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Retired NBME 22 Answers

nbme22/Block 3/Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressure 🔍 / 📺 / 🌳 / 📖
tags: pulm repeat

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 +7  upvote downvote
submitted by trump2020(3)
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oYu gyus are wya htvnkirogien h.sti irhcoCn phixyao usseac tnespirhenoy ude to NSS niaiovtatc and EOP ictonroud.p

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teepot123  pye +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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sGuy I vahe heaortn hh.ogutt

iGvgni rtohe eicshco are ubota ihs hoter rboamanl uvelsa cnierda(es traeicen, ,ucsgloe ucri ,aicd) I esugs eht nusoietq is ngietst us hchwi of stehe alevus lwil rivepmo if his OAS si eomidpvr yb AP.PC

cSine ASO is oen of eht tsom mortaintp ssuaec fo iapodchiit ei,pnyhsoernt ti uoslhd mceo to su taht neoc shi SOA si rtedtea, hsi itnpyeshrone ilwl veopmir ns.oo

oS erdse"ecda BP" saneitd of rteoh aralmnbo la.uevs

hTn(ask to ym isdrfne for hnintgi em obaut )shi!t

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dodgerslakers15  sTih is hte ceorrct ayw of ikithgnn aoubt ihst ntoe.uisq roua^nyPml pyhgoiosyl is nto sceser.nay hTe troo fo the ousnqeit is ngaksi athw lliw vmpieor ervo teim ihwt mtrnteaet fo seepl neap,a iwhhc si lobdo rser,espu iengv atth eelps aepan cuasse idncasree csmeapthtiy nteo dan erferetoh yscmseit TNH. ehT netartmet of esple aepna ithw ,PACP iwll lhep rueedc etmasptycih neot and ovre met,i moprvei BP. +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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PPAC snciaeser aupaeilrntrl sreupsre as hte ldevetae wiaayr eespursr is ttansedimrt ot herot gtinsh in the tayivc n(ulg sehspu on lrelaup etycapisc/va chwih nac nhte spuh on ohter r.ecsusrtut) This nac dela to esrocosmipn of sv,ein gcndunlii eth vnae avca t-&g; desaecder nesuvo rnurte -;> ddesceera bp ro(mf ecaederds arpld)o.e shiT is amslrii to athw esanhpp ruindg lvvalsaa inoetxe(r hses)ap ghohtu the vpsitoie esurpser is iodepvrd by a enmaich pmup tedians fo mniabdlao gmrdsph.ciua/salem I inkht rhate trae leykil srnceaeis enisatd of desrceea sa a coystnaemrop nrse.soep

e’rseH eno etis thta xpsniela it ewll h(te “e”erf tnnecto is hgeuon dna pabrboyl raldyea eexdecs the dthpe neo mgthi dnee to )owkn rcno/lc:aeaevo.ceiafihncmilt-ftstat-hnmr//xutcl-okeie/rtp-yahepaonsyofcmt

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dodgerslakers15  mnPluyrao ohoiplsygy si not acessenyr reh.e heT roto of eht steoiqun is insgak ahtw illw ermivpo vreo itme with traeemtnt of pseel npa,ae cwhih is ldoob r,essuerp veing taht selep npaea csasue ndecersai himtasycpte noet and refetoher tcmieyss H.TN Teh tettnamre of lepes apean iwht ,PAPC ilwl hlpe eecudr ichpttsaemy etno dan rove ,tiem rievpmo P.B +15

Guys don’t forget that in OSA, periods of apnea results in increased sympathetic tone, hypoxia causing pulmonary hypoxia vasoconstriction, thoracic movement without inspiration increasing negative intrathoracic pressure ==> all these factors leads to hypertension in OSA.

To remove all this we give CPAP, which results in decrease in BP over long period. (It is not only about increasing intrathoracic pressure and reducing BP)

+16/- apurva(101)

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 +4  upvote downvote
submitted by ∗meningitis(643)
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Aothglhu ’ist bauto ,PVP htis risearnghec phelde me nrdudnteas bsica shyp, I peho tshi lsehp erenyoev ni oesm way.

eya:awTka nDrgui PP,V vosune nterru srsceea,de adcrica upottu eersd,seca dan hrtae usresserp escrdaee ni het tihrg desi of the ht.are

hWy soed PVP decseare vonues urnret?

  • rictitchnaroa reusprse cmspressoe hetar, uigsacn dlboo not ot return

sesCau ofr eardeceds tfel clrutvnaier uutpto rdigun iaentvol:nit

  • ihfignSt of learvrituricnant tpsemu to tfLe deu to earnidces VR vleoum
  • eecsdareD senvuo rutnre
  • gesaCnh in erasth byiilta to rnccotta ude ot itsevpio speursre
  • lcka of 2O ot rtaeh

oNlarm nyooapsmretc aniecmmhss fro aintaimingn OC adn PB grudni ?VPP

  • seceiradn HR ot eopnsatmec fro scdedaere SV
  • ndesicrea RSV ot natniami BP

theOr Pyisgoochli rsp:eneoss

  • Dcdeaesre eerrablc sopruinef sruserep osb(dy’ rsnespoe ot a alfl in PPC si to aiesr scymites lobod rsepuers and eitdla arcbrlee lbodo slse)esv
  • aeceedDrs laren reifpusno aren(eIdsc DHA, RAA,S nad taPient ash aernl srmpelob os sndeicera tncniraeie and criu adc)i
  • sbPeliso itamunitrlon dncse(riea ucgoesl aiv uncneeosgloeigs e).tc
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meningitis  orrys ouatb eth ,rtiagonftm ehyt ewer sdsepopu ot eb bullets ton iclat.i +30
drdoom  sloko good ot em! ;) isentda fo esktrsais yrt unisg eth lpus isgn for nduoerred ti;sls the sestmy sget snudfcoe iesmmtose abeeusc hte setsirak si oals rof liicsta 😊 +2
meningitis  heY,a I citdeno s: h,O I itndd nkwo eth + nigs ddi !taht reyV mchu eatcpdri,aep I illw ryt tath xnet ti.me +1


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 +2  upvote downvote
submitted by noselex(9)
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I nddetansru eselp pnaea uodlw ceasu pyoaihx dna neracise in SSN ivictya.t So trtmtnaee ulwdo uecdre PB adn atHre .Rtea I wsa tsukc neebtwe hte wto oo.npist yhW wsa het nsreaw oldob reurpess dna ont HR? I ggoldeo uadonr a itb nda dounf usdiest thta whos dpor in thbo HR nda .PB I uegss PB dposr ?moer aCn omesnoe aplees exi.pnal

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madeforupvoting2  PPCA eeiscarsn nlparrtaieul russeerp as eth aetdvele waraiy eupserrs is tanesdrittm ot trhoe hsnigt in eth ciyvta u(lng psehus no pleraul eciypav/scta chiwh anc hetn uphs no etohr stuuscrter). isTh acn leda ot nompceisosr fo ievsn, gidincnul eth naev vaac -> dcaeedsre useovn rrneut >- esdcedaer bp m(ofr acsdrdeee edapl.)ro hisT si rmailsi to thaw nppahes rdingu lvlavsaa nxo(irete seap)hs ohhtgu eht oivsipte usserpre si vrddoiep by a ainhemc uppm isaetnd fo daoblnmia acehpmgus.sdrmial/ I knhti tareh eatr ielkly siseenrac sindtea fo aceserde sa a eocrynotsmap r s’sn .H eesrepoe eno esit hatt snexplia ti ellw h(et “r”efe noentct is ngeohu nad lypbboar layarde exedsec the pehtd one gihmt edne ot okwn) ttm-ep-yaomoheeclayccfreecr-inutmi/ftlvxtnsa/c-oofi/ciaan:srlent/pkohaht. +4
apolla24  I gsesu necsi eacnhsg in RH are ucsh a tstnrneai moeponhnen nad yuo lony vhae ssenutdia craisene ni RH hwen cgerinixes or leik lteuyca nrcpgeeieinx osem ldimace eynrmeecg sv PB atth acn eb deevaetl ofr gnlo idopser of itsem whit on ef.csfet erfTehroe an mienmvpetor in BP si mroe pmita.ontr hsTta’ ym teka. +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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anC soeneom ecrcotr ym nosiaregn :rhee

I saw nihktngi ipeoitsv iraawy esrrpeus wlil rnaecesi vllraaeo ittvalonine nad rasceede xiaypoh ncidued yuaonmrlp ocanst.svtorincoi s,uhT VR frtea aold wdluo eescarde =gt&; mroe ldporae to VL nda eomr aariccd ot.tupu Tnhe wonult'd BP edrease?c

nAy ephl is ad.ppaetceri kTsn.ah

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pg32  I tujs gtouthh fo it as wlfolso: he hsa hhig PB eud ot yrmnalopu nstrincoaooicvts sa llwe as idepraedsw etapmsitcyh tciaivnota (as if he si bnige aratpilyl tnglsrdae all het emt,i beasceu he lysilacab i.)s ierncagnsI xoyniatngeo iwll exral ihs pnralyuom luaevsratuc dan ceasered tayhtpimcse muaolntitsi ouhhtuogrt teh bdo,y iaelgdn to a opdr in odolb peuressr. +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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cesanIerd iniraaarntcl rssuerep atht utesrsl ni usCnsih'g aidtr of eracisden olodb eer,rssup iurareglr ierbgtah,n and caabidrdya.r h,Tus hhgi OC2 udesinc nicsghu tdria dna fi ouy eivg PP hten ti lliw rdeudec 2O,C nad hnte ndow relugate teh aimhtptsecy sroccitnoniavsot. yOiganllir het airbn dha os uhmc 2OC atth ti pzdeasz tuo dna ietdr ot eircneas hte PB in errdo to husp rmoe etgaoexdny dbool to the i.banr

m.Ai/Sp5p.pest/a3tgbssK/:wtC:/kZmiJqch-lofgUAjadrmge.

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lispectedwumbologist  4iarracad" B8 "yd mbp oll +
lispectedwumbologist  heT rsetnoneyhpi ni tcuivrstbeo slepe eaapn si due ot aeincsder ctmihtaeysp tneo ton aesdiencr ainanirclatr esesurrp amol +1
meningitis  iewcldstbiopslgmoe@ut : Be amruet uoghne ot crocret h/eimhr nad oevm on, tno ahugl at hi/.hemr +16
namesthegame22  slueP atre yma be eafdtfec by gusers fo ptcamsyethi yticavti idrgun napeic pssedie,o ohw,eevr hits nrohsaelipti sha nebe sesl dayerl dmetoarnsted nath ttha etwneeb napea dnaoyep. hrnesnti +


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