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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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 +46  upvote downvote
submitted by ferrero(48)
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A eyrv lismira eqstinou I aevh esne in nkQbsa liwl ksa ywh a einptta whit hrgit treha efairul soed ont vleepod eamed and het awenrs is iandersce pctymlhai dneag.ria I got ihst eotunqis nogrw ngliyalior saecueb I edrwaens lngoa thsi ilen of nneraosgi tbu I kithn ni tsih scae ti all hsa ot do htwi EERWH het trexa uprseers is cmnoig o.frm In ihts qeitouns eht pt has dostliica hrosnineyept os uoy anc nktih abuot eht pessruer as gnciom wao"rr"df so ncigrsctntoi pyleirlaapcr ceinsrhtsp nca vrepetn na asirecne ni eprusres ni teh pilayalrc de.b erHewov rof rhitg etahr lfiareu iths xraet fduli si ocimng mrof eht POPIETSO renitocid kawdrsacb( ofrm hte tgihr t)hrae nda tngitocnrsic ralpalyrcipe eishpnrsct nca do iotghnn n(o espoiotp desi fo pilayarlc )deb - teh nyol ayw ot trevpne meead is ot cneeisar mcyahplti naed.aigr

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seagull  eTh ntequiso lercayl alde us ot knthi touab mcisotO surperes by ntlgkia tuboa rinpteo dan r.euni I renwdo ohw amyn oplepe sdeu hatt eiln of iorgaensn ike(l e)m?fsly +20
mousie  atrGe ixn,epotnala I soche ymlhptcai riagedan ofr eth asem geonirans siir(mla Q no dintefrfe )nkab +9
sympathetikey  My saeroginn asw uhmc reom pslismiict m(abey oto eslmp)i ubt ni my ,midn itslocsy BP si emerddteni by cCiaard ptutuO dna ioclditas BP is dnrmeiedte yb sriorltaee. erTro,eehf thaw omsec roebfe het ryalilacp dan salrtegue isrteasnce? etrorsAl.ie s'taTh ywh I adis atht -cipayelrarlp .sacrtsiene +41
cr  het mina ecferfidne tneeweb eht 2 aessc si tath in tsih aecs het pntaite ahs ghih PB +1
link981  So ni kgnenieartdr gnaegalu teh qesnutoi si stleelansyi gaknsi owh ihgh esrserpu ni hte eairtlra tyssem is NOT irmttdasetn to eht nuovse tsysem h(icwh si hwere MAEDE .evpsdo)el uBt ouy wnok tehy vahe ot dda lal hits oinf to rty ueoncsf a bicas ecrnilpip adn amek uyo necsdo segsu leor.uyfs oGt( ti gronw by eth ayw) eauesbc of thwa @freeorr aids fo nkaQb esutsnqo.i +9
hello  o@errrfe htwa are ouy ngklait ub?ota lcpihyamt iaradnge si the grwno a..n.wres +1
hello  ok evrne mnd.i i got t.i arhd to drenadtsun /bc ti swa a gbi cblok fo .xtte +2
asteroides  I hknit yeht yam be lagtink tubao the gnmecoiy omronsyctpae cean:mihms p.gncigBkfj5vbe3m?rroo/ienrf/l/b4/./tp.wstyoN=5/wKbsltowuih4t./hngi:e14o.ocn serdaceI"n atarlrie ro senuov sspeurer osal scnueid iyngoemc itrnccootsin of eoieratsrl nad arlelryacipp etsihnsc,rp hwhic rassei ailtorearr isatsnrece eet(bryh iimiinzgnm the eneicsar ni arpcylila sspeerru) adn eedcurs teh riacvsacruoml esrcauf eara levaailab ofr uifld hreaeogcxnF. xae,pelm suceabe urslaacv mohost emcusl ni ratalier nda ratreaoirl wllsa orccstant hewn pseedxo ot evldeeat sractrnuiaval resrsspeu, hist ymoengic repnsose ceassiern lryrappaecil tsseniaerc adn tcoprets piaalierlsc rfmo a mntcaoncoit rsei in ietrh alvaucnraisrt p.e"ressru +7
stsfyt  maeks .ensse mmeestios we esu o)C(vloBdsnaiCait + etlovaiondni )C(EAI oobcm to ancbael eht rpe,ssrue adn etnvper keageal nda d.emae +

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

+1/- peqmd(74)

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)


 +5  upvote downvote
submitted by staph_aureusxx(9)
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pralepirlayc seiceatnrs = enrsgibcdi the ealrioert.s 'she tgo mlinaim ritneop ni the eri;un dan on ui.nbaml het eky wsa gainpy nenatiott to eth obldo pe.usrsre ueserPrs si lutreaged yb eth esnretisac esvslse sa adrosb cslal ti ichhw si eht rtsirleeoa aka caeriyalrplp csensratei.

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 +3  upvote downvote
submitted by notadoctor(175)
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v'Ie ebne ehcisrnga rfo ym uescor rof this tub n'cat emse ot idfn it. Hwer,veo het ayw I oghttuh baotu it saw ttha eedam papeshn via hte ciisallr.epa fI ereth is desecarin ciraestesn avi the ylcearrpaipl ntrepssihc as mhcu oolbd tdonu'lw be bale ot gte itno eht islapai.ercl Teh olbod udlwo itnedas egt desthnu iav eoosaansstm to eth en.ivs iThs ratliec form ohooccysliyvg.pm psneaixl it a eliltt erttb:e CV :ogiyshoPyl Tessiu aEemd nad leGnaer ilricePsnp of lrcTprisyanlaa lduFi hEagxnec

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 +1  upvote downvote
submitted by chagas14(1)
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ayeMb the qsoniuet si adenlgi hiwt eht cpnteoc fo iocmeygn iaearrorlt tvtissnancrcooio hwihc si a onrhaet aenimed-at m.mnhiaces Teh epr ailrpaycl henticpsr tcctroan in nseoprse ot a asire in .PB I ogt hte Q rognw caebsue I pdekci itmplahcy w.ofl yeTh oevl ot og fro eth t"ahw "esle tnmeele fo nya cp.oti I naocnt find yna asreon yhw het pilhtmcya ioontp uodcl eb ogrwn :/

g//tb/wcn4hw5krn4/Kmlii:t=5apsNo3Bcesb?twopis..cvol./r.snohCkc he the efgrui 1.4 eTh gnMrai of eftSay atiAngs mEdea roaimtoFn – mEdea taySfe Frtoasc

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 +0  upvote downvote
submitted by adong(144)
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In ddtoaini ot hwat ahs dyarlae eneb dais I ihktn na mrpaonitt nptio in het oietuqns swa ortaeygrlu matdstuesnj whihc snotpi mero aosrtwd atlrieraro tenoiru.gla

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 +0  upvote downvote
submitted by usmleaspirant2020(9)
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n0ic1r52dcft00eptn9t2d6c/02b/a2dl7215cfe79oeese79/f3/ba602dde:ou0yo3d90u.df7h.te

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 +0  upvote downvote
submitted by ninja3232(11)
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n"hWe aarlirte eesrpurs llafs, eycnmigo otne is deecrud ni oeltrairse, eercdinags rtihe tnreisscae ot lfow dna maainigtinn cialralyp esrpuers. sTeeh tsbisvoonera gusgtse htta irlalypac prsuesre mya eb uetgldaer roev het seam ganer fo uepsserr saenchg reov hchiw fwlo si leruotgdaueat ni a einvg n.roga ,eddnIe fmor eht ritlneo":a

pN/bs.cw/vn5nBh//wnKo5.s/43.tokmibth.owlg:4i

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 +0  upvote downvote
submitted by hello(429)
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hwy si amspal iconcto rrupsees orngw?

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rainlad  I nithk s'ti saecbue we dlouw ctxepe to ese mseo rome iiatrinrli/manurueaupbo if teh mpaasl onccito eprrsseu hda cesrieand to nsopmeteac +1



 +0  upvote downvote
submitted by ferrero(48)
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A eyrv ailrmsi iqetnsuo I veah nees in nasQkb illw sak why a ntaipte twih gtirh thear ierfual deos ton epeldvo medea adn eht nwsera is iceaerdns haplmtciy gaianedr. I got htis nqsutieo onrwg liligrnoya sacubee I endarwse aglno iths niel of oneganrsi but I tnhki in itsh ecas it lla ash ot do ihwt HEEWR hte aerxt esrserup si mogcni r.fom In tish uqtesino teh pt ahs aodtsilci nyeisnteproh so uoy nac hinkt batuo eth resuersp as nciomg ""faorrdw so rcngtinitcos aplclriparey insrhtsecp nac envtepr an eicrneas ni rsuseepr ni eth alcailypr ebd. oewvrHe ofr igthr erhta elfiaru tshi eatxr ufild si ongmci fmor teh SPPTOEOI niedricto rcbawd(ask mofr hte rghti et)hra dna tcgrniictosn pllryaapceri trpeshsnci acn od ihogtnn o(n eooiptsp ides fo allyricpa )ebd - het ynol awy to vetpner eaedm is to csireena cmtihlapy adrngiae.

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 -1  upvote downvote
submitted by usmleuser007(464)
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orAict ioaclstDi erPssue r

  • Hhgi RTP = ghhi DP
  • High HR = hihg PD
  • ihHg SV = hhig DP

rioctA ylocitSs ursrsPee

  • igHh oiylCatirnctt = ighh PS
  • gHih VS = hhgi SP
  • oLw apmclnoCei = gihh SP

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 -1  upvote downvote
submitted by spow(50)
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I osla tnihk taht teh iotpn egnib daem here is aubot aemn atiaelrr essuerrp MA)P(, hhicw is ahwt trlguteraaouoy mtesyss yalactlu hagecn bedsa .no asuceeB eh has ndsiecera AMP ude( ot danseiecr DB,P) hte clalspriaie illw sritcnoct ot aiaitmnn nnctotsa repl/wsursfeo uohhgtr teh yilarlpac .bed

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 -3  upvote downvote
submitted by divya(75)
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i dot'n ihknt yuo eedn to kthni lla ahtt muc.h kool ta lal eht sinotop and tkinh of thaw eshppan newh yeth nac iAeser., ,B ,C D adn F lla anc scaeu itrntetaisli muedt eB.a rsainignec acleryarippl reaisetcsn leenfdiyti otndes.'

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drzed  aedsrcIen hiacltpmy ofwl wloud nto euasc eittaliinsrt edma.e +1
123ojm  tbu ti st'eodn ays "enrcisae ni," it just ayss r"lgeatyuro asetntjusmd .i"n +1



 -3  upvote downvote
submitted by usmleuser007(464)
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.1 coAtir iDlcsatio serrePsu 1. gHih TPR = ghih PD 2. ghHi HR = ghih D P 3. Hhig SV = hgih PD .2 tircAo lytoScis ersrsePu .1 Hhgi Cltictnyirtoa = hihg SP 2. ihHg VS = hgih S P .3 owL ocpenamCli = hhig P S
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yex  pcMooutcMnvop/ccrcost:t0lml/i2./harig1/oiihsyy hsiT lhsep ,mhosoew het ftirs artp butao paaclriyl eu.erspsr +
usmlelol  tat'sh teh xpe trp::a T eh aeaergv ayacipllr taohiystdrc erespsru si enedrmidet by arealirt dna vnsoeu rerpssuse A(P nad ,)VP adn yb eth iotar of --lcrppspltioyaoetra ainsstscere .A(V)/RR nA sreieanc ni erihte etrlaira ro oesnvu upsesrre liwl ciesaern calpliyra eesurp;rs re,woehv a envig haengc in AP is lyon oabut etohff-in sa vfeieetcf in ncgagihn PC sa eth msea usaobtle hcnage in .VP Buescae onevus rcitseaesn si taylerlevi wl,o encsgah in PV are daeiryl saemtntrdit cbka to teh cilalryp,a dan ornly,vcese eauebsc lrreaita tncseirase is yltalrivee ,ghih agenhcs in AP aer lropoy ttmdietarsn raowsdetnm to eht .apilrlcya +1



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