invite friends ⋅ share via emailtwitter
support the site ⋅ become a member ⋅ unscramble the egg
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 

NBME 22 Answers

nbme22/Block 3/Question#8 (35.3 difficulty score)
A 38-year-old man who lives at sea level ...
pH: increased;
HCO3-: increased;
Volume: increased


Login to comment/vote.

 +3  upvote downvote
submitted by mcl(517),
unscramble the site ⋅ become a member ($36/month)

neSic ouer'y glonsi lla ruoy rabbic itno ryuo e,ep yuo lowud eexpct eth pH ot eb rmeo aillena.k ,oslA einsc three is eecdeadrs +N+/Ha nporiatt, erteh is ssle moidus robaesrbde adn ethfroree nseeirdca sosl fo free ilduf ot het

mcl  useful figure +2  
joker4eva76  Why wouldn't this be similar to a Type 2 RTA where urinary pH <5.5? +1  
mcl  I can't remember exactly what the question was asking off the top of my head, I think it was asking about relative to normal? But I think you're right in that the alpha intercalated cells (AIC) can still dump H+ into the urine and acidify it to an extent. And, like in RTA2, I don't know that the action of the AIC would be able to overcome the bicarb and acidify the urine enough for it to be the usual pH, so the urine should still be more alkaline compared to baseline. Kinda sucks, pH less than 5.5 should technically be acidic but it's alkaline for pee. +  
mcl  JK, normal urine pH is around 4-8, but I guess they consider closer to 5.5 on the more alkaline side...? I guess I would go more off that the alpha intercalated cells can't completely compensate for the amount of bicarb in the pee due to the CA inhibitor, not so much the actual pH. +  
meningitis  Anhydrase inhibitors also affect the anhydrase inhibitors that are used in the AIC in order to excrete the H+. Here is a link:**** +3  
mcl  ohhhhhhhhhhhhhhhhhhhhhhh my god duh yes thank you <3 +1  
meningitis  Lol yw!! +  

 +1  upvote downvote
submitted by yotsubato(806),
unscramble the site ⋅ become a member ($36/month)

stI a ,iuircted so emulvo si idr.eaensc

OCH3 si cneariesd eubaesc zmoeataldaeic edsuerc npiestroobar fo .O3HC

pH is ,isneecard uabeces H3O-C si a aewk bsae, os it kcsus up tyrsa orehdyng soni ni eth nuri.e

 +1  upvote downvote
submitted by meatus(1),
unscramble the site ⋅ become a member ($36/month)

'Im rosry btu wath am I msgsini .rhe.e. I thgothu eht leowh tnopi fo ieitdursc si ot orrctec ueomvl edorolav yb ureiis?ds Hwo dwluo lotat mvoelu eb endir?easc?

niboonsh  the question is asking what would happen to the URINARY ph, bicarb, and volume. dont worry, i misread the question too -_- +12  
link981  Also misread the question, thought about the lab volumes of the BLOOD smh +5  
hyperfukus  yooooo me too!!! this is the second NBME i did this on they purposely don't write urine on the arrow categories to mess u up i swear!!! AHHHHHH +2  
medulla  missed this question for the same reason .. still pissed +2  
osler_weber_rendu  I DID NOT READ "URINARY" OH NOOOOOO. Im so dumb. +2  

 +1  upvote downvote
submitted by adong(82),

the question can easily be misinterpreted. it's asking for urinary pH, urinary bicarb, and urinary volume

 +1  upvote downvote
submitted by usmleboy(8),

LOL. I thought they were asking for Urinary pH, but blood bicarb and blood volume.

Who in their right mind would ask for urinary pH, urinary bicarb, and urinary blood volume by saying ".... urinary pH, bicarbonate and volume"

Am I crazy?