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Retired NBME 22 Answers

nbme22/Block 3/Question#38 (reveal difficulty score)
A 73-year-old man comes to the physician with ...
Blood pressure 🔍 / 📺 / 🌳 / 📖
tags: pulm repeat

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 +7  upvote downvote
submitted by trump2020(3)
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uYo syug rae ayw tihnrnoveikg htsi. rcnCohi xaoiphy escsau epehstniyorn deu to SSN iatvnioact nad OPE .ordnotciup

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teepot123  eyp +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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sGuy I haev trenhao hgot.uht

ignGiv horte ioehccs era tuboa ihs ehort nbarolma sevlau (nsaeiecdr aereitc,n ulo,gces criu ,ci)ad I uegss eht uqeniost is ttiesgn su chwhi of eseth uealsv lilw privoem if his AOS is preidovm yb CPA.P

inceS SOA is eno of hte otms torpmitan aceuss of iidphioatc ,hsnptnoyriee it uoslhd ocme to su that enco shi ASO si etda,rte his yepnhtsreino lwli opemvir ons.o

oS crsdeed"ea P"B etaidns fo retho mlraonab svaelu.

nTshak( to ym irfdnse ofr inhntig me atubo sh!i)t

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dodgerslakers15  hTsi is the eccrotr awy fo ihgnitnk obatu isht enqo.suit auyr^nomPl opyshoigyl is nto en.acsseyr heT oort of teh quosinte is ingksa atwh wlil veropmi voer meit iwht ttatrmene of seelp epan,a hchiw is dlobo pssruee,r vgien ttah speel aenap esasuc drceianes ysctmpteiha ento adn frtohreee ecimssyt T.HN hTe tnatmetre of eelsp epaan hitw PAC,P liwl lehp ucerde apcesmhtyti tnoe nad roev tm,ie ireompv BP. +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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PACP rncseeisa uaeilprnrlat uresserp as hte tdeeavel ywiaar epseurrs is nrtdsteamti to trohe tsingh in eth tyiacv lg(nu shupse no pllreua svt/acpicyea hiwhc cna ethn pshu no rheto t.ueru)rcsst ihsT anc adle to csropsneimo fo ,ivesn cniigldun hte vean vaac &t-;g sreeacedd esnvou etrrnu g-t&; ceddrseae bp f(rom aedesrecd )aoerpld. Tish is riasilm ot tawh shpaenp ndgriu aavsllav oeitnxr(e )sashep hhgtuo eht tpiiosve peusresr is odidvrep by a inhacme mppu setndia of aaldbonim pmrsgu.micaalesh/d I nthik tearh aert leiylk rciasesne snatedi of esceread sa a mycnteorasop .enreopss

r’esHe oen seti atht lnepxias it wlel he(t eerf”“ oncettn si nouegh and ablopryb ayraedl csexdee hte tdeph oen gmhti dnee to kon)w aimanct-camctpp/sny-eimotf/n.lheychla/vhrroekeit:-aeoar/xtlotunec-otsciff

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dodgerslakers15  uorlmanyP oosypigyhl si tno arseceyns rhee. hT e rtoo of het qunsotie si asgkin wtah lwil mrpeiov vroe etmi hwti tttnaemer fo pesle an,epa hcihw si boldo pe,uerssr gvnei htat lespe anepa ssucae cirnsedae acpytetihms tnoe dan eeherorft cesmtysi N.HT heT antemtrte of lepse aenap thiw ACP,P lilw ephl eedcru sphttcaeyim etno nda orev ,teim eopvmir .BP +15

Guys don’t forget that in OSA, periods of apnea results in increased sympathetic tone, hypoxia causing pulmonary hypoxia vasoconstriction, thoracic movement without inspiration increasing negative intrathoracic pressure ==> all these factors leads to hypertension in OSA.

To remove all this we give CPAP, which results in decrease in BP over long period. (It is not only about increasing intrathoracic pressure and reducing BP)

+16/- apurva(101)


 +4  upvote downvote
submitted by ∗meningitis(644)
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hltoAhgu tsi’ abotu PP,V tshi screegnrahi eplehd em dnreuadnts cabis yshp, I opeh isht eplsh veyroeen ni omes ay.w

kTyaea:aw niugrD PVP, unvose ruetnr ered,eascs iccdaar uouttp rec,edesas dna trhea rpusreess eaeecdrs in het hrigt dise of teh rheta.

Wyh odse PPV escadere veuons rn?rteu

  • caircintatrho pesursre scpresesmo h,taer iscngua obdlo tno to ernrtu

eassuC rfo eaderceds ftle lrraunectiv oupttu idugnr eitlnvtnoa:i

  • ifnSithg fo tnnicuelrvirarat utepms ot tLef due to ieanrsdce RV vuleom
  • sderaeceD euonvs reutrn
  • sCaegnh ni harste lyatiib ot rctnoatc ude ot vteoipsi rusperse
  • aclk fo O2 ot htear

olrNma osmrtyoacnep emhcisasnm rof ntnaagnimii OC adn PB nduirg ?PVP

  • craeisned HR to eptcoaenms ofr eeesrddca VS
  • seernacdi SVR ot nantiima BP

eOthr iisPooyhcgl sersnes:op

  • crsedeaeD rlrcebae frsopuein eeruprss sybod’( rssnoeep ot a lfal ni CPP si ot resia sitysmec odobl rpsserue adn eadlti rrbceeal odlbo sesevs)l
  • Deeeadcrs lnear nepoirfus r(daIcesne ,DAH RA,SA and tnPaeit hsa rlaen spmelobr so rniedasce recnanitei adn ruci )caid
  • Psseilbo iniolraumttn aciedsr(ne scuoleg aiv igenougelsocsen .ec)t
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meningitis  rsyro uboat eth firong,tmat tyhe weer eusoppsd ot be tuellsb not acl.iit +30
drdoom  skool ogod ot m!e ;) aedtnsi fo ssiksreat yrt sinug het spul gins for rueerdnod ;itssl eht ystems gets efdcsnou meoistesm bsaeceu eth stkerisa si laos rof atcisil 😊 +2
meningitis  aYe,h I iencdto s: hO , I tdndi wnko eht + igns idd t!aht Vrey chum a,epercpadti I will rty htta enxt eti.m +1



 +2  upvote downvote
submitted by noselex(9)
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I snuantddre lespe pnaae wodlu sueac xiohayp and eircnsea ni NSS tiiy.avtc oS netetamrt udowl decure PB adn Hrate teRa. I saw kstcu tebewne hte wto n.ptioos Why wsa eht enrsaw loodb surseepr adn otn HR? I dlooegg ondaur a tib dna fnodu ieudsts ttah sohw dopr in ohtb HR dna BP. I esugs BP dpors oe?rm nCa mooense lsepea ia.enxlp

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madeforupvoting2  PAPC csesanrie truilpelrnaa rueerssp sa eht evlteeda aaiywr eprsusre si tntmdaisrte ot hoter ignths in teh ivytac u(lgn esshup no ureallp atiavc/csyep iwhhc nca tehn uphs no oreth .rusr)tusect hsTi acn eadl to osiepnmcors of e,ivsn iuignldcn the enav vaac >- acdserdee evonus renurt >- edaescedr pb ofmr( ecddrsaee doaperl.) iTsh si mlriisa to wtah ahpepsn ndugir savlvaal oreei(xtn ashs)ep though eth iptvosei rrspeues si oepidrvd by a meicnah umpp sadtein of nmbaoilda .ealhumcpi/sgradms I htnik rehat rtea eikyll sicaersen tdeaisn of ceseerad sa a yocteamorspn e’rneeH sressp.o eon stei atht laspxien it ellw e(th r”e“fe tonnect si nguhoe and baolyprb dayreal xseceed teh ethpd noe ghmti dene to ko)wn ot-riohluhaympef/tcftanea.m-a:kmtsfelxteaiirtyt/rnpei-ch-nocsvlnace/ococ/ +4
apolla24  I sguse ncsie ensghca ni RH rea husc a etnrsinat eonennhopm dan you ylno veha usstienda neacsrie ni HR wenh iixsgrneec or lkei yceault incigexpener moes acmedli eencyremg vs BP taht nca be leeavetd for lngo rpoeisd of smiet hitw on fetfsc.e feheeTrro an pvoemrimnte ni BP si orme iaptonm.tr ’Tasht ym .etka +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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naC omsoene tcecror my rsoaginne eher:

I was higtinnk itivoesp ryawia eserrspu iwll aiesrcne rolleaav eoitltnvani dan creesaed oaiyxhp ucinded amrnpoyul .isactorsnntcoivo hTsu, RV aetfr odal douwl desrceae =&;gt rome ledaopr ot LV nda oerm rcadcia o.uptut nThe udtw'onl PB ecsa?edre

yAn hepl si .aripedctaep kTansh.

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pg32  I tjsu guthoht fo it sa :loswfol eh sha hghi PB edu to upyraonlm tsvoaosnncoiitrc as elwl sa eadwsrdiep amyhstitpce tconiatiav sa( if eh is enbgi lalaprity rdagntesl all hte eti,m cueaebs he lcsyailba .)is rnnsIegaci igaotxnoeyn wlil lrxea his onyurpmla calvruutsae adn csereead ytihctpames uaisomlttni gtorhuthou teh oyd,b nligdae ot a orpd in bdool surpeers. +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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eerdscaIn iicanratlnar pursesre that truessl ni Cnghss'ui traid of acsneider boldo ursepesr, rgerarlui b,trnhgaei adn yabrdaaci.dr ,uTsh hhgi 2CO nsecdiu ghcusin atird nad if uyo gvei PP nhet it iwll ercddeu ,2OC nad neth ownd eulraetg teh ytpstmiheca osni.iscvoncattor nliyOargil eth rniab had so cuhm OC2 hatt ti zsezpad tuo and teidr ot seincare hte BP in ordre to hsup mero egyxteadno bldoo to teh ia.rbn

td.esrtpi:C-SJg/hmgj.osq/U3bZts/w/fkcmgaeAaKAmp5l.:ip

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lispectedwumbologist  4 a8aBdird"acry" bmp o ll +
lispectedwumbologist  heT ospyhtneerin in sirtvecbuot lsepe eanap is due to nadericse ieyspmahttc eont nto ecsnderai rtiilanrcnaa repssreu alom +1
meningitis  wgioeitdespmuotlbsl@c : Be emarut oehngu to coecrtr mhr/hei dna move on, not uhgla at rhmei.h/ +16
namesthegame22  Pselu reat amy be caeftedf yb gruses fo ciaypethsmt tyitavci ugdinr peican seo,edsip hvrwo,ee hsti silrthaonipe has eenb lses rleayd ettdnseoadrm naht atth eenetwb epana ntysndaoiernhp .e +



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