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Retired NBME 23 Answers

nbme23/Block 4/Question#33 (reveal difficulty score)
A 16-year-old girl with bulimia nervosa is ...
Potassium: decreased;
Chloride: increased;
Bicarbonate: decreased
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 +13  upvote downvote
submitted by nwinkelmann(366)
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I ilrlyatle stuj ederlaiz wyh ihts stiouneq cdeuonsf me so mhuc (dna Iv'e dtire to riugef ti otu a euopcl of em,tis oll). I let eht uloqlaicol tiiofnnide of mubiail (ie.. ivm)iongt ictks ni my nd,im htat I grofot hte aatluc dlmaice itindnoief = moanlr BIM )(&1t8g; + benig gietan and niprugg (wheer gugnpri clodu be uneddic mvogniti ro urieitcd use ro aialtxve use no/adr vsicsexee eese)ixcr. So rally,e twah siht nisteqou asw siakgn is lismpy hwat is het eelylerttoc banelac fo cxseieesv idraa?rhe !EGZE I dame ti os hcum darrhe in my aedh wneh tgnyir to werans ti olingiylar.

Daiherra sasuce nnooai-nn agp .e(i. rmoyphcelr)chie bemaolict is.sdaico Sloot ltyimpndnreoa acnontis -3OCH dan ,+K os seseecixv dihrraae = xcsseevei loss of HC-O3 dan .K+ edrlhCio lvslee ni teh mresu liwl be eainrsdec edu to hte nlamro C/-3Cl-HO lbiuqmreu,ii os as evgaetni garhec idsspaties edu ot sosl of -,3CHO -Cl lilw eisranec rncicegort het oganp-ani.

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drdoom  iaiulBm mesco mfor Gkere uoarvsne" ;hunrg"e eth ertm is a ltliear nteaoinacotnc of the rdsow ofr ox ubos() + renguh simol.() ,So in erk,eG ilmio-uba is yiletalrl ox" u",grenh chiwh si a odn ot how het ordw is duse in emecidin = aleetpurp nad aatsibieln apptteie rfo ofdo eh(t eyvr op"sp"teio fo ioiv.ngt)m +5
abhishek021196  I egaer ihwt ruyo gsroanine tub the ssccail ecsa irtinopcdse fo amlBui sislt erltotelcey trceunabsdi fo mkiplOHaa,ye eOmHolriypch,a dna ltbMoeaic oliaAks,ls gnalo hwit ohret snihtg eilk dtiorap tprrhoyypeh nad dlaosr dnha lssaclue ude to eht denicud mgntvoii. I idtppre up rhe.et F:A/ 20 gP 576 +
llamastep1  eTak ohme ssenl:o ngeriasno &g;t gmmirzeion +3
lulumomovicky  I guthoth moer fo ti by teh go:fwlnilo hte aiepntt soles OCH3 ni het ostsol nda sith hieraadr cuases hte lbMoaeict .sisciaod Bceeasu armonl /ClHCO3 limuruiqbei lohsdu be ea,atnidimn eodrilch sevlel in usmer go up ot otnpemaces eth loss of .Bbrica As het ntteaip is salo LOVOPMHYCIE deu ot PB of 81,/69 enth ASAR acsteavi.t leoedtrnsoA lwli escerain Na nda etwar tiroaoepnrsb ot epke aoemivl dna K iwll be xdtreeec lkm(a.a)iheoyp Alos HPsA-Tea in teh acreitldatne lscle fo het tnelgcilco dctu illw eb tdcteaaiv yb droaloeetsn, uhfrtre orangagiptp eht ieatmocbl css.iaoid +1

bulimia ≠ purging  Bulimia comes from Greek “ravenous hunger”; literally “ox hunger” = ox (bous) + hunger (limos).

+5/- drdoom(1206)

N.B., there are many ways to “purge”; the method of purge determines the observed electrolyte disturbance. A nice description of bulimia nervosa from MeSH:

BULIMIA NERVOSA. An eating disorder that is characterized by a cycle of binge eating (BULIMIA or bingeing) followed by inappropriate acts (purging) to avert weight gain. Purging methods often include self-induced VOMITING, use of LAXATIVES or DIURETICS, excessive exercise, and FASTING.

+1/- drdoom(1206)

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 +1  upvote downvote
submitted by brookly_(1)
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I tgouthh miabliu gevi ries ot oaicmeblt siallkoas anc... seoemon arbeetaol ?

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drdoom  mbReemr,e bimalui ifelts odse ton aenm ug”“pnr;gi it nasme “hg-xreuno”. tI si rupging ..,(eg nelttanoiin mgvnit,io axeavilt eb,usa ciiudert ub,esa xevesiecs re,xsceie or rteemxe atf)ngsi hwihc rteaesc botamecli uncaeb.itrsd ehT ypte fo iesnarcbdtu psnedde no ruoy frreederp ouert fo ”.tx“ie +2


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 -3  upvote downvote
submitted by dr.xx(176)
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Absue fo xvtaseila ;t&g= ulylasu escrdeeda meurs autio.smsp As to eohdlcir nda b,braic htta .epnsded yheT lcoud be desreinca or adeeecrsd.

tar2/13:pt5w/pp/hsw1/lwt3/.405o0/amaff.0gh.0p

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 -4  upvote downvote
submitted by usmleuser007(464)
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tTear isht ikel a IomaPV yrWe(at er,ahiadr iydaoahlrhrc = edcuder HCl ni het le,mun ;&pma aihe)okalmyp

shit wlli edal ot eicalotmb iacsdsoi t/d sols of abbicr ni stolo

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btl_nyc  oChrdiel si nisdecear .ouhtgh +
maxillarythirdmolar  shiT nommtce si o.gdl nl_byt@c, htsi si tluclyaa u.ctcea oyu udlwo eectxp eomlhayrrepihc5v:.mcBbN/8K0lo/isotno.w9./h.wbnhpgw7/kt6sn/i +1


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 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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esBt mocenmt i read was to eratt htsi kile 'sit a .IVaPmo uoY ulwod etg lal rheet totcceely/olmlieabter cridnbeussat.

n08/t/ic9N5wb7shl/igbo/n.t/wv.w.KomBskn6hop.:

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