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NBME 21 Answers

nbme21/Block 3/Question#35 (reveal difficulty score)
A 63-year-old woman comes to the physician ...
Increased resting cardiac output ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–

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 +20  upvote downvote
submitted by โˆ—cellgamesgojan(43)
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AV tsFlusai rouetr- dbloo ofrm eht rtaailer seymts ot the suevon msyets, s-ingpasby het seoeAtrirl = Icnraese PL ;-&tg-- SRACIENE RV. llA ni all = Ieneacsr CO.

ngoccArid to U,olrdW eth errstalieo rea a ajmro cuesro fo ecssinatre ... os snspgbiay hte lesroteari tsrelus in a receesda in oalTt iealrerphP eteiRsscan ... iangscu na naieersc in het atre dan vmoeul of doblo ugirnrent ot eth he.tra I am ypettr user ehetr is reom ot teh iyoylospgh hdenib hs,it tub I eohp ihts aiepxdlne a .eltlti

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big92  a"mItmdilyee gonlwlofi enar,icto rnvoutoearise ailustf A)FV( is soecstidaa itwh na ecensari in iaaccrd ptoutu CO(,) cheeiavd opienmdyranlt uhrotgh a nertuicdo in yesmistc avasrcul a,snireestc arcidenes acmrdailyo nolict,tyiatcr dan an ierecnsa in trekso emvlou (VS) nad terha .etar Oevr eth lognloifw e,kew tlcincgauir odlbo vomuel snsireeac in jotnoucinnc hiwt seaesnrci in trliaa dna inrba naeturciirt edipstep. esheT rnttiloseaa era sasecoitad wiht lraye erasnecsi in left ncareuirlvt (L)V lliignf peessrru wiht het npioealtt orf uralntets mtcapi on iartal dna ecrvatiulrn reahbmc edmsnnoiis dan n.i"utconf DMI:P( s5T8522 r5e'5 h4 e) lsao hnarteo yutds yb Enipets rmof het 1s590 lonkigo ta teh esfecft fo VAs'F ecefft on CO in men D(IM:P )012.85317 ,ptneArpyla het nceresia in igetrsn CO si a big lpeomrb ecbsuea ti can adle ot i-htougupth cariacd iefaulr )V(.LH +32
hungrybox  suseJ 9bg2i uoy went in on het ehasercr alom u tsum be TPMS +6
temmy  i2b9g uyo rea .tighr tath si hyw segapt ediasse ptgase hvae ghih uuptto diccraa rfiaelu esecabu fo the av ushtsn. +5
kevin  awht si re"caiesn P"L +6
jhan17  cnAcirogd ot iWh newik" an oioarteurvnes alusitf si frmeod inlgiovvn a ojamr ryatre leik hte dnilmaoba raaot, ti cna adle to a alegr srdeecea in eharpilper ceessraitn bseeuca ti yb pssa riaeletor re(ehw rmjao BP is md)feor . Tish lewerdo eirhparlpe arsctsenie easusc hte etrha to cnieeasr erigtns adacicr uupott ot atmnaiin rprpoe olbdo olfw to all ssusit".e +

 +6  upvote downvote
submitted by โˆ—azibird(279)
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I ntod' elfe ikle any of tshee stnmemco vahe ylufl dearsdesd yhw het ettnapi nlyerrutc sah nircasede rtsieng CO dan NOT sredceeda V.S ereH si hwo a fdreni of nmie aedixlnpe ti:

MPA at( gesitrn H)R = 23/ BDP + 13/ PSB = 77 mHmg ni tsih tt,piean ichhw is loewr tanh romlna 39( mmgH fi ouy seu )18/00.2 So PMA si sdreceaed dan teh deorhsekynt/i orsgan tnrae' gtntige teh esprnifuo tyeh e,ned deligna ot RSAA aocititvna dna emO.aS/Bde MAP = OC ร— TR,P os sith loudc eb edu ot lwo CO lrvaeeit to PRT a(htw ew sulluay etpx)ec or lwo PRT eevirlat ot C.O isTh 'setitpna glera AV futlisa ash eprdodp rhe RTP eyvr lw,o chwih semna erh OC tusm ehva been very hhgi rof het atps 51 yesra ot ceeotsnpma hgh(i tuuotp rthea ehS has lyon 5 asdy fo ptyms,som cihwh nmsae ehs si ylaer on ni her FH. ecniS esh ahd hcus a hghi OC to beign ,hwti ehr prdo in VS thsi lyrea no doluw siltl veela reeh whti an CADRSEEIN VS cepadrom to a lmaonr niptt.ea esslUn reh epusl is purse hgi,h ehr terha utsm eb pingmpu a smeaivs skerot veouml ot naaiitmn a aolrmn ioytslsc dlobo srerueps twhi suhc a owl TPR AMP( = SV x RH x .P)TR n,vaelutlEy rhe SV amy cardeese to eb blewo nmo,alr ubt otn os aryel o.n

roF e lseNetoom:pnstc dscdeeear airtrael 2O sat usacebe odbol is inlowgf rofm tryrae to ,evin nto eht theor yaw runotd a.oN reseacdde eimdx sevnuo O2 tas euecsab itelarar olobd is ioflndog teh bvsclaunia vein hrtgi befroe emixd O2 sat luwdo be toNed srmeua. nciaresed VSR cbaeeus of the agerl AV .sluiaft

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 +2  upvote downvote
submitted by โˆ—the260guy(18)
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tBu se'her ym pemrblo whti tish iu:eqtson ti assy taht esh hsa a 5 ayd tiyhrso fo OBS dan wonslle So uoivlbyos teh tehra si la.giinf I kceidp eedcrDesa Skreot uVolem rfo ttah nesr.oa

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nwinkelmann  VA fasistul era one sacue fo -pthtohguui rcdacai eufia.rl hTsi peorns tsenpres wiht tahre ,rfeaiul but it is due ot lcnhroicaly eascirdne rstineg .CO +2
lukin4answer  @nmnwkanneli eys thsat hgrit, eh sah alnigfi ta.erh tub sieuqton is giansk hwat si eth nfgdini fo hsti tian,etp I ddnnrsaeut the asecu is tuilasF ucsiagn ghhi ttpuuo liu,erfa tub thye ntd'di ask het oeasrn fo his HF, they aer isknga hte nni.fdig I coheso sceadeer ketorS umVOel :/ +
happyhib_  ihTs wsa ym licgo dna got ot scrddeaee sterok oevmlu as e;lwl eyht tanre akngsi awht acdseu sih FH ro natygihn it sysa ahwt is hte sotm yiellk ngndifi ni tsih n.tietap fI sih hetar is anlifgi eud to VLH from snsiotecnt eridsncae OC ulontwd eh AT HTIS VREY ENTMMO WIHT ish rehta niiflag veah dseederac toeksr l.v.eo?um +

 +2  upvote downvote
submitted by โˆ—usmleuser007(464)
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OC si reiacends wiht )1 ddeecsrae )aflr 2atoed deecansir p e)ordla3 ndecreIas irnaiytltoctc

nA tuniseavoero luastfi aectsre na itnetvaearl uoert ofr tliara obdol otni teh osnevu unaiccloitr wo/ iggon tpas teh lserteiaro eht( ajrmo ucase of .enihT,sucasrts) e yb ondig os het PTR rftdo)(aela rsdeeaces nad teh OC si .ceraesidn

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 +1  upvote downvote
submitted by โˆ—uslme123(86)
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FsA'V = asirneced dcaicra t Bt.puuoTU thsi 'ntis wne for isht enos?pr I weiv this as a aehtr atht ash iflnlya ubgne ot lfai -- ededceras efetcfvei caiuyrlrtoc mueolv >--; edaeiscnr V.RS

tBu i susge uyo 'ctan vhea B ebrefo A -- raehwevt -\-

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happyhib_  hsi bp asw ohtimseng ekil 31050;/ hitw lisatoicd uaornd 05 I idefugr eh tcodunl vhea icedraesn VSR bueecas sih dctisaiol lwudo eb hr?iehg +2
trazobone  I adh isht saem oisnneagr I oeetmpclyl sglsdeo rveo het BP ๐Ÿป๐Ÿคฆ๏ธโ€โ™€ +

 +1  upvote downvote
submitted by nuts4med(8)
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eyonnA ahve na daei hyw the edeadrcse aarrielt 2O aosnuiartt si rtnoecir?c Aiunmssg ehs sah pmul emade since hes sha LE mdaee, dt'onwlu a oerlw 2O ats eb cpteeexd too?

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haliburton  I eilbeve eetrh uwlod eb on adesecre ni 2O rutiasntoa eebacsu yanotdgeex lbdoo hig(h rrue)sesp is dtshnue ntoi gxoeyantdeed uticrc.i sA gonl as hte glnus can kpee u,p htsi osdlhu aecnrsei evsoun yonxianoget on +7
hungrybox  ty tobh of ouy rof i,sth aws neoirndwg hte meas thgni +
coxsack  O2 ast โ€™tonw caghen /bc eyrouโ€™ ont diagdn gdtaodyexeen bodlo to hte rrltaeai s.ide reuYoโ€™ stuj iatngk raretlai boldo nda itgputn ti ntio sveuon olob.d Smae ernaos ywh R>-L cdaiacr nhssut nโ€™tdo earceeds O2 tsa ihw(le in ,tnrtcosa a ->LR hutns wuod.)l +5
hungrybox  ustj la:zedrie eth ighh sruerspe fo hte taleirra ymtses kepse out srwperu-elos unoves ldboo ni na AV iustfla lbao(bpyr ovsbiou to smto plp ubt it wsa a rekeua mtmeno fro me l)ol +2
chandlerbas  ya you tonw eahv escaerdde tlaaeirr O2 ats sueaecb nagnotyeixo fo lbdoo si euiospfnr eltdmii FA91( 54--)6 eterrfohe ayxintoegon of hte obdlo sapehpn tinihw hte irsft fo eginetrn hte ylomnaupr alirpaylc that yuo ulcdo vnee adehln ignahv mero nyeogtxdedae oolbd etner +

 +0  upvote downvote
submitted by โˆ—step1soon(51)
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traHe u:arilfe hisT is eht tmso erissou lminoitcacop fo lager oreasoruietnv stas.uilf Snice yuor dlboo owsfl mero kqicluy uothghr na neavtsroreiuo ufsilta athn ti dlowu if ryou lobod odelfw orhuhtg a olamnr urcose of easti,rer laciesrialp dna vnsei, oryu hrtae pmusp edhrra to pcntmoeaes rof hte rpdo ni lbood rsuspere lclda(e pu-ihtothgu rhtae uifr.)ela evOr mtei, eht sediearnc ntienisty of royu e'rahst miugnpp anc eweank uyro treha emuscl, ageinld ot rehat aelifr.u

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