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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 aer ayw ngirokvihnet t.ihs inocCrh iayphox ueacss nohrepysinet eud to SSN nvoactiita dan OPE n.upctdoori

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teepot123  ype +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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syuG I eahv hneorat .htguoht

Gnivig hreot cseiohc era bauot hsi ehort ambaonrl lauesv naeeisrcd( riacnete, gsol,uce ciur ,)daic I sseug the uioesqnt si ntegsit us hciwh of hseet eslauv liwl eirpovm fi his AOS si repvmoid by APC.P

neSci OAS si noe fo eht smto ptiramotn suaces fo ihactpodii ,netnyspihore ti solduh cmeo to su that neoc hsi SOA si edt,aert hsi tpiysreheonn wlil moeprvi oon.s

So cedaree"ds BP" idtasne of rtoeh rnlbamoa sa.vlue

ahnTk(s ot ym nfdseri fro inhngti me btuoa s!t)ih

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dodgerslakers15  sTih si the eroccrt yaw fo ntgihink uatbo isth tiusnq.oe nuaPy l^mro iooygphsly is ont ay.ecnress hTe orto of hte ioneqstu is ingksa ahtw will irmeovp rvoe tiem ihtw nrteatemt of plees apnae, ihwhc si lodob ,repersus gvien thta lpese apean acuess snercdeai yistaephtmc eont and tfroerehe tceisysm NTH. ehT tnmeattre of lespe eaanp hwit CAP,P llwi hpel redeuc ticetmhapys tneo nad evro mie,t moipver .BP +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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CPPA necaisres panlirlrteau erpsusre as eht atleeedv yaiwra ersuesrp is ettirtmsnda to trohe gitnsh ni teh yctavi lgnu( eusphs on paerlul tcspvcya/iea whhic anc nteh psuh on htero )r.ttucsersu Tsih can lade ot oinerpcmoss fo niv,es ludiincng eth neav vaca gt-;& dsecredae nsoveu trrenu ;>- rdecdeeas pb rofm( sadcderee alde.o)pr ihsT is ilasimr to twha hnespap urgdin allvvaas exn(troie hpasse) uhhtog eht tioeipsv eresusrp is pdioerdv by a ncmihea mppu tidsnae fo oamnibdal eapurd.laicssm/hmg I nkith areth trae kiylel ensecasri eadstin of deaeercs as a ynrpmaeocsot e.esronps

ser’eH eon seit htta lxneaips it well te(h re”“fe connett is neoguh nad abpylorb yerdala eseexdc het pdteh one hmtgi dnee ot o)kwn rtchiryets/tmamatekuane-lnth/cnacot/atyxifoeo.pi:on-la-mfopfesiev-l/cchcr

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dodgerslakers15  aluynmPro ylisoyghop is tno ncsraesye he.re hTe toor of hte enqsotui si kniasg htwa lwil mpevoir vero time iwth reaetntmt fo spele an,aep hciwh is dbloo ,rsereups ngvei tath elpes eanpa casesu eidcnrsae ahmpttisyce oten nda efhortere ytissmce HN.T eTh eetmrntat fo esepl aanep iwth APPC, lwil pelh ecuedr mtitpecyhas etno dan erov imt,e pevorim .PB +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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hthlouAg ’sti tuoab V,PP itsh hcirragnese delhpe me nnadrsedut isbac ,shpy I ehpo hsti slhep eeroeyvn ni eoms a.wy

wT:yakaea urDgin PV,P svueon entrru eesac,rdse cciraad potutu acreesds,e dan earth epessrsru esceader ni eth rhigt sdie of het a.erth

Why oeds PPV dacesere euvosn u?rrnte

  • otthcicrrniaa eurpsser mopscsseer eah,rt cnagisu boold tno ot urnter

esaCus for dracedsee tfel caeuilvrntr upoutt indrug lieiva:ontnt

  • tnSihgfi of ectatnuiivrrlrna sueptm to eftL deu ot aiecrsedn VR uvemlo
  • rsDceedae ovesnu ntreur
  • asneghC ni ethars ibyalti to crtotacn ued to isipoetv rupreses
  • lakc of 2O to haetr

mrNloa onoyetasmprc cinshmmeas orf innainigtma CO nda BP ndurgi V?PP

  • neersdiac RH to ecmntsoape orf desaredce VS
  • anseridce RVS to aaitinmn PB

rOhte shyolPgoici os:spsrene

  • rDceeased alcreerb iofeprnus srpresue d(yos’b nresspeo ot a flla in CPP is ot sraei stycsmie doobl rssreuep and dialte lbeecrar odlbo )vsseesl
  • rcaDdesee nerla ipsrufeno nrsIdeeca( AH,D SAAR, dna aienPtt ahs eraln lberspom so nieescard aiceetnnri and iruc ia)dc
  • bPssoeil imoiatnltunr r(cniseeda gcoluse via gcoleugesoinens )ct.e
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meningitis  ryors obaut het tiagt,orfnm yeth rwee peopssud to eb ustlelb not lca.tii +30
drdoom  kolso odgo to em! ); ndaiest of kesitsasr yrt siung the pusl nsgi fro ndoeeurdr s;tsil eth symtse gste fneudsoc mseismtoe csbeeau teh tisskrea is oals rof lictisa 😊 +2
meningitis  eh,Ya I inetdoc :s h,O I ndtdi oknw eht + igsn ddi at!th yVre hucm capder,teaip I wlli rty ttah xnte tmei. +1


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 +2  upvote downvote
submitted by noselex(9)
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I tdnresdnau lsepe aenap oudwl saceu oahyipx nad nrciaees ni NSS .civyitat So mtttneaer ulodw uerdec PB dan etraH Rea.t I swa uskct newtebe het wot otopi.ns yhW asw the snewra blodo psureser adn not RH? I egodglo roudan a ibt adn nfudo esstuid ttah sowh pord ni othb RH adn P.B I ussge BP psodr o?mer Can oeosenm splaee iaepnx.l

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madeforupvoting2  PPAC sarnseice ptanarirellu eerpruss as teh eelvteda wayair srseurep si rmtntatsdie ot herto nitsgh in hte cvtayi ugln( uspehs on aellrpu v/yccpsaatie wcihh anc hnet uhsp no rhote ssuer.)tctur Thsi acn edal to snsimproeco fo envi,s iglninudc the vean aavc -> eadscerde svneou etrurn >- sadeedrce pb rmo(f ascdeeedr .rd)eaopl hTis is slmiair ot ahtw eaphsnp unrdgi asalvvla xenir(toe h)sspae uhgtoh teh siteoipv suprrsee si rdvioped yb a anhmcie upmp dinaste fo iabldonma .urceg/sahamsidmpl I nithk terah eart lleyik sasrniece dtnseia of deaesrec sa a maeyoctponrs sers’res H eo pn .e noe stei ttha pnlaeisx ti llwe het( e”ef“r ttcoenn is hgenuo nda yplborab eaaryld xeesedc teh tpehd eon mgiht eden ot kon)w cuhhtmsestvfyaxtlp.hmcinao-rlc--tept/:aeiefooccenotaia/nimo-ne/tlrfarc/ky +4
apolla24  I gsesu icesn ehsagcn ni HR are shuc a intntraes nmenhneoop dan uoy oyln ehav sdsuaitne cnsariee in RH henw rxeeinigcs or ikle eyutcla epenegrxicni oems acleimd eyrnegemc sv BP tath cna be daleeevt fro nlog prodies of tsime itwh no sc.eeftf eerorThfe na eirtomvmnep ni PB is moer omi.natrpt t’sTha my at.ek +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Can oeosmen rtcerco ym neoaisrng :eerh

I swa kgiihtnn stvepiio rwayai peesrsru lwil resnecia loaeravl iennlitaovt nda csedaree apxhyio edcnidu ploraymun vtcrsoio.soainntc ushT, VR arfet adlo wodul eearsdec &;tg= eorm roleapd ot LV adn omer irdcaca ututo.p Then dtn'uolw BP sc?redeae

Ayn phle si ecp.aadrietp .asTnhk

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pg32  I jtus ohthgtu fo it as l:oslfwo eh sha hihg PB edu to urnoalmpy asoniocrcitsotnv as llew as dpaeeswdri cehtyiapmst caintoivta (as fi he is bigne ipaylrlta srltnedga all eht ,etmi secuabe eh clyiaasbl .)si ancIersgin aneooyxtgin lwil exral hsi nrpoluamy suratcalevu dan eecasrde cityhamspet taulintmios uoohtutrhg the d,oby aednlgi ot a rpdo ni odbol psreue.sr +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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radesecnI naanarctliri uspseerr ttah slertsu in h'snugiCs trdia of irncaeeds bdool u,psrrees griuraerl gtrhibane, nda irrba.yaacdd hTsu, ghih 2CO nceudsi iscnghu rtiad dan if you ivge PP ehtn it wlil ddereuc ,OC2 dan hetn nodw uraelegt hte iecatpsmyht v.nnoocraitioctss iargnillOy teh ainrb hda os uhmc O2C atht ti zpadzse otu and idtre to airnscee the BP ni roder to hsup remo xaoenteygd dobol to eth r.bani

d/ts.opUsp:ZAm35jitkKq:wfiegmJhsS.rgbaCmtlpa///c.-Age

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lispectedwumbologist  a4 daBd8aic ry"r" bmp lo l +
lispectedwumbologist  hTe neiesnhporyt ni ovrbustetci seepl aaepn is deu ot dersnieca csemhtatyip enot otn arsdcenie liarntrancai sreruesp malo +1
meningitis  wltoupdobmtleicegiss@ : Be aerutm eguhno to trrceco ime/hhr dan voem o,n ont gulha ta ih/rhm.e +16
namesthegame22  uselP erat mya eb cfteadfe yb resgsu fo ttspeiycamh tyvaiitc diunrg ieanpc dispee,os rowheve, sthi isaorintehlp sha nebe ssle dyreal sddteaomnret hnta atth newetbe peana hynandersi.oepnt +


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