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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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Yuo sugy ear way keiihogntvnr i.ths orichnC hoyixpa ssueac ypeeotnhisrn deu to NSS onivatitac and OEP ornpo.itcud

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teepot123  pey +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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uGsy I eahv rhnoate uthog.ht

iignvG ertho icsohec rea aubot his reoth onlmaarb laveus icr(seenad reia,nect ougcse,l crui adi),c I gsseu hte tnoquesi is tgintse su hcwhi fo eeths asvleu lwli mopierv if his SOA is dpriovem by .APPC

neSic ASO si noe fo het stmo ptimoratn ecssau of adhtipiioc insyteher,pno ti soudhl omce ot us tath cnoe hsi SOA is tdetra,e ihs ohpyesitennr iwll iepvorm noo.s

oS ddceraese" PB" tnsiade fo hroet alaobrmn selu.va

sT(hnak ot my ridsnfe ofr hitngin me outab t!)hsi

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dodgerslakers15  This si the creorct yaw fo nnhigkit autbo tsih sneu.iqot no^Pymur al igolpoyhsy is nto cnreysae.s heT toor fo eth oteiusqn si gaknis wtah liwl emrpivo roev item thiw tmneetart fo epesl naape, chwih si blodo eers,rspu gienv htta lepes pnaae ssauec rcaeesdin cthamypiset onet adn rhfteeeor yitssemc TH.N ehT eanttrtme of eplse paaen twhi C,APP wlli phel dcruee apiymtsthce eton adn evor e,tim repoivm .PB +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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CPAP siesnearc lnipaurltrae ssuerper sa eth evedleat ayrwai peusrser si tsrneitatdm to rheto thsgin ni eht ictayv n(lgu suseph no pleular tcayspieva/c whhic can tehn hspu on ethro ucuerrst.st) sThi nca dlea ot mpseosocnir fo svni,e giicnldun eht aevn cava &t-g; edaecserd suveon rrtune t-g;& daesceder pb omf(r esddceear pdel).oar isTh si armlisi to htaw apsnhep igrnud aalslavv xoiren(te p)sshea othugh teh etsviiop ssrpreeu si oidepvrd by a aecnmih mupp snetiad fo nbdoaimla desmur/spglama.ich I tikhn heart ater lkieyl neaercsis tidaesn fo redaesec sa a capeonymstro ps.onseer

Herse’ one etis ttha asinplxe it well (eht r”“efe entntco is guoenh dna aoblbpyr dlreaay cesexed teh dpeth noe thigm eedn to ok)nw ntemohe-/hicmcafmo-trl-ktr:/narte.lchi/suea/cnc-pofeyniftoxaaieltysapvoct

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dodgerslakers15  Pulmnraoy hogyyspoli si ton sensracey heer. e hT orot of teh uteoiqsn si ngksai awht ilwl epimrvo orev tmie ihtw tertmtnea fo eepls aep,na ihhcw si boodl ,rsrspeeu gienv ttah peels eapan secsau dacrenise ypetsihmatc eont dna eoethrrfe steciyms HT.N The tremntate of lpsee anaep wthi ,PACP will hepl ucrede tsetmiacpyh teno and over ,eimt mpirove 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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hloghAut ’tis abtuo PVP, siht genchisrear lphdee me ertddunsna asbic ph,ys I pheo hsit lepsh nereevoy in mose wy.a

aTaake:yw gnriDu P,PV vnsueo trnuer ee,scarsed aicarcd uottpu sedars,cee dna treah srureepss eeersdca ni het rhgti dise of hte hraet.

hWy eosd PVP eresaecd suvoen r?tuenr

  • hiraarictctno esrruesp eossmcrsep terah, gucisna boold tno ot urretn

asCues ofr edseecdra ftle rtircnaeluv pttuuo nirdgu l:niitnteoav

  • ighSftni of itnlivrernaucrta psmetu to Letf deu ot sencierda VR eomvlu
  • craDedsee oveuns rtenru
  • nehCasg in arshet yibtial ot rccotatn edu to vspieoti esspuerr
  • lkac of 2O to hater

raolmN tmsrapoeycon saemmcshin rfo gatianmiinn CO and BP idgnru PVP?

  • aicedersn RH ot acmpeensot fro dcdraeese VS
  • deeaicrns VRS to mnatniai PB

Ohetr iPcligohosy eenosssr:p

  • rcedesaDe ceelbrra psoriefun epressru syb’(od snrsepoe to a alfl in PCP is to sarie eiytmscs lbodo sserpure dan dliaet lcarrbee dbloo )sveesls
  • ceseerDda nlaer efpronsui ensaec(Ird DAH, ,AARS nad ttnPiae hsa elran pmsebrlo os sdiacreen aieincnrte nad cuir di)ca
  • ilsosbeP nltitrianuom ceseia(rdn slcgoeu iav seseuingcolgone .et)c
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meningitis  osyrr boatu teh tmfotgn,air etyh erwe esopsupd to eb ustlleb ton i.itlac +30
drdoom  sookl odog to me! ); tnidsae fo stssirake ytr insug hte pslu igsn ofr eudrernod ;iltss eht mysets steg nucofdse momessite seaebuc the tksisare si olsa ofr astiilc 😊 +2
meningitis  ,aheY I eitcnod :s h,O I tiddn wonk het + gisn did !that rVye umch ed,ratcaippe I will rty that extn ie.mt +1


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 +2  upvote downvote
submitted by noselex(9)
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I dnrunaesdt splee aapne udolw ucase haopxyi adn esreacin ni SNS tyaic.itv So teetrmatn duolw eecrdu PB adn traeH aet.R I asw tsuck wbtneee teh wto pnos.ito Why was eth asewrn boold rseseurp dna ton HR? I ogedogl ardoun a ibt nda noudf iudsset that oswh dpor ni thbo RH nda PB. I gessu BP oprds ?omer nCa snmoeeo lapese xlanp.ie

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madeforupvoting2  PPCA ienacssre taelpuainlrr eprsures as het eadetvle ayawri sseurpre si ittnatsedrm to erhto htsign in the aiyvtc glnu( psushe no lrulape tvpeicscaay/ hcihw cna ethn hpsu on rehto trcste.u)rsu siTh can edal to msseoirocnp fo siv,en iinncguld teh vena cvaa -> rcdeesade nuosev nterru -> sedercdae pb mr(of saedederc epaodl)r. ihTs si imsialr ot waht enpshpa ngidur vlsvaaal teorx(ien pe)shsa gothuh teh ioispvte uprseers si ivpdedor by a menhcai pump iadtens fo amoiadlnb a/h.lmpduaesgsrimc I tihkn areht reat ylekil srneiaecs tesidna of ceaeresd sa a stcmoonypare nrs pHes . rsoee ’e noe site hatt iapxseln ti llew t(he er“e”f cttonne si genohu dan olbbypar alryaed cdxesee hte pthde noe mghti dene to n)kwo :tlatihrca-e.mtnnheoi/--cly-nxotefckcsacmmyrc/aoep/rsaatiuheetoifl/vpotfn +4
apolla24  I gsseu ensci aechsgn in RH aer scuh a snatrntei eoenhnpnom dan oyu onyl ehva iensuadts ecnersai ni RH wnhe eicniesgrx ro kile ycauelt xincengeperi omse acdmlei gcemnreey vs BP atth anc be edalteve rfo nlgo poidrse fo tsemi htiw no sefcfet. reeoehfrT na mimtrepneov in PB is meor pat.inortm s’That ym eatk. +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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nCa oeensmo rctcoer ym nsorgaeni rh:ee

I wsa nknighit oiivpset airawy userserp ilwl rincesea llervoaa tanlnitvoei and areeedsc ihayxpo eudncid maplruoyn toaoioscrni.svntc hsT,u RV faret ldoa wluod ceesdare t;=&g moer epdrlao ot VL adn rmeo caacidr to.tpuu eTnh ldtow'un PB edrees?ac

Ayn pehl si arai.dcppete nas.Thk

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pg32  I juts ttuohhg of it as owl:olsf he has hgih PB edu ot lrunoyapm ocntoiovaniscstr sa lewl sa drsweadpie yihcmpetsta nitocviaat (sa if eh si egibn iltaplyar saeglrdtn lla the ime,t ceauseb he slcblaaiy i).s aeIcnirgsn noionagtexy lilw alrxe ish ymulrnpao ucvslureata nad sereadce aehsptciymt nuittisoalm htoutogruh het ,yobd agndlie to a odrp in lodbo p.ersesru +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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renIdeasc inalaracintr pussrree atht sturles in 'usisngCh airdt of nscedaeir dbloo ps,eurres urlrgarie gb,anither adn iadrar.ydacb hs,uT ghhi 2OC cduinse hsciung tirda nda fi uyo evgi PP then it lliw rddeuce O,2C dna nhte donw eurgtale the mietcpaysht isvnsnioactrco.to Onrigyalli eth inarb dha so hucm C2O atth ti aezpszd otu dna tedir to nsacreie eth PB in rroed ot ushp rmoe etneoxadyg oldob ot hte banri.

m/3s:Ct5mmaSp/spopere/gAsAiiUc.bwKqt.tg/JZ:.akfjh-dgl

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lispectedwumbologist  ar "yadir B4c"da8 pbm o ll +
lispectedwumbologist  Teh eprseoytnihn in tcoeuitvsrb plsee aapne is due to dreesnaci thsyiaptemc eont not eidrscaen ranincaialrt pusreers maol +1
meningitis  ituwsd@seigeoobllpmct : eB atruem ghuone to crretoc /hmhier nad emvo n,o ton ulagh ta ermh/i.h +16
namesthegame22  sleuP tera yma be cdeeftfa by egusrs of eyhpimstatc ctavtiiy gunird pienac e,eissopd wrhevo,e tish spitoalniher ahs neeb essl eladry dttedesnmaor htna ttha ewbeten paaen oedty ie.nshnnarp +


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