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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 yrve imsilar qiteunso I ehva enes in aQknsb illw ask ywh a itepatn wtih htgri rthea eluiafr sdoe tno vepldeo maede dan het erwnsa si cdsiaeren plhytaimc .enigadar I tog hsti otusineq rogwn orniayilgl esbeacu I dnaewesr along this ilne of reionsnag tub I khnti ni stih ecsa it all ash to do with HEREW eht xaetr rperseus is cigmon .romf nI sith squintoe eth tp sah olistacdi pennohstiery so you anc tnikh baotu het psuerres as mcniog ro"ard"fw os iscrtocngint apcrllaiprey etssinpcrh cna tpvreen an ieancrse ni eurpsesr ni the rlaplycia dbe. Hveerwo fro ghrit harte filarue shti xeart ldiuf is nicogm ofmr het OTEOSPPI nricedoit dabwrcsak( mfor eht tgirh ethra) adn nsnoctcigrti appeicarlyrl psircntehs cna do tonginh (on itseoopp sedi fo alcylpari db)e - eth yonl wya to epretvn eaedm si ot necarsei ytlmhapci reaaidng.

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seagull  Teh oesutqin aeylcrl adel us to hitnk uboat omcOtis usserpre by knaigtl aobtu rneoitp adn rui.en I nodwer hwo naym peopel usde hatt einl fo igenorsna ik(el fsey)l?m +20
mousie  reGta inxepatno,la I ohsec paclyhimt rgdneaia ofr the asem earoisngn aiirlms( Q no ridtfefen bkna) +9
sympathetikey  yM sgrnniaeo was hmuc omre imssiticlp bea(my oot l)psmie but in ym nmd,i lsiscyto PB is mdeenidter yb ciradaC upttOu nad iiactdsol PB is meidernedt by rseliraet.o re,eThroef htwa cmose oeefbr teh larclyipa dna seagteulr teac?sreins otlierAre.s Ttha's wyh I disa that ya-lerripclap tsceianesr. +41
cr  the anim dfnfeciree btneeew eht 2 caess is ahtt in stih ecsa hte eiantpt sha high BP +1
link981  So in karneitredgn elnuagga eht uqsntioe is elislestnay ngkias ohw gihh rreuseps ni hte irtearla smyste is TNO antemsittdr to teh unoevs estysm h(wihc si hreew MDAEE esp.odevl) uBt uyo kwno yhte eavh ot add lla hsit ifon ot yrt oneufcs a cbisa eiclrinpp dna kema yuo encods gusse roueylfs. to(G ti rgwno by eht a)yw uebsaec fo wath @ferorer aids fo aQbkn tqonui.sse +9
hello  oerfrr@e tawh aer yuo katlngi o?tuab lycmpaiht raagdien si het gnowr a.nr..ews +1
hello  ok vneer nmi.d i ogt .ti rdah to trunandsed cb/ ti asw a igb colkb of xet.t +2
asteroides  I nitkh eyth mya eb akintgl btauo eth imnogyec nayosmcrtoep hmceai:nsm iglujogi1t.//lKvh/4itfwi/4ywb3bt/5.okpbcworcneer=Bo.r?/5stn.s:fnohnpg4m/.eoNdan crI"ese trrelaia or soeuvn rsupsree oasl cenuisd eimogncy insrctcointo fo ortearlsei nda ecalparpilyr tssncpeh,ir hwhci eisasr eorrlairat cnisrtseea (ehtrybe iginmmiinz het aicenrse ni aplilracy seurser)p and desuerc het iocumrsaclrva sruafec raae aaevllaib orf ulifd egcnhxraF e.o l,xaeepm ebausce laascrvu ohstmo mculse in rlreaita and terarroali wlsla rcaocnstt wehn eepoxsd ot eladevte atlnsrrauvcia eurres,sps ihts ygeoinmc seeornps nareicsse racaylleripp ircneesats nad tsrtcope pirlialecas ofrm a ottaccminno esir ni reiht nrsaaivtarluc u"e.rssper +7
stsfyt  kemsa .nssee meotemiss we ues Cai()BCdaoinvtlso + inoteoldavin CA(EI) mboco ot labncae eht upe,srrse nad eeptrnv egalaek and amede. +

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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elrlaipcprya tnsrceisae = iedigcsrbn het iarteorl.es he's otg nmmilai opnirte in het ;eruin nda no lbn.uami the kye aws ypangi tentoitna to hte oodbl .esrpuser uresPers is eurgldtae by eth eiasrscetn svsseel sa dorbas cllsa it hwhci is het earitlsoer kaa arrplcpailey intaecr.ses

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submitted by notadoctor(175)
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'Iev bnee acreghins rfo ym ceorsu orf hsit btu tacn' esem ot fdin .it veerow,H eth yaw I uhgttoh aobut ti saw atth eadme spnpeha avi eht lcral.ieaspi If eerth si aersdniec eensaricst iav teh iyaalrlpcpre sinptcsrhe sa muhc dolob wltuond' eb abel to teg onit eht rliliape.csa hTe dolbo louwd edtsian tge dusnthe via osoasesntam ot hte s.vien ihTs talrcei mrof .vligsychmcoypoo elspxani ti a tiellt ttbeer: CV ogy:Psolhiy iusseT Edmae nda ranelGe rnliPsipce fo ascryapllrainT iuldF Eahcngex

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submitted by chagas14(1)
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byaeM eht nioeqtsu si eaglnid hiwt the opnetcc of mcgoyein ireotrlaar ooctoavcsstiirnn iwchh si a ornehat eaein-dmta .semcimhan Teh pre lyrpicala tpsncrihe otatrcnc ni sropense ot a saeri in P.B I gto the Q gowrn asceeub I kcedip hlmapicty .wlfo Teyh vloe ot go fro eht thaw" el"se leeemnt of nay otcp.i I coantn indf yna neasor hyw eht ihmaptcyl nootpi ouldc be wgonr :/

w.4lpvpbitcKnktgwosns4:3hmo/s.osiiBr/.c/th/r/?bcal.5nweo5=NhcCk e eht eigruf 4.1 Teh agrnMi of tfeSya Agtisan edmEa onmFirtao – damEe teSfya tsoFacr

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submitted by adong(144)
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nI doiidant to wtha sha rldaeya neeb iads I hnikt na pmotntira iotpn in eht ionetsuq saw truregyaol ujtdmaestns cihwh oipsnt ermo oatrswd rraiotalre aneitluor.g

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submitted by usmleaspirant2020(9)
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eb206du5e2.2dtfu00afa2oe9d3/cddn0/f99.i1ohynf69e707tclce/e7bdrs2ocp37020te:/dt51

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submitted by ninja3232(11)
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eWnh" riraetal euprerss sll,fa ogyncmei ento si dcdruee ni sil,traoree isceerdagn trhie esasintcer to lwof nda ngnanatmiii ipcrallay .eeprssru eheTs ooeasrsvitnb gesstug thta craliaylp resespru aym be uetgedlar vreo teh smae egnra fo prruesse hsgaenc ovre hhwic fowl si taouldetgaeru ni a vneig gor.an e,eddnI omrf eth rt"aln:eoi

:hN4gpomwvn/K.i5n.t45/w3.osnb/cBw/tbk/so.ihl

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submitted by hello(429)
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wyh si msapla ionctoc sruerspe ?wngro

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rainlad  I ihktn ist' cebuase ew lwuod teepcx to see oesm omre ani/aitbrnlropruieumaui fi teh pmasla tncicoo prsusere dha ceesriand ot pseocmanet +1


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submitted by ferrero(48)
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A eryv iasimlr nisoqtue I hvae nsee ni bkaQsn will ask wyh a tnaepit ihwt tihgr hatre euailfr sode ont oveplde daeem adn the raenws si eeraicsnd ytcmhliap nia.gerad I gto stih qnteousi orngw yorailnlig euabsec I wnresead lnoga sthi enil of iasennrog utb I ikhnt ni hsit asec it lal ash to do thiw WREEH eht treax spsueerr si oicmgn m.for nI isth isuqenot eth pt ahs tialdsico hopnyitsrnee so uyo nac htkin aotbu eth usrerpes sa nmoicg d"fwaor"r os ccontingrtsi riplyrlaceap prshcenist nca nevprte na acerensi in rspseeru ni hte ipralcyla eb.d weevrHo orf igthr raeht lfiurea stih aerxt ufdil si cnmgoi ofrm het POPISOET rioncidte dka(abwcsr rfmo teh hgtri ht)rea dan tgsnrccnioti elaricyalppr cstnhpsrei anc od notighn (on petosopi dise fo yclarpila d)eb - teh yonl ayw ot evprnet emdae si ot ircneaes pylhcitam n.agaiedr

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submitted by usmleuser007(464)
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cAroti oiilcsDat urPesrs e

  • Hihg TRP = ihhg DP
  • hHig HR = hhgi DP
  • gHhi VS = hihg PD

oirAct tciolySs rP eessur

  • Hhgi oitcintlartCy = hghi PS
  • igHh VS = hghi SP
  • Low ncoipCelma = ighh PS

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submitted by spow(50)
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I aols nthki htta teh potin gbine dame reeh is tuboa naem aierltar epursesr P),A(M wchhi si hwat erogutaluoyrat stesmys aculalty acehng sbead o.n eucesBa he has ardsniece APM ud(e to eaiscdrne P,B)D hte iaelilaspcr lilw cnttsorci to tnaaimin oattncsn erfeolru/sswp ohghutr eth aypcalrli .bed

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submitted by divya(75)
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i tond' nhtki ouy eedn to iknht lla atth c.umh ookl ta lla the stoonpi adn nhtki fo ahtw phpeasn newh htye erc,ei snAa. B, ,C D nad F all cna eacus tslinteiatir mBedu.t ae icneangirs arepyrilcalp rsticnesae liindeftey seno't.d

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drzed  ndIsaerce htpiamlcy oflw uwold otn suace tstinirtaeil dme.ae +1
123ojm  btu it te'dnso asy sea"nerci "n,i ti sujt yssa egyrlturo"a mstadujntes n".i +1


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submitted by usmleuser007(464)
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.1 itrAco aiiDotlcs ePrsuers .1 Hihg PRT = hhig PD .2 High HR = hgih D P .3 Hhig VS = hghi DP .2 tcroiA itySlcos rePsuser 1. Hghi litrotcyatCni = hghi S P 2. High VS = hghi PS 3. Low lpnComeaic = high SP
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yex  oiiry/ccuhioco:tMglcyho1vastprM/pln/osi2ct/.0m hsiT selph eswohmo, het firts trap atobu plaayiclr e.psrerus +
usmlelol  tstah' teh exp :a:prt h Te rageave yalilpcra tdcyahsotir resepsur is ddrintemee by tailarer dan oveuns eruspssre AP( adn ),PV nda yb eht itrao of caoptoary-terlipl-ps erscaseitsn .R)V/R(A nA seaciner in hieter lretiaar ro sovnue uesrpres ilwl sincaeer irapaclly srspee;ru wev,erho a vnige nhgcea in AP si ynol oabut -fhtiefno as eecfifevt in agnhgnci PC as hte eams bstuaeol eaghnc in .PV sBeceau neusvo scnrasetei si eaiytlrevl w,ol egcsnha ni PV ear lyredai msattndeirt bkca to eht alyirc,lpa dna rl,eycvsneo esuabec aatrelri rassniecte si illvyteera ghih, sgnceah in PA rea rypolo mnatrtetsdi sanowmdrte ot eht yalrlicpa. +1


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