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NBME 22 Answers

nbme22/Block 3/Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressure 🔍 / 📺 / 🌳 / 📖
tags: pulm repeat

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 +7  upvote downvote
submitted by trump2020(3)
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ouY sugy are yaw nnhroivetigk is.th hircCno pyihxao asecus ioneysphnrte edu ot SSN aonctaivit adn OEP rpoun.docti

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teepot123  pey +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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ysuG I vaeh naehtor th.othug

vgiinG oreht cseoihc are buato ihs tehro alrbnmoa alsevu (aincesder rianece,t ,ulosceg icur ad,)ic I gesus eht qtsnoeui si ittesng us hiwhc fo eeths uvslae lliw peovrim fi his OSA is rmpiovde by .CAPP

icnSe SOA si neo of eth omts tmnaripto essacu fo ctidpiioha roenyeit,spnh ti ohldsu ecom ot us that ceon his SOA si tta,deer sih hneersnyptoi liwl mievpro noos.

So ddceas"ree P"B tadesin fo treho ralnabmo vlesa.u

(ashTnk to ym feisdrn rof iihgntn me aobut its!)h

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dodgerslakers15  shTi is the orctrce wya fo hgitnkin tuoab isth ieso.qtun onulma^Py r opyolhiygs si tno seyar.csne The roto of het oueqsnti is gkanis athw lwli vmeopir eorv tmie htiw neartmett fo lseep nap,ea ihchw is boldo ,epruress iegvn taht elsep pneaa ssacue dincrseae scetiytahmp ento dna rfoerthee cysemist HNT. heT earntemtt of esepl epnaa whti ,CPPA lliw hlpe deeruc stmthicaype ento adn rvoe m,ite pvmiore P.B +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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PCPA sseaicern ripltarlnuae rusrepse sa eth ealeedtv awaiyr uerpessr is tsaidtrentm ot ohtre sithng in the avcyti ngul( euhpss no rpellau evs/caayicpt chwih acn tnhe uhps no teorh u.srcr)ettus hisT nca dael ot isroocpnesm fo sv,ien ucnniigdl teh evna acav -gt;& ercesaded sevoun rrenut -;> ecdarsede pb (ofrm edcrdsaee odp.la)re isTh si risilma to awht pepsnha gdiunr vaaavsll oexnte(ir )hspaes thugoh the iipoetvs sepsruer si edprvoid by a iahecnm mppu steandi fo oniaadlmb gsare.mdhalm/ucsip I tnhik terha tare elilyk scnsreaie dsiaten of srdcaeee sa a coyepmanrost srsenep.o

’sHere oen eits thta psaxelni ti wlel (eth ”reef“ tteconn is nhogue dan rpaoblby ayerdla ecsexde eth edhpt one mhgti nede ot ko)nw tee/ymtptsf/hhcfe-nap-caiatsl/c-/rvlmnueioetacockrnte-l:fh.ictioaaomxryon

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dodgerslakers15  urPomnyal polsohgiyy si nto csnyeresa .ereh heT root fo eht oisnqetu si kngais htwa illw vrmoeip reov mite thwi rttmeetan fo plsee ,npeaa hcihw si dlobo srsrp,eeu ignve thta epsel aaepn sueacs cdeasiern theyicpsmta toen dna efoerterh cissmyet NHT. eTh ateertmtn of eples paaen wthi PCAP, lwil hepl creedu tychtisepam note nda vore ,etim mpoevir BP. +15

Guys don’t forget that in OSA, periods of apnea results in increased sympathetic tone, hypoxia causing pulmonary hypoxia vasoconstriction, thoracic movement without inspiration increasing negative intrathoracic pressure ==> all these factors leads to hypertension in OSA.

To remove all this we give CPAP, which results in decrease in BP over long period. (It is not only about increasing intrathoracic pressure and reducing BP)

+16/- apurva(101)


 +4  upvote downvote
submitted by ∗meningitis(643)
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lAhthgou t’is uaobt PV,P htis ncagerrshie peledh em tredusannd isbac pys,h I poeh tihs selhp evneeyro ni soem .way

kwae:aTya guirnD P,VP unveso reutrn ca,eeesrsd icdarac outupt ece,sdersa dna arteh eurssespr eeascder ni eth rigth dsei of the .traeh

yWh soed PVP eercsdea nouevs e?utrnr

  • ichinatactrro psreures empsesrcso rte,ha agusnci odolb tno ot rteunr

Cauess rfo eesreddca ltef tlurcaervni topuut durgin lnnttaveii:o

  • Sfiihntg fo rcvnnlurraiiaett tspuem to tefL due ot eandescri RV vmluoe
  • Deeedscar seuvon erntur
  • aegsChn in srtahe iitlbya ot tncctaro eud ot vipestio rsrsepue
  • ackl fo 2O ot harte

raNolm tesprncmooay ammesscinh ofr namnitiigan OC and PB iugrdn VP?P

  • nrdisecea RH ot stcmnapeoe ofr erdeedasc SV
  • rcnasedie SVR ot naatiinm BP

tOreh hoiylicoPsg see:prsson

  • Dceraesde rcleaebr spruoinfe supsrere dyo’(sb neseosrp to a lfla ni PPC si ot arise iemstycs odolb rseupers nda ldeati elrebcra dolbo esvessl)
  • asecederD relna psorfniue randecIe(s A,HD SAA,R and Piteant has anrle pelromsb so ndeericsa rainecient dna ucir c)ida
  • Pieslsob iomlurittann s(dieaernc gelusoc aiv oeeelgocsnsugin .ec)t
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meningitis  rryso buato teh igm,rtontfa tyeh ewre ussdppeo to eb etllbus tno ct.iail +30
drdoom  koslo oodg to me! ;) saitnde fo tsrkiaess yrt unisg het slpu gsni fro rdeurdeno ss;tli the sseytm gtes sfoedncu tosmemise esbaceu the rksseiat is alos rof lacitsi 😊 +2
meningitis  a,eYh I dciotne s: h ,O I itdnd wnok het + nsgi ddi tath! erVy mchu p,padreciate I lliw try hatt xtne .mite +1



 +2  upvote downvote
submitted by noselex(9)
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I undrentads plese anape dulow cuaes oahpxyi nad creaisen ni SSN yt.itciav oS ametntret louwd eecurd PB dan Htrea tea.R I asw kusct etwbene teh wot is.otpon Why wsa teh rsawne loobd rrsesepu dna otn HR? I odgegol uonrad a itb and fduno udeists thta owhs rdpo ni tboh HR nad P.B I uegss PB drpos o?rem naC mnoeose seapel e.npiaxl

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madeforupvoting2  APCP iersnacse uprienrtlaal eepurssr sa eht detealev wiaayr esrrpues si temtndsitra to hoert ntihgs in eht ayivct (glun pesshu no lurlepa it/aepsyvcac wihch acn etnh hpsu on retoh et.rrustsc)u shTi can dlae ot rniecspoosm fo in,sve nlincudgi hte neav vaac -> ardesecde svnoue rnteru -> aedescedr bp mr(of cedaredse lproa.d)e hiTs is aiilsrm to wtha seahppn unidgr alsvalav eero(xint sepsa)h uthhog het eopisitv srseurpe is vdiopder by a ecahimn pump sitnaed fo imoldnbaa ds.lresicam/uhapgm I kihtn thrae atre ykliel sasenrice entdsia fo decseaer as a ntpmoeycosar r.He s op rsne’see eon ites atth xinspeal it lwle th(e “f”ree ctnnoet is ougneh nad pbyblora ealydra secexed eth phetd neo ithmg eedn ot kn)ow cmia--ffo.yrchhtcuiktealfeoc/nse-ra/tpoaln:mlrah/xttcmoy-po/isnattevicnee +4
apolla24  I ugses icesn shncgea ni RH era hucs a aeinrsntt hnennopoem adn oyu ylno aevh itansduse ieanrecs in HR ehwn xieirsngec or ikle ualecty rnxeiiengecp mose imdlace remycneeg vs BP ttah can eb etdeevla rfo goln idsrpeo fo metis wiht no f.etefsc eorhTefer na pemermvniot in BP si omer raptimto.n tsT’ha ym ak.te +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna mooeesn otrcrce ym nenoasigr :eher

I aws ktnngihi eiositvp araiyw rruspsee wlli erseacin ellvaora noaeltiitvn dan rseeacde oixayph edincdu omyrnualp ni.rociscnasovott hsTu, RV raeft alod woldu rceseade =g;&t more dlareop to LV dan mero cadcria uou.ptt hnTe 'lnwotdu PB eeracse?d

nyA hlpe is e.ircepptdaa s.nhkaT

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pg32  I tjsu uohttgh fo ti sa osf:llow eh hsa hhig PB ude to uyrnalomp oissoiconvtrcnat as lewl sa wdsipedaer hctieptyasm oavcttanii as( fi eh is neigb lariapytl serntagdl lla eth meti, bauesce eh blalsaicy s.i) nncsIregia nyaoeiongtx iwll rxlea sih napuylomr alatvscureu nda ersaeedc maptiytcshe asiuotlmnti rthuthuogo hte dboy, eidngal to a rpdo in lbodo srereusp. +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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nsaredceI aratarlninci uspreers thta ressltu ni ihugssCn' iatrd fo eariecdsn lodob u,rserspe rreuiglar grneahb,it dna r.aabyidrcda suhT, hihg CO2 eudcnsi ichngsu ridta dna if uyo vgei PP enht ti lwli ucdeedr OC2, and etnh ondw aeelrgut hte thsteipycma ovsitscr.oantncio iilrnylOga eht rbian ahd so mhuc C2O ttah ti zpaszde out nad itder ot ieesarnc het PB in erdor to upsh emro dtneyxgoea odbol ot het .inabr

.A5/dtU-/g/e:w3mZCpAoshSjcmigmstfiaapJse:k.qpKl/tbg.r

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lispectedwumbologist  4darad8 "B" ycair pbm oll +
lispectedwumbologist  hTe yretpnhsioen in uvcirotbtse leeps aneap is deu to secainedr yctpmathsei etno ton aicsender rrniaalicnat usreersp moal +1
meningitis  pbueemocgtltiilwdso@s : eB traemu hugeno ot rcertoc emhih/r nad evmo ,on otn alugh ta ie/rh.hm +16
namesthegame22  elsuP trae aym be eetacffd by grsues of miphctteyas tviytcia nidrgu nepaic ios,epdse ,vohewer tihs piheiolsartn hsa been less eralyd esnmtdaedrot nhta thta weebnet enapa sintrap.e ehydnno +



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