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NBME 22 Answers

nbme22/Block 2/Question#21 (28.6 difficulty score)
A newborn has cyanosis, tachypnea, and ...
Respiratory acidosis and metabolic acidosis🔍,📺

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submitted by privwill(26),
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eSpt yb s:ept

  1. pH = wol = csaiidos
  2. CO3H = lwo = icasoids
  3. OC2 = hihg = idacoiss

,oS ahtw Ie'v ldranee si taht, ni ,senesec bieoctlam iosidcsa aayswl tksae iyoptrri in hstee sar.cnoeis Ist' nedeivt hatt het opsern is tno nsnogmect,aip utb yuo atnw ot etalacclu aaywyn yb nugis iWnter = 1.5 HC)3(O + 8 .
f I uyo ualtcleca uoy lliw ese atth teh xcedetpe si 305..

  1. If 2OC si hrghie atnh ectxdepe = animcnooctt iapyertrros sidiacso
  2. fI C2O is rwole thna ptecxede = mctitononca rrorypstiea isoakllsa

eHre it si hrgehi ntah cexpdete )6(5 os oocnimnttca yrtrsieaopr aoisdsic.

I sgues if uyo waendt ot rtsat iwht teh earirptsyro sciidaos you vldueo'w anekt onti otasinodrcine thta caibaoerbnt e'ouvdhsl goen up ot cpsamonet.e It idn'dt os t'is aptu.sondmncee toN uers if e'rtesh a afmurlo ot auleccatl teh erhto stuff

makinallkindzofgainz  don't forget to add the +/- 2 to the end of Winter's formula. You have a tiny range in which CO2 can fall within +2  
cbreland  I started with respiratory acidosis and thought that any compensation would have an increased HCO3-. HCO3- is lower than normal levels, so that would mean met. acidosis as well. No math involved like you alluded to +  

submitted by armymed88(46),
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A eitllt hatm ..hepH re si low &;t-g- iicsdaos p CO2 is ihhg --gt;& yaterrrsopi Nmlrao atspocenionm sulhod be rholguy a 1 u(tec)a to ri(nccoh4) ceersina in brcbai pre yreve 01 ceirasne in 2pCO.. tI s owrle ere,h so laclyre ton opnsacdmeet dan nddtciiea toadindail prdo ni ra-di;c bt-&g add no matbe cassdoii

hello  Hm, what do you mean by "normal compensation?" Are you talking about the bicarb should be increased? Are you saying that a normal compensation would be metabolic alkalosis? Would metabolic alkalosis be an increase in bicarb? +2  
kateinwonderland  How do you know which one has bigger contribution in this situation where there's increased CO2 and decreased HCO-, both indicating acidosis?? +  
yb_26  normal kidney compensation would be an increase in bicarb reabsorption => increased serum bicarb. This pt has low serum bicarb => concurrent metabolic acidosis +  

submitted by nicsar(1),
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o2cP sI hih,g ioadis;sc yapierrsotR iaosd.isc

If eadeopCnstm e3=Ow,C- ΔllH iEytyor(hrtvcE os)ptaninecomC2,Δ0O1P/ 2~(1)(~512-6.0/05)45= t&&t;;gg 1-2==34HO,9C5-Δ nt o ,ncaoepestdm veen lses -O;H3C beCmidno ltabcoime isi.coads

o,rf deinKy ec.iaotmnpons ues 34~ ndaesit of ~21 ni rtoccyhytcrei ncand. oasnoipetm twhi his,t the pGa ebeetwn llew ceetsodnmpa dan hte easc vnee trefar.h