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Can it be an X-linked disease if both females are affected and boy is not? I think unlikely
under Bortezomib, the proteasome cannot digest viral Ag and presents it to the membrane-bonded MHC-I. Therefore CD8-Tc cannot recognize the host cells containing relapsed VZV. That is probably why shingles is one of the popular side effect of Bortezomib.
low IgG in response to infection/vaccination leads to broad bacteria and virus infection or reactivation.
bacteria: strep pneumonia, Hib
virus: JC, HBV, CMV...
I don't think it's worded that weirdly. The guide wire should be advanced superiorly just beyond the testicular artery to approach the right renal artery.
this is the second explanation that makes sense to me that I see downvoted. if you see something wrong and downvote, please explain! I want to know what im missing
Maybe someone downvoted because in this question, there wasnt a mention of renal agenesis but rather urethral obstruction although that would lead to Potter sequence as well.
Just a side note, CYP2D6 is responsible for metabolism of cardiovascular drugs. The dirty mnemonic is that since a 2D Echo is used to image the heart, CYP2D6 metabolizes CV drugs.
Would like to add that the IA antiarrythmics = Quinidine, Disopyramide, Procainamide also prolong QT interval and can lead to tosades de Pointes and they would most likely present with Cinchonism (headache, tinnitus with
quinidine), reversible SLE-like syndrome
(procainamide), HF (disopyramide),
thrombocytopenia. The decreased HR and BP point towards Sotalol.
Im glad you can regurgitate sketchy but none of those drugs were options here. It's as simple as which of these can cause torsades.
just to add to the explanation above," cutaneous larva currens" is a specific finding for strongyloides. Also the picture they used is the exact same one on wikipedia lol
they really should add Wikipedia in the list of top-rated review resources with A+ level of recommendation in FA2020)))
also a side note:
cutaneous larva CURRENS is pathognomonic for strongyloides whereas
Cutaneous larva MIGRANS is for ancylostoma braziliense or nectar Americanus
FA 2019 pg 159 . Bendazoles because worms are bendy. (Treatment for roundworms)
Praziquantel is for Cysticercosis (Taenia Solium) and Diphyllobothrium Latum
Mefloquine : treats malaria
Hydroxycloroquine: treats Malaraia, also RA & Lupus (immunisuppresive & anti-parasite)
Dexamethasone: Steroid for inflammation
FA20 says Ivermectin OR Bendazoles for Strogyloides, so in a future question, if Ivermectin is listed, that could be the right answer for this as well.
FYI it's also in the Sketchy.
copper intrauterine devices are hormon free FA2017 page 622
they needed to specifiy. I eliminated IUD bc patient states no hormones.
The question doesnt make sense. IUDs are typically contraindicated in nullipara because of increased risk of expulsion and intractable abdominal pain, among other things such as perforation. The pt is 22, likely to be a nullipara. Why cant we prescribe a diaphragm instead which is a non hormonal method too, and remove the vaguity of hormonal vs non hormonal IUD? :/
in practice many nullparious women have IUDs. I think this question was seeing whether you knew that some forms of IUDs are non-hormonal and that the other methods are far less effective,
IUDs are definitely not contraindicated in nulliparous women.
I SCRATCHED OUT NEUROENDOCRINE FOR THE SAME REASON!
I SCRATCHED OUT NEUROENDOCRINE FOR THE SAME REASON!
They are talking about Kulchitsky cells = pulmonary neuroendocrine cells (PNEC). These are the cells from which NE tumors of the lung i.e. small cell ca arise from.
Inhalants intoxication causes disinhibition, euphoria, slurred speech,
disturbed gait, disorientation, drowsiness.
Withdrawl leads to irritability, dysphoria, sleep disturbance,
SCHIZOTYPAL = Included on the schizophrenia spectrum.
Pronounce schizO-TYPE-al: Odd-TYPE thoughts.
Bulimia comes from Greek "ravenous hunger"; the term is a literal concatenation of the words for ox (bous) + hunger (limos). So, in Greek, bou-limia is literally "ox hunger", which is a nod to how the word is used in medicine = perpetual and insatiable appetite for food (the very "opposite" of vomiting).
I agree with your reasoning but the classic case description of Bulima lists electrolyte disturbance of HypOkalemia, HypOchloremia, and Metabolic Alkalosis, along with other things like parotid hypertrophy and dorsal hand calluses due to the induced vomiting. I tripped up there. :/
FA 20 Pg 567
Take home lesson: reasoning > memorizing
And even if it was Wilson disease, it would have the exact same consequence leading to Fanconi syndrome.
Fanconi syndrome Generalized
reabsorption defect in
PCT = Increased excretion of
amino acids, glucose,
HCO 3 – , and PO 4 3– ,
and all substances
reabsorbed by the
May lead to
(eg, Wilson disease,
Polyuria, renal tubular acidosis type II, growth failure,
electrolyte imbalances, hypophosphatemic rickets =
Fanconi syndrome (multiple combined dysfunction of the
proximal convoluted tubule).
At birth, immature UDP-glucuronosyltransferase = unconjugated hyperbilirubinemia = jaundice/
kernicterus (deposition of unconjugated, lipid-soluble bilirubin in the brain, particularly basal
Occurs after first 24 hours of life and usually resolves without treatment in 1–2 weeks.
Treatment: phototherapy (non-UV) isomerizes unconjugated bilirubin to water-soluble form.
that was my reasoning as well. guess not.
Shitty NBME grammar strikes again.
No. No guys. Bundle of his located below AV node and it can generate impulse. it calls junction escape rhythm and narrow complex. Below this is purkinje, bundle branch & ventricular muscle. those are wide complex
The atria and ventricles beat independently of each other. P waves
and QRS complexes not rhythmically associated. Atrial rate >
ventricular rate. Usually treated with pacemaker. Can be caused
by Lym3 disease
Just in case anyone is wondering like I did, the low platelet count explains thethose multinucleated cells. They are Megakaryocytes in Bone Marrow Biopsy.
Also, don't forget that autoimmune thrombocytopenia purpura has 2 demographics: young kids, which generally resolves spontaneously fairly quickly, and then young adult females which is a true autoimmune condition that doesn't resolve. Patient's age + thrombocytopenia + essentially normal rest of heme pannel = autoimmune thrombocytopenia purprua in child.
That is exactly how I approached this question. Normal heme panel and a decreased Platelet count in a young boy after an infection just made me intuitively select ITP.
LOL. Achey Granpa Meynert. I'm gonna steal this from you.
Achey grandpa Meynert = ACh / Basal Nucleus of Meynert
Dope Cousin VT = Dopamine / Ventral tegmentum, SNc
Uncle and aunt Raphe and Sara = Serotonin / Raphe nuclei(medulla, pons)
Cousin Gabby always screaming NA-NA-NA = GABA / Nucleus Accumbens
Norepi = Locus ceruleus.
ACHey GRANDPA MEYNERT TREMBLES in the BASEment; DOPE cousin VT SNaCks DOWNstairs by the kitchen TAP; NANA GABBY ROCKS and ANXIOUSLY cooes...; "NENENENE... NENENENE...NENENE...NENE" to CRYING BLUE-eyed baby ELSIE; aunt SERO and uncle RAPHE DULLY PARK in the DOWNpour. CAPS = relevant info, lowercase = irrelevant. Includes diseases: DOWN, ANXIOUSLY, CRYING, DOWN = anxiety/depression; TREMBLES, TAP, ROCKS, PARK = movement disorder; GRANDPA = Alzheimer's. Note: ELSIE = LC = Locus ceruleus
The extended "NENE" series is just for humor - shorten if you like ;)
Also, ANXIOUSLY applies to both NTs in that sentence: GABA and NE.
I almost didn't even look at this review but then I thought "maybe someone has a cool mnemonic." and would you look at this.
Allergic contact dermatitis because of contact with poison ivy.
Urushiol-induced contact dermatitis (also called Toxicodendron dermatitis or Rhus dermatitis is a type of allergic contact dermatitis caused by the oil urushiol found in various plants, most notably species of the genus Toxicodendron: poison ivy, poison oak, poison sumac, and the Chinese lacquer tree.
Every morning: "I think i'll go over glycogen storage diseases, lysosomal storage diseases, and dyslipidemias after questions this afternoon."
Every afternoon: Nah
oh my god are you me
I recently found a program called Pixorize. It's pretty much Sketchy for biochem. Wish I discovered it sooner cuz it has helped for a lot of the painful things like this!
Cherry red spot basically means niemann-pick or tay sachs. Two differences between is:
1- No HSM in Tay Sachs, HSM in niemann-pick.
2- Both of them has muscle weakness but there is hyperreflexia in Tay Sachs, but areflexia in niemann pick disease.
In stem cell HSM is not described and hyperreflexia noted.
HSM - HepatoSplenoMegaly.
Cherry red spots think of
Tay Sachs, deficient enzyme - HeXosaminidase A, accumulated substrate GM2 ganglioside.
Niemann-Pick - Spingomyelinase, Spingomyelin <- which is not even a choice.
FA18 Pg 88
Dirty USMLE has an incredible video that makes these super easy to get.