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 +2  (nbme23#9)

I thought of this as squamous cell carcinoma of the lung causing increased PTHrP and hypercalcemia.

d_holles  I thought this was medullary thyroid cancer but demographically SCC works better.
smc213  Medullary thyroid carcinoma increases calcitonin levels leading to decreased serum Ca2+ by increasing Ca2+ renal excretion. So high levels of calcitonin secreted by the tumor may lead to hypOcalcemia. Source: Pathoma

 +0  (nbme23#25)

The thing is, the spinothalamic tract crosses 2 vertebral levels up and then decussates at the anterior white commissure to get from the right to the left, so how do I know which vertebral level I'd be working on this guy?

chris07  I think the assumption here is that we are dealing with the cord section at the level of the problem. The picture is incredibly misleading. You have to orient yourself. The dorsal columns F, E, A, B are facing the patient's posterior. Once you properly orient it in 3D space, you know that what's labeled "right" is actually the patient's left, and what's labeled "left" is his right side. Super confusing.
sne  The input arises in a limb/part of body at the level of lesion, enters through the dorsal root (pictured between A and B), decussates and ascends at the anterior commissure, and finally synapses on the second order neuron in the lateral spinothalamic tract. So the spinothalamic tract is responsible for contralateral pain and temperature sensation. So AT THE LEVEL technically would be in the dorsal column
nwinkelmann  also, @chris07, I think you're wrong about the labels being wrong on the image. Becuase the spinothalamic tract = contralateral pain and temperature, and the patient's pain is on the right side, you would want to target the left spinothalamic tract for pain relief, i.e. the area labeled H. The area labeled D would be the right spinothalamic, purely because that is how the image is labeled. If you assume the label is different, you will get it wrong.

 +0  (nbme23#30)

So I got this one wrong because I thought that since he didn't have hepatosplenomegaly and ascites his liver was still fine, but I guess if he already has gynecomastia, hypogonadism and the ever obvious spider angiomata he's definitely still ok

Now that I think of it, you don't need hepatosplenomegaly to have alcoholic liver failure I believe.

bigbootycorgi  sorry my bad this was the wrong question i responded to but i still got this one (ED one) and the gynecomastia one wrong i think it's liver for this one because they say it has regenerative potential and because even though the small intestine has regenerative potential, it can apparently fibrose? i have no idea, i put small bowel
kateinwonderland  @bigbootycorgi : I put small intestine too. From what I've searched after, it says that liver fibrosis reversible -> no evidence of fibrous scarring
goodkarmaonly  Just to add to that, a cirrhotic liver is a small shrunken liver so you wont be able to find hepatomegaly anyways. The other signs are the stigmata of Liver disease




Subcomments ...

So I got this one wrong because I thought that since he didn't have hepatosplenomegaly and ascites his liver was still fine, but I guess if he already has gynecomastia, hypogonadism and the ever obvious spider angiomata he's definitely still ok

Now that I think of it, you don't need hepatosplenomegaly to have alcoholic liver failure I believe.

bigbootycorgi  sorry my bad this was the wrong question i responded to but i still got this one (ED one) and the gynecomastia one wrong i think it's liver for this one because they say it has regenerative potential and because even though the small intestine has regenerative potential, it can apparently fibrose? i have no idea, i put small bowel +  
kateinwonderland  @bigbootycorgi : I put small intestine too. From what I've searched after, it says that liver fibrosis reversible -> no evidence of fibrous scarring +  
goodkarmaonly  Just to add to that, a cirrhotic liver is a small shrunken liver so you wont be able to find hepatomegaly anyways. The other signs are the stigmata of Liver disease +