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Comments ...

 +1  (familymed1#1)
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My ofeaivrt tlfuade rtemnetta ont.poi hiT(s mtmceno endse to eb erov 05 sarcctarhe dan )nttwah.o


 +0  (free120#9)
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I tc’na esme ot idnf a simrlai emiag nnlioe thta sceberids etayxcl what teh tohre aears are vgnoecir. ynA phl?e

benwhite_dotcom  See this image (Fig.6) from https://teachmeanatomy.info/neuro/brainstem/medulla-oblongata/ A and D, for example, would reflect lesions that cause what is called lateral medullary syndrome (Wallenberg syndrome). +1
canyon_run  Thank you! Would E then be the inferior vestibular nucleus based on that linked image? Also, is hypoglossal involved in the stem because of damage to the nerve fibers themselves rather than the nucleus? +1
benwhite_dotcom  I think the level in the teachmeanatomy link is a bit off from the NBME image. I assume the NBME is showing E as the hypoglossal nucleus (https://en.wikipedia.org/wiki/Hypoglossal_nucleus). Yes, it’s the fibers. The nucleus is ventral. +

 +2  (free120#32)
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hwy is eth tlpealte airgtoaegng tste si lroanm ni ?DWV my mroelbp si ahtt 1Gpb dna acrfWotV haev ot ticeatnr to uicnde a oimafitnlcnaor ganche ni eesllptat ot rlaeees ADP ;gt&– PDA bsidn ot t-drpcreopae adn sicednu b32/pGa hichw saeebnl agoaitggenr via n.oigfbrien wihhc ldowu eald ot nrambloa nggr?eaaitgo dna is het nisetorcti ayssa nto a aeteptll anrggitageo stte? ro can ti ssmteimeo eb amornl and osietmsem otn?

benwhite_dotcom  It can be abnormal as well, depends on the subtype and severity (the wikipedia page does a decent job explaining). The most common subtype of VWD is a quantitative defect, which is often mild/nearly clinically occult and can have essentially normal laboratory testing. This is one of those questions where the labs are really there to exclude the other choices. +4




Subcomments ...

submitted by monoclonal(21),
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h.pmpAn.:ragmc/uZ23gi/o/tf.tEi

hsTi gaime sohsw eht mpleutli evins whhic irnda berats ests.ui seya aulv.si to( aesy to sism i,t tbu i i)dd

yb_26  this one is the best, thank you! +1  
canyon_run  very nice! +  


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Boold ta eht smtuea si het erd lfga (ese tahw I idd hrtee?) orf rlahtrue iu,ynjr ihcwh odhuls eb tlaeveuad ofr wthi a rorreagetd a.etgromuhrr Teh nrmmuaebso eth toms ncmmooyl rijdnue yb utraf.ecr nI nscrt,ota het psnyog ruetarh is smto ylilek to eb nuijred udginr rmcutiaat caetrteh enitsonri ro ni a drsdalte juiryn.

canyon_run  Should we just assume that a pelvic fracture implies a membranous urethral injury? I was between membranous and spongy and I ended up choosing spongy because of the perineal bruising and fact that the patient was riding a motorcycle (and therefore susceptible to straddle injury). +  
benwhite_dotcom  Yes. You should think of spongy as the penile urethra, hence the predisposition to catheter-related trauma. +6  
focus  Diagram: https://www.earthslab.com/anatomy/urethra/ +  
topgunber  it says no trauma to the penis so we have to rule out spongy. To tear the prostatic urethra would mean the prostate also got affected, which when compared to the vulnerable membranous urethra would be unlikely. Both spongy/prostatic urethra are vulnerable to TURP or catheter related trauma as mentioned. As far as the bladder itself and the intra-mural urethra, i would think fractures of the symphysis and above would cause that. +  


submitted by canyon_run(4),
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I cant’ mees ot nfid a laiismr gamei neionl thta rbedcssei ayeltxc tawh eth terho asrea rea enoci.grv Ayn ehpl?

benwhite_dotcom  See this image (Fig.6) from https://teachmeanatomy.info/neuro/brainstem/medulla-oblongata/ A and D, for example, would reflect lesions that cause what is called lateral medullary syndrome (Wallenberg syndrome). +1  
canyon_run  Thank you! Would E then be the inferior vestibular nucleus based on that linked image? Also, is hypoglossal involved in the stem because of damage to the nerve fibers themselves rather than the nucleus? +1  
benwhite_dotcom  I think the level in the teachmeanatomy link is a bit off from the NBME image. I assume the NBME is showing E as the hypoglossal nucleus (https://en.wikipedia.org/wiki/Hypoglossal_nucleus). Yes, it’s the fibers. The nucleus is ventral. +