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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 letllyair jtus leaidrze ywh shit uotneiqs cunsdefo em so umhc a(nd eI'v eitrd ot ifergu ti uto a oclupe fo meti,s oll). I let eht ailoluclqo otnnieidfi of aumiibl ..ei( intom)vgi sctik in my id,mn htta I rogtof teh aatulc lcaeidm tndneiiifo = lonrma MBI ;t&)1(8g + ignbe ngetai adn prinugg rwh(ee rnuggpi loucd be nddeiuc nomtiigv or iecuditr use or xteaialv sue adon/r veecisesx .exeri)ces oS ealyr,l hawt tihs senoqitu wsa gksain si mliysp tahw is het eelrcltoeyt elnbcaa fo vsxeeicse arhi?ared EEZG! I dmea it os hmcu erarhd ni my hdae wnhe rtygin to wesran ti yarligli.on

hiraeraD ecssua n-anonnoi gap e.(i. hmcerpieoyhlcr) ibomlctea sidis.coa toSol ryaetdmnoplni stinaonc OH-C3 adn +,K os xesieecsv ridaerah = csveseiex olss of 3-COH dna .K+ direoChl elvsle in eth esrum ilwl eb ceedrsnai ued ot eth nlorma OHl/3--CC ubqil,eirumi so as inaeegvt carehg sasdtispie deu ot sslo of HC-O3, -lC illw crsaiene rgccetinro hte oanga-np.i

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drdoom  milBaiu ecosm fmor rGeek vuraosne" hn;rueg" eht tmre is a eillatr cncoaatnoeint of teh wdsor orf xo sob)(u + rgnehu so)(i.lm ,So ni ,ekerG uami-ilbo si ratlleily ox" r"ghe,un whhic is a odn ot woh het rodw si udes ni idencime = rltapueep dna saialbiten ipeatpet fro dfoo e(ht yerv eooptis"p" fo o.tiign)mv +5
abhishek021196  I reage ihwt ruoy anisrgeno btu teh asiclsc aesc rodntiipesc of limaBu litss eeecltorlty tncubdriaes fo Okaap,yHmeil ,yOmarcoHhpeil nda iMateclob ,kalsslAio ongal thwi toreh ngisht kile prdiota yryorehptph nda drsola hand luaselsc due ot the eudncdi .tgoiinvm I prpidet pu eethr. F:/A 02 gP 765 +
llamastep1  eTak ohem :nosesl nsgeniora t;&g omziigemnr +3
lulumomovicky  I hhgtout eomr of it yb eht follo:giwn eht tainetp olses OHC3 ni eth otslso adn hsit iadraerh euassc teh Mobitcale aiscodsi. uBeasce laonmr H/C3OlC riiilemuqbu ldsouh be atie,amdnin coheridl lleesv in rusme go up to mencpoesta teh sols of B.icbra As eht iapnett si osla IOEYHOCMVLP due ot BP of 6,8/19 hnet ARAS evaiac.stt esltroAoned ilwl sneierac Na dna retaw irnorebspaot ot kpee almovie dna K lwli eb edxteerc .eaamyo()ihkpl sAol AeasP-HT ni the dttaiecnrela eclsl fo the etilgccoln udct lliw be aatceivtd by seootnarled, rterfuh noigagprpta eth melitoacb .oicsdasi +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 hhottgu iluibma eigv esir ot tmoieclba ksaaolisl ..ca.n soemeon laaebotre ?

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drdoom  Rmrbeem,e libmaui sftiel esod nto maen rg;”“gunpi it smena “-urxoghne.” It si ungirpg .g(e,. alintnnetoi ioimtn,gv aevxltia eusab, rtuecdii ueb,sa isxeseecv ise,rcexe or exmetre tisgaf)n whchi tseaecr bcteoailm bunide.rtcsa hTe tpey of cdnbteasrui epsnded on yuro rreefdpre etrou of e”x.it“ +2



 -3  upvote downvote
submitted by dr.xx(176)
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ubeAs of sixatvlea t;&g= uyasllu dredcseae seumr osuip.tams sA ot rldioche dan biab,cr atht spednd.e eyTh lcdou eb nidsrecae ro ecad.eresd

31//5.wat4h0.pp.p//gfl/tarf30/5mw:00owsa2t1hp

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 -4  upvote downvote
submitted by usmleuser007(464)
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rtaTe isht ilke a aVmIPo rtWea(y ead,ihrar ldyaacihohrr = ecedudr ClH ni teh ne,mlu m;&pa paohymiakl)e

siht illw edla to catmelboi iaosscdi /td osls of aicbbr in oostl

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btl_nyc  iorCedhl si ernicsead gotuh.h +
maxillarythirdmolar  iThs mnotcem si ldo.g _ctln@by, tihs is llcatuay t.ecauc you duowl tceexp c leimahrpyherowbtkn/n8hlcib./o.ph6w:w9imBo.7gsNn5/sv/K.0/ot +1



 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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Bset moncemt i aedr wsa to trate tsih elik 'its a .maPVoI uoY oduwl get lla ethre /iebyeeltclatmoeolctr saitnueds.crb

/Bnmonc.wpw.h/hlNivkt9in//tK7.o6ss.wbgo:850/b

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