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NBME 23 Answers

nbme23/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man has a diastolic blood ...
Precapillary resistance 🔍 / 📺 / 🌳 / 📖
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 +46  upvote downvote
submitted by ferrero(48)
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A veyr aiimrsl uqtisoen I avhe nees in bkQsan wlil aks hwy a intpeta iwth htigr athre irfuale osde ton eovpedl eeamd nda hte rsawne is ceeisrnad icltahypm rgenaia.d I got hsti oinutqes rngow illyoiganr bsceaeu I nasedwre anolg hsit ilen fo nisenorga tub I inthk in tsih easc it lal sah ot od wiht HWEER eth arxet eseurrsp si ncoigm m.fro In hsti tequisno teh tp has sitolicda orhntpysieen os yuo can nkthi auotb eht pesuesrr as mgionc f"ado"rrw so ccrntngsitio icplyerlraap hcepitsnsr can eretnvp na rnaeesic in srserepu in het araipllcy .bde oerHvwe fro trhgi earth eafrlui shti txera fildu si mnicog omrf the POSOTEIP cintdeior rkda(cbwsa mrfo hte htigr he)rta adn rctnitgsicno aycalirplerp ssticrphne cna do gnhiotn (no espiotop eids of ycllapiar )edb - the noyl wya to vntrepe edema is to aceinres thylmacip .eiandgra

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seagull  Teh qstueion cllarye aeld us to tnkhi oabtu tOmosic reesusrp by gklinta utoab oerinpt dan e.niur I orendw hwo ynma oepepl udse that niel fo naionergs ilke( sfly)e?m +20
mousie  eraGt etaliponnx,a I oehsc thpyiaclm agnadier orf the mesa gireoansn smarlii( Q on endfitref b)nak +9
sympathetikey  yM eionsrgan aws hucm rome icmslstpii aby(me oto lsi)pme utb ni my ,imnd yslcotis PB si eddierment by aairCdc ttpuuO adn adiloitcs BP si eertednmdi yb siaerel.tro frh,Teoere htwa scemo obefer the liaacplry and sralueget ?eectnassri ereAr.stiol 'tsTha hyw I asid atth ppleyarclir-a .snctesiera +41
cr  teh ianm rfedfeicne tbnweee het 2 cesas si thta ni itsh seca the pttnaei hsa ihgh PB +1
link981  oS in rdetagninker lganuaeg het snqtiuoe si eseliatnyls sganik owh hghi suerserp ni eth ateriarl ystems is NOT msnirtaettd to eht suenov msytse h(chiw is reweh MEDAE ev.sedlo)p uBt you onwk yeht vhae to dad lal sthi onif ot rty foecsun a absic ripicepnl nad make uoy eonsdc sgues foesu.yrl oGt( ti ngrow by het a)wy escbaue fo hawt ferrr@eo siad fo nQbak neots.quis +9
hello  or@reerf twha aer uoy angtlik o?abtu yhtmiapcl indaaerg si eht nwgor .n.ae.wsr +1
hello  ok enrev .mndi i tog i.t drah to dntunedsra /bc ti aws a ibg olkcb of tx.et +2
asteroides  I ihnkt ehyt amy eb klintag tauob hte ecnigymo cespyomntrao h:menisacm llrmf/.kop=4Kwgnjnts4tgNb/w4.ioeo/u/e5tr:h./op?ioftwn3c.n/r5hyB.b/gicobsiev1"drsneIace raaielrt or snveuo seerprsu losa ceidsun oycneimg itncscniorto of oraisrtele adn pacreiaylrlp ec,rhtipnss hcwhi rseasi rerotialar eceritanss h(etebry imnginizim eth ecreasin ni aylaclpir s)surreep adn suercde the ulorcrviacams sefarcu eraa vlaelaiab for fuidl F.neac orhxeg pxelae,m beauesc lsaauvrc oothsm meclus ni atreilra nad aartrieolr slalw ctrtcoans nhew ospexde ot eltedaev acavatrlsnrui res,ruseps sthi ocyginem ornsepes iceesnsar paryrlpecail neiestracs dna eottsrpc ailciesalpr rfom a ccnnaotimot seri ni hrtie uarvrniascalt speerur"s. +7
stsfyt  akesm esn.se oseesmitm ew ues tvBln(Cs)oidaoiaC + elnntidooiva CI(A)E ocomb to aelncba hte ssreurep, nda renpetv egealka nad me.dea +

I think they are referring to maintenance of GFR and blood pressure relationships. Ergo the mentioning of the renal function. The precapillary resistance is "glomerular" precapillary resistance, so if that increases then GFR remains the same => prevents leakage of proteins and albumin => less edema.

https://www.youtube.com/watch?v=IRZsniaCfVQ

+1/- peqmd(74)

this is the concept of blood flow autuoregulation at the tissue level in response to increasesd arterial pressure via arteiolar remodeling via smooth muscle hyperplasia ....

+/- msw(4)


 +5  upvote downvote
submitted by staph_aureusxx(9)
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lacpepirraly asiserenct = dgirnceibs eht ti.roersela sh'e tog imnilma niprtoe ni het ;runei nda no l.unmaib hte key was iypnag aetntinto to teh loobd s.rseupre rseuPrse si duraleegt by eht caierentss esvelss sa rodasb laslc ti hhcwi is het eralositre aka aypclilprear ia.sertnsce

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 +3  upvote downvote
submitted by notadoctor(175)
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'Ive nbee isercahng rof my oscuer for tish ubt n'tac msee to idfn it. eH,oevrw the awy I tuhtgho autob ti saw tath aedme hpsnepa iav eht cieiplaar.ls fI teerh is eaderinsc aisntsceer avi eht yleraplaprci nhcreipsst as mhcu oodbl udwnl'to be lbea ot tge niot eht ielacpialsr. heT bodol lwduo iedtnas get tsnuedh vai asotsaneoms ot the e.svni sThi eicltra rfmo lpoiocsgyco.hymv xailpnse it a teitll rtetb:e VC l:Pygoyoshi siTsue emdEa and earGlne linPiecspr fo Tialnpyarcsalr dFuli ncEehgax

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 +1  upvote downvote
submitted by chagas14(1)
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yeabM eht tqinsueo si anldgei tiwh eth tcepocn of ioyegmnc tairolrrea vontscsracinoito chihw si a otarehn in-aaemted mcemh.snai ehT rep ipyllarac itpechnrs crtnatoc ni ssepnero ot a raeis ni .PB I otg eht Q wrgno ceeaubs I cpkide aymlcpthi o.fwl eTyh evol to go rof het "what lsee" teneelm of yan .oipct I notanc dnif yna ronsea hwy teh lpcmyhait oontip dolcu eb rwngo :/

5cloh4pbw?/onorg:swsk/no/5vmNsat.i/enbB3=i.t.scK./hlrt4ciwpehC kc eth fiergu 4.1 eTh rnaigM fo atSyef igAnast meEad rFmoiaotn – aEdem yteaSf cFsaort

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 +0  upvote downvote
submitted by adong(144)
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In addiinot to thaw has drylaea eneb sdia I nhtik na rattomipn intpo ni the tniusoeq saw toagrluyre tmsnjadutse ichwh positn ermo ostarwd rlraeatroi a.inrtguole

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submitted by usmleaspirant2020(9)
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.29df9d2oc/u26e52a21f/p73oydt0te9c.5ndn3d02c1eo/6a0sci7fddheebrlf00bt9070et:/u7e

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 +0  upvote downvote
submitted by ninja3232(11)
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"henW raltirae respersu fl,las enocgyim tneo is dcederu ni eriasrolt,e ngdirceesa ertih irteenassc ot folw dna itamninigna laiprycla e.errupss These bverooniasst gusetsg taht cilylpaar psrseeur mya eb uatleerdg erov teh meas aergn fo ruessper gehcans roev ichwh wfol si tuueeotalragd in a vgeni .orang eInedd, mrfo eht "alt:oerin

t/sB5nnk:i4o3shgvi.tKb/N4cb5oww.h//lo/.pwm.n

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 +0  upvote downvote
submitted by hello(429)
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hwy si maalps oncoict esepursr wr?ong

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rainlad  I nthik 'tsi bcuesea we dluow pcteex ot see eosm omer upuriumaibienlatror/ina if the spalam cooitcn rsurpsee dah adncreesi to ntoseaepcm +1



 +0  upvote downvote
submitted by ferrero(48)
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A evry mraiisl eotsniqu I heva snee in skQanb illw sak ywh a aenttpi wthi tgrih htare leaifur edos otn eovlped madee and hte ernwas si ecsdernia ymplacthi anraegi.d I tog sith osinequt wngor onygrilali ubceeas I eeswdanr agoln tihs inle fo gseaniron utb I thkni in siht aces it all hsa ot do iwth EWHRE eth eatxr ueserpsr si gomnci frm.o nI iths etsniuqo eht pt ash otscidlai resnyeithonp os yuo acn nhikt uatbo hte srsueepr as mcngio rwo"dfa"r os ictrnncigost ieprrlcpayla crepnthiss anc eptevnr an ecsranei ni prreseus in hte pacarlliy de.b vHerewo fro ghitr haert elaiufr ihts taerx lfiud is cmogin ofrm teh OISOETPP iercodnti aswbdakc(r from teh rgith tehr)a and cgoitnsrtnci lceppryaalri tnrchsepis acn od ihntong (on tppsooie dsei fo yllarpica )bed - het nylo ywa to etervpn eeadm is ot aesrcein pyiclthma nerg.adia

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 -1  upvote downvote
submitted by usmleuser007(464)
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itorcA alioDtcsi srPee rsu

  • High PRT = ghhi PD
  • ihgH RH = hhig DP
  • Hhig VS = hhgi PD

rictAo Siyotslc euPr ssre

  • hHgi clirttaityCon = hhgi PS
  • hiHg VS = high PS
  • woL omlceCniap = high SP

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 -1  upvote downvote
submitted by spow(50)
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I laso tinkh atth teh otnip ebngi amde erhe is obaut anem aerlrita sesuerrp ()PMA, ichhw si ahtw yotaeturrlaoug mtsysse uatcllya ncgeah dseab on. ueBeasc eh sha redciesan APM (edu to eecdsanri )DPB, the relicpaalsi will tntorcics ot iinnaamt ncontats olp/ufeerswsr oghuhrt the lprcilaay d.be

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 -3  upvote downvote
submitted by divya(75)
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i 'otdn nitkh uoy eden ot tkhin all htat h.ucm kool at lal the tsionpo nda kithn fo ahwt nhppaes hnew htye c.na ,esrAei ,B ,C D nad F lla acn esauc tttslairinei Bt.ma eeud eirngnscai rrycplileaap inasrctese itlefdeyin nts'od.e

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drzed  deneaIrcs aclytmphi lwfo luowd nto uecsa ttislranetii mead.e +1
123ojm  tbu it ones'dt ays c"niaeers "ni, ti tsju assy gyortua"lre tmjtuessnad .ni" +1



 -3  upvote downvote
submitted by usmleuser007(464)
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.1 rcAito oailisDtc ressPeru .1 Hihg TRP = gihh DP .2 hHgi HR = hgih D P .3 ihgH VS = hgih DP .2 iAcort oysctlSi sseeurrP 1. hiHg tryitnctiaCol = gihh PS .2 Hihg SV = ihgh SP 3. Low epCmnaloic = gihh SP
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yex  r.ios/rl2aicctMoMil:uhspi0omcytthg/ncp/yoo1c/v sTih esplh w,ohesom the tfirs atrp atoub laicraypl up.resser +
usmlelol  s'thta teh xpe p:t:ra e hT arevega acpiarlyl shtordtyica rseepurs si ednrtemeid yb rtearlai nda onvuse rsrpesseu AP( adn ),VP and by teh atroi fo laptoprtyoceip-arl-s nesiectssar R(V/.)RA nA eneirsca ni irteeh etlirara or onuvse seserpru lwli aesrceni lcaryipal psesreu;r heevorw, a vigen anhceg in AP is nlyo otbau -ftofeihn sa fviefcete ni cnggahin CP sa teh emas letsobua cehang ni VP. asecuBe vuoens nscaertsei si tiaerevlly lo,w ahegcns ni PV are raeylid ttatsnmiedr acbk ot het iacll,rayp nad snerocve,ly ceeabsu arlriaet creaetinss is veylletria ihg,h ehsncga in PA rae lpyroo edsttritnam nrtosdamwe to teh .paacrylil +1



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