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Retired NBME 23 Answers

nbme23/Block 4/Question#45 (reveal difficulty score)
A 32-year-old man has a diastolic blood ...
Precapillary resistance 🔍 / 📺 / 🌳 / 📖
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 +46  upvote downvote
submitted by ∗ferrero(48)
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A ervy irasilm iosuntqe I haev seen ni asQbkn illw kas hyw a aetpnit thiw rhtig rhtae euafril sode ton dlpevoe dmeae nad teh anerws si eidrnasec thpycmila inea.radg I otg hits otnuiseq ogwrn oigillnray ebseuac I ndseewar gaoln tsih ieln fo nneragiso btu I tihnk in htis csae it all ash ot do ihtw EEHRW hte atexr rersspue si nmcoig mor.f nI hsit eustinoq eht pt hsa tscodaiil npnoieseytrh os you acn hnkti abotu teh uepsrser as igconm "adrwf"or os ttcnrcgisoin ppecaailryrl resshnpict anc tevpnre an ieansecr ni espseurr in eht racpllaiy ed.b Hewover rfo gtrhi heatr liaefru itsh ertax fuldi is cigonm fomr teh OOPITSEP enortdici kdawabr(cs rfmo het htgir ehart) dan tgnsnictorci rcprapllaeyi cinspthrse can do iontghn (on eopopits edsi fo caiaylrlp )deb - eht ynol yaw to evnrtep amede is to narcesie cilayphmt .aangirde

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seagull  Teh ntsueqoi yealrcl dlea su to khitn butoa citOsom sseprreu by gtnailk oubat oenptri nda u.ienr I dowrne hwo amny plpeeo sued htta neil fo nasnierog klei( fylem?)s +20
mousie  eatrG anoxielpnat, I scohe hcymalpit deiaanrg orf teh msea nsgneaori mai(srli Q on fedntreif b)akn +9
sympathetikey  yM eianonsgr swa hucm eorm tpcsiislmi eybam( oot ielsp)m utb ni ym ,mdin tilscyso BP is idremnedte by ciaardC Oupttu dan sltodaici PB is dedetmenri by rleoai.tser ee,orhTrfe waht csemo rfoeeb teh yiacrllap dna eltaurseg ?ceriasenst .rtlsoereiA hstaT' ywh I adsi tath prelylarp-aic sa.etecrnsi +41
cr  eht inma edecfrenif tenebew eth 2 ecsas si that ni sith ceas eth tpniate sha ghhi BP +1
link981  oS ni dertnganrkie ugegalan the tineouqs si sslelneytia ksgain owh hihg reresups in teh aairlrte stsmey is ONT ettintsardm to the nousve mtssye hi(wch is eerhw AEMDE .oldvse)ep utB uoy kwno teyh heav to dda lal shti foin ot try scfueon a csaib einrclppi nad kmae yuo esoncd esugs frelyous. oG(t ti gornw yb eht wa)y aceusbe of htaw of@ererr sadi fo Qnbka tnisoqu.se +9
hello  forrre@e hwat era oyu tglanki bt?aou yphcitmla aaengrid si eht rwgno s.ew.r.an +1
hello  ko veren n.imd i otg it. hard to srntaeddnu b/c it asw a igb olckb of tx.te +2
asteroides  I tkinh heyt yma eb niagtlk uatbo the niemoycg oonmcaspreyt esh:cnaimm co.K/es.ryweotcwNiwt.jen.?5g/rBfo:vi.43gp/o4lhbhomn5k/nbstb/g4tpri/1/=lnufionI"cae rdse ritleara ro oneusv uperesrs aols usidenc eigomnyc ctoonciintsr fo roeeairstl adn rrllyipapcea ser,hnpctsi hwhic aisesr errliaoart eantierscs (teyhreb imgzmniini het sinceaer in ipalrcyla repesr)us dan drseeuc eht csolmrciauvar saceruf reaa ilvealaab rfo fdlui ce.onxrhgeaF x,eemlap eacseub ralcuvsa ohstom ulesmc in ieatrrla nad laaitreorr lsawl srntotcac nehw psxeedo ot lteveaed aaracsvturlni ,usrrespse isth ocgyenmi oesnrspe iacsneser elyaprlracpi snitrscaee nad srotptec rsaeacilipl mfor a ocamtnocnit ires in rhite arnuicvaartls rsere"s.up +7
usmleaspirant2020  4af/polpumatonahgt//o4nlmowmw/s2f+altw4r+/s:odscowcFd.ihe+eoBRar.lpg2/1 hits tpurice !pshle +3
stsfyt  smaek .ensse misetemos ew eus da)ltCCsaBvion(io + evniaondlito )ICEA( bmoco to naelacb the r,seerpus and nvperte elkeaag adn meeda. +

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

+2/- peqmd(75)

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)

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 +5  upvote downvote
submitted by staph_aureusxx(9)
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liaprryleapc aencseirts = ebcgsiirdn hte ie.esrtarol 'esh otg aiimmnl irteonp ni hte uiern; nad no i.lmbnua eth kye saw apigyn tninoetta to hte oobld epre.srsu eePrsurs si tegedarlu yb het resctenasi seselsv sa obdras lascl it hhiwc is eth eialsoterr kaa pyrapcirleal ncsisatree.

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 +3  upvote downvote
submitted by ∗notadoctor(175)
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'vIe nebe ahicrgesn orf my usocer orf hits tub atn'c emse ot dfin .ti oev,Hrew eht ayw I thhtogu atuob ti saw ahtt eaemd pnaeshp aiv het caaei.pslrli fI htere si sedrenica arsstceine vai hte piyealrplcar tesrnsihcp as cuhm bldoo 'tnlowud be beal ot etg inot teh apeclsii.lra Teh olodb loudw asietnd teg usehntd via etasoonsasm ot teh ies.vn shiT crealit omfr ph.yvsomycolocig eanxilsp ti a iettll ertt:be VC oolhys:yPig Tsuies aeEdm dna eGnlare psPlcinire fo nirlcyaspTrlaa udiFl Exgehacn

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 +1  upvote downvote
submitted by chagas14(1)
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yebMa eth sutonqie si iadlgne whti teh pcocnet fo micneygo orltiaearr sioccovsortnaitn whhci is a rhtoane -daemtaeni seiac.nhmm hTe rep lpiyclaar epthcirsn anctctor ni nrespsoe to a aesir ni B.P I got eht Q nwrgo eubecsa I dpicke mapylicth f.low heTy leov ot go fro teh "athw e"les eltmene fo nya t.oipc I ncnota dnif yna nreaso yhw the thpylmcai tioopn uoldc be nwrog /:

nhei:ssw/Not5ppoBk.ic.wtm/tsgKw/3o.r.b4blcro/=?5/lhic4snnvaeCkhc eth efuirg 1.4 ehT nriMag fo yftaeS atgAins emadE Faioomntr – emdEa yfeatS oaFtscr

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 +0  upvote downvote
submitted by ∗adong(144)
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In oitddina to what hsa rlaaeyd eebn isda I nthki na nompiattr tpnoi ni het soeutqni wsa gaotyulerr taussetndjm cihhw nostip mroe asotrdw lrroiretaa erlga.ntiou

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 +0  upvote downvote
submitted by usmleaspirant2020(9)
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c6fi0f27db9c/ed.fe9t0257cpec905t/7.nudrd6h:y1f3oeetb9e02/02t/2u07do1da0nal23soed

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 +0  upvote downvote
submitted by ninja3232(11)
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hen"W iaerarlt espsrure flas,l igoemncy nteo is eceddur ni aee,tlsroir egnsricaed tireh cnrstseiae to wofl dan inimgnaatni irllaacyp srs.reepu heeTs tinoserabvso gstgsue taht pcylliraa srseerup aym be augtdlere vreo teh aesm eagnr of ssreruep gnshcae vero wcihh lowf si edulrauteaotg ni a nigev ar.nog eIe,ndd rmof eth na"tlri:eo

ims4pBocnwtvbn/.b.gt3..h/wlKs/o/54nhwo5/i:Nk

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submitted by ∗hello(429)
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wyh si mapasl ccotino resspure n?rwog

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rainlad  I ihknt ist' bcaeues we dlowu tpcexe to see smeo rmeo tmlarruei/uainnouaribip fi teh slpaam tocconi rseperus dah nredeisca ot acempeonst +1


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submitted by ∗ferrero(48)
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A vyre miraisl nqetisou I aevh snee ni nQsakb lliw ska yhw a ttianpe wthi hitgr erath alriuef oesd not evlpedo deema nad hte wsnrea si asrniedce imptcyhal erdnaiga. I ogt shti uqtiseon ownrg loiiyanglr seuaecb I dnsarwee lngao siht nlei of eanosgnri ubt I intkh ni ihst acse ti lal sha ot do thiw ERHEW teh aetrx rupseres is icmngo fmr.o nI tihs niousqte het pt ahs aictsoild ryionehtsnpe so oyu nac hiktn batou eth eupsresr sa cmnogi r""daofwr so iticotgncnrs pplcaaylierr trnhesicsp nca vtrenep an rcseiane in rsrepseu ni hte lliyarcpa d.eb eovrweH orf tghri heart alurefi tshi txrea dufil si ongimc mrfo the TOPESPOI diertnico d(wskabarc fmor teh trhig )rteah dan sctircngtoin ylacilrpprea psrschinte cna od nghtoni o(n ieopstpo ieds of rlcailayp e)bd - the lyno ayw ot vrtepen eaedm is to seceiarn patmiyhlc aneardg.i

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 -1  upvote downvote
submitted by ∗usmleuser007(464)
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ctiAro tsailDico s uePersr

  • gihH RTP = hghi PD
  • High RH = ihhg DP
  • hgiH SV = high PD

rcotAi osSlycti Pserur es

  • gihH rCtaoilntityc = ghhi PS
  • High SV = ghih SP
  • oLw poacCeinml = gihh PS

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submitted by ∗spow(50)
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I osla hitnk atth het oitnp geibn daem reeh is boaut mane irataelr rpsuseer )(M,PA hwich is atwh raegoyualtoutr tysssem allutyac ngceha bseda o.n usBecea he has eridecans MPA ued( to easiedcrn ,BP)D the iaceapilsrl lliw srtccotni ot nntaamii asntnotc rssfwrpeoe/lu othuhgr hte ylalaicpr bde.

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 -3  upvote downvote
submitted by ∗divya(75)
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i d'tno hkitn oyu ened to knhti lla ahtt .hmcu ookl ta lla eht ntoosip dna inthk fo atwh ppsnhae nehw tyhe ,esnei.arcA B, ,C D nda F lal nca cueas ielrntstiait mdu.t eeaB ecasiringn lreaailpcypr taeisenscr iedyeinltf dno'ts.e

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drzed  recsIeadn tiylamchp fwlo wdoul ton uaces anrtsltiieit .dmeea +1
123ojm  btu ti ntedo's ays n"cersaie i"n, ti jtus yass ru"tglraeoy ttajsmsnude "in. +1


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submitted by ∗usmleuser007(464)
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1. rActoi acoliDtis Pseerusr .1 giHh TRP = ghih PD .2 ihgH HR = ghih PD .3 ghHi VS = hhig DP .2 orAict ylicstSo ssPeeurr 1. ihgH inttialtrocCy = ighh P S 2. higH SV = hhgi SP 3. Low lCncimepoa = ighh P S
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yex  asm0g/liipt.1onlicocM/rcu//2hctso:rcoyMotphyvi sihT phsle hwm,esoo teh irstf atpr btoua lilcapray pr.eesrsu +
usmlelol  t'tash eht xep p:tr:a eTh geaerav cplyilara tcythrosida seesuprr si dmineredte yb lrraaite nad evsuon sreseprus PA( adn ,)PV dna by het rotia of a-pal-rortppyecilots rasscitesen (AV.RR)/ An cranesie in eerhti iaterlar or envuos rseuserp iwll neiasrce rcaplayli reusrse;p oehv,rwe a vgien ncgeah ni AP is ynlo uaobt tnoehfif- sa ffeceivte ni igannghc CP as eht msea elsabout cheagn in VP. aeBsecu svoeun stesacerni si lrlvaeytei lw,o henacgs in VP rae arielyd mtneaisdrtt abkc ot the lryl,cpiaa dan lsnv,yreeoc bseecua ialreatr narceisset is ltrayvilee g,ihh hnascge in PA rae prooly drtmitteans mswadnrteo ot eht iarlly.acp +1


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