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Retired NBME 20 Answers

nbme20/Block 4/Question#17 (reveal difficulty score)
A previously healthy 55-year-old man has ...
Renal artery stenosis 🔍 / 📺 / 🌳 / 📖
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 +17  upvote downvote
submitted by hayayah(1212)
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osAl, you n'tohdslu eb eeigsn negoarn-d maaegd ro carneiesd irnen / dnikey eespnros tiwh a opserluyvi ytlhhae iettpan tath jstu pdvedolee ieaslnset NHT. The obdy 'oendts atnw to renecias ernni nweh it has TH.N wrHov,ee if yuo aveh ,ontesiss hte nyekdis krafe out bceesau h'eeryt ont geigntt gheoun wlfo dan khnti het whole ybdo 'inst ,trheei so htye vteictaa teh ARAS s.ytsme Wnhe you give tehm an EA-,IC teh nrine is sitll bgnei ocprddue yb the k,endyi it tsuj ntsi' ibegn dcroteevn to nigi-naoIens.tI

To ealmeniit reoth sico:ceh

  • eH sah raesdncei nreni yctitiva os uoy nca meetainli apimrry loearmstidn.os That sah c.ni toedsr,nleoa ed.c n.enri
  • oN snsig or xss of gusishCn' os hta'st nte.iimelad
  • 1-ly1oBsdeyx-rha dineicyfce uodlw xss hwti the litg.ianae oYud' veah ecd. niern cttayivi (ekndllsioaoeetr- ceffste lslit n)rept.es
  • eEsilsatn NT:H lpaeexidn obave
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sammyj98  I keli yuo gtinskic pu ofr hte iye,ksnd gkniinth re'teyh garsnnieci Rnnie ofr hte itfbeen of eht ohelw y,dbo ubt tlse faec it, the ydneisk rae a ocuepl shleifs cksdi who tanw eth ihgh bdloo rseespur lal orf trlsral ettlfahecSdmrviee.uLenVisyoit +13
trazobone  ^ I lveo evrignewi sMNBE ofr ocstmmen leki ihts 😂 +3



 +15  upvote downvote
submitted by monoloco(155)
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sA a rleu of hubm,t if uyo gevi eosmeno na ACE inbioithr adn htey etg a l,prbome htey dha nlera reaytr ienossst lsuayul( ,bytaelriall or os ew ewer taghut ta our emd ).hcoslo ylbbPaor sha to do wtih aesddceer RFG tahskn to dreeacsed gseniontiAn lescIeIiev–t icnnooctastvisro fo the nefeertf arteoelir g&t;= addecseer dsmoui reviyeld ot cluama nedsa =g&t; srainecde inrne aeselre.

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lilyo  rnciotosViscoatn of eht ETFEEFRN rtlreiaeo atallucy easdl ot srcineead G.RF tI velctiees IOALTSNODVIA fo eth reeetfnf latroeier fcteef of CAE tiniibsroh nicse yeht nudo ignneistoAn II n.tioacs Thsi tnatpie arlyeda has dreesuc narel blood fowl eud to baleltira leran yarter osin,etss eht dnodiiat of na EAC inhrtiibo freturh dercesae FGR ipnmgptro an ariecsen ni rinne ued to slos fo tavegnie caekbde.f +4
drpee  We houdsl ylaaws cetexp RGF to drop a tltiel trafe agndid an tin-bhAioECir deu ot efenftre rrlaetai lasdivn.ioato For thsi enoars we olsdhu saol pxtece niRen evells ot eris via uumlerlrbogtolau edekbca.f oS tis' tno laelry eht rinectao ot the AEC ntbhiiori ahtt viseg tsih waay sa ASR h(icwh is hwy I tog ti onrg.w) I ntikh whta ew ear ptexcdee ot eb nkoligo ta it rea abl suvle:a ial,apkemyHo dan eoracnsdy r.rposeenadmoilshty 1a3/1a5s/7/1fis15/h0ta21ef7gw1gr-hfapw2ip/-o0/04tf0r./0.t0:w.ppp +
stepwarrior  EAC iiirhstnbo wulod aculltya haev eht oeppitos efcfte fo I,I-AT nad esrutl ni refeetfn otaiid.ln tuB the acutal memscinah of esencarid inenr ayivitct epr oWrUdl si lkca fo etysscmi coaositonrncvits by II-AT dlenagi to dbool snhnutig aawy orfm hte deyk.ni +1



 +1  upvote downvote
submitted by medstudent(18)
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I gredtgsul wiht hwy htsi ’nlctdou eb lestenais HNT rfo a ehi.wl I nthki hwta ti csoem dwon to is hsti, dan eonesmo eplh me out fi mI’ ceotimn.l/opgnerw

In btaleirla A,SR ECA inrohtsbii will rsecaeed the GRF ormf ldtainoi of erfeetnf ietorerla dna yteh a’cnt rnaiesec hte GFR etrrfhu eacuseb yrhte’e dlyarae axdem tou on teffrnae tiaolind to kepe up FRG in hte fsitr c.lape

In lsaintees HT,N yse CEA inshoibtri aeerceds FGR ormf niiatldo fo feteernf tles,ariroe oeerhwv tyh’ere ebla to ainaimnt FRG uhorght uriaalottgoneu besueca tehy n’htaev udhtoce reith aefrnfet errle.iato So isth neams htta irenn ’notw lutalcay escrien.a

:TRDL; lBrilatea SRA si ueblan ot use glonutuaertaio ot eroctcr the sdeeaecr in GRF erweh elastesin si bale ot.

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trazobone  I salo tpu nslseeait NHT. Btu uyo uldow aawsly see na rinesace ni rnien ayvttiic ehwneerv ouy vieg an CAiE bc t’si gbconkil het onsaewdmtr hatwapy (on gIAI or aeeosndrlot ecsftfe), gedsleasrr if hte pt ahd RSA or estesnali T.NH heT easm soge for .AsRB So my utthogh rspoces ,si cesaeub rnein dna aestlonrode esllve weer layinitil ihg,h stheo rea uooivsb scsuea fo his H,TN treeeofrh it tn’ac eb elenstsia NltiaTsn.H seE TNH is eerlatd ot na creeanis in OC or ,TPR welhi enyracsod HNT is edu ot uavaerrecaonsn/llr asidssee & SRA ro elstyrarho.onmepids A1F8 p 692 +2



 -2  upvote downvote
submitted by md_caffeiner(83)
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19AF auevnRsl95o :cP2ra siae:esd laenR iapemnmirt eud to sceamihi mrfo nlare earryt tsiesosn ro rrlvuoscimaca . si nderalaees ifunspreo o(en or hbot i)snkdye nCIŽeirN n   ŽICN eogniannits Ž HNTi Ma.n scuaes of rlnae ryatre osiens t:ƒs cirlehotrAostec qoi—plmuapealrsx d31/r nfloera ya,rter lylsuua in droel maesl, ksermoƒ. s rbcuFualsimro id—sslpaaaltdisy d/r32 nolf rae eaytrr ro mtelngsae ecrhansb, luausynuyl og ro aldid-demeg cnelyal,C.i aimlself tsneipta acn eavh ear ryrNTotHcf htwi gvetnaei myiafl yrsthio of emiN cmsytTa,Hr lanre e,zis riscpaelf/tigakn s Mtutirbos. oomcnm eucsa of 2° HNT ni O letartd.suh ergla sevsles are foetn vinoevdl

A19F P 965: rogvnit icne oesnA-nngti hCp rtb ineoytiser,ozlmipnai pal,lneari ,lorpiiisnl hmapirliAsi.NmCE rm tbiinIh CAE Ž DCER TA II Ž ERDC GFR by gneniepiscotoncrrnittv fo terefnef lioa.rerset n CInRrNie t udoe sslo of taegnvie daekec.bf

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