Welcome to bulgaine’s page.
Contributor score: 1
The image shows a staghorn calculi which content is usually magnesium ammonium phosphate (can also be cystine but pH would be decreased not increased) and is caused by urease positive bugs that hydrolyze urea to ammonia leading to urine alkalinization (page 586 of FA 2019)
Patient also has a fever, suggestive of a UTI
Why not calcium phosphate, also at high pH? I was between the two but decided on calcium phosphate because the images of staghorn I've seen seem to be more smooth and rounded. I guess should've gone more based on the pyelonephritis symptoms as well caused by the stone harboring bacteria.
FA 2019 does mention it P 149
"Lyme Disease caused by Borrelia Burgdorferi, which is transmitted by the ixodes deer tick (also vector for Anaplasma spp. and protozoa babesia)."
FA 2019, Pg 146
100/120 = 83% roughly 80%
Not sure what lfsuarez and seagull above mean. Here is my explanation.
Specificity = TN/(TN+FP). This test gave 20 false positives out of 100 people, and only 15 true negatives out of 50 men.
Specificity also equals 1-FPrate, and here the FP rate seems 20% so 100%-20%=80%.
abnormal test result means pt has cancer =>
TP = 35, FN = 15 (50-35), FP=20, TN =80 (100-20) => specificity = TN/(TN+FP) = 80/100 = 0.8 (in % will be 80%)
true negatives are 80 out of 100, not 15 out of 50
If you replace the values from the question in the table of page 257 of FA 2019, yb_26 explanation is correct. Abnormal test = patient has cancer = test +
Question says 35/50 men with prostate cancer (so all 50 have cancer) only 35 have abnormal test results, meaning that TP=35 (disease + test +) and FN= 15 (disease + test - because they do have cancer but the test was not abnormal for them ).
20/100 men without prostate cancer have abnormal test results meaning all 100 DONT have cancer but 20 show that they have cancer when its not true so FP=20 (disease - test +) and TN =80 (disease - test -)
First off, do yourself a favor and check this out - https://www.youtube.com/watch?v=NJYNf-Jcclo
The LDL receptor is found on peripheral tissues. It recognizes B100 on LDL, IDL, and VLDL (secreted from the liver). Therefore, an issue with that would cause an increase in those, but mainly LDL.
Since in this question we see that Triglycerides and Chylomicrons are elevated, that points towards a different problem. That problem is in the Lipoprotein Lipase receptor. This is the receptor that allows tissues to degrade TGs in Chylomicrons. So, if it's not working, you get increased TGs and Chylomicrons. Additionally, you get eruptive xanthomas, which are the yellow white papules the question refers to.
There is much easier way go to page 94 in first aid. This kid has Type 1 Hyper-Chylomicronemia which is I) Increased Chylomicrons, Increase TG and Increased Cholesterol.
It can be either Lipoprotein Lipase or Apolipoprotein CII Deficiency
The video sympathetikey referred to only mentions pancreatitis in type IV but according to page 94 of FA 2019 it is also present in type I Hyper-chylomicronemia which is what the question stem is referring to with the abdominal pain, vomiting and increased amylase activity
thats not the only difference in that video....
Pixorize has a set of videos on all the lipid disorders that made it a breeze to answer.
Pixorize is basically sketchy but for biochem and other basic science subjects.
Pancreatitis was a huge clue for me to think of hyperchylomicronemia