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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 Fslaiuts uro-rte blodo frmo eht eariratl eysmts to het ounvse syes,mt nssip-agby teh Aestoerilr = eIercans LP -&--gt; EISRENAC V.R llA in lla = necIaesr OC.

rcogAindc to od,rlWU eth aetesirrlo ear a romaj csruoe of etnsricsea ... so ybngpassi hte oaseltrire lresuts ni a srecedea in loatT hlePperiar niaRcesest ... iausncg na anicsere ni eht etra dna elovmu of doolb tnirngeur to eth rathe. I ma ytpter usre ehrte is reom ot hte plsyoyoghi nibdeh i,hst btu I ohep this deepxnila a e.tllit

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big92  dmi"ltemeyIa oloigwlfn tocaie,nr urrnoevoestia luaifts (VF)A si dasatcsioe tiwh an eniresac in cadrcia uoptut (),OC eahivdce lmrneopadnyit ghrothu a ocinruted ni steciysm rcslvaua sestr,aenci neiacdser iolmcdaayr itoyacitnlt,rc nda na ciearesn ni ostrke meovul V()S nda aterh ra.te revO the gonloifwl eew,k racgcliinut odlob uolmev rasineecs in untcncniooj with ecnsiresa ni rtaali and nibra iearuittcnr dpetpi.se shTee isoattarnle ear isaseoatdc htwi erlya anesesrci in eftl ntviaerclru )L(V fgilnil upsreers whti eth opitneatl for enulrstat mctaip no iaarlt dna ecanlruitvr ahbmrec sinneosdmi nda iuo."nfntc DP:IM( r4' 2e55)s2Te 58h5 saol rneaoht sduty by seEnpit form hte 1s095 lonikog at eht teefscf of 'sVAF ceffte on OC ni men PI(DM: 11875)3.20 eyt,prlAnap the ceiresan in rnitgse CO is a gbi elobmrp beseuca it acn dela ot hh-tiogutup racaicd fleiaru .H)L(V +32
hungrybox  usJse 9bi2g ouy etwn in on the hresarec olma u utsm eb TMSP +6
temmy  92big ouy era hig.rt hatt si why esgtap eaedssi astgep haev ghhi upoutt aiccrad rafuiel ubeaces of eth va shsu.nt +5
kevin  htwa is ncia"erse "LP +6
jhan17  Acirocgnd to Wki"nhewi an oeuotsirrvena stiuafl si mrdfoe lingvvion a oarmj teyarr like het nbimdaalo rao,at it nac leda to a aelrg edearecs in ilerarhpep esernsctia eaeucbs ti by psas troiraeel hrwee( omarj PB si re)mfod . hsTi rwodlee leeprrahip eenstsriac aucsse eht etarh to cserneia etgirns raccida tpuout ot innmtaia eprrpo oblod lofw ot lal .eustiss" +



 +6  upvote downvote
submitted by ∗azibird(279)
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I odt'n leef lkie yna fo sehet menscmot heav fluyl sddrdasee yhw eht tnaepti ncluryter sah aedinecrs ginrtse CO adn NOT esdeeacrd .SV reHe si who a derifn fo imne ealdnepix i:t

PMA a(t rsentgi )HR = /23 DPB + 3/1 SBP = 77 gmmH ni thsi ,tnteiap chwih is oelwr nath lmnaro 9(3 mHmg fi uoy eus 8/)0021. oS MAP is asrcedeed and the yi/rnheseotdk oangsr 'trane gigtten hte iposfnure hety ,nede indelag ot RASA ciaoitvtan dna Oa/Bme.Sde PAM = CO × RTP, os sthi ocdul be ued ot wol OC lrveetia to TPR wth(a we llasuuy ptcex)e ro wol PTR airvteel to CO. sThi 'satitenp geral VA ifsluat ahs dpoedpr rhe TRP eryv lw,o hihcw emsan erh OC smut heav been eyrv hhgi rof eht tsap 15 yares to atnmeopsec h(gih tutupo rhtae ealur.fi heS ash ylon 5 sdya of omtsysp,m wichh msena seh si erayl no in her .HF eScin esh adh hscu a ihhg CO to bngie ,with rhe dopr in VS itsh elrya on odluw lilst eaevl erhe tihw na DNEIASCER VS drceopma ot a lronam t.enitpa nUssle her ueslp is rpeus ,hhig hre rahet smut eb gnipmpu a smiasev otkser uvleom to nnmitaai a onlrma lossyitc doobl sseruerp hwit cush a low RPT M(AP = SV x HR x )T.RP ylEev,unalt ehr SV amy aedceesr to eb ebolw na,orlm utb ton os lyear on.

Fro sesltmneNc:ooept draedeesc atiralre 2O tas busaece dbloo is onlifwg mfor rearyt ot ienv, nto eht torhe ayw .tdor Noanu dersceaed xedim esouvn O2 tas acebseu laeirtar oodlb is idoofgnl teh ilcsbnaavu vnei trhgi orebef midex 2O ast wuold eb sue.rNedoa mt ceasrdnei SRV ebscuea fo the eaglr VA lufsia.t

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 +2  upvote downvote
submitted by ∗the260guy(18)
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But eres'h ym bepmolr ihtw hsit s:uqitneo it says that ehs has a 5 day yitsorh fo SBO nda slnoelw gls.e So ulvsobioy teh eahrt is i.gflian I diekpc eDcdseaer orSkte muleoV rfo ttah son.ear

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nwinkelmann  VA asitusfl rea noe useac fo hgiupoutt-h ccdaair liuarfe. iTsh preson tnsseerp tiwh arthe ,lruieaf ubt it is ude ot ayclhnoilcr eisdranec erisntg .OC +2
lukin4answer  wanknml@inne yes ahtst it,grh he ahs igilfan h.rtea ubt eqituson is gsakin htaw is teh dfngiin fo shti patetni, I dtsnrdunea eht useca si lsauiFt cusniag ihgh optutu ul,ifrae but htey 'ndtid ksa the searon of sih ,FH they ear nagksi het ii.nndfg I ecosho seaeercd eoktrS eulmOV :/ +
happyhib_  Tshi swa my gicol adn ogt ot eardeescd tskroe mvuole sa lew;l tyhe entar anksgi thaw uedacs his FH ro yahtngin ti ayss hwta is hte most yekill diningf ni sthi piaetn.t fI ihs etahr is lifgnia ude ot VHL rmof cntostensi ndreeaisc OC wlndtou he TA TSIH RVYE EMNOMT IWHT his tearh linfiga veha esdceeadr ostrke ?.mov.eul +



 +2  upvote downvote
submitted by ∗usmleuser007(464)
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OC si iersandce ithw 1) arcedseed dr 2aae)lfot nrdcaseei lrda poe)3 enIdercas litoacnctityr

nA eeovaonrisut asftuil etscaer an tneterlvaia ouetr ofr latari ldoob onti het onsveu noitraclicu w/o oggni sapt teh reaortelis t(eh jrmoa uscea of eesnuchT,tsa. )sir yb dgnoi so eht TPR l(a)refoatd raeseceds and the OC is aeenisrcd.

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 +1  upvote downvote
submitted by ∗uslme123(86)
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VFA's = ieesdcnar arcdiac o TtuUpB.tu this s'tin enw orf iths rpse?on I ewiv hsit sa a harte htta sah linflay nbuge ot ifal -- dasereedc ieevefctf arcutcryloi lemvou -;t&g- rnedsiace V.SR

utB i egsus uoy cn'at ahev B brefeo A -- retwveha -\-

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happyhib_  sih pb wsa nomthsgei ilek 3;/0501 iwht ocdasliti aruodn 50 I dfgeuir he dunloct haev crinesead VRS acseube ish oasilctdi dwluo be rehhi?g +2
trazobone  I hda iths same oernasgin I lptoyelemc esdlgos oevr teh BP 🤦🏻♀️‍ +



 +1  upvote downvote
submitted by nuts4med(8)
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enonAy aehv an adei ywh eth eeradecsd rlraeait 2O nauraotsti is tcroe?cnir nusimAgs hes ash mupl eadem nicse seh sha EL e,meda 'tnldwou a eowlr O2 tas eb eexdepct too?

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haliburton  I ebeviel heert owldu eb no sardceee ni O2 aosnatiurt ueceabs yxeatnoged odobl (high rsp)eurse is tdshneu inot nxteedegdoay trc.cuii sA gnlo sa eth ngsul nac peke up, tish odhlsu eaiecsrn nuevos exgaooiyntn on erg.eaav +7
hungrybox  ty hotb of yuo rof hi,st asw nnrdoewgi teh esam nhtig +
coxsack  2O sta ’tonw enchag /bc reuoy’ ont angdid xgynedtoaeed ldoob to eht ertraial ed.is eYuo’r sjtu aitgkn tlriraea ldboo nad gpnuitt it inot vusnoe lbdoo. maeS asneor hwy >RL- aadccir suhtsn ’tdno esderace 2O ast l(wieh in rtso,atnc a L->R nhuts lwd.u)o +5
hungrybox  ustj ld:iareez teh ghih eprussre fo hte eaalirrt mtysse esekp otu suorrwsele-p nsvuoe lodob ni na AV tasilfu (blrpoyab ivsuobo to stmo lpp tbu it swa a eeuark emomnt fro em )oll +2
chandlerbas  ay uoy wont heav resdadcee elaairtr 2O ast eubsace gtyonoexnai fo odlob is fuioepsrn etidlmi (1A9F -5)4-6 ofrhertee nxitaenoyog fo het oldbo snehpap ihinwt eth tifrs dos3.nces fo reentnig eth lpuaonmry aircllyap taht uyo oludc eevn dehnal aghinv mreo oegnadxeeytd lbdoo rteen +



 +0  upvote downvote
submitted by ∗step1soon(51)
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rteaH frauie:l hTsi is hte osmt sesriuo aictionomplc of alerg iaotsnueerorv tsfsl.uai cenSi uory olbdo lswof rmeo uyqlkic oghtrhu an rsvoieurntoea ulifsta anth ti ouwdl if oyru oldbo wdloef hrughot a nalmro rcoseu fo rtai,eers lcapiaerisl dna eni,sv oyru ehart usmpp arehrd ot paetsmoecn orf eth rodp in blood espuesrr ldlcae( touh-ptiguh trhae iflre.au) Over ,ietm eth arenscdie ntenitysi fo uryo sa'hetr imgnpup anc weanek ryou teahr eulsmc, ngeidal to ehrat a.rileuf

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