E cdecekh esascc nicems'dei durg rsvedae tefcfe ah.tpol.or.rerglcfaeia otn sldite rof tzch +2


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 +0  upvote downvote
submitted by j44n(141)
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bPeissol uecsas fo orhargatecal end:culi tids,oeaicnM shuc sa rtiaenc seatdei,sv tsssantrepnedi,a scaicthoynpits nad high loobd usperser d.gsur Odiiop e.us lraHeb tmsenulespp, hscu sa e,nlfen nasei ro ueregknef dees

^ fomr hte myoa ii..lc.cn. ehmasips on eht HTN sdgur

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 -6  upvote downvote
submitted by minhphuongpnt07(5)
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gditT=eiha;z& ehatil;acp&ec=gyrm txOxniyo (qG edoucpl otrin&g;-tpe ncri Cag+2)=&t; lpiepn sigrdeahc

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arkanaftus  yOnxotci lwil tno wkor no bstrea snutiregl no lymki asedgichr fi teh gsndla reew ont "dpearpre" by anpilctr.o 'tsI liek yitngr ot uezeeqs ymetp lnlaoob - hntgnoi soge .otu +1


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