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Retired NBME 21 Answers

nbme21/Block 3/Question#35 (reveal difficulty score)
A 63-year-old woman comes to the physician ...
Increased resting cardiac output 🔍 / 📺 / 🌳 / 📖
tags:

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 +20  upvote downvote
submitted by cellgamesgojan(43)
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AV Fiusstla ote-urr odbol mofr eth arteliar etssmy to hte sneuvo se,tsym ay-ingbsps the tosAreiler = cersanIe PL ;t&--g- AISNRCEE R.V llA in lla = eIeacrsn C.O

giconcdrA to ,drUolW het talioeserr era a rmajo coersu fo enaircsste ... os bpngysias the iratoeerls estlurs in a dsereaec in atoTl pParleheri sanstReeic ... gcuians an erancies in teh raet and elvomu of loodb niunertrg to eth t.ehar I am pretyt rues there is mero to hte glhyoosyip eibdnh h,its tbu I eohp htsi leeadpxin a itel.tl

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big92  emtmyd"laIie lwofnlogi ,oatinrec eveuroinators usaitfl AVF() is taedsosaci hitw na arscenei in raiccad ttouup ,O)(C eedciahv pimtnoleryadn hhortug a unorteicd in tyecisms lacsvrau ersstnci,ae deersncai laciodyamr tya,intltriocc dan an eeracsin in koerts vmleuo S()V nad rtahe rae.t eOrv het nllowofgi kw,ee girctcluani dbloo louevm eensrisac ni oujcnnnoict ihwt cseasnire in ialrat dan aibrn tariucinrte sppdt.eie sheTe eriatntoals rae itsaosedca iwht ylear ainscrsee in ltef tcaelvrniur )V(L nilfgil epsruers thwi hte paniltteo for luaenrstt mitacp no raliat dan tcrulvnaire bemcrha seondmiisn nad c.ofni"unt (D:MIP 552)e2T s 5 4her'85 laos arhonet tuysd by Eestinp mfor the 9s015 inokolg at eth tefcesf of VsF'A ceefft on CO ni emn DMI:(P 0.3)281751 nypA,artelp hte eciarsne ni gnirest CO si a ibg lropbem acubese ti cna aled to uupoghh-tit adcrcia lrafuei .)LHV( +32
hungrybox  useJs 2b9ig you twen in no hte asheercr mola u tums be TPMS +6
temmy  g92ib you are h.tirg atht si yhw gapest dsiaees geatsp eahv hgih uptotu aiccadr feailur seuaecb of eht va n.hsstu +5
kevin  ahtw is neca"rise "PL +6
jhan17  ccrdoAgni ot keiw" hnWi an nsrvtriuaooee autfils si mdrefo inoivlvgn a rjamo yeratr ilke eht lmbnaioda rtoaa, ti anc aled to a lrega seedcrae in perlphiear ctiesnreas uebscae it by sasp ioetrrale hre(ew jmrao PB si emfd)ro . Thsi doewerl ihlpaererp tcaeniress scusea teh hater ot iceneasr stnregi ciacard otuutp ot tmanaini errppo oolbd fwol to lal u.e"ssist +



 +6  upvote downvote
submitted by azibird(279)
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I n'dot elfe kiel yna of sehet cosnemtm vhae fllyu eddradsse wyh hte ptainet uernclyrt ahs aesdicner sgreint CO nad TNO rdeacedes SV. ereH si who a nfierd fo mein ndieaplex :it

PAM t(a setgrin RH) = 23/ PDB + 3/1 BPS = 77 gHmm in shti ittnpe,a ihcwh si owrel tanh amroln 9(3 mHmg fi uyo esu 1)020./8 So MAP is eeacdesrd and hte /iynsktoerdeh snraog a'enrt gtiegtn het seonfiurp they edne, ndiegla to ARSA ovatcatiin dan ede./OaSBm MPA = OC × PTR, so sthi oulcd eb ude to low CO lrvateei ot PTR h(awt we alyuusl tecex)p ro olw RTP rtivelae to O.C shTi pnti'sate grael AV aftlius sha rpeopdd rhe TPR yver ,wlo ihchw msnea her OC stum aehv been ervy hhig ofr teh spta 15 ersya ot pmcantsoee (high poutut htera afru.eli Seh has only 5 aysd fo mossyt,pm wcihh esman ehs is yrale on ni rhe FH. nceSi she adh ushc a ghhi CO to biegn hw,ti reh rpod ni SV hsit leayr no wduol lsilt lvaee erhe ihtw na CNDREESAI SV reomadcp ot a amlnor .eainttp seUnls erh lsuep si resup ,ighh hre rahte ustm eb nguppim a msiesva toskre oelmvu to aniatnmi a rlamno solciyts dbloo eupsrrse itwh husc a owl RTP A(PM = SV x HR x TP.R) llveutEan,y her VS amy sdeeecra ot be loebw ,noamlr tbu ont so elyra n.o

Fro lc eNos:ptnotemes daedecrse eaatlrri O2 ast uesaecb dobol si fgwonil from yerrat to n,vei not het trohe wya uN odnrtao. eeaesdcdr xdmei evusno O2 tas cseaebu araretli oblod si oolgnfid hte luavcsbina eivn htgri beorfe xmdei O2 sta wludo eb .tNoesmadeur raecesnid RVS ebecsau of eth gearl AV fti.uasl

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 +2  upvote downvote
submitted by the260guy(18)
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tBu hseer' my leprmbo iwht ihts en:squoti it ssay tath hes sah a 5 ady tyoisrh fo SOB nad lnoewsl .lesg oS uobvisyol eht atreh is ii.ngalf I dckeip edcresDae Skroet oVmlue orf ahtt san.eor

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nwinkelmann  AV uisatfsl rae eon seacu of upgoh-ttuhi idarcac feir.ula Thsi onepsr nseestpr ihwt tehra luiearf, btu it is due ot clroyhnlica dnereaisc gtriens CO. +2
lukin4answer  lkenwnnma@in yes thsat rh,tgi he sha gifalin ehr.ta utb sieutonq is nagiks htwa si eht iingdnf fo htsi in,etapt I aesdtnrdnu teh seuca is laFtuis iacsngu hhgi tutpou ,ulieafr utb etyh dtndi' ska hte ronesa fo hsi FH, eyth aer niksga teh diin.fgn I hcseoo eeeasrcd tkSoer mVeluO :/ +
happyhib_  sTih aws my iolgc nad ogt to eadedresc oetsrk omlevu as wel;l teyh atren snkiga twha asdcue his FH or nahtiyng it ysas awth is eth toms ykliel nngiifd in hsit npta.eti fI ihs rahte si flagini due ot LHV ormf ctotsesnin irescedna CO otdwlnu eh AT ITSH EYRV TNMMOE WIHT ihs tehra ilganfi ehva radecesde trkseo vm?.eluo. +



 +2  upvote downvote
submitted by usmleuser007(464)
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CO is dsaiceenr twih )1 erdesecad tlf ea2)daor dnieaesrc o)d re3pal dranseIce taointtcyilrc

An vtarneeuioos istfaul trceaes na naetieatvrl eourt fro taalri obdol niot eth suoevn uclniaocrit /ow iggon astp hte oistrreale ht(e amjro ucsae of uisah.s,)Tcs neetr yb ondgi so het TPR ade)altro(f eacesders dna the OC si eir.dcsena

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 +1  upvote downvote
submitted by uslme123(86)
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sAV'F = isedenacr icdcaar . pTtutouUB siht in'st nwe rfo tihs eor?nsp I vwei itsh sa a etarh htta sha yinlafl guenb ot flia -- sdceeadre ftefcveie racrlcyitou lvuoem t--&g; rsiacdnee S.RV

utB i essgu you ant'c aveh B boeref A -- vehwaert -\-

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happyhib_  ish bp asw itgsneohm keil 5;100/3 with taiicosdl anodur 05 I gfdurie he ntdulco vahe neasdcire RVS ecseuab shi astilcdoi ldwou eb ihghre? +2
trazobone  I hda htis sema easiornng I lptoylmeec edsslog voer the PB 🤦♀️‍🏻 +



 +1  upvote downvote
submitted by nuts4med(8)
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ynAone evha an adie wyh hte cddereesa raraliet 2O outsaatnri si ctcn?irroe umgAssin seh hsa puml emdae csnie seh sha EL daeem, dotnlwu' a owler 2O sat eb ecxedetp o?ot

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haliburton  I ebelvei rhtee ouwld be on rdesaece in 2O satuniorat buasece xedagyoetn oolbd (hhig er)serpus si snudeth otni gadnetxeydoe .irccuit sA onlg as teh usgnl acn epke pu, isth ouhlds nscariee eosnvu gxonyienaot on .eaagevr +7
hungrybox  yt otbh fo oyu fro h,ist asw iwennrogd hte eams thgni +
coxsack  2O sat nt’ow anegch bc/ ’yoeru otn ddniga eayegddtonex dlboo ot teh aitlerar esd.i uo’reY juts itagkn rrealati doolb dan tgnitpu ti tnoi ovsuen lobdo. meaS eonsra yhw RL-> iarcdac htnsus ’tnod eedresca 2O tsa hlwei( ni atoscrtn, a R-L> nuhst .)wudlo +5
hungrybox  jsut :dzleiare teh hgih sueprser fo the liaartre smstye espke tou erulo-rswpes uveosn bdool ni na AV itfalsu b(oplbray vbiuoos to tsom ppl btu it swa a ukeaer moetnm for em ol)l +2
chandlerbas  ya ouy wotn heav eeesrcdad rltraeai 2O tsa eebcasu extnayinogo of olobd is runespfoi eimdlit F(19A )45-6- terehefro onyatixngeo fo the odlob penspha ntiwih het risft dseonsc3. of ninetreg the yorupanml alpyalicr hatt oyu uoldc even nledha navigh more exeyendotadg oldob neter +



 +0  upvote downvote
submitted by step1soon(51)
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ertHa ar:ifleu sTih si the stom eorsisu naipmlotiocc fo rgael reotisueovarn s.utlfais neicS oruy boldo sfowl meor uqklcyi thghuor an voiteenarrsuo flatisu htan it wdolu fi your ldoob lwdofe hurohgt a lornam seucor of ra,rieset calispeliar nda ,venis ryuo trhae suppm drrahe ot seenmacpot ofr teh ordp in dobol sseuperr lcadel( guphtuo-ith retha ra.ifuel) vrOe itme, the dnesciare nnttiseiy fo oruy 'atshre gpinpum nca neeakw oyur hetra seuml,c endialg ot eathr iera.flu

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