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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 rea wya eghvnornikit ist.h nocrCih yxipaho casuse ersyointphne deu ot NSS tanicvotai adn OPE ontidpu.cor

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teepot123  yep +


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 +5  upvote downvote
submitted by ∗drpatinoire(19)
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sGuy I hvae taneohr thoh.tgu

vGigin ohtre hicceso are bauot hsi oetrh naoarmbl usveal ner(ascide aceten,ri lugeosc, cuir cia,)d I ugses eth nqostiue si etngits su whchi of tsehe vaelsu will imorevp if his AOS si ivpredmo by APCP.

Sncie SOA si noe of teh smto inttmopar acusse of icotihdiap enihn,stoeryp ti doushl meco to su taht ecno his SOA si ardett,e shi syneitrpnhoe liwl mriopve n.soo

So "aeddeescr BP" itsadne of otrhe abanorml lusvea.

nTs(ahk ot my reisdnf rfo tniihgn me butoa hsti)!

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dodgerslakers15  Tsih is het etcrocr way of hikignnt batou hsit teu.qnios oym^n uaPlr yopohilgsy si ton cssa.ereny ehT root fo het uinotsqe si sgaikn awth iwll imrvpeo rvoe tiem whit eantettmr of lpese pa,ane chwih is bdool u,repsrse given htat lepse epaan auecss nseicreda temitysahpc toen nad reeerthof tyscesim .HNT heT nateemttr of sleep napae hwit C,APP lilw ehpl eerucd ctpmetisyah oent adn rove ite,m rioempv PB. +2


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 +5  upvote downvote
submitted by madeforupvoting2(16)
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CAPP erssienac rptairaeulln eserspur sa the evledate yiarwa sprsuree si ittemdrasnt to ethor hisngt ni eht vtcayi ugln( upehss on lpelaur iccaaty/epsv ihwhc cna nhte uhps on teorh us.esur)ctrt This nca aeld to coripenomss fo evins, gnucidiln eht nvae aacv t;&-g rceaddsee enousv enrtur ;-gt& eecseddar pb ofrm( seaeecrdd r.dae)opl ihTs is silaimr ot twah naepsph dingru vllvsaaa (neroixte essahp) hgtuoh the speotvii usrpeesr is opeviddr yb a aenchim upmp eaistnd fo mialnoadb md/eaiuaspcrm.slhg I knith rtahe arte ykiell ceeiarnss ndsieta fo decesear as a prmyonostcea seoes.pnr

see’Hr eno esit hatt sxpailen ti ewll t(eh “fee”r ntcenot si guenho adn lrbaboyp adlayer ecseexd het dtphe noe ihtgm eedn ot okwn) /niimsfcitttmhak:rmp/x//aluooiftsyct-parenv.-eecoeleec--ryacloncntaftohha

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dodgerslakers15  lmPayunro lhopiogysy is not ycereanss e.hre The roto fo eht nuqseoti si skaign twha illw orepmiv eorv meit whit etmaetrnt fo esepl a,naep ihwch is bodlo pe,seusrr nvgie ahtt eslep apean useasc cniaedser espayimthtc ento nad hterofree ysstemci H.TN hTe aemtenttr of eeslp eaanp whti ,APCP llwi hlep ceured cmehtiatspy tneo nda vroe teim, privoem BP. +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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uhhogtAl si’t aobut ,VPP hsit cegnishrear dpelhe me ntddsaneru isabc ,psyh I epoh hist hpsel ryeeoven in esmo wy.a

waeaTa:yk Druign V,PP unsoev urtnre e,ssardeec dccaair ptotuu cesre,eads and rheat sueseprsr drceesea in het rthgi dsie fo eth earh.t

yhW soed PPV cseeaerd veusno rrte?un

  • rncttiaricaho esrursep croesssemp h,aret ugcnasi bldoo ton to rutnre

aCsues orf esrdceaed tlef cteinuarrvl toutpu gdnriu ant:iivltone

  • itfnihSg fo aurrraittlinecnv umpste to tfeL eud to direceasn RV ovlemu
  • crseeedDa unveso nerrut
  • nCehasg ni teashr ibtyila to cnoatctr due ot oieipsvt peerssru
  • clka of 2O ot eathr

morlNa mtnscoyorpae hamnisecsm ofr itaminginna CO nda BP ugrind PPV?

  • easeidrnc RH ot sepamconet rof eeddcresa SV
  • ierdnesac RVS ot iimtnnaa BP

Orteh lyPioigshoc nrs:ospese

  • ereadceDs rlreaecb ronsipfue urpessre (b’odys sseonerp to a flal in PCP is to reisa iyectsms dbloo srrspeue dna aelitd cebarrel oodbl ess)levs
  • cdeDeesra arnle unepisrfo eIrcn(easd H,DA A,ASR nad Panetti sah lrnea mrpbleso so riecnsaed nriteciena adn crui cida)
  • sbislPeo rniomtniulat (dairnesce lseguoc vai snuceoioenelgsg t)c.e
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meningitis  rroys botua teh fn,tmaroigt tyeh eewr dsupopse to be sblutle tno tlici.a +30
drdoom  olosk dogo to me! ;) ntsadei fo serssakit try insug eth lspu gnsi rof nuddrroee ;tssil eht syetms egst fudnsceo meietsosm bascuee the iktrseas is sloa orf ciislat 😊 +2
meningitis  haeY, I dtenioc s: O,h I dtidn nwko the + sing ddi t!aht ryVe uhmc apdiert,pace I lliw yrt that nxte meit. +1


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 +2  upvote downvote
submitted by noselex(9)
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I dsntredaun lesep aeanp wludo cesua ayxpoih nad niasrece ni SNS a.ctityiv oS rattentem dwlou ecdreu BP adn eHart t.eaR I was cukst ebeenwt teh otw .nopstio Why aws eht rwanse doolb uspesrre adn ton R?H I lgdoeog drnoau a tib adn nofdu essditu that hows rdop ni hbot RH and BP. I susge PB rpsod o?erm aCn esoeomn slapee xiplnea.

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madeforupvoting2  PACP esiaenrsc urnlirlaptae peurssre sa eth levadete aaywri srpeeusr si tneidsatmrt ot rheot sngthi ni hte ictavy ug(ln upeshs no pueallr icvat/easycp hhicw acn nteh pshu on eotrh t)srseructu. iTsh can eadl ot scosmreipno fo ensiv, cdinlgnui hte evan acav -> asedecred vsnueo nuretr -> ceddeersa pb m(rof eseecdard )pre.dloa hTis is mlisrai to wath ehpnpas iurdng aalvvlsa ieexrn(to pa)shse hghuto eth otviesip erprsesu si pideordv yb a imnchea mppu sdtanie fo admioblna a/pdam.iegluhrcssm I khtin rthae eart eklyil nssearcei dnesiat fo asdereec as a pmnooyrteasc se s.oesp rHen’ re one itse hatt paxneils ti lelw teh( ”“rfee ectnont is ugeohn and lpoyabbr rdeaayl cxeeeds eth heptd eno higmt need ot wkon) a-rohianc/emtefcf//anynhtch/rovicua-r.opaocyisxl-t:eomfep-tctltleieknmsat +4
apolla24  I eugss eiscn hsaceng ni RH are hucs a aittrnnse emnnpeonho dan ouy yoln aveh nutaisesd iecrnase in HR newh sgeeicnixr ro elik aucltey xeneriegcipn eoms admecli eycemengr vs BP atth can be eeveatdl orf goln opeidsr of setim iwht on ef.festc roeeehTfr na nimmproeevt ni PB si remo orptntiam. Thats’ my eat.k +1


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 +2  upvote downvote
submitted by ∗cathartic_medstu(37)
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Cna nosmeeo rcroetc my snoregain r:ehe

I saw giiknnht piitevos waiyar pusrrsee illw encersia leoalrav alnitnvetio dan ercsaeed ahyxiop dcidnue umrnpayol tavooisntcscnri.o ,hTus VR trfae odla olduw edsarece gt&;= rmeo apoledr ot VL nad eorm criacda uptuo.t Tehn tow'ldnu PB eercasde?

nAy eplh is pcepairda.et ha.ksTn

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pg32  I just tughtho of it as llo:osfw eh hsa hhgi BP ued ot pnoruamyl osniosontcvitrca sa lwle as epdsrediwa scatyetpihm iaaonvctit sa( fi he is gnieb yalrpailt ratsdelgn lal teh eim,t ecuebas he lcyaibsal is). reInniasgc igeooxntnya wlil elrax hsi rpolmuyan uetuvlcsaar nad edecersa hmyscpeaitt stutnailmoi ogotutuhhr the ,odby nailged to a drpo ni odbol urpes.esr +1


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 -5  upvote downvote
submitted by ∗welpdedelp(270)
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erdaeIsnc aaclirnirant ueserrsp tath esusltr in sC'nishgu rtdia of seecrniad doobl ru,reesps garirurle ngtiberh,a nda brdyacirda.a T,uhs hihg 2CO eiuscnd shnuigc riatd adn fi yuo gvei PP ehtn ti illw rdeudce O2,C and then odnw tegelura the thitypeasmc irvnistaocotosc.n liylanrgiO het rbani dah os umch O2C atht it aspzezd tou nda iterd to rscneiea het PB ni rdero ot shup erom yogeanedtx lobdo to teh .nbiar

JCeArws/so:g:edstaipkbp.KUt/lhAam/iSZ53.gfg-m./jmcptq

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lispectedwumbologist  "d4draB"acayi8r pmb l lo +
lispectedwumbologist  Teh hsniepntryeo in rbiosvuctte psele npaae si due to sreicdane iptsmthycae teon nto saeniderc crnlainartai reesursp oaml +1
meningitis  sogiibltldc@ospuwemte : Be urtema unogeh to cortrec emh/rih nad omve on, otn ughal ta mhre.i/h +16
namesthegame22  slueP erat may be cfeefdat yb ugress fo hmpeytsacti ittyciav rnidug apeicn oepsi,sde e,hoewvr iths rtelphnaiois ash nbee slse ryalde sdrtnedoemta ahtn atth ewenbet apaen prn ehied.noyanst +


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