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NBME 19 Answers

nbme19/Block 3/Question#41 (reveal difficulty score)
41 yo woman, 34 weeks gestation; ...
Decreased functional residual capacity πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—strugglebus(177),
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hTe CI lvaue nidnctoae ,1 whihc sanem thta ist nnfignaiitics

submitted by βˆ—cassdawg(1536),
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ishT aroti is used to eimntdree aairrpoptep udpootirnc fo lgnu cnstrautfa, os tshi bbya odluw ton aveh taoarpeppri torudcionp of rcusnatatf fi dhiertb at het emit of hte atior tciu.llnaaco It wludo og onit eontalan tyasrepirro tisesdrs mn.ysedor

;LT:DR nfcatsautr eaecssred ulgn ,oicler so teh aklc of startfnacu in this bbya illw saecu na scaidneer ocielr hicwh llwi eceresad eth claunontfi rudeiasl cpayatic FA( 0022 66-12p66)

tunaacrfSt si asscyrnee ot ercadees fsuaerc onitnse fo ailvelo nad esairecn mceailnpco fo the lsugn rb(ereemm hewn eth gnslu haev rteerga ai,oncelpcm isht kesma the ugsln ieraes ot f.)lil ftcarauSnt lsao pelhs to evrtenp arlaleov clasploe sa the lkac of aartscunft llwaso rehte to be gnaiyrv fcuaers issntone wteeneb rlgea and lamsl iovelal (waL of paaeL,lc) so kalc fo tnrcsauatf udlwo lead ot deperwisad etaeisalcts raeall(vo cels) eBeucsa ncsafratut sverse to sdarecee teseh ofsrce cwihh oalmlrny favor acploels of eht lnu,g ti laso svrees ot ereadsce eht guln

Lack of attusfrnca ni a byba = drecniaes lvoearla urefasc ,snitone wlreo acon,lmipce emro laoralev pol,aelsc reom oecirl lsse( iasdurle u)olsemv

oatTl ulgn cyiaacpt si nunahdecg ceubase htiw euhogn erfco oyu cna tlisl enapdx het nglus ot ulfl picya.act

geekymle  hey ya! thanks for the explanation, but i'm still not able to understand why decreased functional residual capacity. +2  
cassdawg  Not sure if this will help but another way of thinking of this is that it is similar to pulmonary fibrosis with decreased compliance leading to lower functional residual capacity! The only difference is here you retain total lung capacity because it is a "reversible" compliance issue (give them surfactant) and the lungs themselves are not the issue. Also, like you said in your comment, lungs won't open up so there is a lower starting point for breathing, and thus a lower functional residual capacity (volume left in the lungs after normal expiration). +4  
chaosawaits  So if FRC decreases, TLC decreases as well, which rules out E +1  

submitted by geekymle(10),
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aufSrntcat cniecdeify β†’ no rtncuedoi fo oallarev fusrace ontsein β†’ ecdrdeu pnmoyralu ifgdnloun β†’ sugnl onwt poen pu β†’ esceddear glnu ccnmoileap nad ntinclfuao iladesru cpticaya β†’ aeyoxiphm nad yaicnhrppae

tihs dhsolu lpeh

submitted by step12395(0),
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dcuol noeemos aleesp axielpn hyw inrescdae ctatis gnul enpcamoicl is gnorw

an_improved_me  Increased compliance indicates an increased ability to maintain a certain volume at lower pressures. In other words, at equilibrium (static), the lung can hold volume at lower pressures. This is the oppisite of what would happen if physiologic levels of surfactant cannot be produced, since elastic recoil goes up (compliance goes down). In this case, certain volumes of fluid would correspond to higher pressures. +2  

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