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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 satiuslF o-eutrr loodb mfor hte larietar esysmt to eht onsevu st,ysem -spnbisyga eth rAslereoti = creaneIs LP -tg;&-- INSECARE R.V llA ni lla = rcanseeI O.C

cAgidocrn ot r,WoldU eth lteaiesrro rae a ojmra eorsuc of snceseirat ... os pgynbassi eth teiaorlesr esrslut in a ceedaers in laoTt erlParipeh asteeRcins ... nuiacsg na neaecris in eth taer nad omlveu fo oldob ngrnrueit to the hatr.e I am rttype eusr erhte is eomr ot hte yhsooglpiy idebhn ,ihst btu I epoh isth ipedaxeln a tlitel.

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big92  emealIytmi"d gliwnloof era,ntioc eitruoanoesrv utiafls )(VFA is adctoesisa hitw na srecneia in aaicrdc uoutpt C(),O aeviedch ldomeypntanir hgutohr a rtdiceonu ni mycestis racasvlu ssitceern,a deairncse rcodaamyil tltcc,tairinyo nad an nairsece in otkres uvlmoe V(S) nad etrah te.ar Orve teh fliowgonl ewe,k cnruigtilac blood ueomlv sricaesne ni tuocnnjnioc whti nascsriee ni alrait nda brian reucitnitra pdiestpe. eTshe niatsaltroe rea dsoaeisact ihtw eylar enciarsse ni tlef lriauvcnert V()L glnfili sprerues iwth eth notlpitae ofr lsarneutt acmitp no iartal adn nraureictvl berhamc nsoidsnmie dan tinocn.uf" IMD:(P 5)52r h54s'5 eT8 2e aosl torehan stduy by isnEtpe ofmr eth 0s195 linoogk ta the tfecsef of Vs'AF fecfte no OC in nme (ID:PM 13).587102 apylAeptrn, the rneiscae in nesrtig CO is a ibg emlpbro eeasubc ti can eadl to h-hpigotutu accdrai erfiaul H.(L)V +32
hungrybox  Jsues gi29b uoy enwt ni on het rearesch omal u sutm eb TPSM +6
temmy  2b9gi yuo rea g.itrh atth is yhw ptaesg sesiead tagsep vahe hhig tutuop iaadccr rleuafi cesuaeb fo eht av ussh.nt +5
kevin  hwta si "eeniacrs "LP +6
jhan17  dorAnccig ot hke wiiWn" an euoorrasinevt ausitfl is meorfd nvgoiilnv a ramoj ayrter ekil teh amolbdnia ato,ra it anc aedl ot a lrage rsaedece ni lrheparpei escseanrit ceesuba it by sspa laeitorre (hewre jmaor BP is dmefr)o . ihTs eldwero arplhperie eaeirstnsc csseua hte taher to sniercae geirnts icdaarc totpuu to iinatanm rprpoe loobd wflo ot all si.utss"e +



 +6  upvote downvote
submitted by azibird(279)
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I 'dnot elfe leki yan of htsee osmenctm haev luylf eseradsdd ywh the atpiten lrnctueyr sah eerdiasnc nrsgtie CO dna NOT deerdcsea VS. ereH is who a ednfri fo mein dpaeixeln :ti

MAP at( risteng H)R = 2/3 BDP + /31 BSP = 77 mHmg in sthi ptnat,ei hhwic si erolw thna anlmor 9(3 mHgm if oyu ues 8)01.0/2 oS PMA si eddsaeerc nda het shoet/krndyie roangs 'naetr gteintg hte rnpuifsoe yeht ned,e inaglde to SARA aaitnivotc and dB/aeSOem. PMA = OC × TRP, os hist cudol eb ued to low CO eiveatrl ot RPT h(awt we lalsuuy cpee)tx or low PRT itvelaer ot .CO Tish npisttae' eralg AV ftilsau ahs dpporde ehr RTP reyv ,owl hhcwi nsmea rhe OC stum heva eben vrey hgih fro eth tpsa 51 aysre to etscmeaonp (hhig ttuoup haert leuafir. Seh has nloy 5 sday fo p,stmsmyo ihchw amens hse is ayrel no in erh .FH Sncie hes ahd suhc a ihhg CO to giebn iw,th hre drpo in VS isth lyera no ldouw lslit eelva ehre hwti na AEDIRSNEC VS decorpam ot a laromn it.npate nlsUse hre slupe si supre ghih, reh thare ustm be ppgiumn a siamvse krotes umlveo ot itimnana a lnorma stlscoyi bolod userrspe wthi shuc a low TRP A(MP = VS x RH x P)T.R eutn,lavylE rhe VS yma seadecer to be eolbw rmo,lan tub otn os leyar no.

For sl e:ttpsemcNenoo dserdeeca riaaerlt 2O tas baseeuc oldbo is onifwgl from eytarr ot nv,ei ont eht herto wya d aNor.uotn seercdead demix soevun O2 tas sbcueae railrtea odolb is flodniog hte slvacuinba ivne rghti beorfe edmxi 2O sta udlow eb uedt .oesmNra arnseicde RSV esabeuc of eth argle VA lsuia.ft

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 +2  upvote downvote
submitted by the260guy(18)
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Btu hseer' my belprom htiw this qstue:noi ti yass atth she sha a 5 yad rihsyto of OBS nda lwonels gls.e oS suvyloibo eht htera si lfinaig. I ckedpi Daeercdse Sretok muVleo orf htta rn.asoe

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nwinkelmann  VA tsfuails rae eno eaucs fo o-phiuguhtt acacrdi .efilaru sThi rensop seneptrs wtih eatrh iu,afelr utb ti si ude to inycolalchr eiacrndse tersngi .CO +2
lukin4answer  iwemnknal@nn yes tshat hr,tgi eh ahs igfanli erhta. utb ostieunq si skniag awth is the ndginif fo hsit ,tipante I atrusdnend teh suaec is luatFis igscanu ighh ouutpt aelf,riu btu yhte tddn'i sak eth sneaor fo shi HF, heyt era nisakg eth if.dning I ohesoc earesdec orStke OlemVu :/ +
happyhib_  ishT aws my oiglc nda got ot dcerdseea sretok lvmoue as we;ll eyht etnar asknig wtha sduace shi FH or ayhginnt it assy ahtw is het tmos eiyllk ifgnnid in tish tentp.ia fI shi ehatr si ingalfi ued ot LHV orfm cnistotnes daesecrin OC ndotuwl he TA HSIT VEYR NTEMMO HWIT hsi tarhe ifinlga vhae erceedads tsrkeo uem.o.v?l +



 +2  upvote downvote
submitted by usmleuser007(464)
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OC is reeacdnsi htwi 1) rdcsdeeea al2ort)de af rnseiedca 3pre al)od rIesendac itltcairnotyc

An erunoaostvie ftlasiu sctreea na laneatvrtie teruo rfo lrtaia ooldb inot eht onuves ctcrnuialoi w/o giogn tspa hte aesoeltrir e(th aojmr ceuas of Thues,sne)isctr a. by dgoni os the TPR edo)rla(atf scsreedea adn het CO is ec.serdnai

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 +1  upvote downvote
submitted by uslme123(86)
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sAV'F = sincaeedr aiccrad tu TtBpUo.u htsi t'nsi wen orf thsi sr?pnoe I wevi hsti as a earht ttah sah lilnfay ubgne to lfia -- daeseecrd iefcfetve uayocrctrli eovulm -t-&g; rsdacieen VR.S

uBt i ssueg uoy c'tan heva B oeebrf A -- tweevhra -\-

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happyhib_  sih pb swa geiotmhsn klie 00153;/ wthi daoicistl nuroad 05 I dguifre eh doltnuc hvae cderaiesn RVS bsuacee shi csltadoii owlud eb ?hehigr +2
trazobone  I had htis amse rsageonin I myloeplcet elosgds evro het BP 🏻‍♀️🤦 +



 +1  upvote downvote
submitted by nuts4med(8)
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Anenoy eahv na eaid hyw eth seraeeddc arertlia 2O itrauostan is rr?itecnco gAiusmsn hse hsa plum meeda cines seh ahs LE ,aemed t'wluond a lowre O2 sat eb dteepxce too?

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haliburton  I elbieev eterh lwudo be on scdaeree in 2O oituasnrta asebeuc xoagyeednt obodl (ighh sprseeru) is shdunet toni tdenagexoyde u.ricitc sA gonl sa eht lusng nac epek u,p htis lsoduh inarscee nvsueo enyaotnxoig no ravea.ge +7
hungrybox  yt ohtb fo uyo rof hts,i asw drnowgnei het maes gihtn +
coxsack  O2 ast o’ntw ngecha /cb u’eyro ont ngidda eoadndxegtey lodob to het trirlaae iesd. Yuoer’ sjtu niatkg arletira bldoo dan pitutng it otin oeunvs .dolob eSma osaenr yhw RL>- drcaica snsuth ot’dn reecedas O2 sat (ewlih ni otncst,ar a L>-R nusht u)od.wl +5
hungrybox  sujt izela:dre the hghi ereprssu fo eth aiertlar essymt skpee uot lp-usreorwes eovnus olbod ni an VA tfsiual rbalyb(po vboosiu to mtso ppl but it wsa a kaeure tmeonm ofr em )llo +2
chandlerbas  ya uoy ntwo heva cedaeresd lriaarte 2O ast absceue nnaoeyxgito of olobd is uropfsein mitedli 1F9A( -4-5)6 ehertoref nyegontoaix of hte lbood anepsph ihitnw eht srift 3d.cosnes of renegtin hte urnlapomy ipyalacrl tath uyo could enve anldeh avngih eomr adexgeneydot oodbl eretn +



 +0  upvote downvote
submitted by step1soon(51)
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aHter aulef:ir sThi is eth omts eoiurss nctpmiiaoclo fo gearl teroiurnoaves ls.sftiau ncSie yuro bodol wsofl orme cukiylq tuhhogr na rsavotnoeerui lfsuait hnat ti wdlou fi oyru dbloo ewdflo rhtouhg a anmolr erscuo of ,saietrer rlapcaselii dna ,esinv oruy rehat uppsm redrah ot sanmptocee rof the rdpo ni oldbo urrpeess elcd(la t-huhuitpgo htera rlief.a)u erOv iet,m teh icdnreaes iysnnteti of royu tesrh'a pngmipu nca eeawnk royu ahert les,umc algdien ot taerh frue.lai

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