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NBME 21 Answers

nbme21/Block 1/Question#49 (reveal difficulty score)
An 80-year-old woman comes to the emergency ...
Hydrochlorothiazide ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ
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 +38 
submitted by โˆ—xxabi(277),
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eadL temi sbai si seuacd by eylra tdectieon ebgin ucnsodfe itwh rcdanseie lsva.uvri alery itoenedct skmea it esme sa hougth ialvsurv sha cee,rsadni utb eth auanrlt yiorsth of the isaesed hsa nto nbee .aitdcepm


 +29 
submitted by โˆ—hungrybox(1171),
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Hooihczytralorhdedi si a teziihda uerictdi t&=;g dihtezia suriiedct are sctedsaiao thwi olemhai.aypk

Wtah erhto rieucistd are daecatoiss tiwh he?ayklpomai opLo ceidurist.

y?Wh

bitinhoinI fo aN+ rsatrnbioeop cosucr ni obth lopo eictduisr ibniit(h CKNC cnrptroa)oters adn iheidtza reiusdtic int(ihbi lCNa oernttrsrr)ac.op lAl of tish cedarines aN+ essnrecai trnoeleAosd cittyav.i

velRenta ot sthi plmrbe,o roAleodsnet ualegtspuer esirnexsop fo teh K++aN/ ATP tinpaorter robbs(are Na+ noit obyd, eelpx +K tion )num.el Thsi usslert ni miakpehloya ni teh ob.dy

agnH o,n ester'h mero hhgi ieldy n!oif

oreltnesodA oesd oen etrho nitrompat hnigt - titocnaiav fo a H+ lecannh hatt eelxsp +H into het lmnue.

oS, vnieg ahtt tsih tptnaei has iekhyal,poma oyu knwo ereth is lguoranitupe of Asr.dtooneel Do ouy nktih ehr pH owuld be ,gihh or ?wlo xcyEa,tl ti wludo eb hhig cseabeu i.cn dArelootsen g=&;t n.ci H+ ldlepxee oitn het numel =;tg& ctamboiel ioass.kal

Now uyo naenudsrtd hyw hbot polo cisuretid and diheztia dsireiuct nac uscae 'washt cdllea "yclmpihakeo eblomcati i."skaoalls

hungrybox  jesus this answer was probably too long i'm sorry +9  
meningitis  I disagree. It's the complete thought process needed for many Thiazide/Loop question that can be thrown. Thanks. +15  
amirmullick3  This is what NBME should be providing with each question's correct answer! Thanks hungrybox! +1  
amirmullick3  @hungrybox did you mean "All of this DECREASED Na increases aldosterone activity."? +1  
pg32  Anyone care to explain why she feels she has, "lost [her] pep"? Is that due to the hypokalemia? Or hypercalcemia caused by the thiazides? +  
cmun777  @madojo @pg32 I assumed between her hypokalemia (which can cause weakness/fatigue) and possible contraction alkalosis those were the most likely causes for the "lost her pep" comment. I think if they wanted to indicate hypercalcemia to differentiate if loop diuretics were also in the answer choices they would certainly give more context for hypercalcemia sx +  



 +8 
submitted by usmlewarrior(8),
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If hbot ZCTH nda oolp tucisdire reew vropdeid as an rnasew hocic,e rurfthe uelc hatt zhct oulwd eb eht rsneaw ochcei si eth neaoitsrepnt of eth iantetp eenlgif" yn"fnu. hsiT tugsesgs lcmreicpayeah (htascirycpi tneesor)vo hwchi is a edsi tfcefe uueinq ot C.HZT

adong  there wasn't any loop diuretics... +  
the_enigma28  Good explanation!! +  



 +3 
submitted by โˆ—neonem(599),
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dhaieizT duirescti aer het scsal hiwt het rsgetla rsik of yipoak.elamh




 +1 
submitted by โˆ—the_enigma28(59),
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aCn nynoea anxlpei wtah oesd to"ls erh pe"p ?amnse

drdoom  `pep` actually comes from `pepper`; to `pepper` something (including a food dish!) is to make it more vigorous, to give it more kick, to vitalize it. so, to โ€œlose oneโ€™s pepโ€ is to lose oneโ€™s vitality, feel fatigued, feel lackluster, etc. https://www.etymonline.com/word/pep +1  



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