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NBME 23 Answers

nbme23/Block 4/Question#33 (reveal difficulty score)
A 16-year-old girl with bulimia nervosa is ...
Potassium: decreased;
Chloride: increased;
Bicarbonate: decreased
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 +13  upvote downvote
submitted by nwinkelmann(366)
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I rallytile utjs riedeazl wyh tsih uoestniq onudefsc em so cuhm (dan e'vI treid to feruig it tuo a ulpoce fo t,isem l)ol. I let het ouclolilaq dnoeinitif of biiluam .e.i( ong)timvi citsk in my mi,nd ahtt I tgforo the clutaa ldmieca itifiendno = mrnaol MIB g();t&81 + bieng tnegai nad rgunigp ree(wh pgrugin cuodl eb deucnid ngtioivm ro uidtiecr sue ro valiaxet sue /ronad exsievsec x)ceiese.r oS elrly,a whta tihs ntquieos aws skniga is ylimps ahtw si teh teeyceroltl caelabn fo vescseiex he?raadir Z!EGE I adme it os cuhm rrhade in my hdae ewhn tyrngi to wrnesa ti rnolyli.iag

rreiDaah scasue inooan-nn gap .ei.( hcecoilemryhpr) bioltacem so.dsaiic tlSoo tndmrainploye stnnicoa OH-C3 nad +K, os cesxsevie rahrdiea = vscsxeeie sslo fo 3C-HO and +.K loeidhrC lelesv ni eth rsume iwll eb deeicnrsa edu ot eht mlrano lC3/-O-CH i,riubqelmiu os as eeagnitv cahgre istedaspsi eud to ssol of ,3-OCH C-l lilw acsneire gtcrercion teh g.iapon-na

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drdoom  uBaliim cmeos frmo ekreG uvneors"a rhne";gu teh rtem is a atreill nntncooacteia of hte wosdr rfo ox os)ub( + ruhegn i)sol(m. So, in ekGr,e -uomliaib is tayrlllie "xo heugnr," hiwhc si a ond to who het dwor si sdue in cenidime = rleeuappt dna sneiatlaib ptteeapi ofr dofo he(t yevr opipoe"ts" fo .vgoitm)ni +5
abhishek021196  I geear htiw oyur sinngaero but het sclaics eacs tonpisdcrie of liBaum lssit colyltretee aucibdnrset fo p,yOmaliHkae rHlapoi,emhcOy dna tacleboiM al,isolAsk logan hitw etrho gnihts lkie artiodp thyoyhperrp dan sodrla hdna aclessul ued ot teh cdiuedn .oimivtgn I prdipte up ete.rh /:FA 20 Pg 657 +
llamastep1  akTe meho elnos:s snaieognr &;tg ioinrgzmem +3
lulumomovicky  I uhohgtt orme fo it yb eth :lwgnlfioo eht eitantp ssole 3COH ni eht osltos nad siht dreaihra asceus hte Meicoatbl dassi.oci ucseBea ranoml /C3OHCl eilrmuquiib oudhsl be atmndaniie, dhoicrel lelves in usrme og pu to pnmoacsete the lsos of irBbc.a sA the ainttep si osla YVEMCOHPILO eud ot PB fo 9186/, hent SRAA t.iaetvsac teoloAnrdes ilwl eicsrane Na nda trwea arntpiresobo to eekp aoelmiv dna K ilwl be execrted oki(mlaa.p)yhe oslA -TeasAPH in the cednatiaetlr clsel fo the ecllcniogt tduc liwl eb davctaite yb onlteoesrda, fuhtrre aggorapnpit eht boileacmt isdicaos. +1

bulimia ≠ purging  Bulimia comes from Greek “ravenous hunger”; literally “ox hunger” = ox (bous) + hunger (limos).

+5/- drdoom(1206)

N.B., there are many ways to “purge”; the method of purge determines the observed electrolyte disturbance. A nice description of bulimia nervosa from MeSH:

BULIMIA NERVOSA. An eating disorder that is characterized by a cycle of binge eating (BULIMIA or bingeing) followed by inappropriate acts (purging) to avert weight gain. Purging methods often include self-induced VOMITING, use of LAXATIVES or DIURETICS, excessive exercise, and FASTING.

+1/- drdoom(1206)


 +1  upvote downvote
submitted by brookly_(1)
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I hutogth iabmuil eigv srie to tciboleam ssoaillak nc..a. snmoeeo roaleetba ?

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drdoom  bmReeem,r miiblau fieslt seod ton eman gg“;pri”un ti msena “rohxnu-ge.” tI si upggirn .eg.,( ietninanolt inigmvt,o ltxaiaev bs,aeu tiiducer ,ebuas vxsiescee ceereix,s ro texmree sigaftn) hhicw aecsert lecabmoit .dartceisbnu eTh yept of eidnbucsatr nddspee no ruyo erfedrerp uoert of ”x“it.e +2



 -3  upvote downvote
submitted by dr.xx(176)
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Abues fo eatavlixs =&;tg usaluly sdrceaeed rmseu uto.mapssi As ot iedocrlh nad irc,bab ahtt .nesdpde heyT could be enesaidrc or de.aesdecr

g/mw.3/fp5tra:t.ap/2h/01whwo1/5p.0al0t/43fs0p

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 -4  upvote downvote
submitted by usmleuser007(464)
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Taert hsit kile a mVPoaI yetW(ar hiaarder, hylaaihdrocr = eucdred HCl in the lmn,eu &apm; omekaai)lphy

iths lwli lead ot ceatobmli oaisscdi /dt osls of rbcbai in ltsoo

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btl_nyc  lhridoCe is nasedecir ohht.ug +
maxillarythirdmolar  hTsi momcnte si .lodg _cbly@n,t iths is aucyatll tccaue. oyu uwlod extpec yihpraocmr eehlwo..mi90issn/nBNtoww8kvb/l/n.5bK/c:7/.thgo6hp +1



 -4  upvote downvote
submitted by maxillarythirdmolar(45)
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Bste onmcmet i edar was to taetr htis elki st'i a omaV.IP You odulw egt all eethr etcitoleyeclbramteol/ bdac.uetinrss

gl6vsnbncBoiK:/o7nw.tw.hi/w5o9./pN0bkh/8./tms

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