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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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oYu usgy ear ayw tongkenriihv hits. hCicnor aopyxih eucass nstrpehoeyin ude to NSS ancivtaoit and OEP odo.ctrunip

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teepot123  pey +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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suyG I ahve aontreh othg.uth

givGni rheot chiesco aer baout shi troeh raoblman avluse dns(caeeir e,icrnate cueslg,o ricu ,d)cai I segsu eht tseoiqnu is sgnttie us ihhwc of heets leavsu wlil virmeop fi ihs ASO is pvoemird by .PCAP

cineS OAS is eon fo het mtos optitnram ascesu of dcihptiioa enpoi,setryhn it hulsdo moec to us ttah neoc hsi SOA is rt,etaed shi nhoisperyetn wlil opmveri o.sno

So eddsr"eace B"P tseiand fo hoert anbmrlao .lauesv

hkT(sna to ym fseirdn ofr innhitg me buato iht!s)

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dodgerslakers15  shTi is teh eorcrtc way of ninghkti botau shti osn.qeiut Po^nay rulm yigsopohyl is otn nr.sysacee ehT orto fo teh uieotqns is skaign tawh lwli ioepvrm over ietm tiwh tamnrette fo eplse p,naea hichw si boldo sruesepr, geniv ttah plese nepaa csause sdaeinecr htatmseicpy note dan rhrftoeee ctsimyes H.TN hTe mentatrte of lpese pnaae wtih P,PCA ilwl hlep edcure chmtytsipea ntoe dan voer t,eim rmvieop B.P +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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CPPA esarencsi irpnaltlaeru ssureerp sa eht datlevee aawryi psesruer si mtnieatdtsr ot eothr hitsgn in het iyatvc nug(l pesush no lluepra tasvyecic/pa ichwh nac enth pshu no teorh tstr.)uruecs hsTi nac adel ot misporoesnc of veins, iungnlidc het nave acva ;&g-t scredadee nseovu rternu -tg&; sederdaec pb (frmo aedercsed .d)oalpre shTi si lmiairs to awth spphnae griund saalvalv e(etirnxo sehp)sa ohgthu teh ipotisve uspeersr is odvdirpe by a ehicnma mppu entaids of abiomnadl m.is/deslprhgmacau I nkhti htrea reta ielykl saeeicsrn idatesn fo eeasecdr sa a apstomrcenyo spesne.or

’reHes eno esit atht slenpxai ti elwl hte( fe“”er eocttnn is hgoneu nda lorpaybb lydaare cdeexes hte pthde eon hitgm deen ot onwk) ailoloyra/tat:xffm-te/n.nreoahei-cy/ep-eclhcnhkvccmitoao/irat-nptuemtcssf

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dodgerslakers15  yuanPlmor sypolghyio si tno rasceseyn hr.ee eTh oort fo eht setuioqn si ksangi hatw liwl veopmir voer meit ihtw rttteeamn fo eples pae,na wihch is oodlb r,seuerps geivn ttah lpsee panea ssaceu canredies ptecyshtmai note adn retoreefh smctseiy T.NH Teh nrtamtete of lpees apnea wiht CPPA, lliw lhep ueedcr hpatciseymt oent and orve iemt, oepmriv PB. +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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ghAoluth tsi’ aobut PVP, tsih aghernsrcei ldpeeh em ardnutsend absci ph,ys I hpoe htis spleh eeeoyvrn ni meso .awy

akeyTaa:w urDnig ,VPP vsoeun tnrure eearcsd,se cacirad toptuu d,seeserca nad ahrte pessrerus sedraece in teh rhitg iesd of eht .tearh

hWy eods PVP seadcree vesuno etrnu?r

  • chtnoriiraatc ruseresp perscmoess at,rhe ncuasig dlobo tno to terunr

Caseus ofr edcsdaere left rvrnuietlca utupot dungir tviaioennlt:

  • gnhStiif of tnrucltviiaraenr eumtps to Left deu ot asceneidr VR emoluv
  • eeecrsDad uevons neturr
  • gheanCs in esrhta liyiabt to rnctoact ued ot iseotpiv euserrsp
  • aklc of O2 ot aehrt

rlaNmo tpnsearymoco shcnmmeasi rfo iatninnmaig OC nad PB riudng P?PV

  • iaedcsrne HR ot stecmeonpa fro erdcdease VS
  • asednrcie RVS ot atnminai PB

rtheO lghosicoyiP nss:serope

  • cdrDseeae brrcelea unfeipros eussrepr (yodsb’ eseponrs ot a afll ni PPC si to aisre seycimts olbod ssprereu and liated rreabcel loobd ess)sevl
  • decrsaeDe anrel fpsineuro Irdnecesa( A,DH S,AAR dan Peiattn sah raeln bsplmero so sriaecden ietaincnre dan ircu )cida
  • boslsPei tuirmalntnoi iea(ecrdsn ugoslec vai eeucsoonnelgisg .tec)
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meningitis  yrrso taobu eht tramoign,ft yhet wree sdpuopse ot eb bltules not iati.cl +30
drdoom  loosk good to m!e ;) ednsita of sisstarke ryt suign hte ulsp sign orf dronerued t;issl the msteys steg encsufdo tissemome seeuacb het esrskait si osal fro liscait 😊 +2
meningitis  e,Yah I dinecto s: Oh , I dindt wnko hte + gnsi ddi ta!th Vrye cmuh rtedepapaci, I lilw ytr htta xnte iemt. +1



 +2  upvote downvote
submitted by noselex(9)
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I tsuanedrdn eelsp paean udolw ucsea phayiox adn aencsrie ni SNS iyvatci.t So ntertmaet olwdu erdcue BP nad Htear etRa. I was uktsc wtneeeb the otw tipo.nos hyW saw eth saerwn dlboo pesrsure nad ont R?H I deologg aondur a bti dan unfod ussietd htta ohws prdo ni boht HR nad .BP I gesus PB orpds ?mero nCa mnoeeos peesla eix.napl

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madeforupvoting2  APCP esirnsace aniratpleurl psueesrr as teh edvlteea awyrai uperssre si atentmsdirt ot hteor gtnshi ni eht aictyv u(lgn pseshu on peurall ecyicv/tasap hcwhi acn thne usph no htreo trstscu.r)eu Tihs cna adel ot soepcomisrn fo niesv, uldcgiinn the nvae caav -> aesrddeec sevnuo urtrne >- dcerdesae pb rof(m eedcrased re.)loadp siTh si amrisil ot wtha hnespap dgnriu laavavsl n(oteierx s)aspeh hugtho hte vstpioie rerpsuse is dvpdiero by a caiehnm umpp dtensai of dmioabanl aumi./hmlpdsagercs I hnikt erhat raet elkyli eenssarci ndestia of ceardese sa a spyraemntcoo o e’ .seepsensr Hr noe tise atht nlxseapi ti lewl eth( ”eefr“ otntnec si ehungo adn bbpyarol aalerdy csdeexe teh tedph eno tmhgi nede ot )know pi-ltet/ofcamltettryitoh:emccvcurrxh/anmeooncscaet/akphi/fo-lniae-yfans.- +4
apolla24  I gsues cisne hagcesn in RH ear hsuc a naitnesrt epoonnhenm nda ouy yonl hvae teanidssu sraecein in HR hwen xinsrigece or ikel yacletu ngeepxrniiec soem aedlcim ecgneeymr vs PB that can be aeeldtve rfo lnog idoesrp fo mstei tihw on s.fetecf heofreerT na ietopnmmevr in PB si emor apmnr.oitt at’Tsh ym k.tea +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna omeenso trrecoc ym inegsanor e:erh

I swa knngithi toviesip yiarwa spurrese will esaeicrn aeoavrll nitntleiaov nad secderea pxhyaio dcuedin luoypnmra stnir.otanovcicos sh,uT RV trefa oadl woldu eeaecrds =gt&; roem lporaed ot VL adn oerm ricadac ut.uopt heTn tlwondu' BP seaede?cr

nAy phel is pea.itdpreca n.Tkash

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pg32  I tsju toutghh of ti sa wlsloo:f he ahs hhig BP due ot maplnuory tcoocoivtrnssani sa elwl as aeerdipswd yismpeatcth nvcoiatait s(a fi eh si enibg lpiaatyrl sldntgrae lal het itm,e aebeucs he lysaiblac i.)s iancgrenIs naexiyntgoo wlli lxera ihs yulnparmo uaversctual dna adceeesr isttpechyma ttnosmaiuli hgtruouoht hte obdy, elndiga to a prod in oobdl .rruesesp +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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ranecdIse rcnriianltaa sersrupe thta estuslr in gCuihs'ns rdiat fo srciednea lodob rerpue,ss aulrgeirr a,hrenibtg adn yb.aiaarddcr ,uhsT hihg 2CO esiuncd giscnuh ritad dna fi uyo giev PP nhet it lliw ecuddre C2,O dan htne donw aretgule hte hstatpcymei on.iviosrncascott gnaylriOil eht ibrna dah so hmcu OC2 thta ti psaezzd out nda eirdt ot cerenias eht BP in odrre to hpus omre agytexenod bodlo to eht nbair.

sKaaAe/ljsp5-Sptmmkw/Aghfetbgmoq.Z/Ui.i.p:/stcg3rdC:J

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lispectedwumbologist  Bra"dra" dyi8ca4 bmp lol +
lispectedwumbologist  ehT hnternyepiso ni triutbeoscv espel paaen si ude ot isecenadr isapmtetych enot not cnisdeaer lrinraincata pseesrur omal +1
meningitis  wudtlmoeiicebotls@psg : Be mrueta hueogn ot rerccot hmrhei/ nda mevo o,n nto gahul ta h/im.reh +16
namesthegame22  Peslu tare yma be eadcftef by resusg fo stcmapyethi cvttayii rnigdu ipcena sepe,odsi hweoevr, sith ehatpnislroi hsa eebn slse yraled tddotrmensea nath atth eebenwt naaep tedaonnsni .yhper +



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