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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 vyer lmarisi qiunstoe I aevh esen ni kQansb ilwl ska hwy a ttpinea with igrth hetar ufiaelr osed ont ovpedle damee adn het renasw is inerscdea ylchimatp iandraeg. I ogt ihst tuoiqsen rnwog yoilginlra sebauec I erandsew lnaog hits lnie of soiennrga tub I ihknt ni stih eacs it all sha ot od wthi RWEHE teh aetrx seeuprsr is oginmc mofr. nI sith oteqiusn het pt ahs saioticld rpeohnyntsie so ouy cna kniht btoua het erpessru sa mgcnoi dforw"ra" os ctrniisgoctn aaplcerirypl esricpthns can pneterv an ercinsea ni sepurrse ni eht claapylri bed. oreHewv ofr ihrtg rateh urlafei htsi rxtae uilfd si omgcin mrfo teh SOEPPIOT tdioercin karcasb(wd morf eht hirtg arth)e adn rinccnitsgto palyrrpeailc snphscrtie acn do otgnhin on( ootpeips esdi of llrapiayc db)e - hte nyol ywa ot pervent meaed si ot nseeacri ymltpciah .garniaed

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seagull  hTe itqusnoe lcraley adle su to ihktn oubat omtcisO suprerse yb gitlank otabu tinepro dna ireu.n I wednro who amny epeolp edus htat leni fo rgnnosiea kil(e ?yems)fl +20
mousie  teGar txnnaploie,a I ceosh mcalihpyt igdaenar orf hte sema einsraong si(lrami Q no dreintffe )abkn +9
sympathetikey  yM agsoinnre asw cuhm emor islsiimtpc yabm(e oto e)slipm utb in ym m,ndi cilossty PB si eereddnmti yb daaircC uOuttp nda dsoctiila PB si emetdredin yb rlrae.iseto Treereo,hf ahtw mesco ferbeo het acpllyria dan elusaegtr ateeis?crns eeositrrAl. ahts'T hyw I siad htat p-aircareplly n.sateicser +41
cr  eht nmai cifefdenre weetnbe eht 2 csase is ttha in this aesc eht eiaptnt ash high BP +1
link981  oS in inreraedntgk genuaalg eth uteqonis is yellssieatn igkasn how hihg epesrsur ni the rerlaati msesty si TNO dtasenimttr to eht svueon ssmyte cihwh( is hwree DEMAE ls.pv)odee tuB uoy know tehy hvae to add lal sthi nifo ot ytr feosnuc a aicsb epciiprnl and maek uyo sdcoen ussge f.usolrey (toG ti owrgn yb eht way) usebcea of thwa erorf@re isda of nbkQa .enoqsitus +9
hello  e@rfeorr htaw rea uyo kalgitn o?ubta pythlmcai ingredaa si teh owgnr asw.e..nr +1
hello  ko nreev .nimd i gto ti. ahrd ot desdrutnna bc/ it asw a gib bcokl fo .tetx +2
asteroides  I itkhn hyte yam eb gintlak baout hte myeiognc moeyracostpn aehincms:m w4bsgnrgwj.h4lrpNoBipv4fhn1tb.//5beoo?5Kot.low=t/gyrein/uoni/kmi./3:scc/fte.c eIenr"ads taealrir or onuvse srerupes sloa uidescn oycenigm scttniocorin of rsrletaoei dan lreylcappira spcs,rhietn ihhwc raisse eatrilarro aesecnirst et(erybh zmiminigin eht sinercea in cairyllap r)pureses adn cerdeus teh orasmliccvaur aucsref area aelavbali for lifud exaechnrogF . mxe,eapl eabcsue srlvauca motosh lescmu ni rirtaela adn irtealrora llwsa nttsarcco wenh eopxsde to edevealt ractuarvnlsia ur,psseser thsi ecniymog psoneesr resnsaiec yipelcarlarp etrieasnsc dna sotpctre aesiiprlcal romf a aomnnitotcc seir ni htrie uairrcnsltava euspsrer." +7
stsfyt  kmase n.esse seostemim we ues )CionivlBa(soatdC + edovnnltoiia ()CEIA cmoob to bacaenl het eprru,ses nad pnveetr agkelea nda dee.am +

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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yparepllaric sseaertcni = rsgiincbed eht lesai.retro 'ehs tog lmiinam ineotpr in teh ier;un adn no lbm.unia the eky asw gapnyi eaotnintt to het lbodo rrepusse. Psusrree si eulgtrdae yb teh asintcerse lveesss as rsodba sclal ti hchwi is hte easrrlteio aak laiacrelppry ees.saitrnc

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submitted by notadoctor(175)
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Ie'v eben esrinhgca fro my orsecu rfo isth but anc't emes to dinf .ti rHevw,eo the yaw I gttuohh bouat ti was ttah emdea haeppsn avi het eilapcia.lsr If ehret is eeiadnsrc acensierst via het ayrlprapiecl shsctienrp as humc oodbl n'odluwt eb eabl to gte oint the lilsaapcir.e heT ldboo oludw iendtsa egt thdusen avi tesnsmaooas ot teh vine.s ihsT tcirlae mrof pvychco.yloigmso nsxielpa ti a illtte teb:ert VC o:isPlgoyyh uisTes Emdae adn leerGna rlPipiensc of nlsaliraTcayrp ludiF cegxhaEn

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 +1  upvote downvote
submitted by chagas14(1)
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Meyab hte iuoenqts is geildna thwi eht enctocp of gymnicoe aerriolatr tntoiraocvsnsioc hcihw is a heanotr tdmenaia-e asmhcniem. The rep palalyicr terhicnsp rnttocca ni ersnpose ot a iaser ni B.P I otg het Q wnrgo ucseabe I pieckd lctmayhip wolf. hTey lvoe to go fro teh ta"wh sel"e eetlnme fo yan io.pct I tcnoan idfn any aosren ywh eth mtcaypilh ontpio oculd be rgnow /:

.eBcw/N/nntsmlpo4a.?4iKci//biro53hplbockv=ots5ntwws:sr/h.g.ckChe hte efirgu 41. ehT gnariM of eSftay Atsiang deamE artFooinm – aedmE yetSfa oFtarsc

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submitted by adong(144)
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nI diatdnoi to twha ahs edaarly ebne dsia I htkin na toniraptm otpin ni hte snqtoiue was rlgeorutay enjduatsstm hihcw nostip moer twrdoas raeaoirltr glu.atreion

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submitted by usmleaspirant2020(9)
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ta760ouc5t/edy.de9b1af9s272did932d/0d7tf0t000nle225cbeeocp/21de9/:3f.ocfh7e06nur

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submitted by ninja3232(11)
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"ehWn riratale preressu f,sall micenygo oten si uecdder in etairre,slo sgeedniarc reiht scsneetrai to lowf and ngmnaaitini pcrylalia rsepurs.e esThe boeinatsosrv uessgtg tath plcyalria puesrsre yma eb lugadteer voer hte saem rgnae of eesrsrup csgneha orev hwhci flow si aoeugutreltad in a eving .rogna d,ndIee orfm het iloarte":n

omos5plw.4./owN5ht:cBhwi/.K/3nbsgntbi4.vk//n

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submitted by hello(429)
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ywh is aplasm citnooc sueperrs wo?grn

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rainlad  I hiknt st'i seeucba ew udlwo xtecep ot ees meso emro buriprianam/ruuaenlitoi fi hte maalsp cotcoin ersusepr adh icnderase ot ensmaeptco +1



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submitted by ferrero(48)
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A reyv samirli eqotuins I eahv eesn ni snkbQa wlil ska wyh a nttaeip ihwt htrgi ethar fraluei esdo otn olvedpe aemed nad teh rnewas is edisecran mhltciayp .rgeinaad I ogt shti ntuesqio wongr aiylnglrio basucee I raewndse aolgn shit leni of grnianoes ubt I kinth ni sith esac it lla ash ot do wthi EWHER eth atrex serrpuse si noimgc m.orf In ihts ioentusq hte pt hsa otdsiacli ieetrnyonsph os oyu nac nihkt ubato eht rsreespu as goicnm wadrfo""r so nrgcntcisoti paelylriapcr hcrptniess anc nveetpr an reesinca ni rpseusre in teh laralycip ed.b wvoHere for thrig ahtre rflieau siht eatrx ifdlu is mgoicn omfr het ESPPOOTI nidtreico rdaw(bsack rfmo het irhtg )rehat dna tnsciiongcrt alrielrcpapy hectprinss anc od tngnioh (on toeoppsi ised of yaplialcr )edb - het ylno wya to rneevpt eamed si ot eisaernc tlyihampc eig.ndaar

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 -1  upvote downvote
submitted by usmleuser007(464)
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oAcrit cslDtoiia Pe esrusr

  • ghiH PTR = hghi PD
  • hHgi RH = ghhi DP
  • ghHi SV = ighh PD

iroAtc yoSltcsi ruer ePss

  • hgHi ltitaitnyorcC = hghi PS
  • hHgi VS = hihg SP
  • owL lCpiamcneo = hhig PS

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 -1  upvote downvote
submitted by spow(50)
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I sloa nihkt ahtt teh inotp gebin dmea eher is outba amen arialert eressrup )APM(, whcih si hwta yteaugoluoratr ssmytes cyluaalt hgncea ebasd .on Bacsuee he sha nedreicas PMA u(ed ot adceierns B)P,D the iprislacale illw ccsttionr ot tnainiam ntnscaot w/oerfpsulres gtoruhh teh clrialayp dbe.

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 -3  upvote downvote
submitted by divya(75)
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i 'tndo iktnh ouy ndee ot kthni lal hatt uc.mh olok ta lla eth ioonstp dan ihntk fo hwat nhpsepa hnew yhte ieAas ,ecn.r ,B C, D nda F lal anc cause iaettsniltir uB.det aem cnsaeiirng crilpeayrpla sesreitcna eitefinlyd e.'tdnso

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drzed  naIseerdc cmlpthyai lwfo duwol otn eausc ltatnteiisri ea.dem +1
123ojm  ubt it nsodet' ays ne"ecrsai ,"ni it sjtu syas rt"ogluayre dsuttnsjeam .i"n +1



 -3  upvote downvote
submitted by usmleuser007(464)
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1. icAotr taclsioDi Preusrse 1. gHhi RTP = ihhg PD 2. ghHi HR = hghi PD .3 hgiH SV = ghih PD 2. Aorict sSctloyi Peessrru .1 gHih otanyttlriciC = hgih SP .2 gihH SV = hhig PS 3. woL placoiCemn = hihg P S
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yex  itM0:o/tn1/s/o2gipachm.schvrylyruiMpoi/lccocot hsiT shlep wesomh,o eht rtfis prta uboat iclaaplyr ur.esrsep +
usmlelol  'hatts teh xep art::p ehT ravgeea alcpyilar crihaotdyst eseurspr si ddreieemtn yb aarierlt nad oeusnv psursrese PA( dna PV,) dna yb the rtoia fo oyrp-pitlcp-aratlose ssirtacsene A)(/R.RV An ecrnasie ni etrhei aietrral ro snueov srepseru llwi ceasiren aypcialrl p;sereurs evreh,wo a geivn hngaec ni PA is lyno ubtoa fftioen-h as fcefeivet ni inhngcag PC as teh smea lbuaoets chgnea ni .PV euasecB nseuvo neeisrstca is lylteirave l,wo hsagcne in PV ear aldeiry ainetsttmrd kbac to eht iallrp,acy nda vesonelc,ry euesbca ilretaar ntesecsria si tyeilelvra i,ghh egnacsh ni AP rae lpoyor nstmtadteir saenwodmrt to eht i.lacarply +1



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