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NBME 20 Answers

nbme20/Block 2/Question#42 (34.5 difficulty score)
A previously healthy 32-year-old woman is ...

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submitted by loopers(9),
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Vimtogni oodlb nad ocol kisn catdnseii itsh si a ytep of yvciplmoeoh shkc.o oT eutnasrdnd cso,kh bmerreme ttha 1) PB = TPR x O C)2 CO = SV x 3RH) SV = VDE - nV SIE cmeioohlyvp h,cosk ouy rea gonsil i,lduf so tkrseo muoevl si rededceas dan nde iolaictds vuolem is ceds.aerde eeerDadsc VED asnme htat eth lfng"lii "lmvueo si ,dceaeerds chwhi osla esman hte lopaerd iwll eb esedradec (:/pyCtiycuao0F0n0lodogh2pv.//it7soc.%Fcwitmwncrwa/hCs). ,lAos ksin is oloc esacueb r'yeuo eancedgsri SV -;t&g- ecderdeas CO ;g-t-& Ang cI/HI/AetD si dsrleeea ot ctvcaorntosis aingesenrci etrisean.cs Secni rethe si ceaersidn ,nssitceear rteeh is essl boodl wolf gnausic snki ot eb a.y/dcmlolcm

hello  Patient in hypovolemic shock - the clues are low BP and COOL skin. Hypovolemic shock is caused by fluid loss. The patient has decreased preload b/c of fluid loss, i.e. there is decreased blood volume returning to heart --> thus decreased preload. +8  

submitted by hello(349),
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eaPintt ni cheiopovmly oskch - teh cesul rae wol BP dan LOOC isnk. poeclvioyHm sochk is aeucsd yb idluf l.sso

hTe teapint sha aeeecdrsd elpdoar bc/ fo udfli ssl,o ..ei etreh is dedseaerc ldboo vmelou nrrgitnue to rhtea ;-t&g- usht esdecdrae eadr.plo

endochondral   why not dec SVR? +  
sup  @endochondral w/ hypovolemic shock you would see increased systemic arterial resistance as arteries will constrict to try and bring BP back up. +2  
eacv  @endochondral dec SVR it typicaly of septic shock. +1