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Retired NBME 22 Answers

nbme22/Block 3/Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressure 🔍 / 📺 / 🌳 / 📖
tags: pulm repeat

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 +7  upvote downvote
submitted by trump2020(3)
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You usyg rea yaw knviogrneiht sth.i rcCoinh ihxpoay csaues hnetpyosnire ude ot SSN attinvaico dan OEP otcpiour.dn

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teepot123  yep +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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yuGs I evha ntareoh htht.ogu

iinGvg trohe cecshoi era boatu shi hteor onbmaalr vulsae d(iearesnc iarteenc, gcoseul, uirc d),ica I esusg the tqueniso si gitntse su cwhih of shete suvlea ilwl vmepori fi hsi SOA si deivromp by P.PCA

iSnec OAS si eon of eht mtos prmatoint seusac fo iitpoiahcd nt,oenehisrpy it oluhsd eomc ot us hatt ceon hsi OSA si etar,ted ish eitnnroesyph llwi opmrive .noos

So decseed"ar PB" tnasied of erhto mraanlob .aluves

(kahsTn ot my disrfen ofr tnighin em otaub si)t!h

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dodgerslakers15  iThs si teh orcterc yaw fo tnknighi otabu tihs ou.qiestn rPa^moluy n opyshgiyol si nto nryeass.ec ehT roto of eht sneutoiq is niagsk tawh will mpirvoe vreo miet itwh materttne fo eelsp ,peaan hhiwc is oobdl r,spesure vgnie atth eespl npeaa cseasu eriaesndc heiaymcptst toen adn eertoefhr stseciym TN.H heT tmteatner fo sepel naeap htiw PAP,C lwil lehp ceredu imytapcsteh otne nad eorv itme, vrieopm .PB +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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PPCA sncaserei rllpnaaietru esrrsupe sa teh dtaleeev ryawia prssereu is nrmdastetti to hotre snhtig ni teh cytiva g(nlu pehsus no prulela p/iysacceatv iwhhc cna ethn pshu no oerth rturste.c)su hsiT nca dael ot imonseorcps fo seni,v uincldgni eht aenv cava &t-g; eedesarcd ousenv nrture >-; ecedrades pb r(ofm ecsedrdae e)dprla.o Tshi is liimsar ot hwat aesnphp irndug avlasval xt(eionre h)aesps uthhgo teh sievpito spreesur is irdvdpoe by a nachime umpp atnidse fo maiandolb s.h/agramesildpcmu I nkhit etrah aret ielykl iansseerc enisdta of secdaeer as a apmrtonyocse .spneoers

Heesr’ one tesi htat xlenaspi it lwel the( ee”fr“ nontetc si ehougn nda rapblbyo dalaeyr ecxsede hte ethpd one thigm ndee ot nokw) mtt/pechceuoeia-hatfy-x-reyfnc/ov-hns/:alooirttsr.nlcpmfmnoetticaelkaai/c

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dodgerslakers15  rumyaPoln yhlsiopyog si nto seaynserc eehr. T he toor of eth tqseuino is kagsni hatw wlli vmoirep rveo tmie wthi anermttte fo lespe na,eap ihhcw is oodbl esupes,rr ginve ttah lesep anape usesac iecndesar itamsthcype nteo nad treheoefr icmystes HT.N heT mtenttear fo peels pnaea twhi CAPP, illw ephl ecduer ptytcsmeiha nteo dan veor ,time ovreimp B.P +15

Guys don’t forget that in OSA, periods of apnea results in increased sympathetic tone, hypoxia causing pulmonary hypoxia vasoconstriction, thoracic movement without inspiration increasing negative intrathoracic pressure ==> all these factors leads to hypertension in OSA.

To remove all this we give CPAP, which results in decrease in BP over long period. (It is not only about increasing intrathoracic pressure and reducing BP)

+16/- apurva(101)


 +4  upvote downvote
submitted by ∗meningitis(644)
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lgAuthho i’st aotbu VPP, thsi scrarihneeg eedplh em dsnarnteud iabcs psh,y I hpoe stih ehslp eynvreoe in semo ayw.

kyeawaTa: ungrDi PV,P esunov urnter dee,csersa raccida potutu ,eedassrec nad rheat eepurrsss ceresdea in eth ithrg esdi fo hte h.rate

Why edso PVP seeeradc vnesuo ?nrreut

  • riaoitcnhrtca eprussre ssoermpces htear, sncauig ldobo ton ot nurret

sueasC ofr ddeeceasr ftel raretnlivuc uptout ngdriu lntnati:oive

  • ifSigtnh fo enicrnlavtrtriua umspet ot etLf ude ot dianecers VR vlueom
  • ceaDesred onusev unretr
  • naeshCg in aehrst ytaliib to toarccnt edu ot tsoivpei esrrsepu
  • cakl fo O2 ot tarhe

oNmlar percnmyasoto mmchsesani fro iannigntima OC and PB ruidng PPV?

  • iesdncear RH to ncospmeaet ofr easrdecde SV
  • adcinsere VRS ot aamnitin PB

Ohtre ichPysoolgi reosses:pn

  • sDeadecre rabcelre epforinus reusrpes doy’sb( esnsoerp to a llaf in CPP is ot aires ycmsetis odlob eseurspr and atdlie raelrbce dolbo velesss)
  • ecDesreda anerl pnfrisueo rsIenadc(e ,DHA ARSA, nad eaPittn ash laern rlebmpos os eenadrcsi nicirntaee dna crui cadi)
  • Pioeblss nrliouatntim d(sricnaee scelguo iva uigocsongleense et).c
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meningitis  sroyr aubto eth ngtmrfotai, ythe erwe dusoepps to eb blesult nto ail.itc +30
drdoom  kosol odgo to m!e ); sedtina of saisrtske ryt sigun the ulsp gnsi ofr dnderroue ssl;it hte symtse esgt eocsnufd omseetims csabeeu eth rtaessik is lsao fro istliac 😊 +2
meningitis  eha,Y I dicteon :s , Oh I ntddi konw het + isgn ddi hatt! erVy umch cr,iapedeatp I liwl tyr that xent .miet +1



 +2  upvote downvote
submitted by noselex(9)
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I dnuadtsern splee pnaae wuold ucesa opyihxa adn enercasi ni SSN tyctiav.i oS ttreeantm ldouw ruedce BP adn tHear eR.ta I swa skutc nwteeeb teh wot pi.osnto Wyh aws hte wasrne odlob ssuerper adn ont RH? I oegglod nduaor a tbi nda fndou dsetius atth ohws drpo ni hobt HR adn .BP I eugss BP pdrso mo?re aCn ooeesnm eeslpa a.lniexp

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madeforupvoting2  APCP ceisersna aptrliuelarn pssuerre sa hte eetlaedv awiayr uresrpes is rmnitttdsea ot hoter nstghi ni hte yciavt (ugnl esuhps no lluearp tyccepa/iavs chhiw anc nthe shup no hoetr trcr)st.uues hTsi nac dale to ipsrmoocsen fo vensi, uinngclid teh aenv avca -> eedadersc eonvsu rutenr >- seadrceed bp omfr( aeedecrsd oep).dral hTis is rsmalii to wtha enhpaps ungird aaalvsvl to(xieern hpases) houthg eth spovtiie ruprsese is pdeivodr yb a cnehmia mpup astendi fo nmadiaobl ugl.aicmheprd/smas I kthin ahret tear eliykl ieaesrcns dieatns fo crseedea sa a prstonacmeoy sreH r o snesp’.ee oen teis tath apxniels ti llew (hte e“r”ef tectnon is oneghu dna rbaybolp elarday eexcdse the htedp eno imght ened ot own)k a:otnrscet/tthclo.cmh-l/k-rrfttyaacnlxuahe/veiemcetiiano-fo-f/pmsycpeoain +4
apolla24  I ugsse sinec egnhcsa ni HR aer such a rtsentian nnooehenmp nad oyu olny vhea duasetnis srceiena ni HR when esieincxgr or leik cuyalet xngeeiriecpn mseo dimclea cgeenmrey sv BP htta cna eb vdeeeatl for nlgo osierpd of smeti hitw on fe.tsfec heefeorrT na emotipvmrne ni PB si remo nmiotrapt. hTtas’ ym etak. +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna eeoomsn ccortre my nnoarsegi :rehe

I asw nthkngii otvisepi wyriaa sepuesrr liwl esceianr vlraealo nientavloit and reaeedcs oypixah iucddne oalurmynp incatirt.ovonoscs T,ush VR retaf dlao uodwl seeraecd =t;g& omre paloedr to LV adn reom ccdiaar otuupt. Then dwl'tonu PB eae?crdse

Any plhe is icaartdpeep. a.shnTk

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pg32  I sutj uthhtgo fo ti as lslfw:oo he ahs hihg BP ude ot prnymaulo rnacitvcoioostsn sa lelw as dperdswaei iatmsetpchy ocnavatiti (as fi he is ibgne liparlaty engtdalrs all teh tei,m acbesue eh yaicaslbl )s.i icnsneargI tgenixoyaon wlil axler hsi mypnuoral utrulevscaa adn edeecars apettcmyshi atmisuliotn tthuohogur hte ,dyob aildneg to a rodp ni olbod .sereuprs +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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seecIdrna icrtiarlnana uressepr atth urtless in shiCsngu' rdati of eacdnresi bolod ruepses,r greriuarl ahirt,gebn adn bdaya.crraid Ths,u ighh 2CO sideucn hgsuinc adtri dan fi yuo egvi PP hnte it lliw derdeuc C2,O dna ethn nwod geteaulr the ypmhaciestt csooiirvntcsano.t rglnOyaiil the bainr adh os umch OC2 ttah it pdeazsz tou adn edrti to ienscrae hte BP ni reord to hups orem agnyxtodee dloob to het ai.brn

a/-w:.s.5slpeCpU3i.dgsZmmpActAaqJit/h://gtbferjSgKmok

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lispectedwumbologist  d"Biaarda4c8 "ry pbm ol l +
lispectedwumbologist  The pyinserntheo in vturotbices eepsl anape is deu ot crndieeas hyttscpaemi eton not enrdseica riacnrlnaati pereusrs aoml +1
meningitis  gltseo@idlscbuopetwim : Be retuam unhgoe ot rtecocr imrehh/ and emvo n,o ont lghua at /ehirhm. +16
namesthegame22  lPuse eatr amy be tcffeade yb surseg of isecmyphtat tictyaiv ndirug canepi s,pedseoi erew,ovh shti aleiphnoisrt sah neeb ssel lerady ttmedosarden ntah atth ebewtne eapan payrnnndehi. seto +



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