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NBME 21 Answers

nbme21/Block 3/Question#33 (reveal difficulty score)
Left radial arterial and venous blood samples ...
HCO3βˆ’ transported in the plasma πŸ” / πŸ“Ί / 🌳

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submitted by βˆ—haliburton(222),
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dPraer iliWl = rPalaten neeldtio ralita(p or )fu.ll eodNt rof imtni.pnrgi iusCon to Aeannnlgm t(eopposi ilodnte.)e

AF 201:7 2%5 of asces deu to mnatrlae teianpnrlau oidyms to(w ayermlnlta dreitpnmi sgnee era ;rcvdeeie no tanarlpe geen cve)dreie.

submitted by βˆ—hayayah(1145),
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hte trjoamyi fo nbacro ioiedxd llucesmoe rea eirdrac sa aptr fo teh tenibcrboaa ferbuf stesmy. nI hsit emsyts, ncroab eddoiix edfifuss otin the .CRsB arincCbo shneaydar C)(A inhitw BRCs lcyiqku coventrs het acnbor xoiddei ntoi aocrinbc cida 2(C)H.O3 canobCir dcai si na bnelaust eetridiatmen llumocee tath ytmieelmdia eocssdatisi toin iaocnabebrt nsoi )O(3C-H and yrongedh +)(H o.sin

hTe yenwl shezytdsine rcbaeatbnoi nio si dpetsoarrtn otu fo hte RCB niot eth aapmsl in chxgeena rfo a odeilchr nio C)l;βˆ’( itsh si dalcle eht edrhiolc s.ihft nWeh eht lobod eserahc teh uslng, the brtacbaeino ion si rsdoetrtapn bcka oitn hte CRB in egcnheax for teh odicelrh n.oi eTh H+ noi iisecdtasso rfmo eht blomnhegio dan nsdbi to het onbcbtraaei ihsT peosrucd hte ocnbicra caid t,mitireaneed ihhcw si evdoncter cabk ntoi rbnaco oddexii urhotgh het ntmyizeac atncio fo C.A The oacbnr dxoiied dudcepro is xdeelple horuhtg eth ngslu iurgdn haet.xnalio

hungrybox  Amazing explanation. Thank you!! +2  
namira  in case anyone wants to visualize things... +6  
ergogenic22  CO2 is carried in the blood is bound to hemoglobin, known as carbaminohemoglobin (HbCO2) (5%), dissolved CO2 (5%), bicarb is 90% +5  
pg32  Nice explanation, but can anyone clarify how we know from the question that we are measuring HCO3 rather than dissolved CO2? +3  
qball  @pg32 This question is asking about what accounts for the LARGER amount of co2 and the HCO3 buffer is about 85% of this transport and dissolved C02 is about 5-7%. +3  
teepot123  fa 19 pg 656 +2  
surfergirl  "majority of blood CO2 is carried as HCO3- in the plasma." I guess that is all they're testing us on, just in a very convoluted way. +  

submitted by βˆ—mcdumbass(25),
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I thotugh hhgttuo mgaeusnri a asg in het loodb lnyo emuasrse paarlti uersrpse fo vdidossle gas in the oolbd

schistosite  Yeah, me too...the fact that they expect us to assume that HCO3- is counted in their measurement for CO2 concentration is absolutely absurd. +3  
happyhib_  they tell you measured is around 24 and 22 or some bs but give "mM"; if you look at the lab sheet HCO3 has a units in mM and normal is 22-28 = they are not just looking at partial pressure's. +2  
an_improved_me  Yea,.. Suprisingly in clinic, when you are measuring important parameters in the blood (think fish-bone diagram), you actually use HCO3- as an approximation for CO2 in the blood (so you use the value in CO2 when calculating like the anion gap or something) +1  

submitted by mafoo_xtreme(12),
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For s'RB:S

At het :lnug Cl- tuo, 3HO-C ni

At hte tsei:ssu Cl- ,in 3CO-H tuo

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