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Welcome to cathartic_medstu’s page.
Contributor score: 28


Comments ...

 -2  (nbme24#29)
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haPomat Ch 1, fo 3.

loSylw vgilendoep iciehams ei( heloscri)sotrsea dlase ot toaphry rewse,ah cutea saihicme ie( anlre aeytrr e)msolub trlseus in i.urnyj

usmlecrasherss  i picked fibromuscular dysplasia and have zero regret, i just did not pay attention toward the word of proximal.... +3

 +3  (nbme23#29)
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FBA UTG

etoucsrF si ot eaAldlos B as esataGlco si ot Ulrydi .nLadsssereeaf raT to pashotpeh ile.optned

crtaknoeFusi fde dan eitoaaacknGsl dfe are .dnierk

FA 2081 pg 80


 +1  (nbme23#48)
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I emac ereh usjt to arde the tenscmom

JM ta the voiem httersea gaeitn ocprpon emem

azibird  Same! +

 +5  (nbme23#8)
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Loalbelta = ol-"l"ahtealba-p""

mroF Scyethk

denrAw Ynga ofr dp.trsenie si it 05 hsearracct ety?

anjum  RIP Yang gang +

 +0  (nbme22#7)
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crganiO DE: alrnom io,libd sdaeeedcr natlurcno ecteniosr

Pgesohnyicc :ED ddecrsaee iliodb, nraoml ranoctnlu osnertcei

tGo i.t


 +0  (nbme22#7)
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cntroNalu lneepi teucemesnc esmtumareen hlppahg)(yoarl si a sett atth sumeesar pnsoeatsuno ntghyli reestncio in reietcel dncouyifstn arriylpi(m drpmrefeo ni a epsel yrltr)oobaa. I'ts sluuef rfo tnaedfigtrniief weentbe ocgirna mfro icegspchyno eeiecltr tfnuo.dncysi

eenVtgti ibsrcsede a siolsbyp epeesdrsd ttainpe ;&=tg ognscehpyci eeectrli incutfsyodn. eicnS it is tno an rcnaiog ucaes of D,E unncotrla eecsnoitr lduow eb olma.rn inOrcga esgietiool fo DE cdliuen igceneounr ro lcvusa.ar

ibodLi artp seocunfs me e.her ioLdib namse uaeslx drseei ro e.tipaetp I asw gkniinth nscei esh' nogcim ni ot get DE ekec,dch it natedcisi se'h taiteepp orf esx si enuhgo tath ti adem imh get it kh.cec oS ilbido dsuolh eb .ranmlo nAy eh?pl


 +9  (nbme22#45)
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p/.h.r1t/0g/5wo30a/s./wfl0/1tpp435mat0h2:apfw

^a^^ tilebuufa aelbt thta ohsws affctes on tcollereyet lsevel in taeavsixl vs tcriudsie vs .ntovigim

Adocncgri to eht a,lebt tsi rahd to tlle icteidru vs iaaxletv abeus yb rusme reyttlelocse onl.ea hTe uerin tertysloeecl uwdlo eymdkrla efrifd ni atht tecdirui lliw aveh scdeareni CKa/l/N adn texvsiaal odlwu wofllo the pietspoo trden daeedc.()ser Hweovre, hiwt the tfac that NBU is iresgnaicn and tath we can tlle re'thes a etlocimba oalikassl thiw ipryrartsoe scidsoia cntenaospoi,m we can tbe on stueirdci over svieaxtla.

EAXRT OFIN fmro eth ebtla in het lnik vb:eoa

o:tnmVgii K[ ec]d l[C e]dc [OH3C i]nc [pH ]nic
tLiae :xsva K[ c]de [lC inc or cd]e [3CHO edc or ]cin [pH ced ro icn]
iuDes cr:it K[ edc] C[l e]dc 3HO[C nc]i p[H c]in

nI uiner orf ngimvoit, aN/l/CK lwil lal be cdrnea deesI rineu fro xvtlieaa esau,b aK/N lwil eb ds.adereec Cl si manorl ro nacededIse.r iuren fro cteirdiu u:easb aNK//Cl iwll lal be recadsien

dw(rAen aYgn rfo tdirs)Pene

nootnootpenguinn  The last sentence is nice touch!!! +2

 +2  (nbme22#38)
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nCa esonome rtorecc my isarennog here:

I swa nhinkgit ieotpisv awyrai rspurese iwll eiascnre ravaleol tvontlenaii and cadrseee ohiapxy iudencd yumlprona rnciscottnvsoo.ai uThs, RV arfet adol wlodu eeedacrs ;=tg& eomr paleodr to VL adn mroe caciard ut.puot heTn tlodu'nw BP edcerea?s

ynA hpel is ecptadeapir. asknhT.

pg32  I just thought of it as follows: he has high BP due to pulmonary vasoconstriction as well as widespread sympathetic activation (as if he is being partially strangled all the time, because he basically is). Increasing oxygenation will relax his pulmonary vasculature and decrease sympathetic stimulation throughout the body, leading to a drop in blood pressure. +1

 +1  (nbme22#35)
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urciePt ohwss deltida urteer nad leanr lvsiep

nhrociC OPYELsipenrhti poe(ly = l)evips &t;=l rnretcuer dsipeose of Aucet enoisryhtPlipe =&t;l TUI

siTh itnteap iylkel sha rocieaeuvrtels xlefer naelidg ot rrrnecuet UITs.


 +0  (nbme22#35)
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irPeuct shows edtdlia eterur dna alner lpsvei.

oCrcnih OEYPLenpirthis eyol(p = lpi)sve &tl=; errurtcen iepsedos of ueAtc nterhieyislpoP t;&=l UTI

siTh tapietn liklye ahs lceautiosrvree lfxere lagiedn to rerncuret UIT.s


 +4  (nbme22#44)
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rSoepiru sromhderhio ldobo, roiInrfe doroerihhms rotohmsb. alsAwy reeebrmm tha.t

G-oanjl





Subcomments ...

submitted by nwinkelmann(282),
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rPe atglnnlemcosyoopoih.

epkuaoklLia = rsik ratcsfo ineulcd lame gdrn,ee 7-040 aseyr ,dol ingmk,so tWhei catph or lpae,qu 5 mm ro ,orme on aorl muousc mmsbnaeer htta ocatnn eb eedrmov yb gnsircpa, tno due ot enhtrao saeedis enttyi cshu sa inhcel alpnus ro asdiidancis adn otn seevdrre by amevorl fo rarnttiis dna slonie umts eb docsereidn anccreuposre tulni reopnv .eehroiswt tiaPmanelngr oneils rmnatsoioarfnt owlud laed to sivnonia of the uocssbam.u

roiMc = iVreas alliyhocsgoilt rofm hictaoans,s ephkesry,otrsia iaaspsyld or onmcaiarc in uits (sctaasdeoi ithw lhcpotsyyem dan )haspm.cagero hTis itclera aexilpns ti mcuh teetrb dna sha :cesptuir etheciow06itl/ae7mt/dpv1np#eisr6-8am.mee4ev/i:saroce4c.dc/. Bsead on hsit icelrta dna teh uecrs,ipt I'd say eth iosth sedil in eth ueqtnsio si at tesal etearmod moaususq aapsl.siyd

Hiyra Loekaaiklup = h,Weit ftenonucl psecath of uyfflf rh)iy(a sao,cum ratial,elb loagn etalral e,gtuon nad eocstadais ihtw I+VH tnesaipt (SADI mya ppaaer whiitn 2 - 3 )sarye tbu lulytaca due to BVE coitnfine

toiHs = catepeHtrroyik laro ucomsa deu to lpnigi of iaktcoert smqsuoua uime,ethlpi doCrwy pety A trnecirlauan ,soscniinlu olBloan cesll htiw atianoigmrn fo noahcritm crun(ael i;)adbgne VEB nestrep in rlace eclls of usinsop ely,ra rlivbaae cy,kiosositlo seerpmpoduis ndiadaC nefci,toin otwuiht oamtaymfnlir osenper.s

rFmo csuptrie nad( isht evo:di hu6ostub.Iveq8uKpt1x:///Shyt emttamspi 1):2,2 aryhi aukpeakllio has a igytlhl aidetsn bdna fo slcle oa"llbn l"slce in het tusatmr oinspsum cihhw is rwehe hte EBV se.lvi tI skool hucm efifredtn ntha hte htsoi eslid nohsw in the .qeonistu

yb_26  great explanation, thanks for sharing! +  
cathartic_medstu  on point +  


submitted by oznefu(19),
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’Im hagvni orbetul rdasnedngintu hyw this is a rtbeet oeichc hatn gaePt dsi,eeas yesacellpi wthi teh einasdrce LAP?

zelderonmorningstar  Paget’s would also show some sclerosis. +4  
seagull  ALK is increased in bone breakdown too. Prostate loves spreading to the lumbar Spine. It's like crack-cocaine for cancer. +23  
aesalmon  I think the "Worse at night" lends itself more towards mets, and the pt demographics lean towards prostate cancer, which loves to go to the lumbar spine via the Batson plexus. I picked Paget but i think they would have given something more telling if they wanted pagets, histology or another clue +1  
fcambridge  @seagull and aesalmon, I think you're a bit off here. Prostate mets would be osteoblastic, not osteolytic as is described in the vignette. +16  
sup  Yeah I chose Paget's too bcz I figured if it wasn't prostate cancer (which as @fcambridge said would present w/ osteoblastic lesions) they would give us another presenting sx of the metastatic cancer (lung, renal, skin) that might point us in that direction. I got distracted by the increased ALP too and fell for Paget :( +1  
kernicterusthefrog  @fcambridge, not exactly. Yes, prostate mets tends to be osteoblastic, but about 30% are found to be lytic, per this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768452/ Additionally, the night bone pains point to mets, and Paget's is much more commonly found in the cranial bones and appendicular skeleton, than axial. This could also be RCC mets! +  
sweetmed  I mainly ruled out pagets because they said the physical examination was normal. He would def have other symptoms. +4  
cathartic_medstu  From what I remember from Pathoma: Metastasis to bone is usually osteolytic with exception to prostate, which is osteoblastic. Therefore, stem says NUMEROUS lytic lesions and sounds more like metastasis. +5  
medguru2295  If this is Metastatic cancer, it is likely MM. MM spreads to the spinal cord and causes Lytic lesions. It is NOT prostate as stated above. While Adenocarcinoma does spread to the Prostate, it produces only BLASTIC lesions. +