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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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submitted by ferrero(48)
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A ryev amrisli uetinosq I ahev esne in aQnbks will sak yhw a tpainte wtih trigh htaer fraeuil esod not elvpeod dmeae adn eht awesnr is riesndaec pcmitlayh r.edanaig I tog iths ouqtnies nrogw olganyiilr bcausee I derswena agnol iths niel fo aongrensi ubt I thkni ni isht ecsa it lla has to do hiwt WHEER teh xaret seepsrru si mngoci .mrfo nI tish etoqnsui eth tp sha iisoatlcd opnenheytsir os you cna hknit oaubt hte srrspeue as gmcnoi frdao"w"r so sngntcriiotc elarplyicrap resncphist nca netprve na aenescir in rpereuss ni eht piaacllyr edb. eHvweor rfo rtgih areth luireaf siht xtrea ldufi is ognmic fmro hte OTISEOPP eodciirnt (adwsrkbac mfro hte ghtri ta)rhe dna sntinortcgic picpyrlarlea pnisctesrh nac od innogth o(n pstipeoo esid of cylalpari e)db - teh nlyo yaw ot ptenrev damee is to caresine amylicthp a.agrined

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seagull  Teh oqsituen yrlelac edla us ot ihtkn utoab ocmtOis pserusre by ltnkagi atbou enpitro nda unre.i I dnoewr owh nyma elpoep duse atht einl fo srngeiano el(ik lfe?)yms +20
mousie  rateG xlto,ninapea I cheos ytlipcmah ridangea rof het aems oreniasgn iamsr(li Q no frfdniete bna)k +9
sympathetikey  yM rgnnoaies aws much omre mitiisslcp mba(ye oto epm)lis utb in my im,dn lyiosstc PB si demreident yb dacriaC uuptOt and ltisdiaoc PB is nemrteiedd yb iorlre.taes Troerefh,e hwat mceos eoferb the paillrcya adn usltereag cs?srneaeti e.rlAtseoir Tts'ha why I asid atht yprcallareip- te.sersanic +41
cr  het iamn enecirdffe enebewt teh 2 seasc si tath in sthi caes the eatptin ash ihhg BP +1
link981  So in agnirtkdeern anulgaeg the nsqetuoi is elnlatisyes niakgs ohw ighh ruesrpes in het atrerila yssmte is OTN setidamtrtn ot eth novuse stmsye h(cwhi si rehew AEEMD osp)l.veed uBt you wnok yhet aehv to add lla hits noif to tyr fuseocn a ascbi cipelrnpi nda meka oyu ensodc uessg .ylrueosf (Got ti grown by eht y)wa aeeucbs of twha rro@fere adsi fo kQanb i.soueqtns +9
hello  rreref@o awth aer ouy antkigl ou?atb hlmpiatcy igdrenaa is het rngow s.n.rae.w +1
hello  ok nreev nimd. i gto t.i dahr ot usenraddnt bc/ it was a gbi kbolc fo .extt +2
asteroides  I tnkih htey yam be anilkgt uoabt het nyiomcge pynocrsmaeto emmshc:ani /fn3g5nv44k.e.w4ewhB=i/ot/t?rruoges.Krc:jt/bpy/o.fpiotnhilo5o1w/i/.mbbsncgNlnareI"ceds rilatera ro sounve uerrpsse alos sdencui ecnmgoiy ttocsnroncii fo rtrleeasoi nad ipcpaylearrl htscp,risen chhwi issaer roraeliatr eisacnsrte (ytbereh nmgziiimni teh eienrsca in arcpylail uerrs)spe dna resuedc het mlaarusvocric frsceua raea abvliaael rfo ulfdi gheFonr ax.ce pe,almxe eucaseb sucalrav mhtoos csmelu ni ielrrtaa adn rioetararl awlls tsnrocact enwh xdesoep ot eaedtvel cntarvisluara re,persuss tihs iengycmo sorepnes niressace relayparilcp nrcsetesia nda ttpoersc piarlisacle ofmr a nctmaoicnot ries in trieh vtclasnaiaurr usspeer".r +7
stsfyt  ksmae s.esne imetmeoss ew use slanidoBoavC(C)ti + tlnioeovnadi A(EI)C omocb ot canable teh sus,perer dna veernpt alkaege adn demea. +

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)


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submitted by staph_aureusxx(9)
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aclyerpprial cinssaeetr = ecrdniigsb eth setloa.irer 'ehs tog lnmiaim ptneroi ni het ni;uer nad on mau.nbil hte eyk swa gnipay ottentnia to teh bodol upsrr.ees eseusPrr is agdtleeru by teh nestsecari lsseves as oarsdb lcsla ti hchwi si teh eslaierrto aka lyplperacair rses.cnteia

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submitted by notadoctor(175)
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'evI bnee nagserhci ofr my csureo ofr tshi but t'can seem to fidn t.i weHerv,o teh ywa I otughht bauot it swa thta emead nhpapes via hte acaliie.lpsr fI etreh is esnieradc sesrcneiat via eth lipreaapylrc csriptsneh as mchu bdool 'nwtluod be beal ot egt noti the aierlis.alcp heT odobl udlow ntdsiae get neudsht aiv tnssaeasoom to het nisve. sThi certlai mfor p.ohcvmsgoiycyol exanlsip it a litlet bre:tte CV oioPlg:yhsy Tsiuse dEmea dan neralGe lenrciisPp fo cpyTllrraasain Fdlui eEhcngax

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 +1  upvote downvote
submitted by chagas14(1)
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bMyea the qtisuneo is gnedali htiw the otnccep of gcemiyno erraorltia iiocnctnvrtsaoso cwihh si a roehant deiatam-en hmacisen.m The per yaraicpll nscierpht tntcacor in oenepsrs ot a irsea ni B.P I tog hte Q rgwno useaebc I dkpcei mialhpcty wo.lf hTey loev to go fro hte h"twa e"lse eelment of yna pico.t I nnoact fidn ayn roesna hyw eht lacmtyiph poiotn ucodl be owrgn :/

whnhNwB.bc5loop.gc.:tse4l/pnwb/3.4v/oma5is/t=/tnsicsroi?rKk Ccehk het feirug .41 hTe aiMrng of Syafet Astanig deamE oiartmoFn – mdeEa tyeSfa tarsocF

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submitted by adong(144)
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nI aoidndti ot thaw hsa alayedr neeb asdi I inhkt na impnaortt tipno in teh eqnuiost aws rgyelutoar smtsaedjnut chwih optnis oerm towrdas roiltreaar tl.irnoeagu

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submitted by usmleaspirant2020(9)
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5690fdd190/b576nup7od1c29dsd2cee00yl0c002/to.tr3ba9i2ed/oh7a/dcne2.e73ft:ue2eftf

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submitted by ninja3232(11)
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eW"hn rlarieta pseusrer sl,alf eginycom nteo si cdudere ni lertroi,sea rgceanesid ietrh eanescstri ot fowl nda iiinnmaangt yiclrlpaa usree.prs Tehes naesboositvr usstegg ttha raylpclia psursree aym eb gdutleare voer eth mesa anreg fo erersusp sahgenc evro cihwh wfol is oetrdgelauuat ni a inevg .rngoa Ined,de rfom the "role:inat

4/o/Boi54:t//hlont5Nkwgbw.bn.h3wm/Ksv.sc.inp

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submitted by hello(429)
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why si asplma tocnioc ursresep rnw?go

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rainlad  I thnik its' esacebu ew wolud eptxec ot ese meso mero iilrniparaiuamruuboent/ if teh lsmpaa ntciooc rseueprs had niesreadc to cntsameeop +1



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submitted by ferrero(48)
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A rvye armlisi oeuiqnst I heva eesn in Qsnkab llwi aks yhw a titnape thwi rihtg aehtr alifrue esdo tno elvoped emaed nad het ernwsa si erencdsia ylipmctha edigan.ra I tog tish unqoiste ownrg yirnlolagi eusbace I ewanrsde lnoga shit nlei of raeignsno tub I htnki in tish scae ti lal hsa to do twhi RWEHE hte aetrx peuerrss si omncig fom.r In isht tensuoiq het pt ash dscitlaoi ntyoreshnpie os yuo nca tnhik about the perrsesu as gmionc w"raod"rf so oiscnntrtcig rilapecpayrl ihpsrscetn anc evrtenp an icnreesa ni seerrsup in het clrapaiyl ed.b rwoveeH rof higtr ehart uiflaer shti xaret ifdul si iongmc ofrm hte PPTISOOE ioincertd aadrkcbws( mfor the hrtgi e)hatr dna itoitncrscgn erlplcaripay iepctsrhsn cna od gnnoith o(n sopoipet idse of yairlpcla dbe) - hte yonl wya to etnervp demae is ot rcesinae ytiamcphl greaa.din

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 -1  upvote downvote
submitted by usmleuser007(464)
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Aroitc iDtaocisl rerPes su

  • ghHi RPT = ihhg DP
  • gHih RH = ihgh DP
  • gHhi SV = hhig DP

iAtrco Sycitols srer Peus

  • ihgH Ctnroiyialctt = hgih PS
  • gHhi SV = hgih PS
  • Low nopiceCaml = hihg SP

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 -1  upvote downvote
submitted by spow(50)
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I olas inhkt taht eth niotp nbegi made eerh si otabu enma elritara rpseuesr PM),A( ihwhc is twha ryoutagrtuoale emstsys yutaacll nacegh ebasd on. asuBeec eh hsa dinaesrce PAM (ude ot draiescne BD,P) het iasrelpcail ilwl scrttcnio to atnnimai nsttonca reprofwlue/ss ghothur eth aclarlpiy bd.e

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 -3  upvote downvote
submitted by divya(75)
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i 'dton khnti oyu ndee to nhtki all atht chum. olok ta lla hte instpoo dna htkni fo ahwt pnapshe ehnw thye se.arcAi,en B, C, D dan F lal cna ecuas sliittitaren mdaBu.ete enascnrgii cyeapiplrlar srientcesa iidneyeflt o'd.ents

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drzed  nedcasreI lahpyitmc flwo dulwo otn eacsu tinstlirieat ema.ed +1
123ojm  tbu ti s'ndoet asy enea"sric n,i" it just sysa yu"rlreaotg jstuedtnasm .in" +1



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submitted by usmleuser007(464)
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.1 Artcio sDctiioal rruePess 1. Hghi TRP = hgih DP .2 hgHi HR = ghih D P .3 gihH SV = hgih PD 2. itrcAo ltsSiyco serPreus .1 hgiH Ciirytalttcon = ihgh PS 2. ihgH SV = hhgi SP .3 Low iclmaepCon = ghih SP
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yex  o10itch/iyMt.mlpacco:cvipghM2nsoryst/ulior/o/c sihT lpesh ,hooewsm the trfis arpt oubta racyillap esr.urpse +
usmlelol  atsh't the pxe p:ar:t T eh aeergva ilyalcpra yoiactrdtsh userresp si dteeemndri by erlaiart nad seounv ssrurseep (AP dan P,)V and by the rtiao fo lrpra-oseip-aptoyctl tcseserinsa )R(/.RVA An sieceanr in etehir iaretarl or unosev suerpsre ilwl rsiceean pylaaicrl psuesr;er eeor,hwv a vgeni ghnace in PA si lnoy uotab hfefniot- as feevficte in hncanggi PC sa eht emsa utsleaob agnehc in PV. ueecBas seunvo eserstanci si lleytarvei wlo, anesghc in VP rea yredlia dirntsemtat akbc to het paiyllcra, dan srnvee,yocl abeusce aiterrla nesaeircts si vyeatilrel ,gihh nsahegc in PA era oopryl edrattsnimt adrtwesnmo to eht .yllpacria +1



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