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Welcome to brethren_md’s page.
Contributor score: 87


Comments ...

 +2  (nbme24#18)
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Lrteala Meuralldy omdnyrSe aeWb()glelnr - see FA rfo ermo selatdi. smopymtS orf ihst rdyonmes match pu with what si gibne snperetde.


 +5  (nbme24#36)
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GeaBT-tF si na iotmnrpta asiobftblr otrwgh corfat. maoatPh h,2C pgae 0.2


 +7  (nbme24#23)
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tmVanii 2B1 is the dttscorira ni tsih qoitunse ceueabs it aslo sescau a ,rdosbbea-ad acitxa igta dna edsraece ni tovbrn.iia tBu - anmiVit 2B1 will ton vhea mytsosmp elki tHclmeioy Ameina sre(daeecd ioegmlhn,ob eieadsrnc .HDL) timnVai E = raewns, ees eolbw ofr nnlaaix.toep

gonyyong  Also the MCV was normal, not megaloblastic like you would see in B12 deficiency +8

 +7  (nbme24#2)
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Clissac seepl epana ni the tiat.npe natsioCes of gbnerhati suasce lntrncuao pxioyha adn stymecis oeuhhrdaptrsnesytnihey//nmricd htdae can pisret.s aP2O is armnlo guindr yad dan eecdadesr idgrnu eipeodss dan at hntg.i icClalalsys nees in esObe itpnseta uchs sa eht pitneta ni het euonqsti .semt

tinydoc  Caused a cessation of breathing rather than a ↓ in lung volume although a patient could develop an obesity related restrictive lung disease thats not whats happening with this question. +2
sunshinesweetheart  p 665 FA 2019 +
syringomyelia1  p 679 FA2020 +

 +24  (nbme24#40)
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eaMk a nuttepn qeasur iwth a srsoc fo B +B nad B 0;B +B rtssenerep 0%5 cufntnio iwelh B0 rresseeptn %0 un(l)l uitcn.onf oS ni tish es,ac het uanshdb wlduo evah a B 0B neyotpeg leiwh hte feiw has a B B+ eptgoye.n

rossC of thsee two illw etrslu in teh wnlgioofl tpoysneg;e B,B 0,BB ,+BB B+B0 BB = 100% icn,tnfou +BB = 75% ,incftnuo 0BB = %05 nno,ciutf BB+0 = 2%5 tuoicnfn

oS the rweans illw be 1 ni 4 vhea a 5%2 ofiuctnn gvein het otegy.psne

tyrionwill  how about the choice of D: 1 in 4 have 50% function, which is true. shall 50% function needs transfusion? +
tyrionwill  In FA, it defines beta thalassemia into minor (HbA2 >3.5%) and major (both HbF and HbA2 go further up), and the major needs transfusion frequently. How can we take this classification based upon quantitive way like in this question? how much percentage of function left does not need a frequent transfusion? +
azibird  D says one in TWO, not one in FOUR. +2
hemehero  Is there a way to know that B+B0 will = 25% function. I was stuck between 25% function and 10% function, but couldn't figure out how to reason between the two of them. +
neil_simmons  The question says the mother has a mutation known to cause 50% decrease in beta-globin gene function of one allele. So if one allele is working at 50% (B+) and the other allele is working at 0% (B0), then that would mean that particular set of alleles would function at 25%. +

 +8  (nbme24#6)
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aosrta-fldenneTisru tueac guln rjiynu )AITL(R is a aerr btu ouisesr ysmnrdeo ehitracdcarez yb ddnsue eatcu setyarprrio ssedrtis olwonglif ofartns.suin It si ddifene as n,ew ecuta lgnu uyrinj (ALI) unigdr ro hnwtii ixs sorhu fraet lbood tpcudor atsinmriantido ni the necabes fo eedlsryactsm-oaapitlo kris cfastro rof I.AL

drschmoctor  Neutrophils sequestered in recipient lung are triggered by donor antigen (e.g., anti leukocyte IgG), which causes release of cytokines, inflammation party in the lungs. +4

 +6  (nbme24#35)
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iStdup siuo,nqet lysnehto sujt aetk ryou etbs esgsu adn mevo on .llo

seagull  β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–ˆβ–€β–€β–‘β–‘β–ˆβ–‘β–‘β–‘β–‘β–‘β–‘ β–‘β–‘β–‘β–‘β–‘β–‘β–„β–€β–€β–€β–€β–‘β–‘β–‘β–‘β–‘β–ˆβ–„β–„β–‘β–‘β–‘β–‘ β–‘β–‘β–‘β–‘β–‘β–‘β–ˆβ–‘β–ˆβ–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–β–‘β–‘β–‘ ░░░░░░▐▐░░░░░░░░░▄░▐░░░ β–‘β–‘β–‘β–‘β–‘β–‘β–ˆβ–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–„β–€β–€β–‘β–β–‘β–‘β–‘ ░░░░▄▀░░░░░░░░▐░▄▄▀░░░░ β–‘β–‘β–„β–€β–‘β–‘β–‘β–β–‘β–‘β–‘β–‘β–‘β–ˆβ–„β–€β–‘β–β–‘β–‘β–‘β–‘β–‘ β–‘β–‘β–ˆβ–‘β–‘β–‘β–β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–„β–‘β–ˆβ–‘β–‘β–‘β–‘β–‘ β–‘β–‘β–‘β–ˆβ–„β–‘β–‘β–€β–„β–‘β–‘β–‘β–‘β–„β–€β–β–‘β–ˆβ–‘β–‘β–‘β–‘β–‘ β–‘β–‘β–‘β–ˆβ–β–€β–€β–€β–‘β–€β–€β–€β–€β–‘β–‘β–β–‘β–ˆβ–‘β–‘β–‘β–‘β–‘ β–‘β–‘β–β–ˆβ–β–„β–‘β–‘β–€β–‘β–‘β–‘β–‘β–‘β–‘β–β–‘β–ˆβ–„β–„β–‘β–‘β–‘ ░░░▀▀▄░░░░░░░░▄▐▄▄▄▀░░░ THis Question β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘β–‘ +2

 +9  (nbme24#46)
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rmtou of inlePa aGndl o)mlei(naaP ussace uraandPi dnoSyemr ieat(lvcr geaz plys)a

neonem  Due to compression of the superior colliculus in the tectum, I believe +8
wowo  FA2019 p516 +3
misterdoctor69  FA2020 p528 +1
qiss  tectum as in the superior colliculus +

 +8  (nbme24#9)
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eharoOccnc sluvVlou vai mefale byallkf.c kBcla f,iels cbakl nsik ndes,luo blk"ca sigh"t kaa( slsn)d.ieBn nitQusoe stem rhee sdsrecibe eth ckbla nsloeud enes ni Ooa.nccchre

linwanrun1357  There is no black in the stem~~!! +4
misterdoctor69  nodules can be hypo or hyperpigmented supposedly! +1

 +1  (nbme24#6)
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inorchC snrctiMeee Iecmahsi aak nslinittea nng.aia nMia suecl rea ialogstnprap ragcistpie ,anip thwgie .ossl ayslUlu eud to lCeaic )(,a ,SAM ro AIM retsa.ishrsecloo

neonem  What's tough about these answer choices though is that you have 2 different viable combos. +
codyluvr95  The ectatic aorta might also mean AAA below the renals, affecting the IMA, +2
sherry  Also since there is this ectatic aorta, the arteries involved need to be adjacent to one another. If there is a choice as in celiac and SMA, it could also be correct. +

 +1  (nbme24#3)
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qseueirR onwigkn ohw to lcatuaelc na noina pga - kolo ti u.p nI siht ,aesc it si a anlmro oanin agp meaoilbtc oiacdss.i wnKo eth uncmnomies LUIEDSPM and .HSASARD elanR lTbauur icidsosa is teh lony wranse ehiocc thta is na lxemape of a lmorna nonai cmbteliao iicod.ass

mousie  Anion Gap: Na - (Cl + HCO3) = normally around 10-12 +2
seagull  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. +56
_yeetmasterflex  glad I wasn't the only one who got very pissed off at the urine values +4
fulminant_life  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 +6
henoch schonlein  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 +17
270onstep1  Actually diarrhea is the "D" in "HARDASS"(reason why I was stuck between Chron's and RTA). Ended up getting it right with RTA.. +1
talha_s  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 +7




Subcomments ...

submitted by neonem(549),
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tsuJ ahd to kown ahtt TsRNI ascce(yiipllf eht oe)uisclnsde uesac tcaicl dsiscaoi

brethren_md  Also NRTIs are hepatotoxic, cause the increased liver enzymes seen in the patient. +5  
sherry  Actually, NNRTIs are more well-known for hepatotoxicity. But I guess NRTIs is the next best option for this one. +10  


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The earwsn is olrpfeyahixe aecbsue eth fnreatfe car of the lucesm thsrcet lexrfe sha to og grhuhto the laodrs raim nda osladr toro linag.ga mDub ueoit,qsn I ,wokn tbu s’it het ynol arsnew atht mead n.esse If uoy tuhr teh ,GRD you ton nyol leos teafefrn oatsimc seyonrs fbrs,ie you salo seol eth nrsyeso oibeds ivdolnev ni eht svourai re.sfxele

oYu anc salo etg elepaxrohify orfm imgngdaa het enrtefef ennsoru ttah ntieanerv hte leucsm (eilk a LM)N, tub as ouy wnko thees ear in eth itreaorn nrho nda nvatrel i.mra

ankistruggles  Thanks! I agree with you. +  
brethren_md  Great explanation. +  
gonyyong  Agreed - I think I got this by thinking about tabes dorsalis (syphillis) and why it has hyporeflexia is due to dorsal root damage +6  
duat98  I'm confused about why it wouldn't cause muscle atrophy. Isn't that a fever of LMN damage? +4  
charcot_bouchard  Muscle atrophy wont occur because alpha motor neuron is intact. Motor control of Corticospinal tract on this is intact. so no atrophy. u can move shiti/ But remeber muscle spindle that is responsible for INITIATING stretach reflex send Ia fibre to DRG from where it synapse with Alpha motor neuron. if DRG is damage ur muscle is fine but u cant initiate strech reflex. areflexia +3  


submitted by medstruggle(12),
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Why si ti not iarnvao ilfocell el?scl I ouhtght het meaelf gonala fo trioeSl nad ygiedL is htaaaslueg/onrc slcel.

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +6  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +36  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +17  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +