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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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,olsA uoy ts'nhludo be neiegs nrnadoeg- ademag or icensdrae niern / dneyki eenrsosp iwth a oireulsvpy ahtyelh pnittea thta juts epdloeevd tesilneas TH.N hTe odby 'oentds ntaw to aiecesrn irnen hwne it sah HTN. ewoHe,vr fi yuo vhae nsstsio,e het syiknde farek tuo sueabec e'rtyeh not nietggt hunoeg wlof nda thnik eht ewlho dboy sit'n teir,eh so tyhe vtcitaae eht SARA stms.ye enhW ouy geiv tehm na ,AEIC- teh einrn si tlils nigeb urddecpo by eht ndky,ie it utjs sitn' gbnei oerctvden to sa-no.igennIiIt

oT ialeenmti toehr :eoiccsh

  • He ash necesirda iernn tiviayct os you nac aelmiinte ymrpiar sorei.dtonlams htTa sah ci.n eadtlso,eorn ced. nie.rn
  • No inssg or xss fo 'nCgshsiu so t'asth lnmietea.id
  • yyr1loshxaBe-1-d fenieiccdy duowl xss ithw teh tleg.aaiin o'duY hvae ce.d nnire atcviiyt -l(neaeoolksreidt ftefcse llist penrts).e
  • snEsteial :THN ependixla bveoa
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sammyj98  I keli uoy kntgiics up rof teh sd,yekin nngkhtii yeterh' rgininesac Reinn fro het fibnete of eth owhle oyd,b btu ltse cafe it, eth ykenids rae a cploeu leshfsi isckd how atwn het ghhi obold peeursrs lla ofr evVliidasaLete.yttcrt rsofrlmneluheiS +13
trazobone  ^ I veol rwgveiien MEsNB rfo nsemoctm elik siht 😂 +3



 +15  upvote downvote
submitted by monoloco(155)
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As a urle fo ,uhbmt fi yuo evig onmeoes na AEC iihrnitob adn tyeh get a opreb,ml ethy ahd ernla etyrar ntesioss saluyul( tlyblaelai,r ro os ew were uttgha at rou edm s.hlo)co rlaybbPo ahs ot od wtih dresacdee FGR hknsta ot crsaeddee sgAinention cIIlieeets–v itsanotcrnvosioc of eth fnreefet reloiatre g&=;t rseecedad misodu eriedylv to lcamau asdne g=;&t ecresiand neirn easree.l

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lilyo  artocictoonsnVis of teh EFFERTEN reoreatil ycltaula lesad to rdcnesaie GR.F tI seictvlee INVOTOLADSAI of eth efretenf irlretaeo fftece fo AEC ihrtniobsi nsice yeth duno sngnoineitA II tcsoian. ih sT ntpitea radalye ash sercude rnlea obold flow edu ot ibltalrea naler eyatrr s,tnisseo eht anddoiti fo an ACE iirbtonhi rhuftre acedseer FRG riotgnpmp na cnisreea in renni eud ot loss of teaniegv .fcekbead +4
drpee  We dlsuoh aslway xpecte GFR ot orpd a etillt treaf diagdn an rntihoCAibiE- eud to fnetefre ralitare nalii.dtavsoo Fro iths rsenoa we soduhl laos texcpe neRin evlesl ot esir iva olaotrlurmelugbu kd.caeefb oS 'ist ton lalyre eht rictneoa to het ECA iobntihri htat gveis shit waay sa ASR hichw( is why I otg ti gorw.n) I tnhki hawt ew rea ceedtxpe to be lgkooin at ti aer bla sva:leu apkamoHeily, adn adrcsnoye soleaydmshtirpoen.r 03wap0f1-sfw5o11/:0/e5/f2f.1pt/2pgiitw00t7p7h0arr1h/gs//a..14-ap +
stepwarrior  EAC boiisrtnih loduw tlyaulac ehva the eotiospp eceftf fo -A,IIT adn rsltue ni eenertff adinitol. utB eht ctaula eimsnmahc of nedrcsaie nrnei tyitvaci epr olUWdr is aklc fo iesmcsty nonsicotvrcoatis yb AIIT- nldiega ot lobod sntugnhi ywaa mrfo eht nidyke. +1



 +1  upvote downvote
submitted by medstudent(18)
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I tgulesrgd ihwt hyw iths dtcolnu’ eb sensiatle THN rof a i.hewl I htink tawh it mcoes ondw to is iht,s dna eonmeos pelh me tou fi ’mI icoopreng/.ltmnew

nI tllabriae ,SAR CEA hnibsiroti lilw eesaerdc hte GRF omfr oiltdian of teefnrfe roarielte nda hyte ’catn saeneicr eth GFR hrfruet aecbesu yrthee’ ydraela eamxd out no eneftraf otdailin to ekpe up GFR in the srift cpa.le

In lsieaents ,THN esy AEC tbiihsinor eradecse GRF mrof diinalto fo fetenerf e,reitraols hewoevr tyee’hr lbea to nmtainai FGR rhtghuo tuoglaiutaerno ueecbas hyet atvhen’ hutoced heirt teraffne rreei.oalt So thsi manse hatt nrnie ’otnw tclayual cs.neeair

:RTLD; aBelilrta ARS is beluna ot use igtlaanoruueto ot cretcor teh rdceesea ni RFG ewreh eitaelnss si laeb .to

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trazobone  I salo tup snstaeeil .THN Btu oyu uldwo wsyaal ees an incaseer in niren ititvyca wevnreeh uoy gvie na CEiA cb is’t gblincok eht etsdnmrwao whyptaa n(o IIAg ro rodseoenatl )t,efcefs erglrsdaes if teh pt adh SRA ro lsesiaent T.HN The saem gseo orf .ABRs So ym otghtuh eprssoc ,si ebcueas rinne and rsnodaetelo elevls rwee nliaiiytl hhi,g tehso era uovoisb cuasse fo his ,THN rteereofh it a’tnc eb nseslaite HtTai.eNEs nls NHT si eterdla ot na recaisne in CO ro ,TPR heliw cosnayerd NTH is ued to a/vaeraonlrsrenlcu sesdiesa am;&p SAR or lnrepasmyt.rsioodeh 1A8F p 629 +2



 -2  upvote downvote
submitted by md_caffeiner(83)
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9A1F :s5 va9RrunPe2aclo eei:assd anlRe atmenipirm edu to caemhisi fomr alnre ryarte onstisse or ilaocrusrmacv n.asea eisdrle sprofueni eo(n ro ohbt snik)yde I  nŽeNrinC IC ŽN insaingnote Ž THNMani. uacses of ernal treary stsneƒ:sio crlcteeioshAotr iqlspa—mrxauepol d/r31 o larfne eatyr,r asllyuu ni lodre elmas, osƒm kr.se rcbsrmiFuloua dapissiyslaaltd— d3/2r fealnro eatyrr or egeamntsl ehncbsra, glsy uulyauon or daidd-meegl fylsCi.leic lalma,en tatenpsi anc aveh orNaferrcy tTH iwth inegtvea mailfy hstyoir fo aeyTmcNH,stri m alner z,sie icerkfntisplga/a ustrMoitb.s mooncm ecaus fo 2° NHT ni tlu.rs dthaOe argel sselves ear ntfoe onidvevl

F9A1 P :659 sio ncoe-itentggA nrinnv Cizrilrmetysoheni,nt paiopb a,rpanleil iioirnspl,l .mNhlpmimCEri riAsa nIhtbii ACE Ž ERCD AT II Ž DREC FGR yb ipnnoeertcvr sniitngcto of eerftenf eiaostrr.le Irenni NCR doe tu ssol of veaientg .debcaefk

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