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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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uoY sygu aer ayw trnoniekgvhi ihs.t oCrnchi iaohpyx uasecs tpneoiensrhy due to NSS tvcianotia adn PEO tdc.iuoronp

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teepot123  epy +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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ysGu I ehav htrnaeo gtt.uhoh

vGniig troeh sociehc are taoub sih hotre lmraaobn saulve rneiedca(s ,atcereni c,leogsu cuir ,ci)ad I essgu eht uienotqs si ngetsit su hcihw fo ehtse ulaevs will omirepv fi his ASO si deirvmpo yb .PAPC

encSi OAS si noe fo hte msto oitrmnatp cesusa fo hipitcdoai oenspt,nreyhi ti sduloh cmeo ot su thta noce sih ASO si ta,redte ihs yrnonieptseh will peomvri oons.

So dse"cderae PB" tsdaeni fo ehrto nmaarolb vlsuea.

hnTs(ka ot my feirsdn ofr innghti me obuat his!)t

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dodgerslakers15  sTih is the rcocrte yaw of hngitkni tbuao hist io.eqtnus mPy an^urlo opyglhoiys si ont ac.nsseyre Teh orot fo hte nuiesoqt is nasgki ahtw iwll vempori eovr tmei twhi etematnrt of leeps ap,nea cwhih is odolb sser,erpu veign ttah lpees npaea usscea esdacenri hyatcteimsp teno adn ftoereehr icssymet TN.H eTh taeettrnm fo lsepe eanpa tiwh A,PPC wlli hple deceru tsayicmthpe noet and orev im,et imeorpv BP. +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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ACPP nrciseeas lneprialurat rseeprsu as the eevaedlt wiraya perersus is attdrimtens to hoert thsnig ni teh activy nulg( hesspu no pelarul avcc/yetsaip hhiwc anc nthe uhsp no tehro )r.ruusesttc ishT acn edla to meconrssoip fo i,sven idcgninul the avne cava -g&;t cdeerdaes eosunv errtun ;g-&t erdesedca bp f(omr eacsrdeed lprd)o.ea Tish si iasrlmi ot thaw ephpasn drunig avvllsaa ioexrt(ne s)aehps ghtuho teh tovipsei rsurpees is vodrepid by a niehcam mppu idstnae fo aboadimln as.ershulm/adpicmg I hitkn arhte rtae eikyll rienescsa nedtisa fo aesreced as a noaetsocmypr rseepns.o

He’rse one tise ahtt pxneasil it elwl te(h ”“eerf nttncoe si ghueon and laoprbby dyaaelr eesxdce eth tpedh neo ghtim need to w)nko /liiektoeacolftcfecaahspeycaauttl-i:no/-trvettpnnycr/omcheish/-noxmrfma-.

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dodgerslakers15  Pnylouram yoihpsoygl si ton eyansecsr .rehe ehT troo of the inuosqte is nagisk hawt lwli remoipv rvoe imte twhi taremttne of spele npea,a iwhhc is lbodo ,seurpser evign atht peesl apaen aecssu edescniar hseityatmcp noet dna teefoerhr msteciys HNT. The ertmtnate of esepl npaae whit PAPC, llwi pehl dcuere sythtpeaicm tnoe and vore temi, mvoreip PB. +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(643)
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gthlouhA it’s buaot PV,P htis rcasnrheeig hpdlee me srtdnedaun asbci ,pyhs I peoh htis eplhs vnereyeo in esmo a.yw

a:ayakweT ugnrDi VP,P uvoens urtenr es,rdesaec iaccard uuptto ,crseedesa adn etrah esrresspu adsceere in het trigh ides fo the rhae.t

hWy edso PPV rsadecee envous rtnreu?

  • ocraainchttir eurpesrs esosepsmcr aetr,h gcnasui ldboo ont to enrurt

asusCe ofr eeesdarcd lfte tuelrvrcian otuupt urdign vanti:oleint

  • hStfigni fo nvtauriictearrln tuemps to Lfet edu ot eaesrndic VR oevmul
  • recDaesde nvesou nutrre
  • snaCgeh ni aehrst iayblit to acrtcont ued to epvsiiot prrssuee
  • aklc of O2 to retha

mlNaro apcysnormtoe cmnseihams rfo nnganimiiat OC adn BP gidrun V?PP

  • esidearcn HR to sacmenopte orf sedecrdea VS
  • derenscia VSR to iinmanat PB

hetOr yocisighloP senso:erps

  • seeeracDd lceraber sfureipno prerseus ’dosyb( oeperssn to a allf ni PCP is to arsie isymtsec bdolo uerrsspe adn ieadlt craeerlb obold eevls)ss
  • ecadDsere lrane fpusrione (Iaseerndc ,ADH RA,AS nda iatPnte hsa rnela eblrspom os ensadcrei arictennei dan ricu cda)i
  • eosilbPs nmiiuolnattr arnsdceie( clsuoge avi nigugnolesecseo c.te)
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meningitis  rrosy utaob eht tnri,omfatg ythe weer usppoeds to be tebllus otn a.iiclt +30
drdoom  sloko ogod to em! ;) adteisn fo atksirses try ignus eth psul sngi ofr dedoreurn sti;sl het essmyt gtes dcfnsoeu emitsseom baeecus eth starkeis si olsa for aicilst 😊 +2
meningitis  Yeah, I diocnet :s h,O I niddt nokw teh + ngsi ddi t!tah Vrey cmhu ipd,preatcea I illw ytr ahtt next tiem. +1



 +2  upvote downvote
submitted by noselex(9)
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I sdurtnenda elesp aepan udolw asuec iaoxyph nad ascnreie in SSN it.ytvaic So nmetartet luwdo urdcee PB dna taerH .teRa I saw stkcu newebte the owt soitnop. yWh aws hte areswn boodl uprsrsee dna tno HR? I ogelogd ruonda a tbi dna unfod tisueds thta hsow odrp ni otbh HR adn P.B I sguse BP srodp ?eorm Cna eoenmso sepeal .pniexla

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madeforupvoting2  PPCA seseacinr anuitalrrple rusrsepe as hte edavetel aawiyr srepuers is netmtdaistr ot hotre thgisn ni het cavtyi (nglu speuhs on ulpaerl yvacastiec/p whcih nac ethn usph on eohrt ttus.rrcesu) sTih acn adel to srspemiocno fo svnie, idlcungin eth enva caav >- ceedaserd uvenos ternru >- seedcadre pb mor(f arsceedde raepodl.) isTh is alriims ot hwta pnehaps iunrgd avvaslal nixerte(o assphe) uhogth hte eosiptvi rsupeser is irpeoddv yb a acmnhei mppu tieadsn fo iaonmabld scupisadramgm/hel. I ntihk trahe etra lkyeli icesrasen iasednt fo eredasec sa a naysomcteorp s rpesHe’os er.e n oen itse ahtt elnpxasi it ewll t(he ef”“re oectnnt si henogu dna pabblory areyadl esexdce hte pdeth noe htgmi ened ot oknw) slafcpehim/tncmnhycrxp-tlaooto/amniv/el:fnaite-rea-acs/fhkortto.eyct-cuie +4
apolla24  I gssue iecns ahsgenc ni RH era cshu a nnairtets phoneonenm dan yuo nlyo aehv sastdenui iaecnres ni RH henw rcgixieens ro ikle cteuayl nenexecripgi osme imedalc nrgecyeem vs PB thta anc be aelevedt ofr gonl peordsi of etmsi wthi on ts.cfeef fhrToreee na mpnmveteoir in BP is more moartni.pt ’shatT ym a.ket +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Can seeoonm ccotrer ym naogreins er:he

I aws nitkhngi teviispo aiarwy pserreus liwl seirance rloeavla ielntontavi nad csedeaer oxhapyi eidcudn parlynmuo otiivtoosncs.arnc suh,T VR ftera laod lwdou easeecrd ;t=g& rome aldpeor ot LV dna orem rcadcai up.outt nhTe untw'lod BP ?creeseda

yAn lhep si itraepacepd. nThka.s

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pg32  I sjut thhutgo of ti as :sololwf eh hsa high BP eud ot nmlurpaoy aonvsciisctonrto sa wlle as epidersdwa ttysimceaph aatoitcnvi as( fi eh si eignb alpratyil tadgrlsen lal the eti,m aucsebe he iacllbasy )s.i aneiIsrgnc tgxoeonnayi liwl larxe ihs lnoymrpau ltveuaauscr adn racdeese cpsyhteimta stotailimnu gohotuturh hte ,obyd nleigad to a ordp ni lodob reeus.spr +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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Iseedrnca ainanrlicart epsrsreu thta stelrsu in ssnu'hCgi rdait of sadrcneie doobl seesru,pr lrraregiu b,rinethag nda dbcrydria.aa ,uTsh ihhg C2O usiencd higcsun ratid dan fi yuo gevi PP enth it liwl durdece 2,CO dan tnhe nowd elgrtuea eht hipttymcsea stsonr.ctvnaoicio rniliglyOa eth irnab had os uchm CO2 hatt it azpezsd tou dna tdrei ot asrcinee eht BP ni erord ot upsh ermo ydnaexoetg doblo ot hte r.iban

3:/tS/.wad.ppjgtbmogm:srcsiAa.hAm-etfZ/epgJKkUlq/i5sC

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lispectedwumbologist  yrdariaa "cd8"4 B bpm ll o +
lispectedwumbologist  ehT eneihspytonr ni iuoctvrebst elesp enapa si deu to dncaeiser cpisteahtym tneo not eiansercd iltaicarnnar uspreers lmoa +1
meningitis  beditwm@egtpsulloscio : eB rmeatu nghuoe ot otrcrce e/hhimr dan evom on, otn gluha at ei.rh/mh +16
namesthegame22  elsuP raet yam eb fcetfead by rgssue fo tapysehmict ctvaitiy dgirnu cnpiae se,isoepd ,oheevrw hsti poiasirhlten ahs eebn sels eylrda onemdatretsd tnha taht wneebte pnaae aipntnrnsheeyo.d +



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