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NBME 21 Answers

nbme21/Block 4/Question#25 (63.2 difficulty score)
An 80-year-old woman cannot concentrate her ...
2.0🔍
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 +22 
submitted by flashvoyger(22),
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hTe itqenosu is ngkias oyu hwo mchu rawet umst het awnmo keta ni ot atniianm hte smea tali.smooyl Tish mawno ketsa ni 405 Omsm fo teusol pre .ady isTh si a tniu fo smueetaermn -- htnki of ti elki smrga.

oFr ehr to peke hte easm yioalslomt hse usmt ctreexe 540 msmO per dya. The yoln ywa for rhe ot ertceex eth eustlo si iva eht .sedynik heT noly wya rof ehr indeyks ot xtceree 045 Omsm si if ethy xereect 1 tlier of tarwe aols. Tihs is teh mxa toraitnocnnec atht her ydksien acn orcupe.d r(eH nikydse ear otn u“lwforpe ohug”ne to kmea erh eunir yna rmeo docttnraecen than )tt.ha

Tsih woanm si laso ognsli nhaoetr ieltr fo traew ot sec,ef aiswentg dan riaespintro. shTi is the issble“enin atewr o”s.ls Thta nmsae if hes gnsoil 1 rltei of erawt ot a,tesw pitesrnairo dna scefe rep yad upls 1 lrtei of rtwea to ruien s(euaecb ehs eends to osdsevli hre oelsut in !egnm)sih,to rfo her doblo to ytas hte asem liaytsloo,m hes utsm elcrpae hte erawt hes oslt thsu m,tus ta ummmin,i idnrk 2 itlser of rweat erp dya.

jean_young2019  great explanation!Thank you! +  



 +19 
submitted by cantaloupe5(72),
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She’s tagiinnk 045 Omsm erp day so ehs esden to xeeretc 540 mOsm rpe yda to animatin .iuilqmeubri ouY c’ant tusj erxctee mms’sO yb vslhteesme -- htey aevh ot be olvdediss in soem otnmau fo t.rawe

’eLts ysa oyu xreetce 405 mOms htwi 005 mL fo twera -- atth amsen ryou dnykeis are ritgctcoanenn reniu t:o

504 mmsO ÷ 500 mL = 900 /mLOsm

utB hte aimmumx hits lasd’y syneidk nca ntnortcaeec euinr ot si 504 ,Lm/smO os hse ahs ot rceexte mreo aretw ot get it atth dutile. Thta amnuot of taewr si 1 L, sceuaeb 540 m1O/ms L = 054 .OmLsm/

oNw ’rhtese gnhiotn optpngis reh rmfo extgeircn het 054 ssOmm ni na vene emro tdiule eurin -- for maxeelp if esh dnkar na xreat L fo rteaw one yd,a the eiyknds ulcod tge rdi fo atth xrtae L with hte easm moautn fo 450 Osmm by inlidtgu the iurne ot 045 msOm ÷ 2 L = 522 s/mLmO. But eht siuetnqo assk rfo het mnmiium atunmo of atrwe -- iwhhc si 1 L by teh eidsnky +( 1 L omfr eth teohr fstuf for a toatl fo 2 ).L




 +13 
submitted by burningmoon(15),
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(Wra)1te K1g =aetwrL1 esO5mmrwk40at/ g Letr=sO0mawm54/ et rniaMw 2HO nedeed to desiovls 054 lsoteu yb iekydn si L1 ta )W(2etawrre rtOeh scf(ee et L:tlTao.1al) = tea+)1w(r )r2L=w2(tea




 +8 
submitted by yotsubato(980),
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shTi etiqnosu si pt.sudi eWtar itnkae rfo a athleyh avildiudin is .02 L a .dya




 +3 
submitted by madeforupvoting2(12),
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oT naimnati smplaa oaylstloim -t&g; eeNd ot latcxey rapeelc lla teh ludfsi tlos ni hte yda

eSh cnanot ncrtnetoace ruine vbaeo 405 gmk/sOm , so het mimmuni muotna of ewtra eruqerid ot be eeetdrcx yb ndisyek is 1 to( eterexc teh 405 smmO she utlumaacsce per yda.) The minmumi ceotnrexi rweat udireerq is sayeceirsnl ta mxa crnetotannc;io if you erwe to ysa drpcueo lirdteu i,uern yas mg,/5mOs2k2 htis oulwd uriqree 2 L of rtew.a heT oqenstiu tsawn teh mmuiimn pblessio traew m,ovelu os we essmua s’ehs cneoarcttngni ot het ma.x

1 L ossles rmof ykeidn + 090 mL bieennisls + 100 Lm ni tawes dna esfce = L2 slosse tg;-& eden ot ignest 2 L of rewta ot clprea.e

jesusisking  So helpful, thank you! +  



 +0 
submitted by misrao(1),

Can someone explain the correlation between 450 mOsmol/day and needing to excrete 1 L of water? Thanks