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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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You gsyu are awy oirnektigvnh ht.is iConrch ohypixa csause ensyotniphre eud ot SSN tnitaivcao adn EOP .cdpiuotonr

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teepot123  yep +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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Gsyu I vhae rhaoten toutg.hh

iivngG ehrot cicohse era aubot shi oethr aonblmra sevalu crdanseie( ,neritaec ,slgecuo ciur c,ida) I gsues het unsotieq si nestitg su cwhih fo etehs lsvaue llwi rieompv fi shi ASO si dvirpoem yb PC.AP

Scein SAO is neo fo eht sotm attrpnmio cussea fo acdiopihit eyroistnhpe,n it sudhlo ecom ot su taht econ his OAS is etrda,et hsi esthnrpoyeni iwll orivepm oos.n

oS ddcer"aese B"P senatid of reoth bonamlra sv.auel

khT(sna to ym ersfnid fro tginihn me bauot !is)ht

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dodgerslakers15  hTsi si het ecrrotc yaw of ikngniht bauto htis quno.eist ynumlPao r^ goyopyishl si otn synesrc.ea Teh troo fo hte eutoinqs is iagkns wtha liwl moerpiv orev emit twih eentttarm of pelse a,aenp hhicw is lodob ueser,psr gievn thta pesle anpae scaues eracsiedn eacittpmhys toen dna ehetrreof eistmscy .NTH The trettnaem of peels apena htwi P,CPA ilwl lphe uederc hiaeycspttm nteo dan roev t,mie mirveop P.B +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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PAPC caniesrse aulrtnelpria rpseeusr sa the ealdteev ayiwra seesrurp is ttaerntidms ot tehro sgtihn in eht citavy nlug( puessh no rpaeull t/pecsayicva ciwhh nca nhet usph on oreht suersc.rtut) Tsih nca lade to smrosoecpni fo ,vnesi iuincnldg eth vean cvaa ;t&g- cedseaerd nuosve enrtru g;-t& esdraeedc bp (rmfo adecdeers dl.r)poae isTh si mrisail to hatw senpahp dniurg vlaaslva ietrxon(e hpssae) utgohh eth oitivesp prursees si peddiovr yb a nmaihec pump tdeisan fo miaadobln saammhlgcseu/ir.dp I kinth rthae rate kyliel eesarsnic esdaint of saercede as a orynetsomapc rnepsso.e

r’seHe noe esti thta pnsxalei ti lelw ht(e ”free“ nteotcn si geounh nda lyobpbar laedayr eecsxde het thpde one gitmh ened ot kn)ow acai-neiytseponccnar-rtiftmcumtpaxihk.cleltvconh:oe-/f//ah/als-ytoetferom

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dodgerslakers15  lronmyuaP pgosiolyhy si ton crasnesey rehe. Th e ootr fo hte osuqinte is gnkias thwa wlli ivopmre eorv ietm hwit ametrtent of eslep n,aaep ihhcw si boldo usre,resp eignv taht esple npaae sacseu eidsencra ympattesihc otne nda hrtoreeef styiesmc .NHT ehT etrtnamte of lepes panae ithw P,ACP liwl elhp rceeud sycpmhtaiet ento dna voer t,ime mrveoip B.P +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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hoAthlgu sti’ autob PVP, tish nrigrseahce peehdl me ndrndutsae bcasi yhps, I eoph htsi elphs veyeoren ni osme awy.

keaw:aTay nurDgi PV,P nvesou nrtreu ssc,eradee cidraca touutp c,eersdeas and atrhe pesssrure esadeerc in hte ghrit ised fo the aerth.

Wyh deso VPP cereedsa evusno rer?unt

  • crniothcrtiaa epruesrs moscpesesr trh,ae uisancg lbodo otn to trnure

Csueas fro dereasdce lfet unevrlcarit uoputt udingr e:niionavltt

  • thSngfii fo vtierrrcutnilana spteum to teLf eud ot esndiaerc VR uemolv
  • eeadrDecs vnsueo rtrenu
  • hCnsgea ni atrhse talibyi to notcacrt eud to iseoivtp psuresre
  • klca of 2O to ehrta

lrmNao nypcmsoortae nscmishema for agmnnnaiiit OC dan BP unirdg PV?P

  • ecdeasirn HR to enaceotpsm for sreaddece VS
  • deecnirsa SRV ot iaaitnnm PB

rhOet iyhsPoilcog :rnsspeseo

  • caDeserde raeblcre pnsuiorfe eupsserr ’(oydsb eprsenso ot a flla ni PPC si ot iaers stmseicy dolob prrusees nda ieatdl eelracrb dobol es)sselv
  • ceDeasrde aenlr piesofrun (enecrIdsa ,ADH ,ASAR dan itatePn ahs ealrn brlompse os desncreia netnariice and iucr adci)
  • oiebsslP oatimnntuilr nsceei(adr usocleg iva cuogesgnnelsioe te.c)
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meningitis  ysrro tuboa teh t,otmgarnfi ehty rewe pessduop ot eb eltlbsu ont ctl.iia +30
drdoom  olsok oogd ot !em ;) isdneta of saktsseir ryt ugsni eth lpsu gsni for dnrdreoeu t;isls eth tssyem egst uodcnfes etmeosmis eabsuce eth artiesks is oasl fro taiclsi 😊 +2
meningitis  e,haY I inocdte s: ,h O I ntidd okwn hte + nsgi did atht! rVye cuhm ieacrtp,epda I llwi ytr that xtne etm.i +1



 +2  upvote downvote
submitted by noselex(9)
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I rdeudsntan esple eaapn dulwo uaecs oayxphi adn raneseic in NSS tacyi.vti So tmeatrent owudl eruced BP adn arHet t.Rea I asw kcsut tbwneee hte tow npst.ooi Why wsa teh nsrawe boodl ruressep adn ont RH? I odleggo dounar a tib nda fnodu itussed htta owsh dpro ni hotb RH nda .PB I ssgue BP sdrpo rm?eo anC oemenso saeelp n.plixae

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madeforupvoting2  PPCA rsncseeai nauillerartp espsrrue sa het dvaeteel ayawri uessperr is simtrtndaet to roteh gthsin in eht vyitca gl(nu speush no lelprau cac/apiyesvt hichw anc enth phus no rohte re)stcr.uust sTih can edal to sencpiosrom fo snevi, ilngudcin eht eanv acva -> scdedeaer neuosv rtenru >- ecseedrad pb (romf ecddserea pdaor)el. sTih si almrisi ot twha snapehp igudrn lsaaavvl rin(eeoxt eahsps) hhuotg het pitsoiev psrreeus si drpideov by a iamnhec pupm denstai of dimaoblan srsu/midmaag.ehcpl I htnki thrae aert ikllye aceesrnsi anidest fo decseare as a arnsoemypoct nep.r’ o essrH es e eon iset that xlneapsi it wlel eth( e”rfe“ otnntce is oguehn adn paorlybb dyrelaa esedexc eht pehdt neo gmtih deen to okn)w mstoalncft-ireppeaisya.-ui/ochfo/:neaynerioacx/ocml-tlt/kvhehacntr-fecttm +4
apolla24  I ssueg inesc ehcngsa in RH ear schu a siennattr nnoepoehmn adn oyu olyn hvea seiudnast ciraeesn ni HR hnwe sieirengcx ro ilek ltceyua rnigceeiexpn some cmleiad gceryneme vs PB ahtt nac eb aeeltedv rof nglo sprdoei fo emits whti on .fetcfes feoheTrre na eevtmonmirp in PB si emro im.ponrtat th’Tsa ym t.eak +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna oseneom cerrcto ym onneisgra eehr:

I asw nhgnikit ipsteivo ryaiaw euesprsr lwli esrceina arlovlea onnvtlaieit nda aresecde xoihypa eddinuc ourypmlan ocsovs.intnaotcir sh,uT VR tefar alod wodlu scederea =&;gt ermo eroplad ot LV and oemr cciarad .utotpu ehnT 'lwuntod PB easredce?

Any ehpl is p.iadearetpc Tas.hnk

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pg32  I tujs uothght of it as wl:folso he hsa hghi BP ude to lpouaynmr iosonnstavocictr sa wlel sa sidweeadpr ythcpaimste avtanoctii (as if eh is begni pillyrtaa rtdsenlag lal eht teim, ecuebas he sciaablyl s).i criennagIs xeootnngyia wlli xelra sih ayounlprm eaavruulsct dan creasede yestmhpatic tatuoiilmsn tuohtgoruh teh b,doy leiangd to a rpdo ni olodb e.psrersu +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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Iansedcer iranlctaanri eeurrpss htta tlssuer ni iCunshg's dtari fo rsniedcea doolb rse,psreu iuergrrla neirb,gath and yabaadirr.cd ,uhsT hgih 2OC isdunec scnguhi rdiat and if oyu vegi PP hnte it wlil dcredue 2,CO nad enth owdn truelaeg hte hepmytsaict ocinvotrssoin.act iOnlyagril the inbar adh so mcuh CO2 taht it zeazdps out and ertdi ot ancersie teh BP ni drreo ot suhp emro eadxyogtne ooldb to eth rnbia.

/UC:sshJ/ifp5:jblwtaer.m3-mt.ZpagoAdqSKcgsgA//t.kemip

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lispectedwumbologist  riy8"r d"c4Bad aa pbm l lo +
lispectedwumbologist  The eesnynirhpot in oscrbetiuvt lesep apaen is due ot nacdeisre cesaptmyith enot nto nsrdeeica nnaaltaicrir ersrpesu omal +1
meningitis  sloibiemdws@eolptutcg : Be urtema egnhou to ocrtecr mhih/er and oemv ,on tno lgahu ta e/rh.imh +16
namesthegame22  luePs rtae yma be cetafedf by ugsrse of tsmphecaity tcvitiya nudrig eiacpn pi,eossde w,roheev this tpilheirnosa ash been slse rlydea tdsntdoaeerm than htta wetenbe aenap eytadinprneon.sh +



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