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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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ouY uygs aer yaw oivgtirhennk .sith oihcnCr oyapxih ssecau ypionrhnetes edu to SNS avatcitoni adn OPE icdpr.uoont

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teepot123  yep +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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uGys I vhea oatenhr hgott.hu

ivingG oreht hsoecic rea autbo ish teroh armnboal usalev iecd(resan anectr,ei geosucl, uirc d,)ica I ssegu teh ountsqie is tgneits us hhicw fo sethe alseuv iwll vimopre fi hsi AOS si vedorpim by AC.PP

Seinc AOS si eon fo teh somt ntptoamir csaeus fo oipitdhica rneetpiys,ohn it uhodls come ot su tath enoc shi AOS si ,ttredea shi nteyonrephis will pveiomr o.son

oS eescdda"re BP" antised of eorht aroambln ev.laus

snT(ahk ot ym dnrsief for nitingh me aotbu s!ti)h

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dodgerslakers15  sihT is het rtecroc wya fo gitkihnn autob stih tequiso.n oPrynmu ^al yoyphgsilo si otn n.essycera heT rtoo fo het usqioetn is nkasgi thaw ilwl vpmieor vero meit tihw mttarenet fo eples aean,p ciwhh si dlboo u,rrsspee gvien ahtt elesp aapen assecu enedircsa ahsmtycetip tnoe nda etreorehf tsismyec NT.H ehT tnemtatre fo eslpe aapne twih PAC,P lwli eplh ceudre ecpitthymas tnoe adn evor e,mit oervpim PB. +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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ACPP eniasercs rlanruletiap rerpsues as the eeaelvdt riaawy surpeser is rniedtmsatt ot etohr instgh in het yictva (lung susehp no lpeualr yvpite/casca ichhw can tnhe phus no tehro e.usursr)ttc shTi cna dlea to mooeispcnsr of vin,se uinldncgi teh vean avca tg-&; drsaeeecd uevsno nrreut -gt&; easeerddc bp (rfmo eedreacsd re)laop.d shiT is riilmas ot whta phsepan uirdgn lvaavsla ixtenor(e pashes) huothg teh vtoispei upessrer is drevipdo by a iacemhn umpp asenidt of ndolaibma ar/cmmaissp.hduegl I nkhit thera etar lekyli ansserice estadin of acreseed sa a cemntyaorspo .roenessp

reHe’s eon seti tath liaxepsn it ellw te(h feer”“ tnneoct is gnouhe and lpaybrob dyraela edeescx eth hdetp eno ightm need ot okw)n ntk-x-feipphlths/foctcceao:ec-ehlnttaueriacyytsc/nr-ra/m.maioo/laviftomen

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dodgerslakers15  oPmlrnuya yigphoolys is ton ysnsarcee rh.ee he T otor of eth nituseoq is kngais awth liwl epvmroi eorv imte hwti teatrnmte of epesl aneap, hwihc si lbdoo serurp,es ievng ttah eelps apane usaces naediesrc iamctysphte eont nad ehefteror tiecymss T.NH ehT etamtnetr of splee npeaa hwit P,PCA wlil elhp ereucd htapicysmte oten nda ovre tm,ei pvoiemr 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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hltguAoh si’t uabot PPV, stih isecgreahrn leedph me nndduaerst ibasc shp,y I hpeo sthi esplh ynveeero in omes .way

eaw:yaTak iurnDg PV,P evsuon rtrnue ses,ereacd ricdaca uoputt a,csereesd dna taher spseeurrs sacedeer ni het thirg deis of teh t.eahr

yWh dseo PVP edecrsae eosunv re?nrtu

  • harciniotcrta sruprese repemsssco ther,a cgnisau olodb ont to uerrtn

auessC fro draesedce eltf avlunrcrite toutpu diugnr iv:etloinatn

  • tnghifiS fo ruclanirtieravtn smpeut ot eftL eud to nceidaesr RV emvolu
  • asrcdeeeD oneusv urenrt
  • eChagns ni atrehs lbtaiiy ot arcnttco ude ot evspiiot srspeeru
  • clka of 2O to ethra

laorNm ocmotrnpeysa secahismmn rfo ignaiatinnm OC dna PB ingurd ?VPP

  • dersneiac RH to cepeamnost fro eddreaecs VS
  • rcinaeeds RSV to imannati PB

rhtOe iPcoosiglhy eps:rnosse

  • cdserDaee eracbelr efrsoiunp usrerpse sbdy(o’ sopsnree ot a flla in PCP is ot aires essicmyt dlboo rrusepse and ieatld ecbrarel odlbo l)ssesev
  • cDrdaseee nrael esornfuip ede(nIscra H,DA SA,RA nda tniteaP sha erlna lreombps os irnsecead teinnecria adn curi c)dia
  • soslPieb arlmunnttiio riaseed(nc ulgcsoe avi eonsgelouseginc .ect)
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meningitis  ysorr otbau eth ,mtgniotafr hyte ewer peosspud ot be tselbul tno ciit.la +30
drdoom  lsoko godo to m!e ); adentsi fo sirskatse try sgniu het psul gisn orf nedoreurd ls;ist the ytmess tsge senoucdf eemmsstio eucsbea eth aiekstrs si osal rof tasiicl 😊 +2
meningitis  aY,he I tdoeicn s: ,O h I dtndi onwk het + nisg did !atht ryVe hcmu aeip,cprtdae I llwi tyr ahtt netx .imet +1


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 +2  upvote downvote
submitted by noselex(9)
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I rsdutanend epesl anepa wdulo ceusa ypahoxi dna eaincsre ni SNS ttyivci.a So amntreett ulwdo rudeec PB nda aertH tea.R I wsa ctsuk wtebeen teh wto nptis.oo Why wsa eth rewsan olobd erssupre adn tno ?HR I olodgge aruodn a bti and udnof dusseti atth hows prdo in boht HR dna .PB I eusgs BP spord ?emor Can nemooes lepeas nxpile.a

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madeforupvoting2  CPAP ssreeicna rinpuelralta pserurse as eth edetlave ywriaa usrreesp is rtndtesamit to rtheo nhtsgi in the aitvyc (lnug ehupss no arllepu cta/eacpsyiv hwchi nca ehtn pshu on ertoh )rtstcruuse. ihTs anc leda ot ooerpcsimsn of ,nseiv ilnnigucd teh evan acva >- ceedadesr noesvu nrteur -> deasrcdee bp (ofrm ceededars dpe.)rloa iThs is srilima to wath ehapspn irudng alavlvsa rxn(teoei )speash hhotug eth ptioesiv sseerrpu si doiverpd by a aimehcn ppum anedsit of anmolbida lmdh.arpmusicsage/ I inkht htera erat lilkye caeinrsse dentsai fo dreceesa sa a tprsmooynaec e rr penH.se o’sse neo tsei thta sxienpla ti lwle (the ef”“er otntecn si ugheno dna pblyarob lyaedra eedsxce eht ptedh neo gtmhi deen ot k)won ccotrice-t-ehemcmsohnt/h-rneuafitfyeoerayast/./ttoalc/pnc-olvpmlfkaai:ixn +4
apolla24  I sgeus csnie eahncsg in HR rae suhc a ianrsntte onnoenpemh nad ouy oyln vhea stanisdeu neriaesc in RH ehnw ceiexisngr or lkei ltucaey egpxericnein oesm mdliaec rceegmnye sv PB taht nca be eelatdve rof goln oiedrsp of eistm htwi on feft.cse erfrToeeh an vroitmpnmee in PB is ermo ino.rpttam ’shtTa my .ekta +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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naC enoeoms recoctr my aosenirng h:eer

I saw tigknhni itpoesiv wairay srpreesu illw nsreciea lolrevaa tiltnvnioea and edeeacsr ayoixph icudend uplarynmo nnstcioatirv.soco ,Tuhs VR fetar adol ulwod dseecera ;tg=& orem drelpoa to VL adn ermo iracadc otupu.t ehnT on'twlud PB sdear?cee

Any lhep is ppaeica.tdre ahsTn.k

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pg32  I sutj ohgutth of ti sa lwo:osfl he hsa hhgi BP due to pumnalyor notaoccisivrtsno sa llew sa rdidewsepa ehpmtysatic itavoaicnt sa( if eh si giebn rypailtla nrtadlesg lal het emit, eacebsu eh ayilclsab is.) iecnIransg nayooxgenit iwll rxale ish aluompynr aelucursvta dna eecdraes etsmcyahitp oitnsumtial ootuhugthr hte bdoy, ildgnae to a pord ni bdolo s.pseruer +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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redesIcan nnalcriaitra esprrsue htat srueslt in nsgh'Cius iradt fo isercndae odblo erpessru, uarilegrr aenrhg,ibt nad adcyi.rdbara sTh,u hhgi 2OC uedcnsi nsugcih aidrt dna fi ouy vige PP tnhe it ilwl reuedcd ,C2O adn nteh odwn eraueglt eht pttsychiaem .ocsnnvotarisicot lngiOylari eht abnri adh os cumh OC2 thta ti epszzad tuo dna ietdr ot necseari eht BP ni eorrd to upsh more eoxeadntgy oolbd to eht ai.rbn

saAjttg-5e:qmACJphZoalSifrwmsU/p/d..tKb/sgep:3./kcgim

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lispectedwumbologist  dac8 yi" ara4d"rB pbm l lo +
lispectedwumbologist  Teh setyhoenrnpi in evurtsciotb espel anpae is edu ot decrainse eamhtypisct tnoe otn ecsednair tlcrarnnaiia rsurespe maol +1
meningitis  loctsbdlei@uipgewsmot : eB rumeta gnhuoe to ceotcrr mieh/hr adn omve n,o tno gahul ta /ehmi.rh +16
namesthegame22  Puels aret yma be efcafdte yb segsru fo ympeitacsth ctiiyavt urgdin acnepi eos,edsip vorwe,he hits anlporihiset ash bene lses leyard stodmneatder anht ahtt ewtneeb enaap hnt.d ieorenanysp +


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