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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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VA iusasltF urter-o ldobo rofm hte lartirea ytssem to eht eonusv mssy,et ig-snasybp eth tAroeesrli = sreeaIcn LP tg-;--& CENSIREA .VR llA in lla = acInseer OC.

iAncdcrgo ot rldU,oW het irlertoaes era a oarjm ercsou of srsaiceten ... os pbsnayigs eth rlestoerai stsleru ni a reeaescd ni altTo aeprPilhre tRescsaien ... ngsucai an escniaer in hte aret dan lvuome of lodob nriegrunt ot hte her.ta I ma ryptet ures hteer is orme ot eht oogisphlyy dehnib sthi, utb I pohe isth ieaexlnpd a illt.te

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big92  atdIyi"lmeem oloiwfgln ,eaiontcr teoseoriuvarn istfual VFA() si scasitaedo thwi na eiecnras in idcarac ouputt )(,CO eivcdhae lamdritponeyn rohugth a oirdcuent ni esytmcsi avacrlus s,etieacsrn ecrsdiean ordlyimcaa rcitytlnicoa,t adn an icearnse ni rkesot leoumv )(VS dna thear rte.a evOr eht olnfiolwg e,wke cuaicntrgli bldoo ouveml raesensic in joccninutno whit aernceiss ni ailart dan anrbi tuaeitnircr eedsptp.i eeTsh sottilanrae rea oascasdeti wtih alrey eassenirc in fetl tvnclrireua VL() gilfiln sspurree hitw teh openltait orf lsutnerta mtpcia no ilaart dan rutnirlveca mbrcahe smeniisond adn c".tfnnoui D(MPI: )h2sr5T' 554ee 285 osla teonarh ysdtu by Esiptne mofr het s0915 kogioln at het fefsect of 'sFVA eectff on OC ni nme DPI(:M 085)3172.1 rn,yplpaAet the sniereac ni gtnisre CO si a gbi pebmorl easecbu ti anc leda ot pt-huoiuthg adcaric elafuri H.L()V +32
hungrybox  essuJ gbi92 ouy nwte ni on eht ereacrsh lmao u tsmu be SPTM +6
temmy  2b9gi uyo era i.rght htta is ywh peagts dsaisee gseapt eahv ihhg touupt icadarc ruailfe usebaec of hte av sstn.uh +5
kevin  athw is eea"iscnr "PL +6
jhan17  ncoigrAcd ot iW"wneh ki na erinouatoesrv ltsufai is modfer iogivnvln a ormaj aryter ielk hte maoilbadn a,rtoa ti acn leda to a gaerl cseeraed ni rrehpielpa eanssircte eebcasu it yb spas raieteorl her(we rmaoj PB is ef)dmor . Tshi lworeed eeprilaprh ancreisset auescs het rhtae to ernsaice nteirgs caiacrd tutuop ot itnainam eporrp lobod flwo ot all ues."tiss +



 +6  upvote downvote
submitted by ∗azibird(279)
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I d'otn elfe elik any of eetsh omtesncm aevh fully esrddasde hyw eht tpatein yrulrcten sha reicdenas sitergn CO and OTN adceredes .VS Hree is who a nfeird fo emni xeanipdel ti:

APM t(a srngeit )HR = 32/ PDB + /31 SPB = 77 mHgm in hsit ttpi,ena cwihh is lwore hant loamnr 3(9 mgmH fi yuo esu 0)802/1. So MAP is rdcaeesde nda teh n/ihsydeeorkt ganors nter'a etitngg teh fpeionurs yhte dn,ee ladngie to SAAR nitaaticvo adn eOaBeSm/d. MPA = OC × ,PTR os hits odcul be edu to lwo OC eirvetla ot RPT wtha( ew uuallsy e)texpc or lwo TPR teirvlea to CO. This ttp'nseia egrla AV afutsli sah dodperp reh TRP eyvr w,ol hhciw aemsn reh OC tmus vahe enbe eryv hihg for the tpsa 51 sarey ot asemocpent hhi(g otutpu ethar felau.ri She sah lnyo 5 dasy fo soytmm,ps hiwch seman ehs is ryeal no in reh F.H icSen esh adh chsu a hhgi OC to bgeni with, rhe dopr ni VS tsih laery on louwd still valee hree twih an ERIESDNCA SV damrecop ot a rlanom tpntiae. elUnss rhe pselu is pruse gh,ih reh eahrt stmu be pgpiumn a mssavie ktsoer uevlmo to iaiannmt a lrnmoa ytolssic oldob sperseru hitw shcu a low PTR MPA( = VS x RH x .)RPT antl,uvleyE rhe VS may rsdeacee ot eb ewlob rmlan,o tbu ont os raely n.o

For e: tNlentcooesspm ddsearcee tlaiaerr 2O tsa acuseeb oobdl is ioflgwn fomr raerty ot in,ev ont teh htero awy Ntod n.uroa deeraecsd edmix vonsue 2O sta abesuec aelirtra odobl is gioodfnl hte iuavabslnc nvie irght boefer ixdem 2O ast lowud eb rsote.dmauNe readesicn VRS ubsacee fo hte eglar VA utlfa.is

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 +2  upvote downvote
submitted by ∗the260guy(18)
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Btu 'sehre ym prlbemo ithw hits oe:tuqsin ti asys ahtt hse sah a 5 day tryshoi fo SBO and elwsnol ge.ls So uislyobov hte htaer si ifan.lig I pkicde adceerDes kterSo mVouel rfo htta a.noser

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nwinkelmann  VA uftsisal aer eno uesca fo uhu-ohttipg ariccad .ieaurfl siTh eprons nesspetr ithw rhaet ialrufe, ubt it si ude ot calihcrynol eicdasner iegtnsr .CO +2
lukin4answer  nnw@enmlkain sye taths ,gtrih eh sha gnfaiil rte.ha but otqeisnu is asingk htaw is eht nfinidg fo stih p,tiatne I aesdtrnund hte ausce is auiFslt scniuag hgih tuotpu afur,eil ubt eyth i'nddt ksa teh onarse fo sih ,HF hyet era isgank teh gn.idifn I osceho esdreeac treokS OVelmu :/ +
happyhib_  sihT aws my lcoig and got ot eecresadd streok veumlo as wlle; teyh enart askign awth caedsu shi FH or gahinytn it sysa awth si eht tmos lielky nigifnd ni sthi atpinte. If shi rteah is aiiglnf ude ot HLV form ssninecott ieseadrcn CO tolunwd eh AT TSHI YEVR TMNMOE HWTI his ethar ainilgf have sdaceeder tkerso l?ovmeu.. +



 +2  upvote downvote
submitted by ∗usmleuser007(464)
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CO is nrcsieade ithw 1) eeaddersc frea2oad)lt isacneder 3)rpela od srIcdeane tnicaoictlytr

nA aoritunsvoee afusilt reetasc na ervtalenita rutoe fro tiaalr odblo iotn het ouvesn lutricnacoi w/o ggnio psta eth earstlireo e(ht ramjo sucae fo eTcihn)uasrst .se, yb inodg os hte TPR la(a)ertdof craessede and eth OC is naes.ercdi

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 +1  upvote downvote
submitted by ∗uslme123(86)
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V'AsF = sinceaedr acdarci tuUtBp o.uT ihst 'nist new for shit npe?sro I viwe tsih sa a rtahe atth ash yilnalf ubnge ot alif -- ecersdaed eftecveif irtrycucalo veulom --tg;& caierndes .RSV

tBu i geuss uyo nt'ac eahv B eerbof A -- teharewv \--

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happyhib_  ihs bp aws gnoiehtms ekli 01350/; whit iasdoictl ondrua 05 I rdifueg he otuldnc vaeh resdeiacn RVS eueacsb sih itdiasloc wuold be gh?ehri +2
trazobone  I dah sith same gnesraino I ycmpteleol lsgodse vreo het PB 🏻🤦️♀‍ +



 +1  upvote downvote
submitted by nuts4med(8)
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oynnAe haev na daei ywh het dsaerdece iaretlar O2 oasrtiunat is rrcectino? susimAgn esh has plmu daeme sneci hse ash EL eamd,e uodwn'tl a wrole O2 sat be extdepce t?oo

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haliburton  I bveelei teher dlouw be on deeaecsr in 2O notatsuair eabcesu edgeyoantx lbdoo (ghhi rep)srsue si tduenhs ntio deexdgtoyean .criituc sA glno as teh nlgus acn ekep pu, siht suhlod escnriea uvnose tyngneoixoa no ga.ereva +7
hungrybox  yt obht of ouy fro ,tshi wsa godnneriw het easm gnhit +
coxsack  O2 tsa ’otwn cenagh c/b eru’yo ont inagdd dyenoxagtdee bolod ot hte rrliteaa .sied eYu’or just niktga lrteiaar doblo nda tngtpui ti oitn ousevn .bdolo aSme rasnoe hyw >RL- cicadra hsnuts ’nodt cadseeer 2O ats leiwh( in attrs,ocn a LR>- shunt do).luw +5
hungrybox  jtsu eiladre:z hte ihhg repesusr of eht ieaartrl etsyms ksepe uto wp-ursroesel nosuev boold in an AV asutlfi rayopbl(b osbviuo ot mtso lpp btu ti aws a ereaku nmemot for em oll) +2
chandlerbas  ya uyo otnw ahev raedsdece tlaeairr 2O ast acbeesu yognaitenox fo bdloo si pufinreso teidlim 1(AF9 )--645 htrreoefe ongxnaoiety fo teh bodlo pshapen wtiihn the fstri 3o.dssnce fo enetnrgi eth uraoylnpm arcpailly taht uoy dluoc veen edhaln ianhvg eomr toyegdxenead dolbo nteer +



 +0  upvote downvote
submitted by ∗step1soon(51)
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raetH lurfai:e isTh si eht stmo uoiessr inalccotimop of grela uiasterernvoo .lifsutsa enSci yruo odlbo wofsl erom iqlukcy hutgohr na serrvoanoutei tuiafls hatn ti owudl if yruo oldob odelfw urohtgh a nalmor reuocs fo esrai,tre ilacspaelir adn sve,ni oyru hrtae pmusp rrahed ot eaepmsocnt rof eht rpod ni dbloo peuerssr l(dlace hg-utiouhpt teahr urla)eif. rOve imt,e teh enreadsic yttnniesi fo ruoy 'rsheat pinupmg nca eaknwe yrou ahter ecmlus, ndilgae to threa fe.urail

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