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NBME 22 Answers

nbme22/Block 3/Question#2

A 30-year-old man is brought to the emergency ...

Increased serum angiotensin II concentration

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submitted by bubbles(31),

Just as clarification, capillary hydrostatic pressure would decrease because of systemic vasoconstriction in response to aortic rupture/systemic hypotension?

lolmedlol  i believe you get peripheral vasoconstriction and central vasodilation in the first stages of shock, which would cause stasis in the capillary beds, which would mean decreased capillary hydrostatic pressure, despite interstital hydrostatic pressure going down as well. https://www.sciencedirect.com/topics/medicine-and-dentistry/vasoconstriction and amboss shock description +1  
trichotillomaniac  ^ this type of question is really hard for me to conceptualize. the link above walks you through it step by step with pictures. Theres not much of an explanation in FA. +  
trichotillomaniac  Overall is has to do with osmotic vs hydrostatic pressure. osmotic pressure stays the same and hydrostatic decreases. Hydrostatic pressure is the pressure pushing fluid out of the capillary and in the setting of blood loss this would decrease in efforts to keep as much fluid in the intravascular compartment as possible +  


And it would decrease because you have massive blood loss from the aorta, the compensatory vasoconstriction wouldn't be able to conquer that.

+/- drmohandes(2),


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submitted by jboud86(1),

Page 576 of FA2019. This is the renin-angiotensin-aldosterone system working. A decrease in BP is sensed by the renal baroreceptors causing a release of renin.