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Welcome to boostcap23’s page.
Contributor score: 26

Comments ...

 +0  (nbme24#48)

This mentioned anywhere in FA or other board prep resources or just supposed to be common knowledge lol?

 +0  (nbme24#25)

I knew about acral lentigious melanoma in African American's but because I learned that it has nothing to do with UV exposure I didn't pick it and went with forehead.. Why did they talk about how he goes on a boat every weekend and doesn't use sunscreen if they just wanted us to know that African American = Acral Lentigious :( maybe I'm just dumb

mamast16  did the same, maybe we're both dumb :( +

 +4  (nbme24#31)

Even if you didn't know anything about the gene mentioned they tell you the PROTEIN serves as a precursor for making the hormones thus it has already undergone translation and the only choice that makes sense is Post-translational modification. Additionally, mRNA means it has already undergone splicing and post-transcriptional modification as it would be called hnRNA otherwise. (FA2020 pg 41)

 +1  (nbme24#43)

Doxorubicin = Cardiac problems Bleomycin = Pulmonary problems One hint to tell that it's cardiac and not pulmonary is the BILATERAL crackles/effusions since blood is backing up it would affect both lungs while Bleomycin could present as unilateral. Main though thing is the S3 which makes it automatically cardiac-related (dilated cardiomyopathy) and not pulmonary so the answer is doxorubicin.

Subcomments ...

submitted by catch-22(67),
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sherry  I agree. I was hesitating between the two choices. I still think cohort study is better regarding the "risk". I hope this kind of questions wont pop out on the real thing. +1  
soph  I think key here was they were measuring risk though +  
yex  I also chose cohort, since it is comparing a given exposure. +  
raspberryslushy  I was also thinking retrospective cohort study - just as time efficient, can look at risk, and the Q stem said the cancer was common, and I think of case-control for rare conditions. It's like they forgot a cohort study could be retrospective. +1  
boostcap23  The classic example they always give for why not to do retrospective cohort is because patients who have whatever disease your testing for are more likely to remember all their risk factor exposures than a normal person that doesn't have any disease. Of course in this case I'm sure the people running the study would be the ones who figure out how much arsenic was in the water but this also would be very time consuming to figure out for each individual person in the study. Thus a case-control study where you look at a group of people with >50 arsenic exposure and a group <5 arsenic exposure and simply see who has cancer and who doesn't would be easier and take less time. +  

submitted by neonem(527),
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medskool123  i get why its borderline now (I guess I kind of always thought suicide was the biggest part of that) but can someone tell me why its not paranoid? Is it just a matter of the "better" choice? The "youre the only one i can trust" thing lead me to that. +1  
drmomo  same here +  
aneurysmclip  Paranoid is where they don't trust anyone or are weary of people. because she said she trusts only the physician can be a bit confusing, but she describes her coworkers as jerks, not that "oh they're out to kill me, they're government agents watching me" +  
boostcap23  Splitting association with borderline in FA 2020 pg 555 and 565 +1  

submitted by seagull(1166),
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I tthhugo tsih asw a ptye 1 TRA utb I aws wn.gor yAn ssgi?tsngeuo

seagull  It looks like it was a type II RTA. The difference is incredibly subtle from the info given in this question. +9  
gonyyong  He has Fanconi syndrome which is generalized reabsorption defect in PCT which leads to metabolic acidosis and hypophosphatemia → can lead to rickets Also, does lead to type II RTA +14  
duat98  Also the proximal tubule is the place with the highest phosphate absorption rate. That's why PTH works here mostly and a little bit in the distal tubule. +5  
boostcap23  Another easy way to go about this one is the question tells you he has metabolic acidosis, the only that can happen with is Fanconi/Type2 RTA. The rest will cause hypokalemia and metabolic ALKALOSIS. (pg 586 FA) Personally thought if they were going for Fanconi syndrome they would describe a lot more symptoms for the kid like growth failure or hypophosphatemic rickets but its NBME so. +1  

submitted by azibird(92),

Why are there lots of RBCs but few RBC casts? That made me think about a post tubule process.

boostcap23  Any amount of RBC casts is an abnormality and indicates tubular pathology. Normally should have none. Just like how even a single neutrophil in CSF is abnormal. +1  

submitted by diplococci(1),

I was confused because UW 19280 says pulmonary artery systolic pressure will be increased to maintain forward movement of blood. How does this not lead to pulmonary vascular resistance being increased?

boostcap23  Pressure doesn't necessarily equal increased vascular resistance. Pulmonary resistance regulation mainly increases in areas of hypoxia, and decreases in well-oxygenated area's to send blood to well ventilated areas, nothing to do with an acute MI. In fact in MI there is vasodilation of apical capillaries and the V/Q ratio will approach 1 to accommodate the extra blood. In this patient, you can see his systemic blood pressure is low yet his systemic vascular resistance is high (due to sympathetic constriction of vessels in response to low CO). I just thought of it like how in normal resting state ventilation is wasted at the apex so in a volume overloaded state that extra blood could go up to the apex. +1  

submitted by russnels(3),

Why would this not be ABO incompatibility? Is Rh incompatibility just more common?

boostcap23  Yes for newborns specifically Rh incompatibility is more likely and also much more severe (see pg 405 FA 2020). ABO incompatibility would produce only mild jaundice and is actually quite common. +1  
mguan1993  in addition i took the description of baby being edematous to mean hydrops fetalis, which Rh incompatability is associated with +  

submitted by 123ojm(7),

Specifically didn't choose coronavirus due to the evidence that COVID-19 is spread fecal-orally. How does it get through the GI tract if it's inactivated by pH < 6? Can someone explain why my thinking is wrong?

hello  ...COVID-19 is transmitted via respiratory droplets. +2  
123ojm  Right but some research has come out saying it's also spread fecal-orally. So I'm wondering what I'm missing in this question. +  
tyrionwill  Don't trust US CDC in this pandemic. They always downplayed the truth. Cronavirus does spread mainly by droplets, when they drop, they contaminate the surface, then fecal-oral could be a second pathway. Wearing mask, social distancing are both to prevent a droplet. +  
boostcap23  I thought covid used to be low yield when this test was made and they didn't mention helical so I didn't pick it smh I'm an idiot. +1  

submitted by tbarbacc95(-1),

Anyone else think that B was on the proximal straight tubule?

actinickeratosis  yurp +6  
boostcap23  Yupp :( +1  

So does someone know what is phase 0 for? It was an option... somathing like "let me see if i can study this thing?"

cheesetouch  via google - A Phase 0 study gives no data on safety or efficacy, being by definition a dose too low to cause any therapeutic effect. Drug development companies carry out Phase 0 studies to rank drug candidates in order to decide which has the best pharmacokinetic parameters in humans to take forward into further development. +  
boostcap23  Phase 0 is an extremely small dose (1% of normal) given to easily rule out any harmful effects. Basically used as a quick way to eliminate further trails/research on drugs that don't work. +1