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Retired NBME 23 Answers

nbme23/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man has a diastolic blood ...
Precapillary resistance 🔍 / 📺 / 🌳 / 📖
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submitted by ferrero(48)
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A veyr isrlami stqueino I hvea enes in bskQan liwl ska yhw a ptietna hwti hrtig terha riuafle odse ton pdeelvo eadme nda the sewarn si aenderisc imlpayhtc .adargnie I tgo siht tiqoeusn rnwgo oyngllirai cabsuee I rwesenda olnag this ilne of gnneorisa but I ktnih ni isth csea it all sah to od tiwh ERHWE the txaer spreesru is gmncio f.mor nI htsi oqstnuei eht tp ash talisicod oesnteypirhn os yuo acn inhkt abuot eht eseurspr sa igcmno rawf""dor os gtsocntniric ireacylprpal teicphsnsr acn eertpvn na enreacsi in reserusp in eth cilarplya ebd. evwroeH orf irthg hrtae aifulre hits xreat dlfiu si noicmg rofm eht TPOPEISO ecindirot wdsrabakc( fmro hte gthir r)aeth adn ngtiicrctnos larerpylciap hicensrtsp cna od gonniht o(n tsopoiep eisd of yalplrcai db)e - the yoln awy to tvreepn mdeea si ot ceineasr yctalhpmi gdnra.aie

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seagull  heT uisonqet yerllac aled su to itnkh ubtao Omsitco eresrpsu by inlatgk taobu rioentp nda .uinre I ordwne woh namy oleepp edsu atht ilne of sannoireg eki(l l)sfey?m +20
mousie  etarG epa,nxltnaoi I hcseo lcamiypht ngaedrai fro eth amse aroegsnin m(airlis Q no enfterfdi bank) +9
sympathetikey  My oasirgenn aws hmuc oemr sitiiscmlp m(byea oot smlpie) tub in ym ,ndmi otysscil BP si enemddreit yb iarCcad tuuOpt dna cslotaidi BP si deiemtdrne by sl.earteiro fr,eoThree wtha ecsom ferobe the aipcrayll nad arelgutse stc?neerias sorlieArte. hTtsa' why I said taht leriycrap-pla iet.resnacs +41
cr  eth ianm ffeecnderi ewbteen hte 2 saesc si thta in tish caes het ateinpt sah ighh BP +1
link981  oS ni eeaginnkrdtr gaulenga eht siqnetuo is ietsslleyan gkiasn ohw ghih uspeersr in teh rleatiar yssetm is ONT dteitastrnm to eth nsuoev msstye hcwhi( is reehw AEDME o)v.esdelp Btu uoy wokn tyhe evah ot dda lal hsit fino to ryt escfoun a isbac priiplcne adn meak ouy neoscd eugss .srleoufy otG( it rnowg by the )ywa aeuecbs fo whta @feerrro adis of abnkQ iosuqe.snt +9
hello  orr@efer waht rae oyu glniatk ub?ato cyplmthia ednairag si eth rogwn n..rs.wae +1
hello  ok erven d.nim i otg .ti hadr to dtesadunnr cb/ ti wsa a bgi klocb of xt.et +2
asteroides  I khitn tehy amy be tgilkna taoub hte ecmyingo ptarocsymnoe mhsic:emna /iso.iKoebtip=51.g.tphl3en4/yfnoBfhu/gbN4r/o/ilwjs?c5wevmnc4n.wg:r/tr.kbto/oe eIa"rdsnc treairla ro vuonse sreusper slao neudsci moegnyci crcooitnntsi fo erlasireto and pcryalairelp srsiphtc,ne iwhch ieassr eiotarralr sntrecisae ryheteb( innmigziim eth nsiecrea in rcyllaipa sepseurr) nda eesurcd het salvrmccairou reasufc eraa vilbaaale rof idluf ehrga.cxnoFe px,lmaee abueesc casauvlr ohmsto emuslc ni lerarati dna oeirtarlra wllas crotnatcs when seodpxe ot vletedea avuircatnarls pssrr,eues this ncyomeig orpesesn ciserensa rrypaclileap tnseaisrec nda ottepcrs illeaarspic romf a mttocacnino rsie in hiter vaainctlrusra preues"sr. +7
stsfyt  emaks nesse. oimsmeset we seu o()idClaniovsBCta + oevaiitoldnn AEI)C( oocmb to aecalbn hte erepss,ur dan nepvrte ageakel nda .dmaee +

I think they are referring to maintenance of GFR and blood pressure relationships. Ergo the mentioning of the renal function. The precapillary resistance is "glomerular" precapillary resistance, so if that increases then GFR remains the same => prevents leakage of proteins and albumin => less edema.

https://www.youtube.com/watch?v=IRZsniaCfVQ

+2/- peqmd(75)

this is the concept of blood flow autuoregulation at the tissue level in response to increasesd arterial pressure via arteiolar remodeling via smooth muscle hyperplasia ....

+/- msw(4)

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submitted by staph_aureusxx(9)
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rappcrlaleyi csrneatesi = rnisdcbegi teh ioterrsl.ea se'h tgo lnmiiam tprnoie in eht ue;irn dan on mban.uli eth yke asw apynig eantnttoi ot the olodb esusrep.r srrsePeu is adleetrgu yb teh tnsreaecis svsseel sa arsodb lcasl ti hhiwc si hte eselirrtoa aka ylaripaceprl rseitean.sc

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submitted by notadoctor(175)
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v'Ie nebe irasegcnh rfo ym ocrsue rfo hist utb n'cat eems ot nfdi .ti veH,erwo eth ywa I ugohtth taubo ti wsa ahtt eamed esanpph vai het aperl.lsacii fI htree is scraeidne isscenaret iav teh lypaairprelc shcepnsrti sa mcuh bodlo 'lowundt eb blae ot egt tnoi the scilrel.aapi ehT dlobo ouldw itendsa tge uhtsedn via aseaonsosmt ot teh evi.sn Thsi rtclaie omrf v.yocpmslcoiyohg penailsx it a ettill teter:b VC gPyholyio:s seusTi madeE adn alreeGn iPseinlrpc of srnpiaracylaTl idFlu xhnaEegc

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submitted by chagas14(1)
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eMayb teh uteoqins si inaelgd htiw hte occpetn of egnmioyc irrtaraeol tnnsoovtoaccrsii chhwi si a ohaertn dinteme-aa cmheam.sni heT erp pcilayrla hsciterpn ncaorttc ni snoprese ot a rsiae in B.P I gto het Q wrnog aescbeu I peikdc yltcahipm w.ofl Thye lveo to og rfo het w"hat les"e nelteem fo yan ic.tpo I cnntoa idfn ayn oserna yhw hte mcthailyp otpino lcoud eb gorwn /:

noakBc4wmon./ttihwop/i3/brK5.wl=gt.ncvl//?r:sNspobi.5s4hcsecCk he eth riefgu .14 The iganrM fo fyetaS tangAis dmEea imoatFrno – meadE atfyeS Frtocsa

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nI ditdnaoi to ahtw sah dayerla eebn said I tihkn na arnoitptm niotp in het intqouse wsa yguaolrtre smnatdjtseu chwhi iptnso oerm sdtowar raatelorri aonurietgl.

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submitted by usmleaspirant2020(9)
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1/s077/09aifu2c2h3l2eyc2tct5606eoet.abeu0d50p:d9.2co3dbofe/ddf1n70/0d9ef27nterd9

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submitted by ninja3232(11)
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"nhWe tarerlai perreuss llsaf, myiocneg ntoe si rceddeu in itelo,srrae scaneegrid ethri etscinsrae to wlfo nda aagntmiiinn alrlaiycp eeps.rurs heeTs nsaoobvetirs eugtsgs hatt claprialy srersuep yam be euldaertg reov the amse eragn of speesurr sechnga oerv wihhc olfw is eaguladuoertt ni a vngie roang. ed,ndIe rmfo the rteo:"nali

soic/Btm.b/gvw4lN4inh.3ow5Kw5n/b.kpns//.h:to

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submitted by hello(429)
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yhw is pmasla ticcnoo esseurrp nrow?g

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rainlad  I iknth i'st sbcueae ew udwol tepxec to ese mose eomr rilr/mrbauotuauiniepani if teh sapaml oticocn ersreups hda cenerisad ot stemcnopea +1


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submitted by ferrero(48)
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A very armiisl tnsiuqeo I ahve nees in ksabQn will kas ywh a tipaetn wiht thgri arhet elarufi oesd nto oepedlv eamde dan teh ranwse is dsineaerc thmyclapi aareing.d I gto isht esuntqoi wgonr raillongiy bascuee I sadeewnr nogal htsi leni of nesrnagoi btu I nthik ni ihts scae ti lla sha to do wiht WHEER teh atxer ssrupeer is cgmion m.rof In hsit istneuqo the tp hsa dolciaits pnehteoinsry os oyu nca knhit oaubt eht rsspeuer as nmcoig rr"owd"af os isnntitcogrc arlpralceiyp cinphetrss cna evepnrt na ecsarine in erseprsu in eht irallpayc dbe. eervwHo rof rtghi hetar aeufilr sthi reaxt lduif si ncgimo mrof eth IOSTPOEP noerdtcii wcd(asrkab fmor eht htgir eart)h nad tniorcngtsci pylprelcaari tessipcnrh acn do ohitnng (on soeptoip desi fo llyapirac be)d - eth loyn awy ot rnpteve demea si to ceraiens cyhitalpm .dgaanrie

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submitted by usmleuser007(464)
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rocAti lDiosaict rsePsru e

  • Hhgi TPR = ghhi PD
  • Hgih HR = ghih PD
  • hHig VS = hhig PD

cAoitr tSlciyos sreues rP

  • igHh oltintyraicCt = hhgi PS
  • High SV = high SP
  • owL Clpacmoein = ihgh SP

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submitted by spow(50)
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I losa inhkt atht teh intop bgeni edam reeh si tabuo eanm artierla preusrse AM)(P, wihhc si awht eatlytaorroguu smtsyse lacuatly ehgcna besda no. caeusBe eh ahs dnaesecri PMA ued( ot dircsenae DP),B het iillsarpaec wlli itctrocns to animitan snoatcnt /ssrfoweruepl hrghotu teh lrpaacyil b.ed

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submitted by divya(75)
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i ton'd nhkit uyo eedn ot nithk all ttah h.cum look ta all eht stiopon adn nhikt of awth psanhpe wneh yeth i A,erascne. ,B C, D nad F lla nca ucaes niislrtattei a.t umedBe esgincarin cyrlalipepra saicenerst ilynefteid d'eston.

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drzed  aeIdenscr cilmphyta wofl dulwo ont esuac istnritliate .mdaee +1
123ojm  ubt it oestd'n yas ias"recen n"i, it stju yssa ygtrlar"oeu jtatmdsnesu n."i +1


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submitted by usmleuser007(464)
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1. itrAoc sDtoliiac urePessr 1. hgHi RTP = ghhi PD 2. giHh RH = ighh PD .3 igHh VS = ihgh PD . 2 croitA ciotsSly usrPeser 1. Hgih tytoactClinri = high SP .2 hHgi VS = hhgi SP .3 wLo peoiCmnlac = ihgh PS
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yex  st.cutiocva://nlc/0ryiiilroycptooc/M1gmso2hpMh siTh elpsh o,meoswh hte rstif part tbuoa cparyilla spsree.ur +
usmlelol  tsah't eht pxe :rta:p Teh gvearea apcaiylrl taicohrsdty ueprsers si merneitded yb erriaalt adn onusev sresrupse P(A and ,V)P dan by eht orita fo slpreat-tcar-pilyoop cserteinsas /(V).RRA nA nerseaic in thriee raleitra ro unovse errsepsu wlli nesicera iyaclrpla eprr;uses e,orvehw a evgni egnhac in AP is noly ubtao fnifeoth- sa teeicffve in gchniang CP sa teh same abteulos ehangc ni PV. csaBeeu nevuso neisrtasce si aerievyllt wol, achsgen ni PV are ieldrya atteidsrntm cbka to hte arcipalyl, nda eslrecoy,vn bcesaeu rltieaar irseeascnt si raleitlvye ,high cahsegn in AP era lrpyoo tdntratmise snetmdwroa ot teh plciryla.a +1


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