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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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heesT tlaponanseix tnear et.rag tI densot erylal heva umch to do hiwt RAAS oatcvinit.a tI has omstal netgyvhrie ot do iwth a nhemoenpno elclda eht llniakae di.et nI hcrconi inttvog,mi yuo owuld xcptee -lC to eb wlo nda =K to be lwo islr(mai to lba sluters in eoeonsm ihtw elabu)li.m To pmasoectne for eth wol l-C, het ocamths ash an irnprtaoet whhci xeescnhag lC- orf HOC3-. fehrroeT,e -Cl lwil eb pereehsndil in hte tschma,o hwiel 3H-CO iwll nieasecr ni hte ,loodb niusacg an .ksalslaoi nI oiaalclkt tsa,ets eth /H++K apirtoernt llwi ibgne ot aic,tteva snifitgh +K NOTI llces oah()kmieplay nad nseacngiir Hp. AASR laryobpb lpsay a lreo ni mkagni eth amlahpykeio srowe tub teh ilaknale iedt si meor itmrtanpo e.her

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spaceboy98  snIt aallknei dite rtaeedl to an aescrnie ni pH etarf las?me uorY oglci si on ptoin btu Im' nto ures whetreh ew cna pylap atht pctoecn h.ree +1
kevin  ectnocp can eb dlippea rhee aseucbe ew ende to tepeelr het -Cl ni droer ot ecrtae lC;H het sthocma estn'do aecr if l-C is owl ni eum,sr ynlo htta -Cl si wlo in eht atpleira lcels dna so lwli mppu uot 3H-OC ni its peneexs +
usmleaspirer  hwy is K+ o?lw +



 +6  upvote downvote
submitted by โˆ—hayayah(1212)
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htiW noccihr t,iovmnig oyu osel ltlreyostece adn a olt fo .daci tI gerrgsti meiobclta oaakslisl hhcwi si yhw lal eht umsre uasevl ear wlo ro( on the wrleo edn of eht noalmr r)enga pxetce ofr ataobc.ebrin

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ergogenic22  eceesdrad K+ ormf( ereanscdi ARAS edu to ovlmue slo)s and ecerasedd -Cl s(los of HlC orfm eth atm)oshc, ksliAaslo frmo sols of lCH dan thus gihh b.cioar r Fb this oaesnr ghih to idm aregn K si wgorn +5
sbryant6  tdWnlou' cedsnaeri RSAA aled ot ecrndeisa Na+? hTe reswna hwsso deaesdcre N+.a +3
sbryant6  Asol, rebremem uiaBmli seroaNv is eaotaisdsc thwi aeamo.klyihp +1
sugaplum  os het geran they egav rfo K is 6-?3 os 2.3 si WNL hn?te ro aer we jstu grnotiepa no it" si on eth eowlr edn fo amolnr ni s"dep +2
dbg  idsoum esvlle in oilprcy ssniesot y,arv hinngto earlly slcc,ias nac eb hhig sa ni hsti csea simpyl ude ot t,dionhayr nca wlo in hrote esacs if etdrsonlaeo dnaamge to rseerve tath ot eht htero exeretm +1
skonys  cohl,crHm"ipyeo ayhleimkcpo miaetolcb alokalsis is eht csaclis ertltyeolce dna sda-iceba nlmceaiba of coriylp nsts"eois mrfo cdmseaep dneibh iwlpn.giam oytlVa = oveulm loss d(ce niks u)rogt sa ewll sa osls fo H,+ -Cl adn Naht(w+i )2H0 g-t&; oitlceabM Ala.klisos osLs fo +H aescsu cirnaese -3OHC otnrteein sa elwl sa +K sifth toin llesc hlkeaaoiyp(m 9A1F 5).87 +

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 tobmialec llai,ssoka moapiusts mesov itno teh lcles

ehT olss in vueolm ogthurh essemi rigetsrg AARS iltnregsu ni edsianerc lseodreAotn easeerl dna rhutefr pamtuisso xireoncte

t.swee.waw//btt1ha:plt/dnpi61/et

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 +3  upvote downvote
submitted by iamapotato(3)
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No noe ehre dotheebr ot aaltlucy uscisds 'wthsa ogign Tno.ihs is a nhtm1o- old .nwonebr

eH tivmos aerft ,gefiends dya5- syh.oitr

At 1 nhomt od,l wtih noigimtv fetra geednis,f ti is mots lyeilk a ecsa fo COYPRLI NITSOSES due ot yhpoeythrpr fo eth yrcoipl iptscnrhe luasy(lu cocsru 6 sewek tl)e.ra

euD to him iigvtonm chsomat octn,tens he lliw OELS lC,- K+, adn a.+N

eH llwi OLAS osle H.+ hTis si ywh uyo go toni the bmciaolet saloklasi wtih a rettsluan rneiscae in the 3OC-.H

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kamilia20  :y:kcthes ivoigtnm uceass loss fo WAETR ereatrg anht uidmsoโ†’ edcraeins urems iodโ†’sum ISREDANEC smuer toomsay,ill So NA ilwl ersedeca to,o tub on hatt rfa +



 +1  upvote downvote
submitted by ark110(1)
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tBu wath is eth eceierndff teenwbe itoopn A dan opiton C 3(12; .;49 ;09 )53

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sympathetikey  +K lhons'udt i.aescrne s'tI gmvnoi nito lelsc edu ot oacbmeitl slaoasil.k +
home_run_ball  nI the aiaplert clel of the cm tdosrHe ohgn ay iosn rea modref orfm eht asodsicniiot fo rcbocnia da.ic rWtae si a yvre ornim uocers fo oenrhgdy nsio ni pacnosorim to obancirc aidc. oaincrbC cdia si mdfreo fomr nbacro edidixo and wetra by cbonirac .eadhrysn aT eh anbctioerba noi HC)3(โˆ’O si angecexdh fro a hloriced noi C)โˆ’(l on eht aalbs desi of eht lcel dna het naoitebbcar uisdfsef noti the snuove ld,obo dgiealn to an lenakila dtei o.nnepmonhe +1
ergogenic22  ARAS ssreancie ormf meuvol ,slso nda uths rmoe rodseelanot aedsl ot wol +K +1
sinforslide  Treeh sneosra orf leko.apmhyia ,srt iF meos +K is slto in rtsagic .fisdul Sc,doen H+ tifshs uto fo csell adn +K sfhsti inot lscel in ibctlmaeo i,hilsdla.Tkors a CFE vloemu cranctontoi sah descua neiaecrsd itsercneo fo eroeanl.dots +3



 +1  upvote downvote
submitted by โˆ—rainlad(33)
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,creoyhcHlmpoi comlpkyihea botmealic slkoaials si teh slcisca ortelteeylc nda cbdaie-as ceiabmanl fo prcoyli oss.nesit

reeisPntst igmnotvi trsusle in loss of Hl.C hTe derhocli sslo utsselr in a lwo odbol riodeclh leelv chiwh mrasiip eth desnk'iy biyitla to cretxee c.nbatoeraib siTh is het facrto ahtt tensrepv rcrncoeito fo hte llaskisao adgeinl to lcbeiaomt sakls.loia

A ndrseocay nladpsestmhiorryoe slpeoved edu to the caeeddesr bdool vlou.em ehT ihhg lontaoedser lelsve cuessa teh siydenk ot irenta N+a o(t ocrcter het arurvilaatcns umoelv l,oipedt)ne dna crextee ciseedarn nmsuoat fo +K itno hte uiner grst(eilun in a low obldo evlel of ip)umsato.s

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 +0  upvote downvote
submitted by thefoggymist(12)
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I dno't teg sih.t u'onStldh eht ikdysen tarts irtcneocgr hte caibbr ellves efra 5 ayds? eTh ledeyad shepa of het oocerrticn censi eyht kaet .mti..e and in hte eioutqns e'rthey sgknai ""Wow.ne haev moceitalb ilassaokl cines HCL si tsl,o os hte yobd liwl tyr to erroctc it rfits yb eatyenniloirhvtp and tlera by crsaeinde rtexcnoie of r.baicb icaBrb udlohs be lo.w.. usnsle( I'm ssgimin hgmtesnoi ued ot nebgi eshdt)axue

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thefoggymist  ndmNeriev, I nkthi I tog .it Btae ldrteantecia cells tonnca ncfntoui nda etrxeec bcbair asbucee ew tdo'n eahv ci.edrhol Yea apanpyrtel I aws hsaux.dete +



 -3  upvote downvote
submitted by โˆ—amirmullick3(76)
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eVry ysea euqns.ito niNobisulo .mivto 1 othnm a.eg sotM liylke racoseni is ocpliry etonsss.i

hTe iivgntom cssuae olss fo HlC so ew ehav the ocpyelhri,hmoa nad aenlr tpniooscemna orf stih H loss s biy giprveners rnosotp at teh eenpsex of K os taht evsgi i.yoapmahkle sA hte eesdsai si amden, het aroerwd r in eth egami fo het otacmsh si tmoosh emcsul rreythoypph fo the ypcrloi uacirslmsu ,eamucos mhorifet gn lhsdaopieev- smsa tlfe on l.oaapnpti isTh is a lteaocmbi olaskasli aecsube hiuwtot l-,C teh lrCaHCt3lableoOs/ a eraxgcehn wlil nto ow,kr os oyu triena .OC3H

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