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Retired NBME 20 Answers

nbme20/Block 1/Question#37 (reveal difficulty score)
A 1-month-old male newborn is brought to the ...
Na+: 132; K+: 3.2; Clโˆ’: 90; HCO3โˆ’: 37 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +8  upvote downvote
submitted by apop(8)
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These nanxotsleaip enrat at.gre It edsnto arylel hvae hucm to od iwht SARA aaioct.tvni It ahs osltma heyeitnrvg ot od thwi a nmpnheooen llcaed eth aiaklnle t.eid In rihcocn itm,nvtgoi ouy uoldw ptxcee Cl- ot be owl nad K= ot eb low mi(alrsi to bla tesrusl ni nmeoseo whti il.)uemalb oT epnmtoscea rof the wlo l-,C the soctamh hsa an anpttoerri hcihw eseanchgx Cl- rof .3HCO- rr,ohfTeee -Cl ilwl eb nelsieerdph in hte soc,ahtm wehli OCH-3 lilw aneesicr ni het ood,lb sinucga an lla.skaosi nI laciotkla ta,sset eht ++K/H rriptoanet lwil gebin ot tv,atciae hsngitfi K+ NTOI elslc oakaihly)e(pm dna innsacegri .Hp ASRA oapybbrl plasy a eorl ni gnakmi het yiemaakholp orwse utb the eknallai tedi si mreo mnotatpir er.he

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spaceboy98  nIst laliknae diet detlear ot an acsniere in Hp rafet leams? Yuro olgic is no tpino tub Im' ont sreu thehwre we nca apypl that ccotepn .ehre +1
kevin  npeccto nac eb ldepaip here sebauce ew ndee ot lpeetre eth -lC in orrde ot ratcee Hl;C hte ohmtsac s'ndteo arec if -lC is wol in ,rsmue loyn ttha -lC si olw ni the tarpeali cesll and so lliw pupm otu H3O-C ni tis epnexse +
usmleaspirer  yhw is K+ ?low +


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 +6  upvote downvote
submitted by โˆ—hayayah(1212)
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Wthi irhnocc vtminiog, uoy lose yreleletsotc adn a lot of ic.ad It girtgesr lboatmeic losliaaks chhwi is wyh lal the umser evslua aer low ro( no teh werlo dne fo hte lmroan na)egr tecexp ofr ro.bbtacinae

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ergogenic22  ereedcdsa +K rf(mo sarenidec RSAA ued ot ovmleu los)s dan sdeerdace -Cl sso(l fo HlC rofm the )omt,ahsc kalAossil morf sosl fo ClH nda huts hihg Fari. o bcbr hits aroens ighh to mid rneag K si rnogw +5
sbryant6  nWolutd' risdenaec SARA lade ot edicseran ?+aN Teh rsnawe sswoh erdeeascd +.aN +3
sbryant6  lA,so bemrerem Baumiil eNasovr si tscoaesiad whti ikla.yopaehm +1
sugaplum  os teh egrna hety gave for K is 3?-6 os 3.2 si WNL e?tnh ro rae ew tjsu itnageorp no t"i is no eht loewr dne fo lomanr ni espd" +2
dbg  uoidsm eelvsl ni lcpryoi sisteson ,rayv tnighno ellyar c,iasscl acn be hgih sa ni stih easc pyilms ude to tihnayod,r nca lwo in treho csase fi esnaodrltoe ndaameg to rrsveee atth ot the threo erexetm +1
skonys  oHhlpomciy"cre, emchakoyilp iotecbmla lsoaiksla si teh casclsi lotctyreele dan -sedaicab iancmealb fo rylipco nstos"sie form aemedcsp enbihd .oVginmy ilpawatl = mleovu olss dc(e ksin tgr)uo sa wlel sa ssol of ,H+ Cl- nda hiNwt+a( 20H) t&;-g oieMbclat i.osllaksA soLs of +H suscea sernicae 3OH-C enttnroei as ewll sa K+ tshif oint lslec imalpka(ehoy AF91 87.5) +

From amboss: The loss of gastric hydrochloric acid from emesis results in increased bicarbonate concentration in the blood and decreased chloride. Some potassium is also lost through vomiting. Hypovolemia leads to an activation of RAAS, which exacerbates metabolic alkalosis via increased bicarbonate reabsorption (as a result of angiotensin II). Aldosterone also causes renal secretion of potassium and hydrogen ions, further exacerbating both hypochloremia and metabolic alkalosis.

+10/- smpate(20)

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 +5  upvote downvote
submitted by โˆ—masonkingcobra(408)
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In oibmecatl alsksalo,i tmsupiaso svmeo otin hte lelsc

The lsos ni vmouel tohhgru emisse rigtsgre SARA isrtungel ni adceirsne nerooeAtsld slreeae adn erfuhtr patoiussm ceoxrteni

.aw1twtilab//ppt/shnwt/6.ee:ted1

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 +3  upvote downvote
submitted by iamapotato(3)
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No eno heer otbdeehr to utyallca cisdsus atwhs' gnigo nT ohs.i si a ton1-mh dol nwbn.oer

eH vtsmio rftae g,ienesfd d5a-y isrth.yo

At 1 hmton dl,o iwth ngmoviti rtaef nseif,egd it is ostm lkelyi a asec fo PIOLRYC NESTOISS ude ot thypprhorye fo teh rciylpo tepcrnish la(syuul usrocc 6 ekwes .telr)a

uDe to mhi gviiotmn cmaosht o,tncents eh liwl OLSE lC,- +,K and .aN+

He liwl SAOL olse +.H sTih si hwy oyu go tnio eth tmebcliao sklasoila ihtw a tnatlesur icrneesa ni eht OHC-3.

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kamilia20  ekch:st:y iigtovnm uasesc sols fo EWATR earrteg nath โ†’umsdio nedracise eusrm midโ†’suo SAECEDRIN smrue oosta,lylim oS NA llwi caeeersd ,too but no ttha rfa +


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 +1  upvote downvote
submitted by ark110(1)
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Btu thwa si hte frdicefnee nbwteee toipno A adn oitnpo C 2;(31 ;94. 9;0 5)3

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sympathetikey  K+ hsntou'ld aeis.cern st'I ginmov tnoi sclel ude ot blimcteao sklia.olas +
home_run_ball  nI het rtaeapil lcle of het ohnegHmo r ycsdat onsi aer dmefor rfmo hte otcsaoinidis fo cicnoabr da.ci eWart is a yrve irmon ucoers of yeorhdgn nios ni marionpsco to aocbnrci c.dai caniCbor icad is oermdf morf acnrob deiioxd dna ratwe yb nocacbir sdr Tneah.eahy ncaibtbeaor ino โˆ’(3COH) si xheaegcdn orf a oherilcd ino โˆ’)l(C on hte lasba eids of het lecl nad het tebncbiarao duefsifs noti hte veuson l,oobd leiadgn ot na kelaianl idte monpn.nohee +1
ergogenic22  SAAR rsseceani rfmo uemvol sslo, dan usth eomr rslonetodae dseal to owl +K +1
sinforslide  heeTr essnroa rof paki.eamoyhl tis , Fr meso K+ si lsto ni ritacgs sdi.luf nec So d, H+ shifts tou of llsce and K+ ihssft tnoi eclsl ni otacmeibl Til, ras.doalhiks EFC olmveu otiancnrtco ahs dacuse iadencers tnsicereo fo oeo.ersntlda +3


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 +1  upvote downvote
submitted by โˆ—rainlad(33)
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coecHpomly,irh lpaymhecoki lmcatibeo olaakslis is eht sccails rltcoeeltye adn aeaibcs-d aecmlianb fo pocyril sneost.is

erttPnises givoitmn ustsler in sslo fo Cl.H The lrideohc sols rlutess in a wlo bodol irdclheo eellv chhiw iipamrs het desnkyi' btaiyil ot reecxet aoecint.babr hsiT si eht frtaco ttah etesvrpn irconroetc fo teh alksslaio ialnegd to oetalicmb .asisollka

A ocsyredan soyrlrnehsdetmiapo ldvepsoe eud to eth dceeaserd oblod eulm.vo hTe ghhi arnedosloet lsvlee cuaess het syeiknd ot eratni +aN o(t tcrocer eht iatrasalunrcv muvole dentpe,)oli nda etrexce iredcsnea atsumno of K+ nito het inreu (neilutrsg in a low lbdoo lveel of )m.psoustai

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 +0  upvote downvote
submitted by thefoggymist(12)
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I d'ton tge ts.ih hou'nlStd the iesknyd rastt iternrccog teh iabrcb levels aefr 5 a?dys hTe eaedlyd shpea of eth conictroer nesci teyh ekat .imt.e. nad in eht utosenqi tereh'y nsikag oe w.Wn"" veah lemoacbit aolakssil ceisn LHC is ots,l os teh dboy illw ryt ot errctoc it trsif by eapeioirnntvhlyt dna etlra yb eidnreasc xerntocei of ibrb.ca bcariB udslho eb .ol..w esnslu( Im' gsinims tseighomn edu ot gebni se)ehtduxa

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thefoggymist  de,mrNeivn I hknit I otg .ti ateB daetnltrciae elslc otncna inucotfn nda trexece ibbrca caebesu ew ntod' haev .erhoidcl eYa naplaepytr I asw axethu.eds +


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 -3  upvote downvote
submitted by โˆ—amirmullick3(76)
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eyVr ayse e.iusqnto uilosnNboi imo.tv 1 mothn ae.g soMt ylekil oisreacn is ypicrlo nssesot.i

hTe tiovigmn sescau ssol of HlC so we vhea het ,yhecopmilroha nda ealrn eamiopstnonc ofr isht H lsos bi sy rsgrevinpe tnorspo at teh epnsexe fo K os that isevg alamehoik.py As het sseadie si e,mnad het arrwerod ni eht imaeg of hte hostmca is ohstom lcsmue hopetpryrhy fo het pclyoir suuricamls a,ucmoes rhftgn omei desvh-iaolpe mssa elft no p.tpialano hiTs is a bteicmalo aklossail eaebcsu whutoit -,lC het raCtC/llbaH aOs3ole ergaecxhn lilw otn rwko, so uyo neaitr C3.HO

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