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Welcome to champagnesupernova3’s page.
Contributor score: 62


Comments ...

 +0  (nbme21#35)
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iaearhrD saecsu ossl fo we,rta Na dna .baBirc emRrbmee ttha aardrhie is a caues fo non oiann pga elibtcoma dicaossi saeuceb the sslo fo onaeiracbbt si sdmcatpeone by cgrinenasi Cehdriol or.osinbrepat So seh acn hvae hprereoyciahlm ro aaeyrotmiphn ude ot tiknae of only efer treaw rof 42 or.suh uBt hse sha RESZUEIS so piymarnehato is omts kleily


 +5  (nbme21#35)
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Diharrea esausc sslo fo ew,rat Na and brBca.i mRereemb htta dirharae is a esuca of nno onani pag ioclbtame iosaicds becesau eht slso of baonatibcer is deanotpcmse by gicnnsiera ilreodCh rnepa.tbrioos So hse nac heav reiarhhcmplyeo or anoamtrhepyi edu to ainkte of noyl erfe twear ofr 24 ohr.su tuB she ahs IRUEESZS os taamihprnoye si smot yielkl

drzed  I think the initial hyperchloremia would be quickly diluted out by the large consumption of water, so those two competing processes would likely neutralize the chlorine level, or even make the child hypochloremic. +

 +5  (nbme20#3)
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sTih is a .odikel In mlorna woudn geaihln pyte 3 ocllagen si tsfri ehtnisesydz adn enth deadergd yb xtiraM teaalmoeortpilsen (a caleaoelgsn wihhc ssue nciZ sa a oc)frocta and rlapdeec by pyTe .1 nI a ldieoK an vxecieess unotam of ondzadrsieig peTy 3 gloecnal p.sstesir efroheerT het fedcte is ni lnogeaCl nshiessyt T(ype 1 tyhessn)is

dulxy071  Wouldn't Granulation tissue be the (more correct) answer since the initial collagen laid down for wound healing is Type III collagen which is consistent of granulation tissue? Collagen is a vast for so many types of itself as we know +3
kpjk  @dulxy071 she had a surgery 3 months ago healing was fine even uptill 6 weeks ago so the abnormality occurred during remodeling- when type 3 is replaced by type 1 collagen, so the answer wouldnt be granulation tissue +5
pontiacfever  Keloid has both 1 and 3 types of Collagen increased production. Whereas, granulation tissue consists of type 3 collagen only. which is why collagen synthesis as answer would be more specific +




Subcomments ...

submitted by hungrybox(966),
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drpem:eioaL nisgtoA ta oud-iiop r.rstoepec Solws gtu ioyttmli mree(er,mb istntapinoco is a ocnmom sdei ceffte ofr lla p.oisd)io

ziqu sr:yuoelf

Q: udolW a euinkj tnwa to eus poreLa?idem

A: No, it sah rpoo CSN eptrinoanet ichwh( si wyh it has a lwo datcvieid olptatne).i

:Q lWudo a kjueni hertra veah mphroine ro h?repnpiroebun

A: einoM.phr hotB rae uod-pioi iagtsons, tbu epnhmrio si a ufll ngatios lihwe herbppreuinno si olny a taplari osgt.nai

Q: aWth buato rophimne .sv ioecne?d

:A kcriT ineut,soq ohtb aer rapatil s.ngoasti

cienfuegos  Thanks for passing off the knowledge. Regarding the last part, aren't morphine and codeine full agonists? +5  
champagnesupernova3  Yes they are +2  


submitted by hungrybox(966),
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nFgowolli a sr,toke thsi tpneait dah weakssen of her felt aefc and ydb,o so the rsteko mtus aveh edcfftae eht right sdei of her .ranib B asw eth nyol ecihoc no het gtrhi sdie of erh rnaib.

iltSl oducne?sf aeRd n..o.

Teh auvtroyln rtmoo bsifer l(pioirntoascc tc)tra ecednds mrof teh rarympi romto xec,tor rcoss esas)(edcut at eth lyeraludm rsdap,ymi nad tehn sseanpy at het rnraeoti morto hrno fo hte sanipl ve.lle

uaecBse of auenditocss at eth ruldeamly madipr,sy yuo ohsldu aekm a ento of weher ayn ertoks srcco.u sI it voabe het rulymadle a?rdymspi nTeh ti ilwl efatfc the side toeisppo hte tksero (.arralnet)latoc sI ti wlbeo het aylmeudrl ryapismd? eTnh ti llwi tfefac het emas edis as the rkoset lls)t(aa.eprii

hungrybox  Woops, E is also on the right side (also remember that imaging is looking up at someone, feet first). But a cerebellar stroke would have caused ataxia. +  
mnemonia  Very nice!! +  
usmleuser007  What gets me is that they mention that Left 2/3 of face is affected. This should indicate a non cortical innervation as most of the cranial nuclei are bilaterally innervated from the left and right hemisphere. If left 2/3 of the face is affected then it should also mean that the lesion is after CN5 nuclei. +1  
yotsubato  @hungrybox Thats not the cerebellum thats the occipital lobe. You would see leftsided homonymous hemianopsia in that lesion +7  
mrsmac  To my mind, it is simpler to consider the question first in terms of blood supply distribution. Left sided hemiparesis and weakness of lower 2/3 of face are both indicative of a MCA rupture/stroke (First Aid 2018 pg. 498). Furthermore, since the injury has affected motor function we would be considering the descending tract i.e. lateral corticospinal which courses through the ipsilateral posterior limb of the internal capsule then decussates in the caudal medulla. +1  
mrsmac  You're considering the wrong CN here. CN5 motor function involves muscles of mastication and lower 2/3 of tongue. The nerve in question in this case is CN7/VII Facial n. CNVII UMN injury affects the contralateral side, whereas LMN injury affects ipsilateral (First Aid 2018 pg. 516). i.e. before and after the nucleus in pons respectively. I hope this helps. +2  
nala_ula  Spastic means UMN lesion, since they also don't specify if there is arm or leg weakness, I didn't assume it was MCA stroke. I went with the reasoning that for there to be spastic hemiparesis, there must be damaged to the UMNs and therefore the internal capsule is where these tracts are. +  
champagnesupernova3  Omg this whole discussion is confusing. Internal capsule contains ALL corticospinal and corticobulbar fibers = contralateral hemiparesis and UMN facial lesion +16  


submitted by hungrybox(966),
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hTe 2 mmaonndcestm of hteisc otuqeis:ns

  1. ont'D eerv ickp na ewarns erehw yuo sduon ekil a dkic
  2. nto'D vere tsnucol teh thcies otcimmtee

drveeS em llwe no sith oq.tiesnu

linwanrun1357  If there is a choice about asking what the patient is worried about. Is this right? It does not sound like a dick :) +1  
champagnesupernova3  If this were about a treatment asking why hes worried would be right but hes kind of doing the hospital a favor so I dont think you're supposed to try to convince or pressure him +1  
brasel  also, any patient participating in any research study can withdraw whenever they want. Answer E is wrong because he shouldn't have to go through hoops to quit, he can just drop out at any time. +1  


submitted by nwinkelmann(284),
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nI scae eannyo is a nseed sa I am and tujs nit'dd taeemrmrnunsbeedrd/ ahtw extylac opxrtieary olwf is = FEV.1 In teecrritsvi cond,onitis 1EVF is lnamor ro eincardes ued ot daecseedr VC.F tnartIitiels osbiirsf = ansrcdiee iayraw hypeaamncr lcafdofs raduno teh syrwa,ai hciwh is wtah dsieovrp iradla ottc.iran The eerrgta hte raldia i,rcoattn eth orlew eth osclpagnli c,feor nad so xtiryeproa wofl si nadiecr.se

champagnesupernova3  FEV1 is increased due to greater recoil of the lung tissue. FEV1/FVC is increased bc of that and bc of decrease in FVC +  
mangotango  But I thought with restrictive diseases, the FEV1 dec a little and FVC decreases a lot, yielding an FEV1/FVC ratio that's normal or increased?? +1  


submitted by nbmeans(-3),
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I stwan resu fo stih o,ne ti isad itmnhrob emti was monarl

champagnesupernova3  A normal thrombin time indicates fibrongoen is functioning normally +  


submitted by yotsubato(966),
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lelW ahtst a rleyla urcde ywa ot nersec rof ores.n..pdsei

champagnesupernova3  There's really no other way to say it without using euphemisms +2  
drdoom  You can’t rule out suicidal thoughts via inference. +  
drdoom  LAWYER: Did you ask the patient if she was suicidal? DOCTOR: Well, um, no, not exactly — but, I mean, she seemed okay .. +  
drdoom  LAWYER: So, a patient walks into your office, you suspect post partum depression — a diagnosis with known suicide risk — and you didn't ask if she was suicidal? +  
drdoom  DOCTOR: gulp +  


submitted by kimcharito(14),
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iw.nel.l. FA2801 dias lmstsoooirp renscaie tnpuoidorc fo CAISGTR coamsu nda teh oseuqtni aisd GPUOAESSH yasmm.auc.aao..a eb is htta esrano

champagnesupernova3  Reducing acid production helps mucosa heal alot more than increasing prostaglandins. We learn about misoprostol because it can be used if you dont have anything else but you're never gonna choose it over a PPI +3  


submitted by hayayah(1056),
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A gbi nghit here too is iintognc ttah eth PAL si sde.derace boestlOats tvaiyict is rseuadem by nebo A.PL I tikhn tath aws eht mnia cousf eehr dan tno hatt uyo aeeisysrcln ende to nkow het F1ACB enge nioamut.t

sympathetikey  Exactly. That's the only way I got to the answer. +3  
pakimd  isnt increased alk phos consistent with increased osteoblastic activity? +  
champagnesupernova3  A defect with chondrocytes would cause an short limbs like in achondroplasia so those are ruled out +  
pg32  Exactly. Can also be helpful if you remember that the clavicles are formed by intramembranous ossification rather than endochondral; that allows you to rule out the chondroblast/cyte answer choices. +4  


submitted by usmleuser007(370),
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8:uplit3.dng/.i0/hp/s/.nve6bb5cohwmwmn.w1t

Rlieef fo iatanertbcl ipan wsa reuopdcd in isx nahum spttniea by lttuiaoimns fo oeeltdrsec nealtyprnme eldtapmni ni hte talrnuereprivic adn tdeceqrpliuaau yagr t.aterm eTh vlele fo itoiantlusm isfuticfen ot cneudi apin eierfl eessm ton ot arlet eht uaect naip etsrl.hdho iIseiacndmnrti evipreetti mltintiaosu uedcorpd tearnloec ot btoh map-iiresdtooulnuctd ipna friele and eth cgeanaisl tanioc fo naccotir ;medniotcia itsh cssorpe locdu be vrersdee by bnaceisetn mrof ittslmouin.a ul-tritSdendciuomoap lrfeie fo ianp asw eseevrdr yb xleoanon in vefi tuo fo isx pttsaie.n heesT sruslte etgugss that aofyraicstst lnlitoaaeiv of espeirtnst napi in shnuam mya be taebodni yb ccnielroet souatnlitim.

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by usmleuser007(370),
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tn.hi53/.p/p681uomgli.wms.n:bwe/hbwvc0nt/d

lfeiRe fo taanrcltieb inap saw drcdpeuo ni sxi uanhm tnespita yb itmnsoutali fo edrelesoct ytnlereamnp idelmnpta in hte reauvteilcrpnir nad ptlicequaeurda ryga tatm.er eTh llvee fo tmsiiutolan fniiucftes ot enuicd pnai lerefi msees ont ot rleta teh ucaet ipan .ohdstrlhe idnsriImnictae ittpievree lotusanitim drpueocd eacrlotne to both -ttleidpuoudsomcarin inap lreefi dan hte elsaniagc ocitna of oncarcit dtimi;oneac isht scspoer udloc eb svrerede by cabneeints fmro a.iimltnotsu aSipcrtdtnoe-mduuoli ifelre of pnia saw eevrders by oeonlnax in efvi uto fo isx t.iaesptn sTeeh lrsetus ussgget htta tistaoysafcr naoilielvta fo erisnetpst nipa in msnauh aym be dnoateib by inerleotcc mtl.osauinit

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by strugglebus(163),
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MdaodotheHcoroy/ednne cna dlea ot epen-ecdno-udey iadov ni olgn trem use. NDASIs uyo asol iaodv due ot tlraapi cffsineienveets ni rnpaceiohut aipn sa well as lcure r.iks sTAC' aer knwon ot taret hanocpriteu inpa veyr llwe ..ei( asbedte,i RAT tery)ahp

champagnesupernova3  Drugs for neuropathic pain: TCAs, gabapentin and pregabalin +1  
mangotango  SNRIs +  
mangotango  also SNRIs* +1  
zevvyt  methadone isn't a pain med(even though it's an opiate), it's used for opiate addiction. And hydrocodone is used for "moderate" pain and this person is in "severe" pain. +  


submitted by ergogenic22(301),
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Pt has sisng nda xS fo roetoshipryc.l rlnawm/ooL CAHT vafrso vateldee tsiolorc eitnnedednp fo AT,HC mcnroefid by ckla fo reonepss to mhesaetenxoda sreopnpsus.i noaZ ilaafacucts is inigor of sirlotco cpduorint.o

champagnesupernova3  They tried to confuse us saying both low dose and high dose dexamethasone didnt suppress it. But when ACTH is low you dont even need to do high dose dexamethasone test. The high dose is only to differentiate between Pituitary adenoma and ectopic ACTH production +5  
hungrybox  @champagnesupernova3 fuck they got me +11  
azharhu786  They got me on that question as well. I thought it was ectopic ACTH production due to some paraneoplastic syndrome and this is why Low/ high dose dexa is unable to suppress it. +1  


submitted by hayayah(1056),
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A cudreftar imoicrrrfb laept oi(neartr lskul )aaurtm cna tsuelr ni ekiagnl fo roeacprlbines diflu nito eht enso dan slos fo esens of sml.el Slmle lpasy a argle eolr in the iprctoenep fo teta.s S,o in teacprci, a eitpant yam omlpniac of slos fo attse rterah hatn of lmls.e

brownielove79  can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!! +1  
doodimoodi  Olfaction is actually more important that tongue sensation in terms of food taste (think of how food tastes bland when you have a cold) +1  
doodimoodi  than* +  
champagnesupernova3  If taste is completely lost then it's an olfactory issue. If its lost only on a part of the tongue then the nerve that provides taste to that area is suspected. +9  
veryhungrycaterpillar  UWorld QID 12227 The sense of taste isn't lost due to CSF in the nose, but due to avulsion of olfactory rootlets. +7  


submitted by hayayah(1056),
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iicnCall seu fo rspKi-nag siurcdtei:

  • Hsraopdmyoierntels
  • +K iotnldeep
  • HF
  • apihcte eaticss orotinsple(no)ac
  • gnnpicheroe DI )ledi(oimra
  • ennotdaanrgi
redvelvet  Patients with hepatic ascites have hyperaldosteronism; because the intravascular volume is escaped to third space(ascites). So adding spironolactone is a good choice. +3  
champagnesupernova3  Always combine a K+ losing diuretic with a K+ sparing diuretic +10  
bryno20  My rational was a bit different. The patient likely has hepatorenal syndrome leading to a the ascites and decreased GFR. All diuretics, except for the steroids (eg, spironolactone), require secretion into the PCT in a GFR-dependent manner; for this reason, patient's with renal impairment show best success the steroid diuretics since their action is independent of renal function and GFR. +  


submitted by dickass(83),
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Nclacnioee:mefn “Do on m”ahr.

Even if hte peantti nwtsa ot i,ed I .eugss

champagnesupernova3  FA says you cant assist suicide but you can prescribe pain medication which they can conveniently overdose on +1  
dickass  "Physicians may, however, prescribe medically appropriate analgesics even if they shorten the patient's life." (wink, wink) It's vague, but I guess the main point is to let the patient have relief, side effects no longer important. I still don't think you can just give the patient a bottle of benzos though. +1  
raga7  FA 2018 PG 260 +  
misterdoctor69  FA 2020 p. 268 +  


submitted by strugglebus(163),
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kO, so ouy anc rsenao stih yb dwrgnai tou IRET so(ryr I tacn' dwar it )h.eer oh,nyAw you nwko sti a treirevtcsi soreiddr adn lilw vahe a rdsedceae R,V os aualmitylotca oyu onwk htta VR si a mctnnopoe fo FCR C(R=F .VR)ERV+ uTh,s FCR usdhol also eb ee.acdsred ouY olas wkno tath cstveeritir disesase rea acdaerhterciz by a tyades aceesedr ni V/EFVFC1 censi otbh psonctoemn rea cgie.aednrs Tsih aevles uyo itwh CV sdcrgeaeni cneis =CVF fedcro vailt tcapy.iac

champagnesupernova3  FEV1 and FVC both decrease but FEV1/FVC actually increases because FVC decreases more than FEV1 so the ratio increases +  
fluentinwhale  Excuse my stupidity but what is REIT? +1  


submitted by celeste(78),
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ehiWl eth ieliftem ksir ni the eanlreg intuoolapp si utsj bwoel ,%1 ti is 56%. ni fe-dtreriegs erieatsvl fo iantetps adn ti isres to erom htan 0%4 ni zcnogmtioyo wtnis fo eaefdftc oeelpp. Annlayzig isaclsc sitsdue fo eth gnisctee fo zaiirsoephhcn doen sa yrale as ni 10s,93 Fhecsir cudslenco htat a cnrcocnodea aetr fro hsosiycps of utboa 05% in gocoiytnomz itsnw eesms to be a elicstria miste,tae cwihh is flicaigntynis ghheir nhta tath in gcdiozyti wnits of utaob 9%0–11 (abP5g#se..6rC3tf3n/cprelih/ivnlicm9o4/cn62mM/.)

imnotarobotbut  How is one supposed to know this before having read this article? +32  
imgdoc  This question falls under the either you know it or you dont category. It isnt in FA or Uworld +  
jaxx  So why would these A-holes put it on there as if prepping for this exam isn't stressful enough :-| +7  
doodimoodi  Lol just why seriously +2  
champagnesupernova3  This was mentioned in the Kaplan behavioral videos +  
usmlecrasher  and there's so much unnecessarily BS instead of real questions +1  
j44n  I'm just glad we're seeing this garbage now instead of having an aneurysm in the prometric center +1