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Retired NBME 21 Answers

nbme21/Block 1/Question#37 (reveal difficulty score)
A 35-year-old man with diabetic ketoacidosis ...
Serum potassium concentration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—an_improved_me(91)
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elcfbco@eakf;

ulsiInn sdoe ypla a lroe in gniignbr acbk K+ tnoi sclle via nioolumatd of /H++K cnxg.aehe ihTs si seacebu it shlep to sedrsad eht taoocetiidck asett fo eht ettnia.p yB bingignr Hp rlcsoe to sbliean,e htree si ntuerr fo +K iont teh ls,lce wiehl H+ csmeo bcka uot fo eth .llcse

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an_improved_me  eo,rwveH you are tr,hig ni thta too ym kwglo,deen hatt is not eth niam way nlinisu csenunfeli K+; ti si orme avi het aANPeaTs as uoy avhe doin.eentm +1


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submitted by โˆ—nala_ula(127)
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In dbctiaei ks,iatcdoseoi eetrh is esariedcn caid in eth lallrtxercuea .secpa ircgdcAon ot AF heret is a lleutranaslrc ftsih deu to resdeaced nlsuini thta lasde to emro H+ ientngre hte elcl ni cnaxheeg ofr +K. sThi elsad ot lieypearmhak whit ldedeetp rlrlealuncait tserso of +K. Tehre is sola ctomiso essuiird thta lased ot ensaredic +K osls ni hte uiren nda ttalo dbyo K+ p.oteenlid heT uiotensq ssak thta si tsmo lleiyk to eedsraec ihwt ilnsiun :eyphrat eusrm simustpoa ninanreotocct ilwl cedeaers sa +K is own edhgnceax rof +H sinied het .lelc

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cienfuegos  tioinadAld UW fun tsfca rdnggarie Ptmasosiu dna sDuAeK : inutaoc iggniv nilinus dan VI flsdiu to yadrheeddt lecmyyirhpceg esuaecb i eofrsc K ni slelc gsacuni saft saercede of alalctuerxrel susoaP,itm hsut eigv K nanttimeuplsepo even henw rsmeu K evdlaeet +3
linwanrun1357  hyW eirnu +K does ont ee?rcedsa +3

This explanation is faulty. Insulin causes K to go inside via upregulating NaKATPase activity. Nothing to with H+ exchange as far as Insulin is concerned.

H and K exchange is separate from this.


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submitted by โˆ—peachespeaches(2)
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I agere ahtt Sruem K eeresdac si eht btteer ear,wns tbu owtdlu'n iUner K osal eecdesar econ odlbo rsagu sgeo wond whti silinnu arettemnt ..e(i ocstmio isrudsei odwlu ensles?)

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