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Retired NBME 23 Answers

nbme23/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man has a diastolic blood ...
Precapillary resistance 🔍 / 📺 / 🌳 / 📖
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 +46  upvote downvote
submitted by ferrero(48)
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A evry amilisr toiqeuns I vaeh nsee in Qbsnka iwll ska yhw a eanptit tiwh htrig etrha airlfeu dsoe otn pleodev amede dan teh nesarw is nraiscdee tmyalhicp dai.gerna I ogt htsi oqtunsei gownr lolanyirig abescue I wrnseade gnloa isth elin fo nsengiaor btu I ktnih in tish seac it all ahs to do htiw HEWER eth etaxr pesuerrs si ncmgoi rm.of In siht oeqsitnu eth pt hsa lsocdatii nensyeoptihr so oyu nca nktih botua teh upsreers as iognmc f""aordwr so gosnicnrittc eyplrliacarp sihntercps anc vrenpet na cerenasi ni esepurrs in teh pyalcrial .bed vewreHo fro trigh ahrte frileua hsit ertxa luifd is iomgcn rfom hte SIOPTPOE nrcdioeit ckrsaaw(bd mrof hte igtrh e)atrh adn gicirscnontt ilpacerrypal ecirphtsns cna do ohgnitn (on otpepois deis fo paylircla )dbe - eht noyl wya ot npreevt amede si ot rnieasce mypilahtc rgnaed.ai

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seagull  hTe tusoiqen lyalcre aedl us ot ktihn utoab cmtsOoi ueerpssr yb nalktgi ouatb irentop nad iuenr. I deonrw who ynam eoppel desu taht enil fo nsnoaeirg iel(k m?fsely) +20
mousie  eaGtr paexnot,ialn I echso thylaimcp naidaegr for het aems naosrigne i(rilsma Q no dnfefriet a)nkb +9
sympathetikey  yM aiegrnnos aws mhuc roem msliicipst yeba(m too )lipems but ni ym ,dinm lsctisyo PB is rmeetdnied yb iaracdC Output dna itdscloia PB si idmetendre yb trreoelai.s f,ehorTeer atwh cmose eeobrf eth iyalpracl adn etueasgrl srcee?naits .rletAeirso sThat' why I aids htat raceipry-pall et.arsseinc +41
cr  teh main dcffeenrei eeewbtn hte 2 sseac is ahtt in tshi scae eth ietpatn sha ihgh PB +1
link981  So in igrrdeknanet gneulaga the sutnoqie si aieesnsyllt sgnika owh hihg rpsresue in het artarile seysmt is NTO tetsimdrtna to eth oevnus ystsme hwih(c is hrewe DAMEE soe.lv)epd tBu yuo kwno ythe veha to add all ihts iofn to try ufsonec a asicb epiprilnc adn maek uoy ensodc seusg refoulsy. G(to ti nogrw yb the yaw) uaeesbc of hwat eerorr@f dsai of nkbQa neqotissu. +9
hello  @erreorf ahwt rea uyo ingaltk uba?ot chyiatpml nagiread is teh wrngo .wen..sar +1
hello  ok renve .indm i otg it. drah to uedanndtsr /bc ti aws a big kbclo fo tt.xe +2
asteroides  I kinth eyth mya be tnigakl oubta the gycnimeo syooernatmcp chaei:mmns mcoB./pno.hj:f5ekih/4wo//wlsg3gowi.rle=tp5b?.tbny1eotnori.c/rtgKvf44u/bi/Nsn"rcaeI snde iatlrera ro nsoveu seeurprs oasl iscduen ioygcemn cnnitorotsci fo rsoaelrtei dna rreailylcapp shrnct,espi hhwic sriaes ritalrroea teieasrcsn behry(te inizmmgnii teh rieecnas in rcalpayli rues)espr nad urdesce eth uciorvcmsrlaa sacufer raea lvabeilaa fro lduif .reg cFeoanhx lap,exme ebuceas rlcusava hstmoo lcsmeu in retarlai dan trleaoiarr salwl conrsatct ehwn exoepds to aeeedvtl tirralunsaacv spresuse,r htis oencyimg nepesosr eneasrisc lcpareaiyrlp cnestsraie and roespctt elilsrapica rmfo a nitmcoatonc iesr in ihetr luiavnsrratca esur."eprs +7
stsfyt  skmea e.essn mtisoeesm ew esu iiaCvoCB(anso)tld + ivtnilnoaoed )(IEAC mcobo ot anaeblc eth e,perusrs nda rveepnt kgeleaa dan dee.ma +

I think they are referring to maintenance of GFR and blood pressure relationships. Ergo the mentioning of the renal function. The precapillary resistance is "glomerular" precapillary resistance, so if that increases then GFR remains the same => prevents leakage of proteins and albumin => less edema.

https://www.youtube.com/watch?v=IRZsniaCfVQ

+2/- peqmd(75)

this is the concept of blood flow autuoregulation at the tissue level in response to increasesd arterial pressure via arteiolar remodeling via smooth muscle hyperplasia ....

+/- msw(4)


 +5  upvote downvote
submitted by staph_aureusxx(9)
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eiacallypprr anescisrte = rsegidibcn teh a.tlresreoi 'hse got anilimm ontipre ni eth i;eunr dna on b.lnamiu hte yek aws yganpi ntatieton to eht dlboo .usepersr sesrPrue is rledtugea by the esatrsneic veeslss sa adsrob sclla it hiwch is the treoerilsa aak yepairpcalrl n.eeatrssci

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submitted by notadoctor(175)
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'vIe bene rnagshcei rof ym ecrosu ofr isht btu anct' eesm ot fndi .it Hoe,wrev teh wya I tghutoh aubot it aws thta emeda phpasen iav het ascel.lpraii fI ehert si cniesdaer eaectnissr vai eht llpiyaprrcae hcsrtpisne as uhcm boold nluw'tod eb abel to get oitn teh peasliilra.c heT olodb owlud aesnitd get tehunds iva setosomanas ot eht vi.sne ishT ercilta mfro cyl.hiomvgcposyo xnlaepsi it a leltti etb:etr VC yPs:oihglyo eiTuss Edema dna elarneG slrcPienip fo lpaniyTrcrslaa Fliud Encxghea

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 +1  upvote downvote
submitted by chagas14(1)
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aMyeb eht stniuoeq si idelgna itwh eth cpcoetn of eygncmoi ratreiarol ncsisatioovocrtn ihhcw si a aroetnh neadaet-im hceas.minm heT epr lpilcayra cetnirpsh natotccr in nrssepoe ot a sarie ni P.B I gto eth Q nogwr ceebusa I cpdeik atchlmyip fo.wl yeTh vole to go fro the "htaw ee"ls etlmene of ayn .pocti I ctnoan find nay nosrea hwy eht ahcmplyti ptinoo udclo be ornwg :/

hnssr/lsm3ow45ot.pgcwhneKt.ociwin4lsipa?=//bN5bk./B:rct./vohCe ck eth uiferg 1.4 The rMnaig fo fayetS snigtAa aemEd maitForon – edEma Sfetya acrtsFo

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submitted by adong(144)
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nI doinidat ot hawt hsa edaraly bene idsa I kihnt na oanrmtitp otpni ni het qnoiseut was ourleryagt uemtasdjnts hicwh tsipno rmeo tdrwaso aierrolrta lngurtaeo.i

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submitted by usmleaspirant2020(9)
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f1nheb5y/t9f0t0.3d29/t2/i7featb:06r.3eucl9ood0nd72ea0de7sc2odfd05d/c2ce702e69up1

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submitted by ninja3232(11)
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heW"n elrtiara represus afs,ll nemgoyci ntoe si derdceu in ri,easertol secinraegd tireh nartiecess ot wfol nda igmnnitniaa raapclliy eep.ssrru eThse nbsavoseorit stsuegg ttah ialcylpra sepresru yma eb uaetledgr erov the asem renga fo sseurepr egsahnc revo wchhi flow is uteeladgtauro ni a egnvi .naogr In,dede orfm hte ol:nritea"

m/3s/h/NbKnw4:s.wnli/4ckBtbv.ooi.5g/op5.tnhw

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 +0  upvote downvote
submitted by hello(429)
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hyw si mplsaa ciontco urepsers ?grwno

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rainlad  I tkhin 'ist besaeuc we wodul cxepte to see some emro irliuuaouit/prmnaariben if hte pslmaa toiocnc resreusp dah aecesirnd to spneoemcta +1



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submitted by ferrero(48)
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A yrve srmiali oseqtiun I vhae nese in nbQask will ksa hyw a iptntae hitw rithg aerth liferua sdeo ton eovdlep demea and eht rawnse is dscenreai hycmtlaip grni.daae I gto htis oietuqns orngw nyrgaoiill ecesbau I rendaesw nlgoa tihs line of oaegnsinr but I htnki in tihs esca ti lla ahs ot do tiwh ERWHE eht rxtae prreusse si icgomn mr.of nI this neqtuios the pt sah sdctoaiil ieynntpohrse so ouy cna tnihk tuaob eht rpresseu as gimcon "frw"ador so sctircngotni rialylapperc hneirstscp can nteprve na srcniaee in eessurpr ni eht lyprlcaai db.e rwHovee rfo tihgr rteah aluefir siht teaxr lfidu is imngco form the SOIETPOP intdoriec bsw(rcdaak omfr the tgihr har)et dan gtrcitnncois rplapilyrcea rnechsptsi anc do otnghin (no sopoetpi ieds of lpariaycl bde) - eht ylno ayw to erntpve demea is to aeecsinr icmytaphl a.ragidne

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 -1  upvote downvote
submitted by usmleuser007(464)
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Atiorc acDitisol rP ssreue

  • Hghi RTP = high DP
  • giHh RH = ghih PD
  • gHhi SV = hhgi DP

tioAcr clSiytos srsurPe e

  • ghHi ytritoncltiaC = ighh SP
  • igHh VS = hhig PS
  • wLo mialoecpnC = ihgh SP

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 -1  upvote downvote
submitted by spow(50)
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I sola iktnh ahtt eth otpni biegn maed here is autbo amne errilata peersrsu (,)AMP ihwhc si atwh guatrooleyurat teysmss ulylaact echagn edbas n.o ecBasue he sha dniesecar PMA ued( ot eaedrinsc B,)PD eht aillpcaeris wlil nrciosctt to imnniaat stcnanot /lrseseoupfwr tuhogrh het arcylilpa db.e

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 -3  upvote downvote
submitted by divya(75)
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i dtno' nhikt ouy eedn ot tihkn lla htat mchu. oklo at lla eht otpsoni dna nikth fo awht snehapp wnhe hety , asiee.ncAr ,B ,C D adn F lla anc aseuc tarintsiltie mt due.Bea iaencgsinr crelpiarylap srnceasiet eyildfetni denso't.

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drzed  racsdeeIn myhtcpila lfwo oldwu nto eaucs aieltintitsr ae.edm +1
123ojm  utb ti tesnod' asy icenesr"a ,i"n ti jstu yssa agrtre"ulyo atusnjmtdes ".ni +1



 -3  upvote downvote
submitted by usmleuser007(464)
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1. ctrioA iicDlaots errPseus 1. iHgh TRP = hhgi DP 2. ihHg HR = ighh DP 3. hgHi VS = gihh PD 2. irAoct Sicstoyl errseusP .1 Hhgi iayCtrcoiltnt = hihg PS .2 higH VS = hhig S P .3 Lwo comieanplC = ihhg SP
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yex  iiyi0h:.M/ccscucyc2/rsvoo/tai1Mgnt/llpmoorptoh Thsi shepl weho,osm hte trifs prat utbao yirlacalp srsu.peer +
usmlelol  ht'ats eth exp t:ar:p Th e gaeerav laayripcl cotasidyrht eprssrue si dimreented by areaitlr dan eonusv prussseer PA( and VP), nda yb the atoir of -ryptlpasiceo-aoptrl rineatcsses /VRR.(A) An ensercia ni ihtere elariart ro evsoun rrspuees illw nsieraec raylaplci sseup;rre hvworee, a ivgne cagehn in AP is yonl tabou tfifho-ne as tifefveec ni gihncang PC sa eht emas betlsoau cghaen ni VP. esucaeB suveon snctaeresi si ltvrayeeil ,wlo seacngh in VP ear ileyadr itstnratmed bakc to eth icayprlla, adn e,evyrnsclo aecsueb rtileara caserisent is ytrelveial ,hghi escahgn in AP are prooly tnisaetrdmt anorswmedt to teh iplrcl.aya +1



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