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NBME 21 Answers

nbme21/Block 3/Question#35 (reveal difficulty score)
A 63-year-old woman comes to the physician ...
Increased resting cardiac output 🔍 / 📺 / 🌳 / 📖
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 +20  upvote downvote
submitted by cellgamesgojan(43)
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VA ustlFasi treour- ooldb omrf teh raaetlir stmyse ot het evsuno ,semtsy gyasbsinp- the rrtoeesAil = ncIreesa LP ;---g&t ERCSEINA V.R llA ni lal = erIescan .CO

ornicgAdc to olrd,WU teh aoetserlri rea a rjamo soecru fo arteisecns ... os ibpgsayns the sielrrtoea usstrel ni a ceesarde in aTlto rhaPerielp nestecRais ... siucgna na neeaircs in eht eart nad ovueml fo boodl utrnering to teh thar.e I ma trytpe suer three si mero ot eht gyplihosyo ebnhid sti,h but I hpoe iths aidpexlen a tltei.l

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big92  ditmmael"eyI loolwifng atiecnr,o eiuavrnteoors slautfi FA)V( is dsaticosea htiw na sarciene ni ridacac uoptut OC,() ehdcaive dtminoyrnplae hugorht a oecdtirnu in yisemstc avlrcsau te,cseainrs denaesicr aoyaimrdcl lttonctcyai,ir and an iesnerac ni sokret umvelo )(VS nad rhtea ar.et Orev eth gilwnolof e,wke tiragccinul obodl evumlo escsianre in jcncutnoion whti enascrise in liarat dna nrbai nacitiuretr spedi.pet eeTsh trnaitseola rae ecatsisado hiwt relay eensicars in tfel ruevatlirnc VL() lgilifn essrreup with eht toplteain rof aerstlntu matipc on laiart adn irtlacrvenu bcherma sdonseiimn nda o.fctnniu" :MPDI( 5e5 s 84T) 22erh' 55 losa nrotahe dusyt yb pnstEei mofr eth 059s1 gnkloio ta het setfcef of sVA'F efftec no CO in emn MI:DP( 15.172)083 ltyrA,npepa the ersnacei in stgnire CO si a gib pbromel esuacbe it acn eald to tuio-phghut ccaadri ileurfa ).H(VL +32
hungrybox  sJeus ib9g2 ouy went ni no teh chsareer aoml u stum be TMSP +6
temmy  9i2bg ouy aer .tirhg hatt is why ptseag ieesasd atgpse vaeh hhgi ouutpt craadci lfieaur caeseub fo teh va sht.usn +5
kevin  wath is n"ceerisa P"L +6
jhan17  cicgnrdoA ot hi" Wnwkie na rteiuoareonvs afsulti si omfder inlngoviv a amjro ytaerr eilk hte iamdbnlao a,taor ti cna eadl ot a lgrea dcreesea ni rpreelahpi scirtsneea uecabes it yb sasp rtreiaole he(wer jarom BP is mrd)feo . siTh doweerl ippaehlerr trsnceseia eucass eth haret to neesairc tesring aicracd uttpuo to nmiaitna pperro dloob lfwo to lla usstse"i. +



 +6  upvote downvote
submitted by azibird(279)
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I td'on lfee elki yan of seeth omnctmes evah lyflu edsdearsd why eth ttpenai rutyernlc sha einecdars rgients OC dan NOT eecdrased S.V eHre is owh a fniedr of inem aeildpnxe it:

PMA at( tirsgen RH) = /32 DPB + /31 PBS = 77 mgmH ni shit attpein, hwich is rlewo anht lnoamr (93 mHmg fi yuo use )0102/.8 oS APM si reeceasdd and teh iseonh/ytkder rosgan etan'r ttggeni eth opeisnruf etyh de,en nieldga ot RSAA ntvaaioict nad e/mOe.aSdB MPA = OC × ,PRT os ihst ulodc eb ude to low OC itveaerl ot RPT (hwat we saluyul pc)txee or olw PTR erleivat ot O.C Tihs iesptnta' gealr AV afislut sah dpredpo hre RPT yver wo,l wichh enmsa reh OC tsmu evha nbee vyre ighh fro hte psta 51 ysear ot amntposcee ih(hg uottup tehar lua.eifr ehS hsa yoln 5 aysd fo msoysp,mt chwih mnsea she is raeyl on in ehr FH. icSen she dah hcsu a hihg OC ot nebig i,hwt hre drpo in VS sith aeryl no wuold ltsil eeval eher ihtw an ICDENASER SV cpdeaomr to a lonrma pn.ittae Uesnsl reh slupe si sreup ghhi, reh trhae utms be mgnppui a emivsas tsreko vmeuol ot mnitnaai a nrmloa stycliso bodol espersur tihw hcsu a owl RPT (AMP = SV x HR x R)T.P unle,laEtyv rhe SV amy erceseda ot eb blowe nmar,ol ubt ton os early on.

orF sescN nttopem:eol edercseda rieatlra O2 ast beuceas bdolo is ofligwn mrof reytra ot ie,nv ont teh oterh wya n Ntdroaou. sceadeedr idmxe sneuvo 2O ats cuabees reiatrla olodb is golnofdi teh cubialnvas vien ightr rboeef iedmx O2 ats uldow be uemdosrtN. ae adreiescn RVS cbsueea of the greal AV u.atifsl

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 +2  upvote downvote
submitted by the260guy(18)
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But sreeh' my bplemro hwti htis iqt:nuseo it ssya ttah hes ash a 5 day tsioyhr fo OBS dan llnowes esl.g oS iyvosubol het harte si .ifglain I edcpik rdaseDcee tokerS uVeolm for that soera.n

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nwinkelmann  VA ialtsusf rae one uasce fo hg-tipothuu diracac al.ifreu isTh rnsope tnserspe whti aerht rleiafu, tbu ti is eud ot oycnlhaclri seeadncri ietnsgr C.O +2
lukin4answer  minnanwlenk@ sey thast r,ghti eh has liifang aer.th tub equoistn si sgakni hawt is eth igifndn of hits tptian,e I denaudntsr hte ascue si taluiFs ugnsaic hghi uoptut i,rlaefu tbu yeth idnd't aks hte nseaor fo hsi FH, they are kgnasi eht f.ngnidi I ecsoho daercese Skeotr elVumO :/ +
happyhib_  ihsT was ym cgoil nad otg ot rscedadee terkso vleumo as ewll; hyte nraet akngsi htwa casude hsi FH or antniygh it ayss htaw si eht otms ieylkl fiidngn in htsi pi.atnet fI sih rhtea si ilginfa ude ot HVL ormf ocnsietnst scndiaere OC olundtw eh AT HTSI ERYV EONTMM HIWT his ehtar ilginfa eavh ereedsdca ktosre l.mou.ve? +



 +2  upvote downvote
submitted by usmleuser007(464)
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OC si scirdenae whti ) 1 ecdserdae l2rdafo ae)t nerdcesai ralp3o) ed adsrcenIe tiiycclnrtoat

An nueovrtsoiea aifutsl srctaee na aatevlnriet utreo orf talair bodlo onit the suoenv ounliairtcc wo/ ioggn tspa hte alreistoer te(h ajmor seuca of teec,sarun.hiT ss) by doing so eth TPR afdert(ao)l rdsasecee nda het OC is rde.snacie

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 +1  upvote downvote
submitted by uslme123(86)
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A'VsF = ieasndcre acadicr TtpUBuu.o t tshi in'st new rof sthi oesp?rn I weiv hits sa a reaht atht hsa lalifny egnbu to laif -- sadreeedc vefctieef arcyulictro lvmeuo -g-;t& redeinsca SRV.

But i gessu you tna'c have B orfebe A -- tvreewha \--

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happyhib_  his pb saw ometsnghi like /10;503 ihtw stlcoadii uoanrd 50 I ufdierg he oldtnuc evah eiraensdc RSV aceseub shi oclisiatd wuldo eb ?erhhig +2
trazobone  I adh isht aems risagneon I eymtloepcl oselsgd revo hte PB ‍🏻♀️🤦 +



 +1  upvote downvote
submitted by nuts4med(8)
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eyAonn evha na iaed ywh teh esaeeddcr etrailra 2O suritotnaa si ciertr?onc usgmAins hes sha pmul meaed cneis hse sha LE ed,ame towndu'l a rlwoe 2O tsa eb txeecdpe ot?o

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haliburton  I evbelie rtehe wlodu eb on srecdeae in O2 oraitutnas bsceeua eyenxogtda doolb (high rsup)seer is shtuedn toni oxeedgantyde icuicrt. sA ogln sa eth nsugl anc epek u,p hsit sduloh sianeerc onuves notgonxiaey no evar.gae +7
hungrybox  ty tobh fo oyu ofr tihs, saw rnwgdoien the msae night +
coxsack  2O tsa otnw’ nacheg c/b uyer’o otn dagdni entedadyegox ldobo ot teh raetlrai die.s ’erYou jtsu tgknia ratailre oldbo dan nuptitg it ntio eusovn .loodb Smae esrnoa hyw -RL> dcaiacr hstuns t’ond sareecde 2O sat iwhe(l ni n,stoactr a >-RL nhust .)dolwu +5
hungrybox  tsju rdel:azie eth ihhg esrerpus of eth tarearli tmessy ekpes uto uops-wsrelre uovnse lbood ni na AV laiftus aolr(bybp bsoiouv ot tmso lpp utb ti asw a kearue nmmoet rof em oll) +2
chandlerbas  ay uyo otnw hvae ecedsedar tliearar 2O tsa ucebase ennoygxtaoi of olobd si isufpnreo emiltid AF(91 546-)- eeherrtfo oixetnayong fo teh dbool shppane twhiin hte fitrs ecds3s.no fo tnreegin eth ynlrompau lylcapira tath uyo clodu enve ehdnla agvinh oemr etageneoydxd dlboo enert +



 +0  upvote downvote
submitted by step1soon(51)
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atreH :ifauerl shTi is teh omts ssoreui mintpicoocla fo grale rioearesuntov uiasfst.l niSce ryuo ldoob ofwls mreo ulkqiyc hgruoht an sranverouitoe lftauis hant it oluwd fi uyro olobd fdwole gtrohhu a oamrln rcesou fo eer,trsai ealpasiirlc nad is,nve ruoy trahe usppm hrdrea ot oeeamtcsnp rfo eth dorp ni oobld reeussrp cade(ll tit-ohpguuh rteha refiu.l)a verO ite,m het saidnecer nyitienst fo oryu hsater' mpgpiun nca eawenk ruyo hraet su,mcel gaideln to rtahe .lrufiae

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