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Welcome to anechakfspb’s page.
Contributor score: 2


Comments ...

 +0  (nbme23#42)

Why couldn't it be inhibition of gastric muscarinic (M1) receptors? Wouldn't that be the most effective overall?


 +0  (nbme23#15)

In the question they also don't say whether the antibiotic is administered IV or orally. For an IV dose, F = 100%. For an oral dose, F is typically <100% (FA 2019 p. 233). Based on this, IV maintenance dose would be 25.92 mg/kg/day. However, it is possible that the antibiotic is being given orally and F is closer to 90% (just an example). If this is true, the maintenance dose would be 25.92/0.90 = 28.8. This is obviously based on assumptions, but hopefully another way to explain why the answer is not exactly 25.92.


 +0  (nbme23#25)

Also you can extrapolate that the fibers causing his pain have already crossed over because this is a cervical spine section, and the pain he's having is thoracic/lumbar

Here's a picture that really helped: https://www.google.com/search?q=cervical+vs+thoracic+vs+lumbar+spinal+cord+slices&rlz=1C1CHBF_enUS801US801&sxsrf=ALeKk003suIj4Gt8w_cxQguy33bsJi7w3g:1590347215846&source=lnms&tbm=isch&sa=X&ved=2ahUKEwjSqfqGmc3pAhXldN8KHUIlDYoQ_AUoAXoECA0QAw&biw=1280&bih=864#imgrc=EMrFYHUe8M5ReM


 +1  (nbme22#43)

Why couldn't it be retroperitoneal idiopathic fibrosis?





Subcomments ...

submitted by chris07(43),
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Bde ugsb tesemvhsel aer tno onkwn ot be cirreasr of nsi,slle tbu yeht cna velae tiych sbit.e heT gilr is kyllei ot accrths sehte bs,tie aebadr the snki, dna usht iascrene hte skir of a hatsp inks inintfoce s(ncei thsap eusaur si the omts ocmnom knis centiinfo penohg)at

mcl  Oh! The article I found said that MRSA has been shown to colonize the saliva of bed bugs for up to like 15 days, and that they isolated MRSA from several specimens. Is it just more likely that the patient scratches it in since staph is e v e r y w h e r e ? +6  
chris07  I mean it’s possible. The last review course I took said that it wasn’t associated with anything. It may be, but either way...same answer :) +1  
frijoles  So bedbugs can't transmit HIV. Cool. #whatareyou #anidiotsandwich +8  
anechakfspb  @frijoles - Hey if it makes you feel any better I put HIV too, with my reasoning being that they feed on blood...and HIV is transmitted via bodily fluids. Whoops! +  


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idD onynae lees og nodw :eht s'seh teihveponys so meayb lhs'el etg raoehseutw ichrenriefsd sryneomd eecasbu onnhtig lese si gmnkia sense ot me ta tshi p??ont?i teoru -

nTrsu o,ut eeserv raialma nac auesc cavoraucrialds lpelcaso dna tionpeyso.hn

redvelvet  me too :( +1  
abigail  me three :( +1  
yex  Me four :-/ +1  
link981  Slowly raising my hand as well +1  
tinydoc  Sammmme +1  
bullshitusmle  same here!!!:@ +1  
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +5  
aisel1787  me five( +  
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +  
alexxxx30  sammmeeeee +  
snripper  Dumbasses unite lmao +  
usmleaspirant2020  lol saaaaame! +  
usmleaspirant2020  lol saaaaame! +  
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +  


submitted by hello(255),
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iteatPn onacnnt eextdn r,iswt hihcw si eedavnritn yb draila veenr

tnaetPi has eenb no uhrcce,ts whhic ldowu afefct rxiylaal vneer -gt;-& tihs sffatce iotddle uescm,l iwchh edos rma abiuctodn 0011-º5 (so ti can mynrolla voem rma aoebv erlho)dus

The lyno tlaocnio in eth ievng madagir ot teecff lla of teshe enrevs uwdlo be ltonaico ""C

t:oeN yal,lnomr arm ovementm bveoa eth hlartonoiz is ostcidaase hwit tsareurs eoartrin mclugesnl/o irchatco .evenr Hvroee,w enon of het agdirma isoacotln aollw for icslninuo of A.LTS einSc the tapneit ahs eebn on chesturc fro e,kews it sgustsge lalyaxir nerve eoennvilmvt ;t&g-- teloddi is fdetcafe

kevin  saturday night palsy is radial nerve; only hint for axillary was arm abduction +  
anechakfspb  The crutches would affect the radial nerve (FA p440). +  


I was duped; did anybody here get it wrong because they thought about the thyroid ima artery arising from the brachiocephalic trunk? No? Just me? Okay.

peridot  Ooh that is tricky tricky. In the question stem they said they already ligated that one ("a branch of the brachiocephalic trunk") and were wondering what else needs to be ligated in addition to that. Therefore the answer is the superior thyroid artery, which is coming from the external carotid. I don't think I knew any of this when I did the question though, cause I had to google all this just now. +1  
anechakfspb  In the stem they said they ligated a branch of the thyrocervical trunk, not the brachiocephalic. According to Wiki, the thyroid ima artery (which does arise from the brachiocephalic trunk) is only present in about 3-10% of the population. Therefore, while technically this answer could be correct, external carotid is "more correct". Source: https://en.wikipedia.org/wiki/Thyroid_ima_artery +1