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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 layrletil tujs iazldree ywh sthi utqisone uecfnosd me os hucm na(d eIv' tiedr ot ergiuf it otu a epuloc of stemi, o.)ll I etl the llloqiouca idoinnietf of iuaimlb .ie.( imvti)nog tkisc in my dnmi, taht I ofgrto hte aultac dilcmae idftioenin = nmrola BMI (8)t;&1g + bgien gnaiet adn gipugrn ee(hwr ggnrpui udloc be ddecuni tioimgnv or rdietuci seu or ietalaxv ues od/anr xevcessei cix.res)ee oS lrleya, ahtw ihst iesqunto was kiasgn si mlyisp hwta si eth lyotleteerc bceanal fo ecvseisxe areaidhr? GEZE! I amed ti so cumh rdareh in my dhae hwen nigryt ot rsewan ti ni.ylrgloia

aiarrehD ssauec n-iaononn pag i(.e. icml)coehrehpyr etbamloic iiasodcs. otloS npelatorymdni aitncsno OH3C- dan +,K os cexeisevs arhradie = esciseexv sols of CH-3O nda +K. rilhodCe llvsee in het ermsu wlli be ancieesrd edu ot eth maronl C-Hl3CO-/ muiiuier,blq so as aiveteng earhgc ipsstdieas ued to slso of -,O3CH -Cl will ecsanire ccgriornet eht g.ao-panin

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drdoom  mluBaii seomc mrfo eerkG rvso"neau her;ung" eht trem is a talleir tenoatcinonca of teh rdows orf ox s)o(ub + eughnr om(.l)si oS, ni Gerek, amuio-lbi si aieltlrly o"x h,eng"ur iwchh is a ond to ohw eth rwod is deus ni iemnedic = puterpela adn alsinitbae tteipeap ofr doof he(t eryv so"pti"eop of )mg.vniiot +5
abhishek021196  I regea itwh oryu asninrgoe ubt het sicacsl ecsa ecsitpidorn of luaiBm tliss ryeltcelote anisrutdceb fo klHaap,yieOm ichyorHm,lOaep and clibeMato isllosA,ka olnga wtih rehto inhgst keli piadrot eyrrtphoyph dan rsdoal dnah lcsslaeu deu ot the uiedndc itign.mov I trpidpe pu thee.r A:F/ 20 gP 675 +
llamastep1  Tkea home enslo:s snoegnair g;t& ozimeimngr +3
lulumomovicky  I tohghut roem fo it by teh li:oolwnfg teh tanipte lsseo CO3H in eth ssootl dna hsit iadrarhe eaussc eht Mbleocita icsi.odas euacsBe armoln /lCOHC3 qimuriuileb lhsudo be midantina,e eihdcorl evlsle ni smeru go pu ot oespacetnm the sslo fo rcBai.b As the aeptitn is olsa CHLEVIYMOOP edu to BP fo 1/968, hetn RASA .titacvesa neseltrdAoo wlil saneirce Na dna wrtea otsarebinrpo to ekep emlavoi dan K ilwl eb ecetredx mko.pahyiea()l Alos Ta-esHAP in eth rttldnceeiaa ecsll fo eth eolcinglct udtc lwil be avitctdea by rn,letasooed hurrfet pgnaaitropg hte tibcmoela di.ssicoa +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 thtouhg ulbiiam eivg eris ot lmetcobia lissoaakl c..a.n oosneme oatelareb ?

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drdoom  m,mbReeer bmauiil ltfeis eods not nmae p;”nirgg“u ti asmen “-xohenugr.” It si piugrgn ,(ge.. eloitaninnt gt,imivon vixaaetl u,sbae rtcueidi ,sebua ssiecevex iercx,ese or xmereet )sfigant iwchh csrteea ilmabetoc nesi.btdcaur ehT tpye of ertiasudbnc ndspeed no yruo epferredr eotru of e.i“”tx +2


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 -3  upvote downvote
submitted by dr.xx(176)
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Aeubs fo avaxielts >=; luslayu caeeerdds emusr mtaosu.pis sA to odelhirc and ,cibarb ahtt dpsdne.e eTyh clduo eb crsdaieen ro eesacrde.d

f11mt0wo/p:p/.0/watht./s25apap0w/035f4./g3rlh

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 -4  upvote downvote
submitted by usmleuser007(464)
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Trtea hits ekli a mVPoIa aryte(W ihrr,adae aracihdyrolh = ceduedr ClH in teh em,uln mp&;a oeiakmahylp)

tsih ilwl edla to alcomtbei oisicsad t/d sols fo abcirb ni olsto

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btl_nyc  derColih is eicsreand htg.ohu +
maxillarythirdmolar  shiT etonmcm is dog.l cnlt@by,_ itsh is cllautya tcu.cae ouy udowl etcepx oirhceyahprmel /ots:i../hgcbNbo/Ko67hslw9wnpBw/n.k0tv5m/8n.i +1


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 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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esBt tommecn i aerd asw to eratt isht kiel 'sit a P.oImVa Yuo dlouw gte lal heter tlltb/ielmcceeetyoora irabsutsn.dec

bBlnNgs9/nowtsio:.ih..n6mwh/Kw8t.0/k/c75ob/vp

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