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Retired NBME 22 Answers

nbme22/Block 1/Question#1 (reveal difficulty score)
A 66-year-old man develops worsening ...
Dilution of serum sodium due to ADH (vasopressin) secretion 🔍 / 📺 / 🌳 / 📖
tags: RAAS

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 +23  upvote downvote
submitted by ∗imgdoc(183)
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I khint aolt of polepe gmtih vahe vroe aihspzedem owh nrpotaitm ANP nad NPB alyerl ,ear sey ti si tpmiatorn to onkw tehes tediepps tge ctreedes by eht iivrlra/turalnetca amrmouicyd drgiun arthe eulri.fa owerevH rtihe overlla esetsecvffein ni teitangr aehrt urilafe si hcz,il a ptcpeorre ldto em ahtt if PAN nda PBN ewer so fsuleu ni nruiatrises tneh ywh do we iveg ?esctiiurd Is't eeubsac RASA vsrewoepro shti sesmty ecenh guinsac eveatngi fecfest adn hte lnedsse oplo of herat .lfuiera AKA why ew gevi CEA hnoirbis.ti

nwKigon ttah NAP gset euadnietrlz by eht ARAS ye,tmss ew anc shtfi uor uscfo kcab to etarh aeifrlu ni htis ,paitnte hrwee icadarc utotpu is areesddc,e iagndle to DHA tocsieern and fniayll ulatiiolnd ien.amortpyah

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almondbreeze  a eocpctn uosunntyolci hzpesadiem by w,u tub I gte swylaa rnwog (:' +4
almondbreeze  doog kwro onde! +1
raffff  hwy oesd eht ybod emak npa ta lla enics sti so eusslse +4
makinallkindzofgainz  fraf@ff - ta selat BPN svgei su a good erramk ofr ehrat ilufare axcbisoanerte :) nhakts !ybdo +1
mannan  aYeh t'is minpratto liyllnicac ucesbea ti sah a hhgi ivisestityn i(f aig,evnet urle o)tu fro teraH raei.ful +1
alimd  tA het easm eitm PNA inhbisit rinne rseeale? +1
freemanpeng  fI ti si Hgih RA,SA Aldo sumt eb ghHi as wIgn(ellIA nucide ldoA mroe hant DHA). Thne atht lduow be ATSEWRTAL- rntteione haerrt anht PURE RWTAE tetnreino. ON apetoaymhnir +
plaguedbyspleen  ishT etitanp is pt-iigcrsdnha dna eroetrhef has owl effeietcv tnruligccia omlev.u I ekli to nitkh ahtt gvnie sih VC ysi,ohrt he si lybarobp on an AEC irotiinbh ro mehtiosgn ils.amri oS ttah veelas AHD to do tis t.gihn sAol gihh oaoesdlnrte igsavn stal its'n emostgihn ew dene to encrsodi evgni het mets adn nsaerw .ehsccoi +



 +12  upvote downvote
submitted by ∗meningitis(643)
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I olsa hogtthu het same as ublbeb,s@ ubt wno niygrt to ui"s"tyjf tsih kcrtyi ENMB eonst:qiu I thnki shit veresvlo on eht tcfa that eth etnptia sah a GHIH lodob reruesps ennmagi we ushold cofsu no na nrawes tath aeipnxsl ohbt drneeisac BP and yoHviopemla e.i:( eraendisc AHD hhciw sorsavcscttino and slao bosbsar reft,waer-e hobt fo ichhw aenercis BP dna csuea laiehoymp).vo

eyMba if htsi etpnait ewer moadepscdtnee whti LOW B,P eon olcud hnikt mero uaobt AP.N

I litsl ktinh hsti utsnioeq is TOO rkcti.y

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meningitis  o,Srry oahyeinp*mtra ghtr?i +1
mantarayray  I thkni ttah i'st not APN eueabsc NAP wlli usace a sosl fo Na tub watre lilw folwol (eyth uuylals go oheg,t)ret wrhesea DHA iwll acseu obtaisornp of noly etawr nda iwll cusae yaahntoempri tx pcee nyol utthgoh ihts opst tegnitg the oqsnteui nrwog ":) +5
mantarayray  poOs orysr eth tomantrgif si csn:uifngo I nkthi ttha s'it not NPA eeucbsa PNA will ueasc a lsos of aN btu eawtr lliw ofllow eyht( asluuyl go ,gt)eotrhe hsearwe DHA illw suaec optsoarnib fo olyn wtrea adn ilwl eacsu niroyptaahem. +4
pg32  aa@ymtran rytpet seru oyu aer thrgi adn that is hte yonl yaw to etg tshi osntieuq ro.ectrc nRirgmembee tath aN norcnontceait rllaey is a uermeas fo warte albncea si ey.k fI eht pt si yaroc,nehitpm thta ujts amesn yeht veha too chmu tewra in teh dbo,ol ihchw is ascdeu by .ADH If eht tipetna aws poLhIVOCME,y ahtt ihtgm neam yeht ear lsngoi oot hmuc .Na hsiT si lsetltiduar yb stp ihtw ASIH.D Tehy rae nhtmiepcyro,a utb ve,mieucol meaginn atht eyht ahve too much warte hr(eatmipaoyn rofm teh D)HA but hrtie Na benacal is ko eu(d ot ncrteixoe fo Na aiv PNBN)PA/ +1
avocadotoast  We dene ot eb itnhikgn aoutb owh aetrh rafilue is a doncinoti htwi a olw tiffcveee icailgturcn lomvu.e Our eitatpn hda an IM dna now ish erath catn ekpe up thiw eht emvuol ol(w C,O) gildnea ot i.osnetgnco hnWe nticegnoso oc,rcus weatr is shedpu onit hte saitirnltite passec and is'nt cgtilirncua in het aeritrla systm.e roF htat ,reoans teh body pmsar pu the ASAR dna HDA ieetspd an aalcut nsaircee ni body r.aewt iTsh si a ontoc-monis eelresa fo .ADH tA siht toipn alamps duoism selevl are eerdmtneid by ieltvare aktien dna lsesso nda hmarponetyia is omnmco ni ehtes inastetp busecae of t.hta osl,A NPA dan BNP n'tdo dhlo a nclade ot teh AA.RS +1



 +5  upvote downvote
submitted by ∗nwinkelmann(366)
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mrFo ta:TDUepo NPESAOGIHETS

eLik msto toerh cesusa of ipnma,yaretoh rhtae lefiuar ipirasm hte blyaiti to rexetec eiedgnst wtare yb niangirsec edutianiirtc ehomnro evsll.e Wnhe dcarcia ttopuu and tscyisem blodo usperesr ear cu,edder e""ymlovcohpi ,emrhoson chus sa ernni w(tih a tsbsueuqen escenira ni gsetnnaioin II ,m)noaoftir rdnctiiaeitu oohrenm ,H()AD and rneperephn,niio nrodeps [-3.]1 tuoghAlh semaeodut tinpaste iwth tarhe eaulfri evah sreiedanc aslpma nad lrcrleuteaxal uildf umse,olv hte obyd ierevscpe oeulvm ipletdone uree(cdd vfieeetcf iletarar dbloo ul)meov cnise the wlo racdica touupt edesrseac eth rsprseeu nigspuref het crraetsooerpb ni eth otircad niuss nda eth nrela ffeteanr .Tlereirto eha redeeg fo unmrlruoeoah ivaacnoitt is nlareegyl etlader ot teh ertvsyie of cdiraac n,coisnyfdut sa esaessds by eflt uvctnlriare otinjcee irftnaco or ailucfnotn aslsc .]2[ ehT uaonomulherr engcahs itlim btoh ioudms dna wtrea etoecnrxi in an emtptta ot rnurte sfneuirpo puersser to monl.ar DHA alreese trclidye eehnncsa waetr nrspioarobte in hte otenlcgcli uu,tebls sehraew gstiannione II dna reeeinpionphnr lmiit disalt rweta yeedrivl an(d bhtyere water neocr)xite yb grwielno eht oralgurmle inarotilft rtae de(u to a remkda nueordtci in lnrae fenosupir) adn by ncniaiesgr arolimxp imsudo adn awter tenooribaspr [].4 nI odidta,ni both eth wol aridacc uuottp dan hihg naginisonte II sevlle are otenpt liutims ot rsht,it negldia to aecehdnn traew etaik.n

H:#ayhtcotwidtthea/th-a/peta2e/ito/cpnt.emuinifspwsh-nptu-erintrlosaw--.matneowr

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 +3  upvote downvote
submitted by ∗bubbles(79)
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hTsi usoeiqtn fncueosd em a lot cbaseue so mnay uonsiqste veha lerddli em on teh arteonpicm of the NAP spaeec nsheaimmc ni smtei of fludi lvaoeord s(a in ).FHC

I utotghh ANP aws a hgeu prealy ni eht lsso of aN ni tricnemuascsc fo vuemlo edrolavo sa in this ptentia hwh(ci is why you ees leocuvmei Oaptamynheri in iesattpn thwi ISADH or iitaeyovrvct fo eth RASA sa ni .FHC)

yhW si AHD nwo bieng dmaen as eth snsbrepoeli ?tagen

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jooceman739  yM nktigihn is hatt APN sceaus r,asiriusten so oyr'ue ilgons tsal dna rtwea ta het asme emit osiso(itmco l.id?fu) aihleM,enw HDA soabrbs yoln efre r,teaw os it uowdl itudle eth rc tC .eo rseurm em fi m'i .orgwn +13
bubbles  hhhO ouy era irthg. Tnhak ouy orf eht i!tpenxnloaa I got os defxita no ttha eno heansmcmi ahh.a +4



 +2  upvote downvote
submitted by ∗dr.xx(176)
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HCF atpitsen tnfeo pldiasy igssn and smoypmst fo acnsdiree niavsersosp cne.tesori

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hyperfukus  fi lal eles fsali i oeph i tujs idrll hsit neo tmsatente in ym brina nda ti eoscm uot ni hte thgri ywa no etts ady nkath u!!! +1



 +2  upvote downvote
submitted by ∗drmohandes(193)
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reHe ew og:

  • daecdesre VL nocilatriytct ltab(airle arslcekc)
  • srdaecede ircdaca ptuuto
  • etcitvaa RAAS → AHD
  • iascrene cthmpysieta tiaictyv → emro RASA → mroe DHA
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 +1  upvote downvote
submitted by ∗moloko270(77)
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:m5micp2u80h./btb2.lw.gntndishon./wep//w78v

nesmd"oyr of ltanu"liodi ypoiylm"sa-tlhoo in esvere vsgceitneo treah laeifur mya be adecsu yb na aoririeppnaytlp hihg ADH ircnoeset ni chwih the eooreprotmsc emtsys si omnadedit by omnonraslo tsm"iuil

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hayayah  Aylpte,panr ni iocrhnc FCH ouy ees porn.itayheam eescauB HFC scaues a ceredesa in caidrac ptotuu adn utinagicrcl oobld eol,umv whhci ni urtn gertisgr a topnycroasme soenrspe eiadm ta eprnevsgri bdool susere.rp siTh tiatlsuems the bdyo to eanitr bhto ewtar nad ouis.dm +10
seagull  i graee iwth ..aH.yyhaa teh RASA esytsm si eatvdaict ude ot proo spnfiouer to hte nikeyd eud to cdempo ather .fileuar +6



 +0  upvote downvote
submitted by nicsar(1)
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pnarimayHote fmro tealrfiHaure pt.

It udohls eb rdpahoapce mfor rtHea fa.ieru

tg&HF;- AAsR &g-t; veseesicx lnrsetoe,dAo DH;A PNA ceesap ,fariue ekli asdrecyon ryemi;lsrnotesdoahp rpetHainyaom

u31o7m//vg8hm9/e9c:.w/ti/1pf2h.-ClJ64n.j-t-0t59wwt5Wlgs/-/4w10

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 +0  upvote downvote
submitted by ∗dubywow(23)
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tecsmaDoeedpn FH. kacL of dlboo olfw ued ot iifgnal ahtre ;&g-t elrwo PB t-g;& sndieacer DAH ot cnaeires doblo ersrpesu kcba to letbas .velle nI HF,D AHD uesptcoa sheostosmia fo aorctucnenitg PAN &;amp .PBN ,hTsu eht emtr c.ptsam"doeeen"d iscAdtoesa thiw tesohnssr of eh,ratb maede nfe(ot of snlug.)

sTih iouvisc elycc isnecutno as odby iispozteirr qaeeudta BP fro i,alsvruv btu ti scome at the xneepse of koreodvrwe trahe ttah tsum kwor rhrdae dna ,dhaerr mallyuetti rixangbaetec het ethra relaifu tnc.dnioio

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 +0  upvote downvote
submitted by ∗asharm10(37)
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Alswya onwk stih Hpyo or peharrmitayne si sbeaeuc fo anehgc in eth voem,lu ihts eiatntp is ngoig hurhtog ahetr ur,elaif nrael eusnrfopi sha enog nodw ttah dsale ot aerseel of ADH cos fo ocoermorsetps mlutat.sinio Nwo ighh ADH wlil rbeaobrs mroe efer eratw tath liwl aled to renyoiamth.pa oS npyartehmiao is oastml lysaaw ertadle ot ihhg HD.A I wonk few fo ouy wlil itnkh utb RASA ssmety si tetaadvic oto ubt ttha rbbsao aN nolga whit waret utb ADH sujt reef tear.w

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 +0  upvote downvote
submitted by ∗hello(429)
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erhTe sah ot be a tetrbe xnnaoealtpi for wyh NPA is rno?gw

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waterloo  If hits tp's NA/PNPB erew gusncai imh to becmoe ichaeptnoym,r why dseo he veah iudlf evaodlro pssmoymt lt(iralbea claecrk,s V,JD gihh P?B) hrT ee hsa ot eb ostemignh lsee gvimnceroo eht ANP mtss.ye +1



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submitted by ∗happysingh(57)
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i naidk fo flee d""od giasnk stih sqtoneiu : utb teh ttpeani had na MI 6 tosmnh ,gao os ywh uwodl it eb lynuleki tath he wsa ldto ot errtcs"it ,lats crtetisr sldiuf )e(arwt " ??

useGs what 'im agnisk is : athw kamse ocecih E shcu an nlueliky ehicco JD,(V sibral-bia ,rlskecac epihlaprer ad)eem ?

&pma; sinm@iinegt : shi bp si 523/18 Hmmg ... yhw si atht IHGH"" ??

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 +0  upvote downvote
submitted by ∗freemanpeng(7)
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t,rilFys I cehos .HDA Wenh I ugtohht tweic ni ,eeivwr I dkceip descrso ADH nad pcdkie M ANy.P giocl to rcoss DH.:1A heT aimn neiudcr of ADH aer mOs adn l/uev.PBom iHsT ,tp Oms obyosuliv ont i,hhg Bp siyovbolu ton .wlo ,oS ssnneone in nderiscea oY.2Du. HA mya ese IngIA slao neduics HAD. tBu ti eemss ot be a nriom iecdn.ur hneleMiwa, if it is ctyeaxl ghih IIn→Ag hihg H.AD n,heT ldoA must be ghhi as lw,le nad igHh dloA S→tal sgrrvne→ipe WHO NCA eumsr dmuSoi eb L"OWo?w L dicraCa tp→touu iHgh SASR nAg(II doAl AD"H) haywapt si ARTOUWDM-SIE roe.etintn OTN peru RWTAE lePenetseoir atn rectrco me

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