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NBME 21 Answers

nbme21/Block 4/Question#25 (56.6 difficulty score)
An 80-year-old woman cannot concentrate her ...
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 +20  upvote downvote
submitted by flashvoyger(20),
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heT eutqoisn is agnksi yuo hwo cmhu rewat stmu the aonmw ekta in ot aiamnnit eth emas saymoot.lli Tihs noawm stake ni 450 msmO fo uoslte erp .dya iThs is a iunt fo enseemtaumr -- ithnk fo it klie .rmgas

Fro erh ot keep het msea stmoylolia ehs stum teeercx 054 smmO rpe .dya heT nyol awy for her to eextrce eth tseluo is vai het ds.enkyi heT noly awy orf erh dnysike to ceterxe 405 sOmm is if ythe erxteec 1 tirel of rtawe laso. Tihs si teh mxa rnicoctantoen taht her idseykn can .dreupco Hr(e dnskeiy rea nto owlrpufe“ oughen” to aekm reh nruie nya emor rcnaeedocttn naht .ta)th

sihT amonw si asol losing nraetho liert of awret ot ,efesc gnwtasie dan oirsinep.tra sTih si eht ibe“nsslien etrwa l.”sso ahTt emnsa fi hes nsligo 1 tlrei fo etrwa to tswae, oprtinaesri nda eefcs pre ayd psul 1 rilte of teawr to eniru eueabsc( hes nesed to dsiovsle her ltusoe in t,mhn)!geiso rof erh odbol ot stay eth maes otsaoill,ym esh smtu lrceepa the artwe seh solt hsut umt,s ta i,mimunm kinrd 2 rielts of treaw pre d.ya

jean_young2019  great explanation!Thank you! +  



 +18  upvote downvote
submitted by cantaloupe5(69),
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seSh’ ikngntai 540 Omsm pre ady os esh nesde ot exrceet 045 msmO rep yda to aatnnimi ieulmqiiubr. You at’cn stju tereexc ssmOm’ by telehsmvse -- yeth have to eb sdvlodies in mseo taonmu of e.wtar

’tseL sya uoy xtrecee 504 mOsm wiht 050 Lm fo awert -- ahtt samen uyor kiendsy rae nrctangencito rneiu o:t

045 smmO ÷ 500 mL = 009 /mLOsm

tBu teh muxmmia sthi ald’ys ykdisen nca rotcnneetac nieur ot si 045 m,smOL/ os she sah to terexec meor ewatr to egt ti tath iutdl.e haTt ntomau fo wreat si 1 L, eucasbe 405 /m1Oms L = 045 .smmLO/

Nwo ees’rth tgonihn gsotippn reh mrof crtnieegx the 504 smsmO ni an neve rmeo lutdei iuren -- rof xlemepa if hes adrnk na exrat L fo rteaw eon ady, hte snydkei uolcd get dir of hatt artxe L tiwh hte mase unotam fo 054 Omms yb udnitilg eth urnei ot 405 Omsm ÷ 2 L = 252 m/sOmL. tuB het ointuqse ssak orf teh mnmmiui auotnm of ewrat -- hciwh is 1 L by eht nydeisk +( 1 L morf eht hteor sfuft rof a tltoa fo 2 .L)




 +11  upvote downvote
submitted by burningmoon(13),

Water(1) 1Kg water=1L water 450mOsm/kg water=450mOsm/L water Min H2O needed to dissolve 450 solute by kidney is 1L water Water(2) Other (feces et al.)=1L Total: water(1)+ water(2)=2L




 +8  upvote downvote
submitted by yotsubato(802),
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shiT ntueiqso is putid.s atrWe iknaet ofr a aheltyh aluiidnidv si 0.2 L a day.




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oT inamnati alpsam lsyoaiomtl g;t-& eNde to xeycalt elaecpr all eht isludf stlo ni hte yad

heS ntcnao eotaectcnnr ierun oevab 450 gkmO/ms , os teh mmimiun omuatn of arwet dreueqri ot eb deecterx yb dynskei is 1 (to excteer hte 054 Omms hes tcuuaelsmac rep .ya)d eTh miuimmn eetncoirx atrwe qduieerr is eaecisyrnls at axm c;riootnactnne fi uyo were ot asy cepdour dulerit ,uenri yas 5Og/2s,mk2m tihs dlouw eierqru 2 L fo rawt.e The qtounsei awsnt teh nimmmiu pebilsos eawrt eouv,ml os ew msesau ess’h ategtronnncci to the xma.

1 L oselss ofrm eydkni + 900 Lm bnssiinele + 100 mL in atswe dna sfcee = 2L elsoss >- dene ot gitnse 2 L fo rwtea ot er.pceal

jesusisking  So helpful, thank you! +