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NBME 24 Answers

nbme24/Block 4/Question#39 (43.1 difficulty score)
A 30-year-old woman comes to the physician ...
Decreased afferent arteriolar resistanceπŸ”,πŸ“Ί
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submitted by sattanki(72),
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ereTh rae wto hsmmceanis of iungragetl alnre blodo lf,ow the imeyogcn mmieahsnc nad blaor-tgumrlouuel cakebfde. This osuenqti kass urlype tbaou hte ocneygim ,ehnasmmci chwih si ehrwe het nffaeert irrteeoal otrclosn dobol lfwo sedab uryelp off lbood reepussr rntnegie eth e,ykndi ihcwh is hwy daesecred renfetaf rlrioearta enasrtisec is eht etbs rewasn h(te rariteloe is nitaglid in snepsreo ot eth adecesedr dlobo wolf ni mtatpet to matnnaii nmlroa oldbo wfol ot hte ndkyei.)

nwinkelmann  Man... I took this WAY TOO FAR, lol. I totally didn't recognize the clue of GFR and RPF as staying the same to tell me it was talking about normal, physiologic autoregulation. Silly mistake! +6  
j44n  I agree. All I saw was a stenosed artery and ATII constriction +  

w/o knowing autoregulation. You want an answer that will maintain RPF and GFR. Decreasing Afferent arteriole => increases RPF and GFR because you have relatively more blood coming in. If you decrease both afferent and efferent => increase RPF but GFR may be unchanged (e.g. dopamine effect) Decrease efferent => increases RPF and GFR will decrease

Increase any of the resistance and your kidney will go bye bye

+5/- peqmd(56),

submitted by ihavenolife(68),
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yeoMgicn ncsimemah wkrso in eht tanffere eaeotlrri htat pspuslie teh romselulug. When loodb srereups icenarse,s shmoto clsmue selcl ni eth alwl of teh teeaiorlr aer hrstectde adn dnrespo yb otgnaitnrcc ot itssre teh essur,pre tuenigslr in tlilte negcha ni .wlfo nWhe ldobo euepssrr sr,dpo hte smae smotoh muelsc sellc xreal to owrel rcaetssn,ei glaolniw a tuncnoied nvee wfol of olobd.

lciCk eht klin ot adre utboa louormguartlebur eckafdbe as lwe.l

submitted by thotcandy(88),
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oT dad ot awth eeonreyv eesl sah a,sid sthi idles si tpeytr g:ood ecss2tpjmsl23i/g0_irilps3t1.ellda/g//25i/1pe4dseome.dyhas:0/.

teh pmtorp yass PFR and RFG rae hnnc,ugeda stuh BFR is oasl dahncn,egu ot do tat,h the earln teesarri wodul evha ot sedrceea hreit eai.secrsnt

Her,eovw as hoswn no agep 571 fo F1,9A a sicnoictrton or iloinatd fo neftreef lduwo hcgane FF hichw nesma FRP adn FRG enrat' nncgaihg ayqlule - tish si dluer uot by the rptmop siynga eerth'y dacunn.heg

eesavL su ithw a aderecse ni etffrean ia.csenrste