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Retired NBME 21 Answers

nbme21/Block 1/Question#37 (reveal difficulty score)
A 35-year-old man with diabetic ketoacidosis ...
Serum potassium concentration ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—an_improved_me(91)
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lbkeefcaco@f;

nnsuIli oesd lpya a oler in ngnrgiib ckab K+ nito slecl via dnmaliuoot fo K/H++ ang.hecxe Tshi is aesebuc it epslh to dsdsrae the dockatotieci attes of teh ti.tpnae By ngnigbri pH lesorc to einablse, rthee si utrren fo K+ oitn the lcel,s helwi +H mscoe ackb uot fo eht slec.l

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an_improved_me  eerw,oHv you ear ih,rtg in ttah oot my geoklwn,ed htta is nto eht iamn yaw nilisnu nselcuneif ;K+ it si oemr aiv the eaATsaNP as uoy vahe imnonedet. +1



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submitted by โˆ—nala_ula(127)
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In ieibtdac isoeoaidskc,t rtehe is eeridnacs idac in eht ultaecelalrrx spca.e ccinrAdgo ot AF erhet is a clrtuealnrsla fhist eud to ceseedadr usinlni atth aleds to mero +H ginnteer eth llce in cxheange rfo .+K This selad to hrpkelmaiyea thiw letddeep aculrilreanlt sroest of +K. reheT si asol ooitscm eriuisds atth lesda ot nseraedic K+ ossl in hte nueri adn taolt boyd +K eentlpid.o Teh etiosnqu asks taht is somt llykie ot ereasecd wiht unnlisi :pehyatr seurm usptmioas inrncntoeaoct ilwl receeasd as +K si now dexnghaec ofr +H deisin the l.ecl

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cienfuegos  dndtloAiia WU nfu cfats negdgarri itsPmuosa nda AKse:uD uaintco niiggv uliinns and VI suidfl ot dyaeedhrdt eyrphiymeclgc cbsueae i reofcs K ni lclse gniacus sfta derecsea of llceaaurlretx moa,sitsuP stuh iveg K saimptoupnleent eevn enhw mures K eleaedtv +3
linwanrun1357  Wyh nurei K+ sdoe nto ederesc?a +3

This explanation is faulty. Insulin causes K to go inside via upregulating NaKATPase activity. Nothing to with H+ exchange as far as Insulin is concerned.

H and K exchange is separate from this.



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submitted by โˆ—peachespeaches(2)
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I greae atht rmueS K acsderee is eth rtbtee swrn,ae ubt do'lwntu neUri K laso esdaeerc ncoe lodbo aurgs gose onwd twhi niusiln eatrtmnte (e..i stcooim suiridse louwd ?ssle)en

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