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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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Yuo gsyu aer yaw kovirtnnehig hit.s Chinorc xaioyph suscea sneoitphreny ude to NSS iciaotavtn nda EPO ooiur.ntpdc

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teepot123  pey +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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Gsuy I veha aoenrth htoug.ht

ignivG terho ecohcsi aer tauob sih rothe armlboan lsuave isreeadc(n ecnatrei, souge,cl riuc ),iacd I gssue teh sqoeiutn is tietgsn su icwhh fo thsee uevlsa lwil eivrpom if hsi ASO si rveodipm yb PAPC.

nSiec AOS si noe fo hte mtso tmpoianrt ascseu fo piadhiotci ht,nyriesnope ti uhldos cmeo ot us taht coen ihs SAO is eatdre,t sih roeisnytneph ilwl mprevio o.son

So arcedse"de BP" asidten of heotr nabroaml aelv.us

Tshkn(a ot my nfsride for gihnnti em outab i)s!th

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dodgerslakers15  hsTi is teh creotcr ywa fo gtnihkin aubto htsi iot.nuqse umn^yProa l oghpsilyoy is ont as.ycesern hTe toor of het ietuonqs is gasink thaw lwil ieprmov eovr mite hwit tnattreem fo lespe aape,n hhiwc si odlob urser,eps vinge thta pseel enaap usasce cedesrnai teiamhypcts enot and eortheref stmsceyi NTH. heT tteanermt fo psele aeanp wthi A,PPC illw elph rdeuce hticmtypesa eton dna oerv mit,e omvreip .PB +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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ACPP scenerisa ulilntreaapr seersrpu as the dvleetae aarwiy rsueprse si tsatmtndier to hoert nghtis ni eth caiyvt nlgu( suseph on rlealpu cac/vpiyetsa ihwch can hten ushp on htreo strr.suet)uc hiTs nac leda to imsrcpsooen fo nvsie, cuindilng het neva acav ;gt&- redsdceea esvnuo ntreru g&-;t aseerdecd pb m(for edecrdase r)dalop.e ihTs si iriamls to htaw espnpha ugindr asavvlal nreoiex(t )phssae guhoth the oeitipvs seeursrp is vepdrdio yb a henaicm ppmu sinated fo iamdanlob heasipmralgm.csd/u I kihnt erhta reat lykeli rcsaseein intdaes fo deeeacsr as a tenmcpsoaoyr rnsee.spo

H’rsee neo etis hatt iaelnxsp it wlle te(h ”fre“e nncotet is nohuge dan pyabbolr yareald esexdec eth pdhet noe mgthi edne ot o)wkn mrftoox-ismifitcn-i-cmy/necpcyvr./aeoatuhofaattnrahclepo/e/tsthlklec-a:ne

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dodgerslakers15  nulrmayPo yohysopilg is nto ancesyesr eh.er eTh toro of the queinost is gknasi waht llwi omeripv voer eitm hitw tmetntare fo psele p,aean hhcwi si boold sps,rruee vgnei ahtt epesl enaap essuca seraenidc tapyceshitm nteo dan ereorfhte myisesct TH.N hTe trtnmeeta of plese panea wthi P,ACP llwi eplh euderc tpamycshite eotn and ervo ie,mt vimpoer .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)

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 +4  upvote downvote
submitted by ∗meningitis(644)
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hlAoghtu s’it bauot ,PPV ihst eeancrhgsir pledeh me netusraddn csiba yph,s I heop tihs pelsh nyevoeer ni smeo .yaw

kTwe:aaay inugrD P,PV onesuv errtnu ceedasr,se cdaacir uoptut esrasd,eec adn areht rpueesssr csereead in eth rhgit dise of teh .areth

Why osed PPV rsdeaece ouvnes u?rnter

  • ornatrcihciat reesrpus sosercpsme ar,het gsunica oobdl ont ot urnter

Cesasu orf desraeedc letf unrvratcile uotput gnirdu t:nilvaietno

  • ghntiSfi of ranctrernuilitav sutmpe to fetL ued ot irdeasecn RV mevolu
  • eDcdereas vnueso rertnu
  • eashnCg in tasehr tayliib to traconct due ot poisvtei srpuerse
  • lkca of 2O ot aerth

loNram catoonesmpyr snimashmec for tnmagnaniii CO and PB idugnr PPV?

  • rasineedc RH to nscemtepoa orf saceedred VS
  • cesedrina SRV to atnimain BP

Oreht ycihPsoliog espres:osn

  • areseDdce lrcbreae ripousfen srpeeurs o(sbd’y pseensro ot a flal in CPP si to reias esyticms oblod srrepesu and eltadi erlcbare bdloo elvsse)s
  • sradeDece anlre sfpniureo ceeanr(dIs DHA, SA,AR dan anttiPe has nrale pomlrbes os eenrcasdi etcnrenaii dna rcui )aicd
  • olisbsPe nitaulntimor aerciends( celgsuo iva onscusgliegeoen .tce)
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meningitis  oysrr buoat teh ,gtfrotianm tehy wree usepsodp ot eb tublles nto .ctilai +30
drdoom  kosol ogod to m!e ); tndaesi fo ssairetsk ytr sungi hte uslp gsni orf nrdereoud tsi;ls hte tmssey sgte osducnef oemtsmsie casueeb hte kitessar is laos rof atciisl 😊 +2
meningitis  haY,e I dioenct s: ,Oh I tiddn onkw teh + nsgi idd ah!tt reVy mcuh ia,teeracdpp I wlli ytr atth txne .emti +1


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 +2  upvote downvote
submitted by noselex(9)
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I unrdanestd seepl eanap owdlu secua iaxpyoh nda serancei ni SSN c.atvtiyi oS ntetremat uwdol creeud PB adn taerH Rat.e I saw ustkc twenbee the two tnoi.ops hWy saw eht ersanw odblo sueesrrp dan otn H?R I olggdeo adourn a ibt adn ufdno idutses tath sowh rpod in tboh RH dan P.B I esugs PB posrd o?erm naC neooesm eelpsa lx.pnaei

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madeforupvoting2  PCPA ricsasene atrrlnipleua reprssue as eth evetadle iwyaar reesrusp is aestdrtimtn to oehtr nhsigt ni the itvyca lnu(g phsesu on plluare viaacye/tcps hhicw nca hnet shup no oreth srtr)cut.eus Tshi can adel to nopoisrscem fo ,isevn niidlngcu hte avne aacv >- sdacreede vensuo renrut >- sdeercade pb fomr( cdaeesder .od)erpla hsTi si irismla ot twah hnpseap gnrdui alavsavl eionte(rx )peahss thuhog teh vsptoeii ursrpees is pdoervdi yb a aehmcni pupm sdteain of nmlaioabd gs/dcpmse.uailahmr I ktnhi aterh trae elkily rnceeissa indstae of eaescred as a acmytesoonrp seH eo ’ .ensesprr one seti htat iexlsnpa ti lewl (teh ”e“fre ntconet is gohneu nad rybbalpo yaareld xesceed eht etpdh eno tgmih eedn to wo)kn oemcvro-h/r/p-faaentf/oriiceca--txyhttln:a/snoclmhanatecueiylt.ctmeiokfps +4
apolla24  I sugse sienc eschgna in HR ear cshu a etsaninrt pheonnnoem adn ouy lony vhea sdetnauis eisaecrn ni RH hwne cenigersix or lkie lyuteac egirpnceixne mseo lamicde ryemcnege vs PB ahtt nca be tdeeavel for nogl odeirsp of iemts itwh on efsc.eft eToefrrhe an novieprtmem in PB is orem np.itrotma h’asTt ym et.ka +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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anC onemose rtrceoc my risaeognn e:rhe

I swa nithnigk vpiiteos aawryi sesruper illw sieeranc vloaaler liievtoatnn dan scdeerea ihoapyx duncedi yruoanpml nviio.naosorccstt Tush, RV rtefa oadl doluw ceeasrde ;gt=& orem dpearol ot LV dan mroe icarcda tutopu. eThn wludt'no BP serdae?ce

yAn eplh is peecra.patdi haTk.sn

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pg32  I tsju uhtohgt fo it sa :olosflw he hsa hhig PB ude ot unmoralyp atcoonvtonssicri as wlel sa edsaedrpiw tysaeihtpmc vtoictania a(s if he is ginbe ityaralpl grndeltas lla het i,tme ecesabu he yibaaclsl .si) Igeacnirns ongayointxe ilwl xrlea ihs urnlpaomy seuatauvlcr nda sradeeec iphamtsctye omntiutlsai uttougrhoh hte ,odyb dnelagi ot a rdop ni dolob ersurps.e +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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csadenIre arrncnialati eserspru that lseustr in sguiCsnh' artid of deecisnra lobod sruersep, lreugrrai hbgierta,n and yabirddca.ra Thus, hhig 2CO dsnieuc isncghu artdi dan fi uyo gevi PP ethn it wlli ceuderd 2C,O adn neht dwon urelgaet het ttpsihemcay snrativscnotoioc. rynOlialgi hte inarb had os cuhm OC2 hatt it zzaepsd otu dan tedir ot necrseia het PB in roder to spuh mero oyngxeadte oolbd to hte a.ribn

ZtceCam.JakoS//h/-sKgmfmdU/.:Ai5tpqsgpA.repgtlbis:w3j

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lispectedwumbologist  daac8Bird"yra4 " bmp ol l +
lispectedwumbologist  hTe hoprietyenns in ttcuveosbir eples naepa is due to esiardnce yaspimtceth toen ont ncedeirsa caranltairin spreures almo +1
meningitis  scdietlgetlob@osipwmu : eB umtrae nhgeou to crcetro /imehrh dan emov n,o nto hgula ta rimeh./h +16
namesthegame22  lPeus rtae amy be aceftdfe by gessru of ptmseihycat aiitytcv riugnd piaecn oe,dsepsi voer,hew hits aineohrtlpis has enbe ssle leryad msoandertdet hatn thta neeetbw pneaa s.tnaehinpe nrydo +


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