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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 ygus ear way etinvhgirnko itsh. incrCoh aophyix aesucs nreseonphtyi edu to SNS taioivctna adn OPE urp.onocidt

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teepot123  pye +



 +5  upvote downvote
submitted by ∗drpatinoire(19)
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Gyus I eavh tahneor gthuoht.

gvinGi thero eoischc aer toabu sih hotre aabnolrm sevaul deecnsi(ra rniea,tec ,ogsulec uirc ac,id) I suesg het teiouqns is gitntse us which of sthee auvesl lwli eivormp if ish SAO is ediropmv yb CPA.P

Sneci OAS is eon of eht most mtniparto csusea fo pahiiotidc eotrispnheny, it houdsl emco to su atth once ihs SOA is teare,td hsi onephsetniry wlli epivomr noos.

So edrceedsa" PB" iatnsed of thore aonambrl vale.us

hksa(Tn to my erifsdn for tinghni em otabu i)!ths

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dodgerslakers15  shTi si hte ctreorc way fo iighnktn tboau isht tiuo.nseq au^omPlryn ilyyghospo si tno cs.esenrya heT rtoo fo eth ineqstuo si gnikas htwa llwi vmprieo reov eimt twih entretatm of lepse nepaa, whihc si dbloo peeurs,sr negiv thta pseel naepa usecas rinaedces taymsthpcie ento nda reteerhof cstymesi NH.T The rttanmeet of eplse apnea itwh ,CPPA lilw hlep rcdeeu scttamiepyh nteo and evor i,tem rpemvoi .BP +2



 +5  upvote downvote
submitted by madeforupvoting2(16)
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APCP recsiesan elalunrrtipa srpreeus sa the taeedvle wyiara seuprsre is inttdetamsr to hoetr thsnig ni het ayictv gl(nu sehusp on lruapel is/vcacaetpy cihhw nac tnhe uphs no etorh serus.cu)rtt sihT nac dlae ot mroesspconi fo esv,in ugnidnicl teh neav vcaa g-t&; acdrseeed eunsvo rnretu -g;&t esdercdae bp fo(rm sdedarece laodp.)re Tshi si riislma ot tawh hsppean igudrn vlaaslav (ionerxte s)aesph thhguo the pisoeitv rrspeuse is veorpidd by a cimahne pmup nieastd of oaanmbdli laspsmuhcdmg/a.rie I hintk ahret rtae lkeiyl asienrecs etdinsa fo adereces sa a pansoecoyrmt ersnp.seo

eeH’sr neo tsei tath iaxepnsl it lwle te(h ef”er“ tnnecto si hogeun dna bboypral draelay xsecdee het tephd noe thmgi ened ot )kwon hfatcenv:otaoykotimicm/hpals-ax.fc-snccr/tntlea/lyceu/erme-apeto-rfoihitn

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dodgerslakers15  uarmnolyP hpiyslogoy si tno esrancyse eerh. eTh oort fo eth ntioqseu si kngisa ahwt llwi poimrve evor meit whit mnetttrea of espel aan,ep hiwch is oobld rsursee,p ginve that eespl aeanp ucases ieerasdcn ipemtayhcts oetn dan eerorthef sytcemsi .NTH eTh ttaneremt fo peles npaae tiwh APC,P wlli hlep udreec tehamycipts eotn dna oevr ,tmei mirvpoe P.B +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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lAhoghtu ’its oatub V,PP hsit igsrencrahe heedpl em sdrnntedau saicb hsy,p I ohep iths shelp nrveeeoy ni smeo .yaw

awayka:Te girDun PVP, uoevns etrurn ra,ecdsees acdriac ututpo ,esrcaseed dan tehar esruseprs deacsere ni het ihgtr dies of het hta.re

hWy oesd VPP adrcesee noveus ue?rtnr

  • ancritatocrhi purerses cspsrsmoee r,teha aniugsc oolbd ton to nrtuer

ussCae for eesrecdda etlf itculnarver uottup ruding olnitinevt:a

  • tnShfiig fo itnratvneacrlriu meutps ot etLf due ot ricnesade VR oveuml
  • screDdaee vonuse nruter
  • ahnsegC in arhets lbiiyta ot rtcncota eud to ivotsepi esrrsepu
  • clka of O2 to haert

lmNaro orocntespyma cnmehaissm fro naiingmtnia CO dna PB gudnri VP?P

  • neacsderi RH ot pcmeatneso orf deecasder VS
  • ensicrade SVR to imnaitna PB

hOetr iilPgoyhcso nrsposee:s

  • rDsdceeea barlrcee psfuireno eusprers o’d(ybs pseesnro ot a llfa ni PCP is to saier csismtey bodlo erreupss dan leaitd albererc dbool esve)sls
  • Drcsdeaee leran nsroeupfi sedeI(acnr ,DHA SRA,A nad etnPati sah lrean slbmrepo os rnseciaed riianeetnc dan icur )diac
  • sPibosel ntmtuaiorinl aier(ncesd cougesl aiv cnsogeengisouel .ect)
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meningitis  rryso botau eth fngmroitat, thye were esdpospu ot be tllesub otn .itlaci +30
drdoom  okols ogod to em! ); dtnaies fo eissrsatk yrt gsiun eth lpsu gnsi orf erruoeddn ;stisl teh ymests sget eocsufnd etiomsmse escuabe the atikerss is alos fro slitcia 😊 +2
meningitis  ea,Yh I eidtnoc :s hO , I dtnid know the + gisn idd h!att rVye hcmu recieaaptpd, I lwli ytr ttah ntex etm.i +1



 +2  upvote downvote
submitted by noselex(9)
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I edrndatuns epesl aanep lduow eacus pxohayi nad irescean in NSS ivia.ttyc So nrmetatte olwud udcree BP adn aertH tRe.a I aws custk neebetw eht two .tnsiopo Why aws eht rswane oodbl errseusp nda ont R?H I odgoleg rdauon a bti nda dunof deisuts atth show ropd ni othb RH dan P.B I geuss PB pdsor ?eorm nCa eenooms esaple xna.pile

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madeforupvoting2  PPCA escrenais llurtrnpaiae supserre as eht atledvee ryaiaw uprsesre si atstmritdne ot htore inhgst ni the vyicta (lgnu hspues no laeprlu pevaacytcis/ wihhc cna hetn puhs on toher uutrtescr)s. iTsh acn adel to sircoenopms fo evni,s cugnlndii het enva vaca -> sddeereac uosevn ernutr -> acdesdere pb r(fmo dseceadre .eporald) sThi is mrsiial to tahw ahnsppe drnuig lasavlva eonr(txei e)hasps guohht eth siiptevo rpesrseu si dvodripe yb a enihmca mupp sandtei of malandibo .siugse/almmcdarhp I tihkn eraht eart kilely eecirasns staedin fo rdceeeas sa a otaoypemsrnc Hee rp’. sseoe rsn one iset that ipenxals ti lewl t(he rf“”ee ttcneno is oghune nad blparoby aayedlr esxcdee het htdep noe ihgmt need ot knw)o --lmitvocriip:xthhca/ohayotinm/rpcaee/.yelfntfsuelnmtaatarstcc/kcno-foe-e +4
apolla24  I usseg cnies engshca in RH rea uhsc a taistnren mhonneenpo nda uoy noly haev saisneudt ereiacns ni RH hewn enrsxigeci or lkei ylecaut iegnpeiernxc oesm dmcilea nerecymeg vs BP hatt nca eb veetelda orf onlg ipodser of mstei twhi on .fseecft oreerefTh an rtpmomvneie in PB si roem mttpnroai. aht’sT ym .ktae +1



 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna ensomeo rccreto ym roasiengn h:ree

I was kntngiih tevosipi yaaiwr ersseupr llwi cinresea vrlolaae tlnoviineat nda dseaecer hopayxi cedinud nlryoaupm otrsoini.cvcsntoa s,uhT VR rftea oadl lwuod erdecaes g;=t& emro daoplre ot VL dan emro craidca tuuopt. enTh nt'udlwo BP ?easedcer

yAn pleh is aeprtiecp.ad an.kThs

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pg32  I tujs houghtt of ti sa lfos:low eh sah ghhi BP ued ot nauyrmlop tasnnisorccoiovt sa wlle sa isdadrwepe yeptcshmiat onicttaiav sa( fi eh si egnbi illyraapt tegdalsnr lal eth ,imte ebuacse he lilacysab .)si ngciasrnIe ieynxagootn lwli aerlx shi apomlruyn leuavrusact dan eaerdces mheticpsyta ioiulsatntm thrguothou the bydo, geadnli to a pord in doblo .eepurrss +1



 -5  upvote downvote
submitted by ∗welpdedelp(270)
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crensdIea cinaatinlarr serspreu htta rleusts ni 'ghCisnsu itdra of incdarese doblo eu,rrseps grarriuel gbirheatn, adn idarcbdrya.a T,shu ghih CO2 ecindsu huinscg tradi dna if uyo give PP hent it lwli ddrecue C,2O dna tnhe wnod lueterag teh tmpsetyciha srs.nonoiivcoattc rgyllOinai teh rabin dah so mhuc 2CO taht it ezsdazp tou nda irdte ot ensreica the PB ni rerod to phsu mroe ygedeaxotn boold to eth nib.ra

iC3/cm:hUwmtgfsppe.tSr/mgb/JsldpAk.Zt:iaKsej5gaA.q-o/

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lispectedwumbologist  "darydcaa"r8 iB4 bpm lol +
lispectedwumbologist  hTe riehneopynts in itsetcvruob lpsee paena si ude ot deeainrcs myhtieatpsc oten ton edncerais itncrarlnaia errpsuse maol +1
meningitis  wlibeispemdcl@sogoutt : eB ruetam neough ot coercrt hriem/h nda moev o,n otn luagh at riehh/.m +16
namesthegame22  ePusl tare mya be atfefced yb sgeusr fo caehpitmtys tcviitay ndrgiu ipaecn is,eeopds evworhe, isht aiesponirhlt ahs enbe sesl laeyrd deasntmedtor tanh htta eweenbt naeap rnpndn yaotseh.ei +



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