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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 ryve silimra eitsnoqu I hvae eesn ni kQbsna ilwl ska yhw a itpaetn ithw gthri rtahe aulfrie sdoe ont dvpoeel eemda nda the sewanr si raeescind lhcyapmit arg.anide I otg itsh qitsnoue gnowr yllairigno aubesce I weenrdas lngoa tihs lein fo renoiansg but I knthi in siht easc ti all ahs ot od hwit HEREW eth etxra prseruse si mcgoni f.mor nI isht seinquot eth pt sha iidasotcl inothersneyp so ouy nac kithn buota het speresru sa ognicm rdarofw"" so nntgoriisctc ylaeialrrpcp strpechisn nac ervtnep na rceansie in eusrspre in eht plcyarali d.eb oeervHw ofr rhtig rahet iealfur tihs exart lufid is gcinmo ormf hte TPIPSOOE cieniodtr kdw(casrab form eth ghrit tear)h dna itogctinsnrc crpylielaapr ncsteripsh can od otinhgn (no ptospieo eids of crapllayi d)be - hte ylon way ot pertevn edmae si ot earsinec yhlmicpat anei.grda

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seagull  hTe qtusnoie rylelac laed su ot itnkh buoat tmsOoic espusrre yb agknilt tuoba penitro nad un.rei I wndoer woh mnay ppeloe duse htat neil of rsnaeiogn (eikl lmf?)esy +20
mousie  retGa nt,epaixnola I hesoc hpytalcim daiernag for teh smae ernnigosa larsiim( Q no fneferdti )aknb +9
sympathetikey  yM anongeirs saw hucm rmeo misitpslci (myeab oot pls)mei but in my mn,id soisyctl BP si dieetmnedr yb dCaaric uuOttp and ailsoctdi BP si eededntrim yb oarirtl.ees hTrr,efeeo atwh omecs rfboee hte ilryplcaa dna ereslatgu rssnceieta? se.tAorlire htTas' hwy I asid ttha pyracai-relpl tarieec.nss +41
cr  het amni fifcenedre bteewne eth 2 scsae si atth in isht csae eth atitnpe sha hhig PB +1
link981  So in kningrraetde guglaane eht uqtesion si eltsneylais kaisng ohw high rsueepsr ni eht ietaralr ymesst si NTO mrnttsdtaie ot het neuovs estsym ihw(ch si ehrwe EEDMA pes.do)lve Btu oyu nkwo yteh ehva ot dda lal tish fnoi ot try nocfeus a ibsca ipelrcnip dna amek you doecns segus luerfyos. (Got it wognr by the ay)w eubasce of thaw re@roerf siad of nkaQb eissqo.nut +9
hello  f@errero htwa era you atkngli bta?uo hictyampl dniragae si eth wonrg e.nwra.s. +1
hello  ko vreen .nmdi i otg i.t hdra to ansdtruden bc/ ti was a gbi kcobl fo x.tet +2
asteroides  I thkin htey may eb gklinta abotu the mgneiocy mcersnoaypot hnmesicm:a ..Klcn4sl/tg//o=:rwitf.jo/hg/mwpsrep4yh1vbNeftn5nob?/kB35toiw.r.ugine/ob4ocisIearen dc" eaalrirt ro enouvs esrrusep olsa uidnsce icomnegy tcsrtionconi fo teaesilror and pcleyriaparl nsrt,cphies whcih eisrsa reirlroaat setniesrca eth(ebry nnizigmimi eth aerinesc in allacpiyr res)repus nda rucsdee hte oaucisrmalrvc rscufea aear avlelaabi for ifdul cxeFoae.h gnr eamep,xl scbeaeu avsrluac mshoto usmlce in lrrieata nad trrliaeroa sllwa nrcstocta wnhe oxsdeep to evdteale acvsaurarlnti urrsespse, htsi enocymgi peornsse csneeisra larclpreaipy necasirset nda ectprtso ailraliescp omfr a itcmocnaont ries in thier vtialarcsrnua sp."euesrr +7
stsfyt  aksme .nsees osmtseiem we ues liCosdCBona(ta)iv + enivlionadot CA(E)I bomco to nlacabe teh sreue,spr adn eenprvt aealkeg dan deame. +

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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ryiarcepllap retsseacni = sncgiirebd the aeirr.soelt eh's tgo aimmnli iprtneo ni eth i;uren adn no namil.ub teh yek swa pgniay onaetttni to eth olbod ep.srusre rPressue is deruetalg yb eht asrctseien sevlsse as rbados lslac ti whhci is the eserlaoitr aka ylprlacpeari ersiatnesc.

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submitted by notadoctor(175)
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vIe' nbee agienhrcs rof ym sruoce fro stih btu n'cta eems ot nidf .ti veHrw,oe hte yaw I thguoht otabu it asw atht emead pehnasp via hte cila.lpairse fI reeth is ndrecisea csenraties iva eth plrcaeiylrap tiecprsnsh as cmuh ooldb ot'udlwn eb blea ot teg tnoi teh .aacsiplrlei hTe oldob ouwld sdneait tge htudesn aiv ansooeasmts ot eth nv.sei Thsi ricalte mrfo glyvymchosiocpo. lepxsnai ti a lltite erbt:et VC lPhoy:oygsi sTsuei dmeEa adn nGerael irspiPnecl fo yrTncprialslaa uFdli axEnhcge

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submitted by chagas14(1)
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Mybea the siunteoq si aigledn ihwt eht necpcot of nmgicyeo rtlaaerori inornscsticatovo chhwi is a rtonhea m-dentaeai aiemhsc.nm heT pre aiclyprla sepntcirh orattccn ni sopensre ot a erisa ni .BP I tog het Q ngwro cbeeaus I ipdeck hpcyialtm ol.fw yTeh elov to go orf het "athw sl"ee netmele of yan pico.t I tcnnao dnif ayn snoera hyw het chliyapmt inpoot uoldc be ongrw /:

t/at5=si3ssoN/ce.wniop.o4?5/p4gktBvhKlimcb./wbh.row/nsrncl:cCe hk hte eiufrg .41 hTe rnMiga fo eafySt agsnitA aemdE oroiFnamt – Eedam yfStea Frascto

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submitted by adong(144)
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In diiatodn to waht sah earadly been adis I hknti na rmttianpo ntopi in het qnisueot asw lgtrrauoye jsmaedusntt chiwh nsiotp eomr wrdsato rtriareoal elt.ungairo

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submitted by usmleaspirant2020(9)
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e3f/en0.67td26en295yuf2i3sf./tdcpdocbo0/:u0fchcrl91dee70t91/52edb2t0090d2ed7a7ao

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submitted by ninja3232(11)
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nWhe" trarlaie repusres ,llafs iycmonge ento si decduer ni eraoltis,er cdenagreis ethri sesnceatir to lofw dan iintagmnian yalcrpila er.eusprs Thees osbotraiensv eustsgg ttah liycarlap useseprr yma eb udlegtrea orev het smea negar of resuerps cehnags ovre hhwci wfol si rttuadeegoalu ni a gvien rn.oga ndeedI, rofm hte oe"rtl:ani

twbp/c5w3/vbss:Bi/mNhkgwKn//4h.o5..nootn.l4i

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submitted by hello(429)
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hwy si lampsa oncicto rreespsu rgnwo?

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rainlad  I thnki i'st bcusaee ew wludo tecpxe ot see smoe meor r/rilaoeimnibinuauuratp fi eht slaamp ctcioon rsspreeu ahd recidensa to npoatemsce +1


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submitted by ferrero(48)
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A rvye silmair uoienqst I aehv nsee in asbkQn lwil ksa yhw a ipatent twhi rhigt ather lfiuera does ont leodpve eedam nad eth wearsn si caereinds pacyhltim driea.ang I ogt isth seqtionu wogrn ranogilliy ceusabe I wdeneasr onlga itsh line of gsinoaner btu I nihkt in htis csae it lal has ot do ihtw WREEH the xetar eurperss si gocmni .morf nI hits eisontuq eht tp hsa doasiitcl eoiheptrysnn so uyo nca hitkn btuoa the rsruesep as mcogni drw"ora"f so gicnnittsocr lracepalipyr eprstnisch nca teenvrp na rinaeces ni rerpuses in eth liplracya d.be eHrwveo orf ightr arteh fiaeulr iths eatrx dlfui si ncoimg fmro het TOOESPIP redioctin rdaw(kcasb form eth grhti ar)hte adn niocintcgtrs eaicplalrypr phicnetrss anc do tohngni no( ptopieos ised fo lrpcailay bd)e - teh nylo awy to tverpne deame is to rscneeia phlmtacyi eardgin.a

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submitted by usmleuser007(464)
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trocAi iciaDotls srr Peesu

  • hiHg PRT = hghi DP
  • ihgH RH = hgih DP
  • iHgh VS = ighh PD

roAict ctiySosl eer usPrs

  • ighH Ctitilynarcot = hihg PS
  • Hgih VS = hgih PS
  • oLw olcneCmiap = hhig SP

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submitted by spow(50)
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I aosl tikhn taht eht ponit einbg aedm heer si atubo name rlairaet erpresus ,MPA)( ihchw si hwta aeyoarlgrtouut sssmtye auylltac ahecgn dsbae on. cseaeuB eh sah drenaiecs MPA ed(u to acsrieden PD),B het apcilarseil wlli csntrtoci to atainmni notactns pssrewfuro/le trhough eth rialalcyp b.de

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submitted by divya(75)
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i nod't khtin ouy ndee ot ntkih lla atth muhc. oolk ta lal teh sopntoi nda tnkih of htaw phapesn wehn tyhe nAac,ies er. ,B ,C D dan F lla can aecus liratittsine dB m.teuea cenrinigas ryaeirapplcl siasercent yldneitefi e.'tdons

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drzed  ceedIrsan lchtyamip oflw wldou ton csuae inattseitlir .dmeae +1
123ojm  tub it otnsed' sya ns"ceiaer ,ni" it juts ssya u"oregtryla djtnsemtsua in." +1


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submitted by usmleuser007(464)
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1. oriAtc osicitalD sPreures 1. Hgih TRP = ighh DP .2 High RH = gihh PD .3 ghiH VS = hgih PD .2 oritAc ycSisolt suPreesr .1 hgiH cnttCoitliary = hgih P S .2 hHgi SV = hihg P S 3. oLw oialnpemcC = hghi S P
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yex  homnc/u/pl/atriolciyossvopi0c.1M2gcMiht:cty/or hiTs sehlp ,wehsoom het rtfis prat abotu yrlapaicl rpesseru. +
usmlelol  t'tahs eht pxe rpa::t eTh ageevar lclriaayp tsaiodrhcty epsrsure is enemddtire by larteair nad noesuv rsupssere P(A nda V,)P dan by eht aroit fo aoylrteolc-pspitra-p stsnaeirsce RV/.R()A An eirsance ni reeiht aerrilat ro nesvou rsperesu lilw neraecis aipalcrly ruerssp;e orew,ehv a gvein cehang in PA is loyn batou tffo-ihen as cifvteefe in ghicanng PC sa the asem ostlbaeu hgenca ni PV. aeceBsu seunov nrsecaetis is yilarlevet ol,w egcshan ni VP are liayedr nmtrtdetsai abkc ot eht pr,ilaacyl and r,eecylvnos esucabe eraailtr srtaescnei si tavleeryli gihh, eshgnac ni AP ear lyporo drntiamtest noretsawdm to eht lciaarl.yp +1


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