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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 tslaFusi trer-uo bodol mfor teh rareital styesm to het useonv mys,ste pbiysa-gns eht trloeiAres = naeerIcs PL &-;gt-- CEINARES RV. llA in lal = escnreIa CO.

crdAincgo ot WUdlor, hte lsaiteeorr rae a ojmra ouesrc of nrectiesas ... os giysapsnb the trlaeorsei susetrl in a adeesecr in ltTao rharPliepe seaietnscR ... sincaug na reacensi in eht taer and oevmul of odbol rnuigenrt to hte ehtar. I am yttrpe rsue ehter is more to eht ylyiopoghs hdiben ,tsih but I ophe hsit pxdinelae a e.tiltl

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big92  ydi"malmetIe igoonllwf ,ceanoirt srootreuivean futsila A)VF( is ocedatisas iwht an aeerscin in ccadrai uutopt C)(,O ecdvihea yordnealtminp tuorhgh a ncodeitur ni seymicst urvclasa eseca,itnsr eceansrdi dayarlomci ntct,lotiariyc nda an sncaerei in ksroet ulovme S(V) and tehar aet.r rOve eht iowglfnlo weke, ugcnicltria boldo vemulo ieenrcsas in oioccnnnjtu thiw enssareci in ilrtaa and bnari truieatrcni ip.petsed ehTse teilntoasra aer siatacsdoe wtih yrael raiesncse in letf avernlirutc LV)( infllig eueprssr tihw eht ntpeiolat for tusnaretl pmatci on airlta dna alrietuvrnc ehabcrm sndnsimieo adn o"ifnu.tcn MP:D(I 8Tr5h5) e5 ' es2542 soal rnothae sduyt yb seinpEt rofm het 1s059 ogknloi at hte sfcefte fo FAVs' eetffc no CO ni enm M:DI(P 73011.5)28 apl,etypnrA eht narceies ni sigrtne CO si a gbi epmlbro ebesuca it cna aedl ot h-gohiptuut crcdaia eurifal V)(L.H +32
hungrybox  esJsu ib9g2 ouy nwte in no het resacehr omla u must eb PMTS +6
temmy  g2ib9 oyu rea r.htgi ttah si hwy tsgpea eaisdse saetgp evah gihh ttuopu dcriaac iafrlue abuseec of teh av nt.huss +5
kevin  atwh is ei"nacres "LP +6
jhan17  rocAgincd to nih ieWk"w na utsioevoarern iaustlf si oredmf inlingvvo a roamj rreayt kile eth aoadblnmi roa,ta it acn edal ot a rgale radseeec in rhrepiapel raseitcesn eaecubs ti yb sasp rloeteira (hewre armjo BP si )erdofm . hiTs ewloedr eirpherpla eerscnsita ueassc het raeht ot ceanresi nrestig cacrdai ptoutu to iiaantmn perorp lodob wolf ot all "stei.sus +



 +6  upvote downvote
submitted by ∗azibird(279)
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I tdon' lfee keli nay fo ehtse tosmnmce have llufy sersddaed wyh eht enptait ruteyrlcn ash icenraeds netgsir OC nad TNO acserdede VS. eHer is how a nferdi of niem aixpeedln :it

APM (at nrestig R)H = 32/ DBP + 1/3 PBS = 77 mmHg in iths ,niteapt hichw si lreow thna lnmroa 39( Hmmg if uyo eus 810/.02) oS PMA is sreeeddac dna the ohtidereksy/n gonras tae'nr iteggnt eth fipornues yteh ,ende delgnai ot ASRA avitniotac nda mea.OB/edS PMA = OC × PRT, os shti cudlo eb ued to low OC lerieatv to TRP htw(a ew usyulal pecet)x or lwo TRP ierveatl ot C.O sTih 'paenitst lager AV uafsilt sha edpdorp her PTR yrve ,wol hcwhi aemns hre OC utsm evah nebe yerv high ofr the stap 15 sarey ot tmcnoesaep (ghhi oputtu teahr uaile.rf Seh sah noly 5 dysa fo t,pmsomys chwhi nsema seh is ealry no in hre H.F Secni esh ahd cush a high CO ot gibne tiw,h ehr odrp ni VS tsih laeyr no ouwld tlsli ealve heer hiwt na IDEECASNR SV mcearpod ot a oarlmn ptia.net Uelnss hre eplus si reups h,hig ehr eahtr tsmu eb niupmgp a saiemvs rksoet oumelv to anmiinat a rlomna ylsitsoc odolb epssurre hitw shuc a wlo PTR (PAM = SV x HR x .)RTP ,ntvaeuyEll rhe VS yam aderseec to eb eolwb mraoln, utb otn os ryela n.o

Fro eestnecNoptol:m s aeedcedsr aialrert O2 sta scbeeau bdloo si igonwlf mrfo teyarr ot ,neiv nto eth eohrt ayw oa.n odrutN aededrsce xdmie seuonv 2O tas ecsebua trrialea obodl si fdoilnog hte aslciavubn nevi girht eeobfr mdixe O2 tsa owuld be teNsdo.umr ea cdasernei SVR eascbeu of the agrel AV laist.uf

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 +2  upvote downvote
submitted by ∗the260guy(18)
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But h'eser ym beprmol ihwt ihts :sonitueq it says ahtt esh has a 5 ady orstyih of BSO dan lwesonl selg. oS oiusoyvlb het terha is inlifa.g I peickd ecarDedes otrkeS uomVle fro htat nra.ose

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nwinkelmann  AV safulsit ear eno suace fo ttp-hhiuguo rdaicac reuifl.a ihTs snoepr spnerest ihtw areht u,fielar tbu ti is due ot cohlrlnyica erdnseaic sgitner CO. +2
lukin4answer  alnknimw@nen sey tstha ,irhtg eh ash lgainif t.hrae tub iqutesno is ianksg twha is the gndiifn fo htsi ni,pttae I sdueanrdtn eht eusca is sitFlau ugsican ghhi uoputt u,leafir utb hyte din'dt ksa eht eoasnr of ihs ,FH etyh rae skniag het ifn.ngid I cseooh dceseare Stoker OlVemu /: +
happyhib_  Tshi was ym coigl dan got to decaedrse okrste elouvm as ;well htey ernta niksag ahtw aeucds his FH or tnahinyg ti sysa awht is hte ostm llekiy gifndin in sith nitptae. fI shi ahetr is finglai ude ot LVH fomr nnsottscie cseaedrin OC nwoudlt eh TA HTSI YERV OEMTMN TIWH hsi ehart gilifna ehva ddraeecse skorte ol.u?ev.m +



 +2  upvote downvote
submitted by ∗usmleuser007(464)
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CO is eidencsra iwth 1) ercesadde ae) frdoatl2 ndcreaies 3p)ld aroe rsaendcIe ilitonyctacrt

An enirsovetoua fuatsil resctae na aeretvanilt ertou for aaitrl bolod iont eth snovue oarcctlunii o/w gngoi satp hte eaisretlor h(te jmaor cueas fo Tne eih)a.sstrcsu, yb igdon so eht TRP eaf(rodlat) sdrescaee dan teh CO si eeicarn.ds

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 +1  upvote downvote
submitted by ∗uslme123(86)
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A'VFs = easrinedc crdcaai put. uTtBUo isth sn'ti ewn rof htsi rpeos?n I ewiv isht sa a etahr atth hsa iyfalln bugne ot lfai -- aseedcedr tefeecvif clariortycu vlmuoe &-g;t- aesrenicd SR.V

tuB i gssue ouy t'cna haev B rofbee A -- vrhaeetw -\-

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happyhib_  hsi bp saw mtheosngi leki 3501;0/ hiwt sdoltiica nuorda 50 I idgfrue he ldocunt have redsieacn RSV aesucbe sih ciosliatd wudol eb rhiehg? +2
trazobone  I adh iths emsa segaonnri I eleloymptc sdeslgo rveo teh BP ‍♀🏻🤦️ +



 +1  upvote downvote
submitted by nuts4med(8)
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oeAnyn eahv an aedi why eth eddaersec eitarrla 2O ntioarsuat si ?itrcceron sAmsguin ehs sah plmu amede iencs hes sah EL de,aem dnt'ouwl a reowl O2 ast be xedpcete oto?

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haliburton  I eebilev eehrt odluw be on cedreaes ni O2 rttsaiuano esaceub yedtaxnoge dloob gh(ih sserrupe) is udtenhs ntoi ydenatogdeex cr.uciit As long as hte lnugs cna epek ,pu sith suoldh eiarsenc soevnu ixgaytnonoe on ega.vrea +7
hungrybox  yt btho fo yuo for htsi, was wrenongdi eth msea gniht +
coxsack  2O sta two’n ancghe /cb or’euy ont adding nexatgydoede bdolo to eht arteirla dei.s erYu’o tusj naigtk rlaratie bdloo adn tgutpin it into vonsue odol.b Saem roeans why >R-L adcciar sutnsh ondt’ areceeds O2 tsa wlieh( in nstca,ort a LR>- tsnhu d.low)u +5
hungrybox  tjus lidaezer: eht hhgi ureersps of teh traareli ymsste kesep tou r-erpsuwosle esnvuo bdloo ni an VA tsfluai rlp(yabob ouivbos to somt ppl btu it asw a kaeeur enmomt fro me )llo +2
chandlerbas  ay yuo ntwo vhae deeacsdre latreiar O2 sta ecbesau ogynotaxein of doolb si iepunosfr miltedi 1A(F9 654--) hefeterro xiaegtoonyn of hte oblod pnphsae ihwnit het tsrfi onecs3.ds fo egntrnei het pnyraouml ayiplacrl thta uyo ldocu even lenahd ihagvn rmoe ytdaxgndeoee lodbo trene +



 +0  upvote downvote
submitted by ∗step1soon(51)
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teHar iulr:afe ishT is the tosm ersious ciipooamcltn of aergl ereroisuotvan l.utfsais inSce oryu dobol oslwf oemr yluickq orthhgu an osanerieuovrt fasuitl naht it ulwdo if your odlbo dwfelo rtohguh a lmarno soruec fo irrtseea, esrlaaiilpc and sevi,n uyor tearh pupms rehdra to atseemconp rfo het odpr in bodol epesusrr al(ecdl toguhup-ith earht eira.fu)l rOve i,mte hte csedeanri ttiinyesn of oyur 'esahrt numipgp can nkawee oury rhate ucslme, ngeilda ot ertah eauifr.l

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