Always be kind! Spending a few extra minutes will make him feel better, solidify your relationship, and not really waste too much of your time. She passed away on this same day, he must be very sad and having someone to talk to can change everything.

AR disease. She's got all the symptoms, she must have both defective genes. Genetic testing for the 36 most common mutations shows a detectable mutation (G551D) in one allele of the CFTR gene. What about the 2nd gene... we KNOW she has the disease. It wasn't detected.

Patient had Cushing disease. Basically had to work out what high cortisol does. All 5 options had 1 thing that was wrong, and 1 that right.

(A) Hyperkalemia and numerous bruises

(B) Hypertension and muscle weakness

(C) Hypocalcemia and hyperglycemia

(D) Hypoglycemia and fat pads between the scapulae

(E) Jaundice and thinning of the skin

D was wrong because it causes hyperglycaemia. E was wrong becasue there's no jaundice associated with high cortisol. Opted to not go for A or B, as I wasn't sure about the electrolyte issues related with cortisol.

Patient had ALS. Combination of UMNL + LMNL --> only answer option that had anything to do with these was atrophy (LMNL). Also, remember that their MCC of death is due to respiratory/ diphragmatic failure!

Alpha (I Error) -- Confidence Interval

Beta (II Error) -- Power

Values have an inverse relationship with each other

"pink, soft, granular, edematous wound" describes granulation tissue, which appears around day 3 and last several weeks. At this time, there is also an abundance of fibroblasts, endothelial cells (which contribute to angiogenesis with up regulation of VEGF) and macrophages as well as keratinocytes.

The infraorbital nerve is a major branch and is the termination of V2. Fractures at the infraorbital region can damage the inferior rectus and the V2 branch, which supplies sensation beneath the eye and till the upper lip.

Next time your attending asks you your top differential for a 2nd trimester pregnant female coming in with severe acute bleeding, say "cervical cancer" and when they question you, flash this question at them as the source. Ah, NBME really prepares us for the real world.

History and image are a type 4 HSR. This is T cell induced. Cd40L --> Cd40 is T cell --> B cell CD28 (on T cell) --> binds to APC's (including Langerhans cells); CD80/ 86/ B7

Options with ICAM, I immediately crossed out because they're associated with margination and rolling, etc. CD45 isn't mentioned in regards to T cells (or anywhere I might add). Leaving us with the 2 options I mentioned above ^

FA 2020 pg 399

misoprostol clinical use - prevention of NSAID induced peptic ulcers

MOA: PGE1 analog in effect causes decrease acid production and increase secretion of gastric mucous barrier.

FA 2020 ,pg 195 Metronidazole MECHANISM Forms toxic free radical metabolites in the bacterial cell that damage DNA. Bactericidal, antiprotozoal.

pg 251 Disulfiram-like reaction 1st-generation Sulfonylureas, Procarbazine,certain Cephalosporins, Griseofulvin, Metronidazole

acetaldehyde accumulates in disulfiram as acetaldehyde dehydrogenase is blocked

PG 353 Biguanides Metformin ADVERSE effect GI upset, lactic acidosis (use with caution in renal insufficiency) clue "sx began after drinking champagne -an alcohol"

pg 610 lisinopril adverse effects: Cough, Angioedema (both due to  bradykinin; contraindicated in C1 esterase inhibitor deficiency), Teratogen (fetal renal malformations), increase Creatinine (dec. GFR), Hyperkalemia, and Hypotension. good thing HCTZ is not on the option pg 609 hydrochlorothiazide adverse effects: Hypokalemic metabolic alkalosis- can have nausea and vomiting, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia. Sulfa allergy

FA 2020 PG 258

Absolute risk reduction BY DEFINITION : The difference in risk (not the proportion) attributable to the intervention as compared to a control.

ARR = (c/c + d ) - ( a/ a + b )

I assumed c+d as 50 for azithromycin and a+b as 50 for erythromycin

= 15/50- 5/50 = .3 -.1 = .2

in FA the example is If 8% of people who receive a placebo vaccine develop the flu vs 2% of people who receive a flu vaccine, then ARR = 8%–2% = 6% = 0.06.

Overthinking screwed me. The question stem asks for a chance for a sister to get the same alleles, not that she is homozygous with them. So I picked 75% instead of 25%. At the top of it, they put 2D6*4(I thought that means that pt. has 4 copies of alleles(two from each parent like HLA). They have to make questions impossible to understand.

FA 2020 PG 212 Common in normal aging increase risk of atrial fibrillation where there's possible Isolated atrial amyloidosis where ANP is fibril protein --)

pg 511 FA 2020

DORSAL Midbrain lesion consequence: Parinaud syndrome—vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

seen in Stroke, hydrocephalus, pinealoma --- present in patient

FA 2020 pg 647 states:

Sertoli-Leydig cell tumor - May produce androgens Ž virilization (eg, hirsutism, male pattern baldness, clitoral enlargement)

Granulosa cell tumor presents with postmenopausal bleeding, endometrial hyperplasia, sexual precocity (in preadolescents), breast tenderness.

Thecoma - presents as abnormal uterine bleeding in a postmenopausal woman.

FA 2020 pg 351

Pancreatic islet cell tumors -- Glucagonoma PRESENTS WITH DVT tx: octreotide /surgical resection