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NBME 23 Answers

nbme23/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man has a diastolic blood ...
Precapillary resistance ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ
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 +45 
submitted by โˆ—ferrero(47)
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A yrve irmials notquise I aveh snee ni akQbsn illw ska hyw a inteatp thiw thigr erath irulfea oeds ont levodep damee nda eht rnesaw si sadricnee hlpaycimt .raniegad I tgo itsh usoteinq nworg noaiygllir eceuasb I eeradswn gnlao hits leni of anoeirsng tub I ihknt ni sthi esac it all sah to od wthi RHEWE hte rtxea ersuerps si ongimc fmr.o In hist entouiqs the pt hsa dlocistia nnypehisorte so uyo nca hktin touab the esspurer sa mngcio wo"adrf"r os ictisongrtcn airpalperycl ptcnisrhes nca epnrtve an enercasi in usrpsere in hte aclaryilp deb. vewreHo orf thirg treah erliauf hist xeatr uidlf is ncmgio frmo the OPITPSEO edncritoi cbwadkrs(a mfor eth htgri re)hta dan sgrcnoctiint irylrcapeapl iescpsntrh acn do nnigtoh o(n ppeisoot ised fo lraycalpi d)eb - teh nyol wya ot nrevtep emeda is ot eraiecsn hmlctyapi daegr.nai

seagull  heT ouetqnsi callrye edla us to inhtk outba tsimcoO srueresp yb tankgli buato rnteiop dan euir.n I dowenr woh mnya pepoel uesd htta line fo oeigransn iek(l fye?l)sm +20
mousie  Gtera npaixoantel, I ecsoh cpalthmyi arigaden rof het asem oigsrnnae armsiil( Q no dfetrnife b)nka +9
sympathetikey  My oagenisnr was cmhu mero tlimpsiics b(amye oto plmsi)e utb in my dinm, slsiytoc BP si eridndetme yb cdarCia tuputO dna aditlsioc BP si itereddmen by orleteirs.a eThrrfeeo, awth oesmc brefeo eth llrpiyaac and teuragsle ?tnsrisceae eesA.rtriol atTh's wyh I iasd hatt ly-arcaleppir enec.saitsr +41
cr  het niam fcefiedenr ewenteb hte 2 secsa si htta ni sthi case the ptneita has hghi PB +1
link981  oS in aenrnkedrigt uaalegng eht usotnieq is etlseysilan gkanis ohw gihh uerpsers in het eritrala etsmsy si TON mntetsatdir ot teh uevsno mesyst cwhih( si hrewe EEMDA dps.le)veo tBu oyu wnko tyhe evah ot dad lal hist ofni ot yrt oncufes a aicsb lppreinci nda kmea yuo secndo esusg s.eyuorfl (otG it norgw yb het a)wy aecsebu of awth @oefrrer asid fo aQbnk eqsnou.sit +9
hello  er@eforr waht aer ouy gtaikln batuo? ciyamplth dgiaaenr is eht worgn r..s.aenw +1
hello  ok nvree inmd. i got .ti radh ot ndaresndut /bc it wsa a ibg colbk fo xet.t +2
asteroides  I khnti they may eb tigankl buota the gceoyimn omstrpoyenac shamiec:nm /n1toceooyso.:m3K.///twspb4Br4wlNhivn/ohi?ne5.i./5u.fbobg=/peggf4nckwrjtritlandee rs"cI lareatir or uoenvs epreruss osla necsdui cinyogem ontisrtnicco fo aerelirtos nda llyaearipcrp nhscpis,etr hiwhc rsseia raioearltr esarcisetn (eytehbr mznmiiiing hte eenarisc ni ryacpilla rpres)sue and ceuesdr het osmcauravlric uraecfs aear alaeaivbl for ufidl xFo.ecn haerg mpla,xee beseacu sruvaacl msotoh uclmse in laairetr nad reaiatorrl aswll ncsttacor ewhn xdoesep to eedleavt nasrvtilrcuaa rp,sseresu ihts nyecomgi sresenop scserinae pyrcepillaar aerstencis dan rtceptos esclriiaapl form a otacotnmnci rise ni rheit viaucarnlrsat rersepu.s" +7

I think they are referring to maintenance of GFR and blood pressure relationships. Ergo the mentioning of the renal function. The precapillary resistance is "glomerular" precapillary resistance, so if that increases then GFR remains the same => prevents leakage of proteins and albumin => less edema.

https://www.youtube.com/watch?v=IRZsniaCfVQ

+1/- peqmd(74)

this is the concept of blood flow autuoregulation at the tissue level in response to increasesd arterial pressure via arteiolar remodeling via smooth muscle hyperplasia ....

+/- msw(4)


 +5 
submitted by staph_aureusxx(9)
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cialpleryrap antecsrsei = gsbinirced het olie.rretas 'ehs got namilmi notierp ni hte ;unier nda on lanb.mui het kye aws yngaip entaiontt to the odobl prresu.es reuPsres si uaedertlg yb eth cssenearit eesvsls as sdraob lclas it hhwic si eht rarsetiole kaa lreaacpylpri tei.rsnesac




 +3 
submitted by โˆ—notadoctor(175)
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'Ive eneb rshganeci fro my orscue rfo siht tbu 'cnta emse to fndi t.i evwreoH, het awy I otguhth buoat it asw htta edmae aphenps iva het ilelacaspr.i fI rehet si cdeansire sisetracne iva hte eiyprlalcarp ptrsseinhc as hmuc lodob udwtlno' eb abel ot get ntoi eth crisepalla.i hTe blood lwodu ndtisea gte ndtehsu via smtasaoosen ot het v.snie hTsi ltraeci orfm gholyomovcsi.ypc slexinap ti a lttlie rbeett: VC oohliyy:gsP Tesusi adeEm dna Gnreeal Pelsiirncp of Tilrrlnyascaap lFidu nEaxgech




 +1 
submitted by chagas14(1)
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byaMe eth unisetqo is idlegan hwti eth etcconp of cenioygm orreraialt icvntnosciaootrs chiwh si a rohtena adeamt-nei em.snhcaim ehT epr apylcailr etrcinphs crcotatn in pnesoser to a asrei ni PB. I otg eht Q owgrn usbeeac I epckid clmtyhpia ow.fl eThy eovl ot og rof eth atwh" ese"l eelnmet of ayn .tciop I actnon nidf ayn saeron hyw eth pyltcmaih pnoito luodc eb nrgow :/

5s?kwieh=3ivt5hmgsKctarowsn/:.sB4tl/4.ibop//cncnrb..pNwlo/oCckh e eht geurfi 4.1 Teh rgniaM fo etfSay sAnagit Eemda nioFrtmoa โ€“ meaEd yetafS stcraoF




 +0 
submitted by โˆ—adong(142)
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In oitiddna ot wtha hsa dyraeal bnee aisd I nthki na nomttpair pitno in hte iontsque swa rultorgeya usdmstnjate cihwh tisnop reom sradtow eoarirtalr .guilerntao






 +0 
submitted by ninja3232(11)
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"heWn ltraarie erspusre safl,l ncogmiye nteo is deduecr in lerosai,etr dsrnageeic terhi estaecisrn to lwof nda tmiagniinna pyicaalrl .pseerrsu heseT ssirnetobavo eutgssg ahtt yaliprlca esrrpsue yam be teuagldre voer eth smae gnare fo eurspres anchegs vore ihhcw olwf is dgtuoreetuaal in a gienv goa.nr n,eedId mfro the :a"lrnoite

nihbkb/5ph:gn.ti4Bl.o5Ksw3/w.wo//.nt4sNovcm/




 +0 
submitted by โˆ—hello(429)
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why si sapmal nictooc ssreepur wn?rgo

rainlad  I inhkt is't eseaucb we uwodl tepcxe ot ees mose omre aiu/iaubreiiurtomnlpran fi eth malpsa niotcco srureeps hda censidrea to meeantpcos +1



 +0 
submitted by โˆ—ferrero(47)
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A yerv isliarm netousqi I ehva nsee in Qbnask wlil ask ywh a ientpat whit hrigt aethr ruiflae deso ton opvleed maeed adn eth wnsrea is rdcanisee phyctilma anaeri.dg I gto siht qiunseto orwng iynalrgoil uscaeeb I rensawed ngalo hits lnie of neisnargo btu I khtni ni hits aces it lla hsa ot do twih WEHER eth ratxe ruserpse is mgcnio .fmor In isth qoniuest eth pt hsa iacdsltio renethsnoypi os oyu can ihtnk uaotb het upreessr sa imnocg "afdrwro" os ntcirigsocnt lcpirapryael cisspenhrt acn eprentv an sneriaec ni eerrpuss in the aialpylcr de.b eHoerwv rfo igrht ahrte lfieura stih eraxt fuidl si coimgn mofr hte TOSOPEPI deniticor k(rawcsbad mofr hte igthr erha)t adn ncircotsnigt yprlecailapr csphsirnet nca do ionghnt on( ietspopo esdi of aipcyrlal eb)d - eht olny awy ot veerntp eadme is to inersaec maylphcit ndgaraie.




 -1 
submitted by โˆ—usmleuser007(460)
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rotAic cDioiastl Pees rrsu

  • Hhig TPR = ihhg DP
  • iHgh HR = hhig DP
  • Hgih VS = ihgh DP

Aorcit iSolcsyt s rPuerse

  • Hgih oirtCailtycnt = ihgh SP
  • gHih VS = hhgi SP
  • Low oneCamcilp = gihh PS




 -1 
submitted by โˆ—spow(50)
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I olas tnkhi atht het ipton ngibe edma erhe si buoat mean araitlre prsuesre PM),(A hwihc is wath ytuaorurlteoga smeysst tlylauac chegna dseab .no aesucBe eh has naredecsi PAM eud( ot ceasnride BP,D) hte pecaisllari wlli trotinscc ot aiinatnm santntco fpelrwesos/ur ohrthgu eth lrpcaylai b.de




 -3 
submitted by โˆ—divya(74)
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i tno'd hiknt yuo nede to nikht lla ttha ucm.h look at lla teh poitson adn ntikh of hawt snapehp nhwe hyte ecrs, a.nieA ,B C, D and F lla can uasec insltrtiaiet uBtd a.mee snagiiernc rpriylaaeclp rstaesneci yefiietdln ntd'seo.

drzed  eInresdac hacymtipl wflo dlouw ont uaecs letrintiisat eda.me +1
123ojm  but it soendt' sya ensarice" in", it jtus yass "tyuleorrag jntuetdasms .n"i +1



 -3 
submitted by โˆ—usmleuser007(460)
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.1 ocArti ialstcoDi ePesrusr .1 ighH PTR = hhgi DP 2. gHih RH = ghih P D .3 hHgi VS = ighh DP .2 irtAco ylcotsSi srePersu .1 ghiH cnirCtlyitota = hhgi PS 2. hgHi SV = high SP .3 Low apmoCicenl = hghi S P
yex  yhMilo2r/tpmycpiot:/0oacls/sovgtoriiunhMcc1c./ iTsh shlpe hewsoom, eht ftsri atrp batou apllciray epurr.sse +
usmlelol  s'atth eth xep prt::a ehT rveegaa rlaycailp ytihtoscard erspsure si temnddreei yb ateralri dna unosve rresepssu (PA adn ,V)P dan by het orait fo -lcapletrospoipyr-at enstrsiecsa /VAR)R.( nA necrasei in ertieh taelrira ro ounesv essruper will isreecna ilcayparl epure;ssr v,wheero a ginev aeghnc ni AP is ylon utboa tfonfhe-i as fetvcfeie ni nhngacgi CP sa eht ames aolutesb ecahgn ni .VP Bscaeeu vneous cssneearit is ilyartlvee l,ow engahcs ni PV era ildarey nmrtteisdta bkac to the ciapy,rall and olnresy,evc aubcese ltaarier etaniscsre si rlietlvaye ,hghi gseachn ni AP era loroyp tsmrnateitd omdtsnware to teh yira.acpll +1



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