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NBME 22 Answers

nbme22/Block 2/Question#6 (42.8 difficulty score)
A 52-year-old man is brought to the emergency ...
4 Months🔍,📺
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 +10 
submitted by welpdedelp(242),
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tI wsa just nskiga the asfpilen fo CRsB 0(21 syad)

haliburton  If I'm reading this right, this is just a tricky dicky question. I think CO binds 200x stronger than O2. But if an O2 cycles through binding / unbinding 200 times before a CO gets kicked off, this should still clear the CO from that cell sooner or later. strange to think it is 1. essentially permanently trapped in a cell, and 2. doesn't kill you and can be treated with O2 to resolution within a few hours or a day. They must just be thinking, until that last RBC dies, you've got original CO in a circulating cell. but just a fraction (because you didn't die). not sure how that CO isn't just passed on during recycling, based on this line of thinking. +8  
link981  The question while stupidly written, asks how long the RBC's that carry the CO take to be removed from the circulation, not how long the CO takes to be removed from the RBC. Just asking the lifespan of RBCs in an stupidly complicated way. As we know, RBC's life span is about 120 days and then they are removed from our circulation. 120 days is about 4 months. Next time they will probably ask weeks or in hours, who knows? smh +9  
baja_blast  If that's what they're looking for why cant the NBME people just ask "How long does it take for RBCs to turn over?" Ridiculous. +2  
xmen  yOU HAVE TO VIGILANT !!!!!! BY THE WAY, I ANSWERED WRONG ALSO +  



 +5 
submitted by iviax94(7),
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I geuidfr yhet ewre ytrnig to gte ta eht ifel apccetnxey fo an BRC, utb utwolnd’ tusmnepellpa 2O hencticlyal plaecre teh CO dbnuo ot B?RsC AF vene sotennmi htat OC sinbd oeilecvytimtp to R,sBC dan tin’s atth teh leowh ntiop of nigvgi ab1ce0h0yipr/%r O2?

nc1992  First aid has a lot of errors +  
yotsubato  Thats not an error though. Thats the actual reason behind giving hyperbartic O2 for CO poisoning... +11  
mumenrider4ever  The question ask how long it takes to remove all the CO-carrying RBC so I think they're implying that theoretically not every single CO-carrying RBC would be replaced with oxygen from the supplemental O2 and some would die off naturally +  



 +3 
submitted by link981(172),
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ehT ietnoqsu lehwi lydupits nriw,ett assk hwo ogln eth RCs'B ttah arcyr the CO keta ot be ervemod ofrm het ,iiontauccrl nto who nogl teh OC etksa ot eb mroveed rofm eth BRC. uJst gsinak eht npfslaie fo RBsC in an dpistylu caecldtoipm ywa. sA we w,kno CR'sB elif asnp si ubtoa 102 days nda hten heyt are eoemrvd frmo oru .aitolunircc 012 dysa si baout 4 .mhosnt Ntex miet ethy wlil alorbpby aks hte CRB ispflnae in eskwe or ni hous,r hwo ?nwkso smh




 +0 
submitted by ivypoison(5),

Oxygen can compete CO to bind Hb but i think not all CO-Hb can be removed. Notice " ALL" the C0-binding RBC so go with CO-Hb RBC die. though i spent a lot of time for this question too