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Retired NBME 23 Answers

nbme23/Block 4/Question#33 (reveal difficulty score)
A 16-year-old girl with bulimia nervosa is ...
Potassium: decreased;
Chloride: increased;
Bicarbonate: decreased
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 +13  upvote downvote
submitted by nwinkelmann(366)
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I eyarlllti sujt irzdeela hyw isth qointues confudse em so cuhm dan( 'vIe idtre to erugfi it tou a euoplc of emsit, o)ll. I elt het qolcuiolla nditfeioin of biamiul (..ie ivnmot)gi cskti ni ym ndm,i that I orgotf hte atucla iademcl ioitfndein = olamnr MBI 8);>1( + gnieb enitga dan rgpnugi hrwee( pgigrnu duolc eb ndudcei onimgtvi ro ctiideru ues or atilevax seu rnod/a ieveecxss rcs.)eieex So llre,ya twah this nsouqtie aws gnskai si pimlys tawh si teh oelyecrtlet balenca fo eesisvcxe idae?rhra GEE!Z I made ti os hmuc harred ni ym ehda when rytnig to nrewas ti gla.lrinoyi

arehDria secusa ono-nnina gpa (.i.e ec)hyhriloercmp omiteclba ssa.icodi tolSo oairdentmnply soinnatc CO3H- nad +K, so svxeecsie earrdhai = viesxeecs ossl fo OH3C- and +K. olieCdhr vselel ni eth mrues liwl be dercinesa ude ot teh mlanro 3-COlH-C/ umiieuli,rbq os sa gitvneae chgare pdsstesiai deu ot slos fo C3O,-H lC- llwi eeairncs gcteorcrin eth o.anang-pi

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drdoom  uimailB coems from eeGrk "vnouesra e;"hngur eht ertm is a iatlerl ntctnoenoaica of het wdros orf ox (o)sub + gneruh lo(ism). oS, in ,keGer amuoil-ib si raeliltyl "xo rgnh,u"e hhiwc si a ndo to how eth dowr is duse in deinmeci = aleerpptu dan aniaslietb aetiptpe orf dofo eht( ervy oops"i"etp of ni.)tgvimo +5
abhishek021196  I agere tiwh uroy areiognns tbu eth lsicsca asec reotpinscdi fo mBaliu itsls celyteetrol abusirendct of peO,iHlamyak ,eyoimcHOlhpra nad caMitbelo laAols,sik oagnl whit othre hngtsi elik otadpri opetryphhyr nad rsdola nahd saulescl ude to the dndceui ntmio.igv I tpeirdp pu .eehtr /:F A 20 gP 756 +
llamastep1  eakT ehmo sonle:s nraegions t&g; mimnieorzg +3
lulumomovicky  I hgthout emor of ti by het floo:lignw hte enittap osles OCH3 in teh sstool adn sthi hriraade uasesc het ibMetalco assdii.oc ecBueas mlanro CC3lH/O uburliqeiim suhldo be imann,atedi lordcihe elevls in esrmu og up ot pomancetes eth sslo fo a.rbciB sA het ttpeina si olsa MLCYOOVEPHI eud ot PB of ,/9618 ethn ARSA .tviscetaa esoAeldonrt iwll ncreesai aN dan tawre itprronasboe to pkee volmiae dna K lliw eb exerdect hkae.aoylipm)( Alos TaeAP-sH ni teh nlcatedaetri cslel fo teh cogcleintl dcut iwll be dtticavae by ol,sortenaed rertuhf pnpgairatog hte amocieblt dsoica.si +1

bulimia ≠ purging  Bulimia comes from Greek “ravenous hunger”; literally “ox hunger” = ox (bous) + hunger (limos).

+5/- drdoom(1206)

N.B., there are many ways to “purge”; the method of purge determines the observed electrolyte disturbance. A nice description of bulimia nervosa from MeSH:

BULIMIA NERVOSA. An eating disorder that is characterized by a cycle of binge eating (BULIMIA or bingeing) followed by inappropriate acts (purging) to avert weight gain. Purging methods often include self-induced VOMITING, use of LAXATIVES or DIURETICS, excessive exercise, and FASTING.

+1/- drdoom(1206)


 +1  upvote downvote
submitted by brookly_(1)
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I guohtht umailib iveg iser to maelticbo oslaklias acn... enmoose eortalbea ?

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drdoom  Reemm,rbe blmiuia siltef esdo ont anem pg”“iurg;n it amens “xerno-hug”. It is gpuinrg .,(eg. innitaetoln mvinot,gi lxtavaie s,beau ercidiut bua,es eseecsvxi x,screiee ro reetmxe )igfnast hwihc rtescea meobilcat .autiecdnsbr hTe yetp of tbusraeicnd eepddns no oury reerefprd touer of .ixte“” +2



 -3  upvote downvote
submitted by dr.xx(176)
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bAesu of liatexvas ;&g=t ausyull rscdeedea mseru uasostipm. sA ot drihocel dna a,bbirc ttah pn.desed eyhT ulocd be ierndseca or deceadrse.

30tfl3/h02o/a.t150tmfa4aw.:w/pwh01r/5pp.ps/g/

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 -4  upvote downvote
submitted by usmleuser007(464)
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rTtae itsh ilek a aoPIVm yaerWt( adier,hra hrohlcrayida = uderedc lHC in the ulme,n m&pa; ik)hopelmaya

tsih iwll eadl ot lbeaomcti scdaiosi td/ sosl of iarbcb ni lotso

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btl_nyc  hiCdelor is irecednas uoh.thg +
maxillarythirdmolar  hiTs tmonecm is og.ld b@tl_cny, tshi si alyculat cucat.e oyu dluow pctxee e lohhiryrecpma.nn68.tp/07wbcs.wb9Nl/m//iohgst5k:v./owKoBinh +1



 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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Btse cenmomt i edra wsa to artet shit keli 'tis a oI.VamP You uolwd egt all ether leeatyeorlet/obmlitcc bud.ianstercs

7./w08c/tBmsKivn9ohN./.hogl.bwsnbn//6o:iptk5w

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