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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 tlrlaleiy sjtu deelzira hyw isth nqoisetu unodfsce me so hucm ad(n 'Iev drtie ot eigufr it uot a lepuco of s,meit .oll) I let het lcoolailqu iieonitdnf fo miaubli (i..e niv)tiomg tkics ni ym nimd, thta I gooftr the atlcau elcmdai einodfntii = namrol IBM (&;)18gt + egibn gnteai nda irngpug ere(wh ggiurnp cdolu eb dudienc vitmigno ro utierdic use ro ltaiaexv ues rnod/a ixesevesc e).ecexsri oS elr,yla tahw isth stqniuoe aws ksagni is ysmpli twha si het rlyotctelee cnelaab fo iseeevscx aerrdha?i EEGZ! I deam ti os hmcu rrdeha ni ym daeh newh tniygr to naswer it g.ryiilnoal

Direaahr cseuas nononin-a gap ei..( ycphhmloerrcei) alotcbeim osdsii.ca tSool pnmtlriyodane cnnotais OH-3C adn +K, os isxecseev daarhier = essexceiv osls fo H3CO- dan .+K dloerChi eeslvl in eth smeru ilwl be reenidsca eud to eth ronlam -HOCl3/C- ,lmueiibuqri os sa enitvgea crehga tiidpsesas ude ot sslo of ,CH3-O -lC llwi screniea ecrgricotn het pagn-aoni.

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drdoom  lauimBi cmseo ormf rkeGe sreun"aov ;enhgru" het tmer si a laiertl nntctcineaoao of teh dowsr rof xo bso(u) + nghuer (.)imlos oS, in keeG,r uoiamlib- si alerytlli ox" uhrg,"en hhwci si a dno to who het dorw is used in ciedmein = uealpetpr nad beisanlati pieeaptt ofr odof h(et rvye s"oipteo"p fo og.mi)nitv +5
abhishek021196  I eearg thiw rouy iarongnse but eth ascslic ceas sdireiocpnt fo mauliB islst teocteeyrll cbiatdruens of iap,emlHakyO reahpy,imOcloH adn eicobMalt A,ksalilso alnog hiwt rteoh itgnsh ilek ioradpt hepryrothpy adn alodsr hadn lsuleacs ued ot het uidcden tim.ogvin I dptrpie up eet.hr :FA/ 02 Pg 567 +
llamastep1  eTka emho :lneoss ongnaeisr gt;& irnmegiozm +3
lulumomovicky  I ohhttgu mreo of it yb het lonw:gofli eht tiapetn oslse HOC3 in teh lossto dan ihst adahrire cauess teh eMbtaolic a.sdisico caBseue nmroal O/3CHlC iermubiliqu lhuods eb amtndani,ei rdecolih vllees ni rsemu go up to aeoncmsept eth sslo of bica.Br As hte nieptat si oasl YECPLMVOIOH eud ot BP of 6,/819 hten RSAA atveait.cs ooelrtdneAs illw isrecane Na and eartw sroranbiopte ot eepk emoaliv and K liwl eb edetexrc a(o.)yemipkhal lsoA AHsa-TeP ni eth tcaeatilernd scell of the onltlgcice dutc iwll be daattvcei by atnde,leoosr trufrhe npgptirgoaa eht laicotebm .sdoiiasc +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 gotthuh iabiuml geiv seri ot omlicabet akolsisla .n.ac. eesoomn ralaeebot ?

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drdoom  ,rbmmeeeR biuilma stleif oesd ont amne n“igug;p”r it easnm “x-enguroh.” It si irungpg e..(,g tninitnolea ot,mvigin ixvaetla seba,u ieutdric aesbu, evexiescs i,escreex ro exmtree fagi)stn hwcih eatresc ombacleti siu.rtanbced eTh peyt fo csbeinautdr eendpds no rouy rperfedre outre of e“.x”it +2


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 -3  upvote downvote
submitted by dr.xx(176)
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Abuse fo vialtxesa tg;&= yuslual eeddsarec muers pam.iosuts As ot hdliocer dan ba,irbc thta sp.eendd hTye cudol be ercaiesdn or adcr.eedes

p/g5aw32//.w/tmhf.pt0wp5/0atrs40:a11oh0.lfp/3

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 -4  upvote downvote
submitted by usmleuser007(464)
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ratTe hist keil a omVaPI yWeatr( drhe,aiar raarhlhcydio = euedrcd lHC ni eht l,umne m;a&p ykeiahpmlo)a

hsti wlli alde to lacemotbi ssiadcoi t/d slso fo cibrab in lsoto

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btl_nyc  hleodriC is rsiadenec hg.touh +
maxillarythirdmolar  Thsi ecnmtmo is d.olg @_bctn,ly shit is acuytlla ucc.eat yuo dowul teepcx l cyimhreoaerhp..oc.b/wgli8vtsm./psnnw:/ot/iBN6hn57hob/w9k0K +1


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 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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tseB encmomt i drae swa to trate hits ilke it's a am.oVIP Yuo uwold get all ereht clrocieytaote/lmlebet dreba.tinsscu

oo6..Ni.n/b0.p/vwcw/8b9BnhigKstt/ohl5k/mnws7:

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