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Retired NBME 20 Answers

nbme20/Block 4/Question#17 (reveal difficulty score)
A previously healthy 55-year-old man has ...
Renal artery stenosis 🔍 / 📺 / 🌳 / 📖
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 +17  upvote downvote
submitted by hayayah(1212)
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ls,Ao uoy thouldn's be eesgin -areondgn geamda or esnrceiad rnein / kyinde ssnopere thiw a ouyvlersip htlayeh aetintp htta stju eeolpdved sieatenls H.TN ehT body oesntd' watn to ecnsaeri iennr ehnw it sha T.NH evorHw,e fi yuo vhae sesint,so eth dseniyk akefr tou esucbea etyh'er nto gttiegn uhengo fowl adn ikhnt hte hlewo obyd ts'ni re,thie os hety catvteai eht ASAR mess.ty hnWe ouy iegv temh na ,-EIAC hte neinr is sillt gbine dopedcur yb teh ,kdyein it sjtu tins' gebin evnctredo ot Ine.niiagt-snIo

oT itelinaem tehro c:isceho

  • eH has earsdecin innre iaittcvy so uoy cna mtiinleae pyrmria etsod.osliranm hTat sha ic.n ,lroodeesnat ed.c e.nirn
  • No gsnis ro ssx fo isgChus'n os ttsah' teenlda.mii
  • x1rsah-oe1Bdyy-l iendyicecf ulwod xss whit eht lia.gnetai odu'Y vahe .cde ernin avictyti rensklo(-laeteoid stfcefe ltils er).psnet
  • aiensElst NT:H eedanilxp vaobe
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sammyj98  I leik yuo icignstk up for eht ke,nsyid nkgithin ety'rhe gniincresa neinR for eth enietfb of hte ewloh o,bdy but tlse caef t,i het skidney rae a ulcpeo selsfhi kdsic hwo wtna the high bdloo erursesp lal rfo nu.emletrefrtitsletidVocSes Lavihalry +13
trazobone  ^ I loev reiwvnige EsNMB rof ecosmmnt iekl siht 😂 +3



 +15  upvote downvote
submitted by monoloco(155)
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As a eulr fo uh,tbm if uoy vgie eosneom na ACE iionrhbti adn yteh etg a erbpl,om tyeh had lerna yrtera snetsosi luuas(ly ltryieal,alb or so ew eewr tahugt at oru dme )o.oslch obbrPayl ahs ot do hiwt cdresdaee FRG nhatsk to seraeddce eoAsginntni IieeItle–vsc ostcrnoitaoinvcs of het erefefnt erotleira =&tg; rcaddeese doisum yvlideer ot lmauac dasen =&t;g icanedesr nneir seeel.ar

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lilyo  airtcVncoootnssi of the TFEEERFN ertoreail yulcaalt aslde ot eecnaisrd F.GR tI tisveleec INATSOIOVADL of hte eftfneer loeitarer ftefec fo EAC ohiibrnits csine hety odnu gAtennoniis II atns.oci iTs h ipnttae erayadl ahs redusce rlaen bolod lofw deu to aletliabr arenl reyatr iotness,s hte itoinadd of na ACE notiiribh htfrrue arseeced RGF iotpnpmgr na ecresnai in enrni ued to olss of nevtigea cefkbd.ae +4
drpee  We odsluh sawaly cxeept GFR ot rdpo a lettil ratef dnadgi na -iEnhAiboirCt deu ot erefenft tarirael diovaastin.lo Fro isth rensoa we uhldos also xctpee nRien lveesl ot resi aiv ulblguaremlutoro ba.eckdfe oS it's nto yaller hte acoteirn ot eth ECA ithonibri htat svgie ihts aayw sa ASR ihw(ch is yhw I tog it rno)g.w I ihtkn ahtw ew rea eedcetpx to eb lgkonoi at it are bla slvue:a akplyem,aoHi dna nscyroead stpyhioor.mleedrsna /rwah01i7/0gs./stt--ap0a:p5/1if1ro0ep.p.01w3fp47f5t//a2/12g01fwh +
stepwarrior  CEA ihonritbis dowlu aaylutcl ahev het opteopsi eftecf of -IIT,A adn etrlus in ffetrene .liitoadn Btu eth aualtc hmencisma of snraecdie enirn icvitaty rpe WordlU si alkc fo ysicsetm stoioniaorcvtcns yb -TIIA landgie ot obdol ughsnnit away ofmr the .nydeik +1



 +1  upvote downvote
submitted by medstudent(18)
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I ggtdsluer hitw wyh stih cdltun’o be netelsais TNH for a hwl.ie I inkth htwa ti eomsc nodw ot is s,iht dan smnooee leph me uto if ’Im n.g/iloepcwenotmr

In tbreiaall RS,A CAE histnoiibr will screaeed het GFR rmfo antioild of eefernft lretiaore and yeht c’nta rnaieces hte GFR tufherr esucbea ’eeyhtr rdlayea exadm out no fafeentr oliditna to kpee up RGF in eth fsitr .alcpe

nI nsaeselit TH,N yse ACE iihbtnrsoi eecrdesa FGR frmo liotnida fo eefrtfne stil,areeor rwveeoh thee’yr able ot inaamitn FRG ugohhrt giutnuatreoola ubescea they ’hnevta cetdouh ehitr efnfrtae eoealtir.r oS tish sanem ttah nnrie nwto’ caaytlul nr.aciese

RL:;TD tBielalar ASR si lnubae to seu rltnotaaieuoug to oertrcc teh aedserec ni RGF erewh tsnlaesie si able .to

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trazobone  I osla put aeslsient HNT. tuB uoy wludo wylaas ese na scraneei in irnen iytctvia rnvehewe yuo veig na ACEi cb sit’ cbnlkiog eht semtwdroan yaawhpt no( gAII ro rtlsonedoea c,fese)tf eegrlsrsad if the pt ahd ARS ro sesnelait H.NT The msae esog orf s.RAB oS my hhgoutt epcossr ,si eubaces ninre nda doleosnaret elvsle eerw tlniyaiil ,gihh hseot rae uvbioso scasue fo ish ,NTH frteerohe ti actn’ eb lsnesteai ssTtilN EaenH. HTN si datelre to na aciseren in OC or PRT, iwlhe oeycndars NHT is edu ot rleaovrca/usnaerln essdaise ;ap&m ASR or teyrrns.ohmpdaosile AF18 p 296 +2



 -2  upvote downvote
submitted by md_caffeiner(83)
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91AF u2c5aeasP:v9 lrRno dsea:sie Rnael amirtipnem deu to siehiamc ofrm neral ertyra esntsosi or macsrlcriuvoa le enaisd sr.ea poefrinus noe( ro otbh ikse)ndy e  nnIiNrCŽ ŽNI C nisniageont Ž THNMi na. casseu of laner yeratr sƒs:sontie heorelotAscictr uilxomsaeap—prql d31r/ lrone af etay,rr lyuauls in leodr sealm, rme.ss ƒok ursrlboumcFia piysdals—saidlat r/23d elnr fao yaertr or mnaetegsl abrsehnc, usulgloyunya ro -dgdedemlia naal.ilslifmc Cl,eey esatipnt cna vhae rcaeyHrNoTrtf thiw etnvegai lyimfa soirthy of tsmraN,cH Tmyie rnlae ze,is genascpkfltr/iai buisso.rttM nmmooc aceus fo 2° TNH ni .e hdtutOrals erlga esssvle era nfteo nvilodev

F19A P 9:65 erinoggn A io-istennvntc Cloimesi ipzytnpnrhoarbi,te ainpaellr, ri,ollniisp Apm m.iEirCisNmarlh Ibihnti CAE Ž CRDE AT II Ž DECR GRF yb roctivtneoscpingnneirt fo terfeenf ireaor.elst nNR neiCrI dute o osls of iaevtneg ecebk.fda

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