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NBME 20 Answers

nbme20/Block 2/Question#48 (reveal difficulty score)
A sedentary 50-year-old man with hypertension ...
Antidepressant therapy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: pharm

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 +13  upvote downvote
submitted by โˆ—drzed(332)
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Fsirt tencsnee fo eth emt:s he sah a ekw-6e oshiyrt .eg(. g;t&2 wekse) of eniprsdose ,()1 fcdtyiulfi pileensg ()2, atgeiuf ,3)( edcedrase atetppei 4)(, nda proo norreoatmnct/mcenoiy ()5

orF a sisnioagd fo ,DMD yuo eedn a 2 eewk tysrhoi fo 5 of eht SSPICGAE msyotmps icwhh he seetm eh( is lyon ismgins idacsiul idoatnei dan snrteiet in )iae.tvtcisi shuT he smtee eht ositgidcna iercirat for a mojra eeivrdseps opseied, hihwc msnae ttah ttretmnae is tdneaicdi hwit an .SISR

oFr the htreo arcrvacosudail tfca,sor eht ylon noes npveor to epovimr ttlimayor rae it,stnas EACi, BB sp(.e oclirvadel in ehtra )rleui,af nda oon.eicpslnotar enNo fo toehs rwee wseanr hescc,io so MDD ertmattne asw teh tsbe he.ccoi

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umpalumpa  Aylucalt, tehgwi ssol adn cseierxe rea het ylon emraseus to daeeecrs laimyottr (rteoh ahtn i)ttsans ni tp hwti mdaipier pdiil bal lesv.au Im' tno ebla to nixplea ywh a loawcl-reio deti si rnwog ti( udshol eescarde wgt;r-idegehc-etaes& oa)tylt;rmi mbeya tehre is no etcidr icorltraneo ni claiclin dstuesi eebenw ielaowocl-r dtei and t.mriylato +1
fhegedus  vene otghhu i tog hsit g,wnor i ielveeb i aehv uigfred uto wyh -oiloracwle dite si .gwnor nI teh rftis nceneset of hte itues,qno it taetss he has low ittepap.e oS ew cna rtetyp humc nrigeo etid adn clesiroa mrof hte .iqnteoau +1
drbravojose  I kithn ybema 2 earys xten is het eyk to escoho etaipnd dniates fo riwolcl-aoe hwich tsaek a lnog trme ot eamk tsi ceefft. +1



 +6  upvote downvote
submitted by โˆ—strugglebus(189)
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ostM fo the pst leuvsa were .rmonal knDgrnii asw'nt oer,utougsa LLD aws ld,im MBI hsa fni.e eH did ehav NTH ouhg.th heT tbggesi krsi scatorf ear teh tcfa that he hda fdreuesf na IM and sadtret ifrfgneus eerves ndesrpieso ehgti(w ina/es.to)xsyl T,ush he si emro at rski fro duii.ecs

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sohaib111  onWt' aihgvn na MI eb a veyr bgi rsik cortaf for etrahno noe Ad ?n aslo if hety dtwnea ihts nsrawe het( par)-dennset,asti hyw odwul tyhe ujts dad htta ish LLD is neiisargn in hte alts nsnct.e..ee +14
dbg  bc yeh'ret OBsS nad sDOB +33
doodimoodi  h,aeY reedcmmodne DLL in plpeeo wtih oreipsuv ertha rloempb si l&t; 010 ezje +1
asingh  It si esbeuac fo eht matemiefr of rmtyltoai is 2 ys,r tivyegrhne eesl lliw tfafec ltare +6
benny  dmd aniecers IM +
benny  Type 2 tebdieas and oarmj eprivdesse serdodir )DD(M rae teidennndep ortsbiontcru to acicdrlausvora eessaid dan to an cnserdaie kirs fo rcliyaadom nfiiaontcr .)I(M +
benny  cb/4nn3cwtt..iw2/1/i/ase3/poC.iMhvnlpc.hwl/:rPmmgst40 +
drzed  oNen of eht clusoardviraca npisoto oudlw ormivep atotmiylr sstn,(iat i,CEA ,BB oeiloatnnorscp rae teh noes atth veha rpvneo irltatmoy fee.)bitn So fi heyt dah utp eon fo oehst, I khitn I lowud heva nchose tath, utb envgi htat teh sert dt'on hngaec olrmyatit ta l,la I ewnt iwth teh rdesst.psnitanea +2
ihatetesting  My igkntnhi asw ttha icnes he ahd an I,M a ebta kroeblc dwulo vrepmoi oyml,rtiat nda poronrpallo si soal usde sa na xtcnailoy.i +2



 +4  upvote downvote
submitted by โˆ—mbourne(118)
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I ithnk htta fi htey dah sotnhegim iekl a"ttins tp"ayreh sa an nesarw c,hocie we uwdol ahev na tmaugrne ofr atth as ti uldow rescaede tryimlota by lgephin erpnvte RNHOETA eatrh c.tatak weHvo,re I hnkti hatt nsttpriasade-ne tpyaehr llwi od a OTL ot nvtpree iud,isec eiwhl gemo-3a ytfta sicda t(hleayh sa tyeh )rea 'utdnlow od AS MCHU ot veeprnt a retah tkatca.

eTh oeisnuqt si cllaisyab sn,ikga o"uY cna nyol pesricerb eno fo eseht ot eepk ihst uded ievla sa ognl as se.lpibos Wcihh noe lwil ehav the best hnecac at ponimgcahiscl a?h"tt

reerheT,fo hte rwasne sodluh be inrsnets-pdeata ty.ahepr

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bharatpillai  why pitsdneastarne etyaphr hutoh?g ehter era ton nehguo reusfeta gniev ot suetggs .D'MDeH s 56 resya odl, otn an eerldly ilgsen mael so otn ta het ihgsteh a"lc"aislsc poonipulat ta sikr of eisiu?cd hte utsnieoq is os g. evaiGumnbosi.u. ,MI wdnt'luo icrconh alohiclco teikna ipsrodsepe mih ot aidldet ohapriaydtmyo?c +1
neovanilla  I td'no ivbeele 'its ahtt eh sha DMD yb hte iaclicln dtefon.iiin Ist' mreo taht sih LoQ sha rlabypob nacegdh icasldylart isecn teh MI nda IMs rea nysolrtg saicasdeto hiwt erecddesa kuotool on e,ifl alscpieely gcionesrind owh ommonc it si to get a edcnos IM oons rfate eht tsf.ir I not'd know teh sstta on sduciie stpI,Mo- utb hpleign eht isptneta' reondpesis to ekma mih moer -tairpvceo to lhep imelhsf etepnvr artheon IM wodlu be reettb atnh "a deti ghih ni mgeoa 3 sA"F ta( es,tal hits wsa ym ittaiijuscnof, as reumnob wsa )yasnig +2
drzed  tsFri ntcnseee fo teh :tmes he ash a e6ekw- rithosy (e.g. g;2&t kes)ew of sidesorpne (),1 tiulicdffy nsgelpei (,)2 ugaeitf 3(), desarcede epatepit 4,() and oopr /ettronccnooynmairme (o)5 rF a dnagisiso of MDD, oyu nede a 2 ewek ytrohsi of 5 of eht ISPAGSCE tsomsypm cwihh eh eemst h(e is noly iginmss ildisuca aetidino adn eesritnt in ec)tis.vaiti hTsu he seemt het sdinaoctig cietirar ofr a jramo prieesevsd iso,pede hhciw emnsa atht ttenmreat is aedtcdnii whti an .SSIR +3



 +0  upvote downvote
submitted by โˆ—peteandplop(42)
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aCn nnaeoy nlaixep yhw tis' otn iaxnyc?tlio yM igocl wsa tish dued sha a mub ktrcei mofr poriusve ,MI adn ihs HR was /icw--hi14m0hn act'n eb odgo ofr eth odl ht.ear I wnte aw/ tyixinocla to ngirb shi HR dan tyeaxin ndeur cooltrn.

Wudol na edpestananirts od hte a,sme tsuh, si it a erbett er,wasn or ovcer a dreiw raeng of smsmytp?o

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underd0g  An SRIS dulwo eocvr tohb desrispoen adn yeix.tna +2



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