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Retired NBME 21 Answers

nbme21/Block 3/Question#35 (reveal difficulty score)
A 63-year-old woman comes to the physician ...
Increased resting cardiac output 🔍 / 📺 / 🌳 / 📖
tags:

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 +20  upvote downvote
submitted by ∗cellgamesgojan(43)
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VA satFiusl erturo- ldboo ormf hte aearlirt meysts to the suevon tsmsy,e sybasngi-p eht rseiAerlto = caserIne LP g--t;&- SENIECAR .VR llA ni all = erIcasen C.O

crAidncgo to lr,WUod het rritoselae aer a arjmo uroecs fo neerssiatc ... so sinpaybgs eth rtelriseao eusrtls ni a sceeerad in aTotl erahirplPe sestaniRce ... acgsinu an enacsier ni eht atre and uemlov fo dbool eunintgrr to teh .areht I am reytpt user ehetr is omre to eht yhpoosglyi ihedbn ,thsi but I hpeo isth nlipexade a itlt.el

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big92  myeildatem"I wolngofil ci,terona nuasritreoevo uaslfti )F(VA is asciaodste hwit an ecaesnir in daicacr optuut OC)(, eahciedv dmnolyprintea hutrgoh a tdneruoci ni scetmyis urasaclv ecit,snsrae endcreais ioclmrayad iyt,clcirtnoat dna an iscaeren in ekorts vemuol SV)( nda rahte .rtea ervO the nlgofwilo kwe,e uticrigacnl blodo vmeoul seriacens ni unjtcniocno thiw raniseesc ni ailatr nad nbira reirtitnacu ippdets.e hTese liotsaretan are sctadeioas hwit arley anercsise in elft alrrintvcue )(LV ifnglli rspruese ithw teh pttoenlai rfo ttnreuals maitcp on aaltri dan acuvlnirret armebhc nsieomsdni and notnfic".u DI:PM( 2 e55 sh' e 5r54T8)2 sola nhoreta usydt by sEpinte mrof teh 519s0 olniogk at het eetcsff of sF'VA etceff no OC in emn (:IDMP 5312)0781. yrAneapt,lp het acenirse in tresign CO is a ibg eorbmlp esceabu ti nac ldae to h-tiptugouh dacirac iauelfr )(V.LH +32
hungrybox  esJsu i92gb uyo nwet in no teh rcsahree aoml u utms eb PMST +6
temmy  9b2gi ouy rea tr.igh ttha si yhw sagpet esedais sgatpe aveh high tutopu icdarac auilerf bcaesue of eth va .snhust +5
kevin  hwta is nieersc"a "PL +6
jhan17  igAcodnrc to kWn whii"e na voeoarruensit uafsitl si edorfm gvivlonin a aomrj ryerat klei the mdaonlabi aota,r it anc lade to a aelrg rdaeeesc ni liprpaerhe insecrsaet cabseeu it yb spas olerretia ere(wh mjaor BP is refod)m . hiTs eewdrol lhrpraeiep rseniaecst seucas het aehtr ot scrieean itsengr arcadic uuoptt ot niaainmt orpper doolb wlfo to lal es."tsisu +



 +6  upvote downvote
submitted by ∗azibird(279)
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I ot'nd elef keil any fo eseht emcontsm aveh lflyu aeeddssrd yhw eth iptnate nleytucrr ahs ecdearisn esnrtgi OC dna ONT dsedecaer VS. reeH si how a dnrfie fo nemi nedalpeix :ti

MAP a(t nrtisge HR) = 2/3 DBP + 3/1 BPS = 77 mgHm ni htis enta,itp hichw is olewr anht anrmol 3(9 mgHm if oyu eus .201)0/8 oS APM is adecderes and teh erytsdkehion/ gnsaro a'nter gtiegnt teh ipsroufen thye ee,dn geaidln to RASA caiitvnaot nad m/aBSOe.de PMA = CO × T,PR so shti udocl be eud to wlo OC retiveal ot TRP (what ew ualylsu e)pxtce ro wol PTR tervlaie to C.O isTh t'tisnaep elgar AV iasltfu sha opderdp ehr PTR vrey wol, hcwih smnae erh CO stmu vhea eenb ryev hhgi ofr hte tspa 15 eyrsa ot etmceoaspn hgi(h uttuop atrhe rauiefl. Seh sah lnyo 5 asyd fo smsoy,tpm hchiw anmes esh is yarel no ni ehr .HF Sicne hes had cuhs a hghi CO ot bneig ,ihtw rhe orpd ni VS htsi ealry no wodlu ltils lvaee heer iwht an IEARDNSEC VS cmdpeoar ot a lramon apttni.e nlseUs reh pluse si erspu ihh,g erh rhate ustm be pgunpmi a iessmav teoksr euovlm ot anaintim a oramnl ctiolyss lbood erpseusr hiwt such a lwo TRP PMA( = SV x HR x .TRP) laulyv,Eetn reh VS amy sceedera to be oblew ,omlran but ont so ylrea o.n

oFr sptemoelnos: eNct ersdaceed artelair 2O ast useecba dbolo si ifwolng fmor reaytr ot ev,ni tno het oreht awy ort oadNu.n csaderede exidm nuvose 2O sta bcaeuse aeiltarr bolod is ofnliodg hte abscnlaviu eniv ihgtr efreob edxim 2O tas lwodu be rue esadtmN.o ieesandrc RVS eeabsuc of eth eglra VA .saufitl

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 +2  upvote downvote
submitted by ∗the260guy(18)
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tuB rhsee' ym lbpremo ithw htis uont:qsie ti yssa that hse has a 5 yda ysihotr of SOB nda lsnlwoe gl.es oS obisuylvo teh rehat is i.gaflin I ieckdp edDsceear orektS lmuVoe ofr htat osra.en

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nwinkelmann  AV utifasls aer one scaue fo gotthhipu-u daaricc uelf.iar sThi snpeor nrsseetp hwti raeht uaelf,ri tub ti is edu ot cyialcohrnl iedscenra gtrines .OC +2
lukin4answer  inmwalne@nkn eys tahts gh,rti eh sah gnfliai ret.ah btu tsuqinoe si kngias awth is teh dfngini fo hist ipetat,n I rdsauedtnn teh ausec is aitsulF cnsgiua hhgi otuptu arie,flu utb yteh t'ndid kas the earons of sih ,HF yteh ear ingska hte idgnnfi. I oehcso scaeeder okrteS ulmeOV :/ +
happyhib_  Thsi wsa ym oicgl dan otg to eacrddsee tkerso ulvemo as l;wel eyth rtaen nsgiak atwh sucdae sih FH or ynaignth it syas wtha is eth smto kliyle idinfng ni htis pi.ttane If shi hetra si inglifa deu ot LHV romf iotsenctsn diranesce OC twulndo he TA IHST VREY NMMTOE HTIW ihs haert inafgli ehav daeceders etrkos me.lo.uv? +



 +2  upvote downvote
submitted by ∗usmleuser007(464)
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OC si eraicsend twhi 1) rdesdeaec lod farae)t2 anrieedcs l3 aepo)rd scerIndea yoirnaictcltt

An oterveunaosi falsiut reetsca na airlnettaev ourte ofr ialatr dobol iont eth euvnso ocrntuaciil /wo ogign spat eth eirelorsat (eth jamor cseau of hasc)ri. usene,stT yb ingod so eth TPR dearfotal)( rseesadec adn teh OC si dcanisr.ee

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 +1  upvote downvote
submitted by ∗uslme123(86)
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sVA'F = isnredeca adccari u opUB.tTut stih sni't ewn rfo shti sno?pre I wvie siht sa a ahret ahtt has alylfni nbgue ot alfi -- sdecreead vfetefice olcuycritra omuvel g;-t-& irnsadeec .SVR

tuB i eugss ouy ncta' ahve B oefreb A -- eerhwvta -\-

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happyhib_  hsi pb aws htgoemsin klie 5/;1030 thiw sadoctlii odraun 50 I deiurgf he utnocld eahv asdicrene VRS eeaucbs hsi iodclitas ulowd eb ?herigh +2
trazobone  I hda isth emsa inogsnera I pmyoeltlec loegsds revo the BP ️‍🏻♀🤦 +



 +1  upvote downvote
submitted by nuts4med(8)
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oenAny veha na idae yhw teh csadeeedr lretaira O2 isottauran is or?rcincte mnAsgisu hse ash mulp emeda eiscn hse has EL dema,e tduwonl' a owrle 2O sat eb ecepdtxe too?

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haliburton  I bievele eetrh dowlu be on adseerec ni 2O asnoutarit eubasec tnaeeoxydg dlobo hi(gh )eersuspr is tushned iont denexoeygtad iircct.u sA ngol as eth glsun nca keep pu, this suhdlo cisneear enusvo gnexaooinyt on .vgearea +7
hungrybox  yt tohb of yuo rfo ,thsi wsa drnoneigw het asem tingh +
coxsack  2O tsa ’otnw eahncg cb/ yor’eu not ganidd dynteogeaxed lodbo ot teh alrrtiae s.die uYr’eo stju natgki ailaretr oodbl and tptgiun ti toni nsveuo oolb.d meSa onesra hwy -L>R airccad hsustn ’dtno eeasecrd 2O sat lwh(ei ni rottac,ns a -RL> sntuh dw.lu)o +5
hungrybox  tsju ldazee:ir eth ghih erseupsr of het aietlrar system eepsk tou leowe-upssrr vneosu lodbo ni an AV fustail y(bplorab obuoisv ot smto plp tub it was a uerkea mmenot fro em l)lo +2
chandlerbas  ya yuo tnow vhae rdeeeacds ailretra 2O sat ueesbca oaitnegonxy fo odolb is spfniuoer etimdil FA1(9 4--)56 rtehfereo inytxgeonoa of eht lodob nsphepa ntihiw the frsit n.ed3ssoc fo geritnne eth ulnmparoy praclyail thta ouy lcuod eenv laendh hivgna eorm eytdgdoxeaen oolbd teern +



 +0  upvote downvote
submitted by ∗step1soon(51)
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arHet uief:alr Tish is hte toms ruisoes icpncaitolom of rgeal euitonoversar tislsf.ua nicSe ruoy lobod owlsf emor uclyqki rthuohg an onvtoreiraseu lsftiua ntah ti wodul if ouyr dbool wofdle urthogh a rmolna rsouec of ras,irete laiipalesrc nad nvs,ie uoyr hrtae mpspu ahrdre ot mcnpeoetas fro the dpor in odblo ruseerps leadl(c ptuuh-tigho ahetr ifa.)relu vOer t,mei eht csniedrea ttnesiiyn of uroy aeh'srt punpgmi acn kewena yuor ather mcselu, liaedgn to hetra lifau.re

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