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NBME 20 Answers

nbme20/Block 4/Question#15 (38.5 difficulty score)
A 45-year-old man is undergoing a surgical ...
Decreasing respiratory rate🔍

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submitted by radion(15),
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smc213  FA 2018 p.486 +3  
lynn  2019 - pg 489 +3  
jaeyphf  2020 - pg 501 +2  

submitted by drdoom(682),
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hello  But, the Q-stem states the anesthesiologist is HYPOventilating the patient. +4  
drdoom  decreasing respiratory rate = retention of CO2 = vasodilation of brain arteries = more filling of tubes = greater intra-cranial pressure +1  
drdoom  @hello shoot, you're right! i ended my explanation with the example of HYPERventilation when i should have done the opposite! (sorry!) ... edit: "By HYPOventilating (retaining CO2), the brain vasculature senses a high CO2 environment and vasodilates = increases intra-cranial filling and pressure!" +3  
dulxy071  @drdoom could you please elaborate on your point. +  

submitted by hayayah(996),
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eH wnsta ot einsreca IPC lc(eaerbr aolasnitdvo)i chiwh he cna do yb eirsednacg het rsoyareript reat nthayl)pv(ioe.into

submitted by cienfuegos(55),
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outdl'Cn oyu loas eedserac hte IF?2O Pre F,A PCP alos siceanser to ayxpoih lsao eadrecsse CPP ehwn PO2 tl&; 50 m.mHg

cienfuegos  Obviously not the BEST option in this scenario, but seems like it could work unless I'm missing something. +1  
step1soon  Its primariy driven by PCO2! only when O2 levels drop <50 mmhg is when the body responds to low O2 pressures +1