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good work. I found this question annoying and gave up doing those considering the amount of time we are given.
Well just don’t include the intake year... because that messed me up..
How would we have known not to include the intake year? From average **annual** incidence?
Do not include intake year because the question stem is asking average annual incidence. The 4000 positives at intake could have acquired HIV whenever, not just in the last year.
literally didn't think there was an actual way to figure this out.
but my thought process was: okay incidence means NEW cases. so the annual average at the end of 5 years would be:
(# of NEW people that tested positive at the end of year 5) /
(# of people at that were at risk at the beginning of year 5) <--- aka at the end of year 4
250/5050 = 4.95%
also if you look at year 5: you'll see that the at risk population is 4800 when 300 new cases were found the year before. 5050 at the end of year 4 MINUS the 300 new cases at the end of year 4 should give you 4750 as the new population at risk. but notice that end of year 5 we have 4800. idk if that means 50 people were false positives before or 50 people were added but in incidence births/death/etc don't matter
it's kind of like UWORLD ID 1270. assuming average annual incidence is the same as cumulative incidence
this was just a bunch of word vomit. sorry if it was unbearable to follow
Anion Gap: Na - (Cl + HCO3) = normally around 10-12
good to know. I keep looking up the urine values but all it said was "varies", then I threw my computer and yelled "does that vary Mother F****ers. I do feel better now.
glad I wasn't the only one who got very pissed off at the urine values
Usually the first thing I look at is whether or not the Cl- is high. Generally if the Cl- is high its going to be a normal gap
i think they gave you the urine values bc you can calculate the URINE anion gap which is (Na + K - Cl). In this case the Urine Anion Gap is positive (5). Boards and Beyond mentions that a positive UAG is due to Renal Tubular Acidosis Type 1 (inability of alpha intercalated cells to secrete hydrogen ions). just another approach to answer this q
Actually diarrhea is the "D" in "HARDASS"(reason why I was stuck between Chron's and RTA). Ended up getting it right with RTA..
So the reason this is not Crohn's disease is actually what BnB explains in Renal Tubular acidosis video. Anytime there is a Metabolic Acidosis with intact kidney secretion of H+, the URINARY Anion gap (Na+K-Cl) is NEGATIVE. This is because the excess NH4 that is secreted into urine is combined with Cl-. Therefore, in Crohn's disease and Type 2 Renal Tubular Acidosis, the urinary anion gap is NEGATIVE.
In this question, the urinary anion gap is POSITIVE so this would be an example of Type 1 RTA because the kidney can not excrete H+.
I got it right by chance, definitely did not understand it in this much detail when I was answering it lol
Could the pneumothorax also cause less ventilation due to decreased lung surface, retaining more CO2 causing respiratory acidosis? That's how I got to the answer at least.
I think pneumothorax would increase RR because you're probably hypoxic. Also I'm sure when you have a lung collapse on you you'd be scared and that would trigger your sympathetic so your RR will go up either way.
there is no bilateral lung opacities as you would see in ARDS
Was thinking some sort of infection b/c of the atelectasis so picked empyema but this makes sense!
does it need to be ARDS to cause "diffuse alveolar damage"?
Also wouldn't mammography be secondary prevention since you'd look for asymptomatic disease already present?
USPSTF recommends starting screening at age 50. 40 by patient choice if there's risk factors.
@_yeetmasterflex thats a good point i didnt think about that