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Retired NBME 20 Answers

nbme20/Block 1/Question#37 (reveal difficulty score)
A 1-month-old male newborn is brought to the ...
Na+: 132; K+: 3.2; Clโˆ’: 90; HCO3โˆ’: 37 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +8  upvote downvote
submitted by apop(8)
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ehseT taposlenianx taenr trag.e It dseton eyalrl evha hcum ot od ithw SARA tctnva.aoii tI ahs latmso hygievntre to od itwh a mnneoeonhp caelld hte leaikanl e.tid In icnrhoc mttgivno,i uoy uodwl teexcp Cl- ot eb wlo nda =K to be wol srim(ail to bla terulss ni smooeen thiw bela.lmiu) oT toenmesacp for het wlo ,Cl- eth ocsahmt sah na arrteiotnp hiwhc esagecnxh lC- orf OH.C-3 eefehror,T -Cl lwil be rnispeeedhl in eht at,smohc lhiew -CO3H lwil nseeicar in teh olb,od ucsagni na aiosskll.a nI tlicaloak ,stetsa het /+HK+ prianttreo llwi egbin to atcia,vet htifinsg +K TINO elslc oak(ylpeah)im adn sgincaerin .pH RASA opbblrya ylpas a orel ni ingmak het ioekahplyma osewr but hte eknaalli tdie si roem piartonmt e.her

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spaceboy98  nIst aaelinkl ited deralte ot na ceeasirn ni pH artfe ?sealm Yoru golic si no pitno tub Im' nto rseu erwehth we can apply that etpnocc .eher +1
kevin  oenpcct nca eb ipdleap rehe cesubea ew need to epterel eth -lC ni orrde to ecrtae lHC; eth toascmh tonsed' crae fi C-l si lwo ni merus, nyol taht -Cl si wlo in eth lpareait cslle and so will mupp uto 3CH-O ni tsi xesepen +
usmleaspirer  yhw si K+ ?low +



 +6  upvote downvote
submitted by โˆ—hayayah(1212)
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ihtW hinocrc mi,iotngv yuo elos eclyrotelste nad a tol fo .daci It risggetr iblteomac kssolaali wihhc is hyw all het reusm vaeslu aer olw (or on eth wroel end fo het omrnal )aegrn cextep rof abiocbanert.

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ergogenic22  dcsadeere +K omfr( esreadicn AARS ude ot uevmlo s)lso dna eeecrddsa C-l o(sls fo ClH ofmr het ,stacmh)o lAkoaisls rmof ossl fo lHC adn uhts hgih ricbrF bo .a hits norsae ihhg ot dmi egrna K si nrowg +5
sbryant6  ntWluo'd sceaerind ARSA edal ot scierdane Na?+ The enswar sowsh recdeadse +N.a +3
sbryant6  so,Al rmmeereb liuBiam aNersov is odestaacsi thiw lhipyeokaa.m +1
sugaplum  os het aregn heyt gvae fro K si 6?3- so 3.2 si LWN thn?e ro are ew jstu anietrgpo on i"t si no the orelw edn of aomnrl ni pesd" +2
dbg  isdmou lveels ni lpcoiry ostisnes a,vyr thnniog reylal scialc,s cna be hhig sa in shit csae iplmys ude ot otiraydhn, nca olw ni rohte cases if aesrtoldnoe aandgem to eresevr taht ot eth ohret reemxet +1
skonys  r,oeoiymchcl"pH yphakimoecl letimacbo loasaklsi is teh asccsli rocltteleey and aae-cibds clmniaabe of iorpcly neosists" from ecampdes inhdbe ait.nglio wyampVl = vmelou slso dc(e nski ut)org sa lelw as osls fo +,H Cl- dan tN+whai( 2H)0 ;g&t- lMctiboae alkliAsso. ossL fo H+ scueas sceairen O3-CH tninoeetr sa lelw sa K+ fisht toin eslcl amei(olkhpya A9F1 8)5.7 +

From amboss: The loss of gastric hydrochloric acid from emesis results in increased bicarbonate concentration in the blood and decreased chloride. Some potassium is also lost through vomiting. Hypovolemia leads to an activation of RAAS, which exacerbates metabolic alkalosis via increased bicarbonate reabsorption (as a result of angiotensin II). Aldosterone also causes renal secretion of potassium and hydrogen ions, further exacerbating both hypochloremia and metabolic alkalosis.

+10/- smpate(20)


 +5  upvote downvote
submitted by โˆ—masonkingcobra(408)
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In cmibteloa lsaoakl,is pistsmuoa vomes tion the clels

eTh slso in voulem tgruohh esmsie risgretg ARAS rienutlgs in eirdscane eotAednsolr reaeles dan ueftrhr suaotmspi ctneireox

ept./w6b/i:hapw.tld1tw/teatnes/1

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 +3  upvote downvote
submitted by iamapotato(3)
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No eno hree drhebote to lalyactu ssdiusc ahst'w ongig oiT .nsh is a -omhtn1 ldo b.nweron

He sovtim raeft ,defgisne d-y5a sroityh.

At 1 nthmo ,odl with toinvimg rteaf ,nefseigd it si toms kielyl a seca fo YRPOLIC STIOESSN edu to rhrpoyytehp of teh cloirpy phnisrcte l(usluya rcosuc 6 eskew a.tl)er

uDe to imh tovgnmii oahmtsc etot,nncs he llwi OELS ,lC- ,K+ and a+N.

He lliw SLOA osle .+H Thsi is yhw oyu og tino hte eobimltac oslskiaal tiwh a etstrlnau nicrseea ni hte -.OC3H

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kamilia20  yhec:tsk: gnimoitv ecssua sslo of ERWAT rgearte tnah mdsuioโ†’ esdrnecai sumer smuoโ†’di RNCEASEDI usrem amsyool,lit So AN lwli seaderec ,oto btu on ttha afr +



 +1  upvote downvote
submitted by ark110(1)
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tBu waht is eht ifefnerdce neewbet otoipn A nda pontio C 1;32( 9;4. 9;0 )53

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sympathetikey  +K dolnsht'u sce.riean I'st ivgonm noit slelc deu to bemolatci aolissl.ka +
home_run_ball  In het ralpetai lecl fo hte tHro dnsa gomych e onsi rae emorfd ormf hte sotisicdnioa of cbniorca dac.i Wtera si a eyvr nmior ureocs fo eohnrgdy ions ni oicparonms ot noicarcb .iadc bacCnroi dcai si oemrdf mofr ncaobr oedidxi dna twrea by ncrabico s.haern e haydT raetbanobic oin โˆ’CO(H3) si xheangecd ofr a cdiorehl noi )lC(โˆ’ no hte bslaa side of the elcl dan the intbaoarbec uffssdei tnio teh soneuv olodb, inladeg ot an aiklaenl ited nnep.onheom +1
ergogenic22  AASR acsreinse fmro movlue sl,so dan huts oemr noetosadlre edasl to wol K+ +1
sinforslide  eerTh saosenr orf paayeo.hklim r,F sti oems K+ si ostl ni ctigsar ulds.fi d en,coS H+ fthssi tou of lclse nad K+ fstshi into clesl ni cimeaoblt Tri ladis., ohlaks CFE oelvmu ctonritoacn ahs aesudc dnaerscei rneoecist of aetn.leorsod +3



 +1  upvote downvote
submitted by โˆ—rainlad(33)
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hciceolrpo,ymH yklhcimpoae emocltaib skollsiaa is the scacsli relcetletoy nad iesbc-daa mnielaabc fo yplcori tesosisn.

tsrietPesn oigmnivt reulsst in osls of .lHC The hilerdco sosl ulrstse ni a olw odlob erlciodh evlel ciwhh imarpsi hte n'desiky tylaibi to ertxcee bnaiteocab.r hiTs si eth raftco taht npvtrese torcorecin of the kasolslia aengidl ot iemoabltc slisaol.ka

A ndsayoecr isleyotrpheomanrds vplesdeo eud to het easreedcd lbdoo oveul.m The ghhi dleeatronso slleev auessc het ykdenis to treain aN+ t(o ccrtero het iulcasvraantr lmuvoe ,nedptlieo) dna xecrete eadcerisn tsnaumo of +K iton hte reuni iunt(ersgl ni a olw olobd evell fo asmi.po)tsu

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 +0  upvote downvote
submitted by thefoggymist(12)
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I o'tnd tge thi.s nSht'olud het kyneisd ttsra cgoreicrtn teh racbib eeslvl aref 5 ?dsya Teh dldeyae sehpa of hte enccoroirt scein heyt ekta .etim.. nda in eht suotniqe yhrtee' signak "nW "o.ew ehav aolmcietb lailksaos necis HCL si tlos, os the oybd illw yrt ot rtccero it isrft yb nhertoiylivpnaet and ralet by nceiaedrs rincxteoe of biarb.c aBricb lsdhou eb o.l..w usl(sne I'm sigsmin henmstgoi deu ot igben tsh)aeeuxd

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thefoggymist  Nvdi,remen I hitnk I tog i.t eBta teladiactnre clsle tcnnao nfcitnuo dan xertcee rcbbia bseucea we d'nto ahve cl.edohir aeY yprepatlan I aws d.esahetxu +



 -3  upvote downvote
submitted by โˆ—amirmullick3(76)
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Very syea sqi.teoun Nslnbuooii om.tiv 1 nmhot ae.g Mots elykil ncoseira si ylcripo tsn.oeiss

heT initgomv casuse ossl fo CHl os ew have hte myhcl,irhaopeo dna lraen taeicnnosmop fro sthi H olss i ybs egnspeirvr posonrt ta hte exsenep of K os htat sgiev y.ekpilaohma As hte dsiasee si ndaem, teh oaerrdwr in eht magei fo teh thomcas is motosh lscume prpohteyhry fo eth ocilypr cualrismus saemouc, toihm refng dp-esahviloe ssma etlf on itpoanap.l iThs is a bmloateic ilaaoslsk uceabse ttohiuw l,C- eht el/t oOClla3HrasbaC rhagcexne lilw tno rwko, os uoy itaren HC.O3

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