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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 sguy rea way iohkirvgntne .hist oirhncC hpxiyao ceasus iytepohsrnne edu ot NSS viaitactno dan POE oindpcout.r

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teepot123  pye +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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yGsu I ahev oenahrt ttho.ghu

Gniivg thore soicceh rae otbau hsi toreh labnmora avlsue ani(rescde icnare,te locegs,u icru ai)d,c I sgeus the oeiqsutn is gnitets us ihhcw of ehtes veulsa ilwl pmroeiv fi ish SOA is ivoeprdm by C.PPA

ceinS OSA si noe of the msot tpairnotm sucsae fo iaidcihpot eniopeyrtnhs, ti ohldus emoc ot su htta ncoe his SOA si ertaed,t his ehryoestpinn llwi veropmi s.noo

oS deardee"cs "BP intased of htero abmonral .selvua

han(Tks to ym snfdier orf nhintig me btaou is)h!t

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dodgerslakers15  Tshi si the occertr yaw of tingnihk auotb tihs eutqio.sn nlyaorPu^m pgiyhlsoyo is ont eyn.scaers hTe rtoo of hte oqteisun is sknaig twah liwl imvopre ervo iemt hwti ttmterena fo slpee paane, hwcih is odobl ,rpuseres eingv thta elsep anaep seusca neadrcise etsicymhapt teon dan foeteerhr ctmisyes HN.T eTh treetmtna fo elpes enapa ihwt PPA,C llwi hlpe eerucd timypetcsah nteo nad vreo teim, pvemroi .BP +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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APPC neeasicrs rrutenplalia spseerru as the eldevate airywa eerssupr si snmtrdteita to toreh htisgn ni the vyitac ugl(n pehsus no pruaell s/vpycaeatci hcihw acn tenh spuh on retho s)rrcetu.sut sihT acn elda to roipceonssm fo nise,v inglcduin the anve cvaa >- redacedes vneuos rteunr -&t;g easecdedr pb rf(mo dacsdeere eord).alp Tihs is lairism to ahwt paensph nirgud lsvlaaav (exoenrti sephas) hguoht eth epitvsio pruseres is pvrdedio by a nacihem pmpu stnedai of aadboimnl liaudsem.smachr/pg I inthk hraet raet yleilk iesnacsre asdniet of eeadesrc sa a opmrotyeacns pe.sosnre

Hees’r eon eits htat lainxpes ti llew ht(e ”free“ cotnetn is eohgnu nda plybbroa ladaery dceexse the pdhet noe ihtmg ende ot kown) m/hfntpeoecttxftkryotcam/ofraaiseh/civ--siacl.clohna-eyeetntlo/umacip-r:n

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dodgerslakers15  nmuorylPa lypoiyhgos si ont rnesycesa hre.e Th e roto of teh onutsqie si ksgnai wtah lilw oimevrp orve eitm thwi tetametrn of lspee neap,a hichw si oobdl eussp,rer vigne ahtt lseep eaapn asusec eniarsecd cmttsyiaphe onet and hretefreo styescim HN.T ehT tntetrema of eepls aeanp itwh P,ACP lwli leph eecrud hyascpetitm eont nad vero etm,i mvipreo 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(644)
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hoAlthug i’ts uboat PPV, hsit haierecsgnr ledpeh em runddnates abics y,hps I poeh sthi lepsh yneveero in esmo y.aw

wka:aTeay Dnrugi ,PVP sneuvo uernrt c,deeesrsa acdiacr uttupo dcesease,r nad thear supesresr asercdee ni teh htgir ised of hte .eahrt

Wyh dsoe PPV eeeadcsr nsvoeu trneu?r

  • ioinhctractar useprser ssemrscpoe hae,tr scuanig oodlb ont ot nterur

Cussae rfo esarecded etlf aluiervtnrc tupuot rinudg tnin:tvleiao

  • Sfhngiti fo iaitrunatrlrvnec etpmsu to teLf edu ot secirenda RV ouvlem
  • cereeDsad uovnse nerutr
  • agehCns ni ersaht yitaibl ot onctatrc edu ot tvepiiso euprerss
  • calk of 2O to herta

oarmNl poyotsmrenac hassiemmnc rfo naitaiigmnn CO dna BP igudrn P?PV

  • cediesanr HR ot ntcpoemesa fro dsedracee VS
  • sidcaeren SVR ot ntnaiima PB

retOh hcosyPiiglo :nssspreeo

  • eseeaDrcd lacerber enpofiusr esurserp yd’(obs repsesno ot a lfla ni PCP si ot saeir cmteissy boldo puessrer adn aiteld bcrelare obdlo e)sesslv
  • eeseDcard eanrl nfisropue sedcar(nIe D,HA SR,AA adn taPteni has erlna bremsolp so esicdraen etnarencii and ciur i)acd
  • Pleosbis uimialtnrnto ese(cidarn lescguo iva osniesgcogulene c)t.e
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meningitis  srryo bouat the inar,ftmtgo ehyt were dousespp ot eb lselubt otn ic.ialt +30
drdoom  losok doog to e!m ); iestadn of kesisrtsa ryt nusig eth ulps sign fro rddornuee tsi;ls eht ysestm etsg nocsfdeu mmoeisets eseaucb eth tarssike si salo ofr tcslaii 😊 +2
meningitis  aY,he I tecoind :s , hO I nditd wokn eth + sing idd t!tah reVy hmuc atpceiedpr,a I iwll ytr thta xetn .mite +1


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 +2  upvote downvote
submitted by noselex(9)
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I dretdansun selpe aanep luwdo eacsu pyahoix dna esraeicn ni NSS iya.ittcv So mtertntea olduw cueedr PB adn etrHa taeR. I was utcks bteween eht two osnpo.it Why swa eth rsnwea ldboo essuerpr dna otn ?RH I olggeod arnoud a bti nda odnfu tiussed atht whos rpdo in hbto RH nda .PB I sgeus PB dsopr moe?r Can nsmooee lpeaes pxl.neia

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madeforupvoting2  PCAP eeinrssac ertulrpniala eesusrrp as hte daetelve waryia surpseer is ttameistrdn to roeht nhstgi ni hte ciavyt ln(ug esuphs on laerlup ccatv/yaeips hicwh nca tenh hsup no oerth ueu)tcs.tsrr ishT can lead ot nosoecirspm fo v,isne licingnud het vnea acav >- eedsarced noesuv untrre >- eedasedrc pb f(omr eerescdda lpreoda.) shTi si siraiml ot ahwt ephasnp rngdui savalval xenreto(i ehpsas) gthuoh hte istopiev pseruser si iorvpded yb a hcneima uppm tedasni fo albaomdni drmuls.imc/hagpesa I nkhit reath erat yleilk siraensce nsaedti fo asrecdee as a comyoeansrpt s.o sHrpe’srne ee oen etsi thta nilaspxe ti wlel ht(e r“”fee ctotnne is ongheu nda lopbybra rdeayal seeexcd eht htdep eno mhitg ndee ot kw)no /rxoo.okhlmettnhaeicylccctimoieesuya:-rmpc-tircase/opnatfa-t-//lvehfnantf +4
apolla24  I egssu nesic gsecnha ni RH era cush a ttiennasr enpmneoohn dan ouy nlyo vhae snuatdsei eacrsein ni RH hnwe eigcxiensr or klei tleycua nnigcprexeei oems iecdaml enygrecem sv PB htta nca be elveaedt fro nlgo oersdpi of tsmie twhi on sfc.eetf reeThoerf na onvirpteemm in BP is orme tmpatoni.r stTh’a ym ta.ek +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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aCn nmseeoo rcrteoc my nnoiagesr reh:e

I aws nthginki istoievp yrwaai ueserprs lwli eensirac alvlreao tonalitvnei dan easecred xoaiyhp dudneci nloayrmpu arnv.cooitotnscsi suTh, RV atefr ldao owdlu easecrde g=t;& roem eaordlp ot VL dna emro cicraad op.uttu hTne ulonwd't PB dceas?eer

Any phel is irpp.edatcea nsT.kah

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pg32  I ujst gtuhhto fo ti sa :oloflws he ahs hghi BP eud ot muylpnrao orcotssvictnaion as lewl as drispedwae ehctstaymip oaivtintca (as if he is gebin altalrpyi trdaeglns all het m,tei eascebu eh lbasylaic i.s) sicnerngIa gxateniooyn ilwl xrela shi nmpolruya uvrlaetcsua adn eearscde tpthmaeyics ottmianlisu oohgruthtu the b,yod egailnd ot a odrp ni lodbo rusee.psr +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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esIednarc nraarlaiinct sserepur atth slruste in C'gsihsnu iartd of acdrinees ldboo rsupree,s arrlirgeu ten,bgrhia nad y.raadcrdbai T,suh hihg CO2 cnsedui cugsnhi ritda nda if oyu vgei PP hten ti lilw eudcdre C,2O dna hent ondw utelarge hte phescyttiam coiosnornctatsvi. niOlryalgi eht nriab ahd so hmuc 2CO that it zpaeszd tou dna deitr to anescrie het PB ni rdroe to uhps eorm enatdogxey dlboo ot teh .nbiar

Z:erotj3-./CmAhKq.ktpgfsUsJbtmp:c5wAm/asa.gSdieigp/l/

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lispectedwumbologist  ay4Ba rd8"d i"acr pmb oll +
lispectedwumbologist  The hnyepitsrnoe ni tcibuosevtr splee anepa si due ot eesdacirn caestthmiyp neto otn asircnede ritinclaaran ursrespe olam +1
meningitis  tseolbsguowecpmi@itdl : eB rmaute ohngue ot oecrtcr rehh/mi nda oemv ,no otn uhgla ta rhi.hm/e +16
namesthegame22  Pseul rtea mya eb aetfdfec yb esrgus fo pytahcmsiet atyvctii dngrui nipaec ois,sdeep ,hewrove isth teprhlaiions sah enbe less deaylr etemartsnodd tanh tath eentweb aeanp reonepn.thyaidsn +


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