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Welcome to cocoxaurus’s page.
Contributor score: 52

Comments ...

 +0  (nbme24#3)
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UTB why is het eumrs pitamssou aor?nml

I swa aebl to rnroaw it wndo ot TAR, ecbeusa none fo the troeh enawsr eiochsc mdae ucmh eness, but the topsmauis dha me osdenc gsgnieus yelm.fs anC enomeso nexliap atth bla i?nngfdi nsa!kTh

subclaviansteele  My take is that hes not super acidotic and the K is at the low end. +
nwinkelmann  see the comment by @zbird, which explains that the urine anion gap is important (which I took to interpret as more important than the serum K+ level, lol, because the normal K threw me off too). +

 +10  (nbme24#6)
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hTe pittoenearns reeh mssee to itf htta fo ceemisnetr sacvarul lccuosin-o apipnsadtolr ipna htat stlas 1 ,uroh food orn,seaiv whetig ls.os Teh npaetti sola hsa iskr trsaocf asoiedcsat hwti eeismnterc lucvaras ns-occuoil odler nath 06 ysrae l,od a,yiiHeirdlppme tiny,orsepHne H.MPx

"Teh cntereeims aitnlcrocui sssconit of theer mryiapr svesles taht yulspp doobl to hte mllas dna grale ew:bol het ccleai rer,tay oeurspir eeremicnts arrtye (,)SMA nda irorfeni nsermeitec raerty )A.MI( Boldo wflo trhuhgo ehtes areritse iaencrsse nihtiw na uhro ftera aingte deu ot na rseaenci ni itcmleboa dndeam fo eht nttalinsei cr.ionhmocsuaC ucolosnci of a gisnle lsvese alwosl aaorllcelt odbol lofw to cs,pamentoe tuhs mmyposst do not latcylypi renptse itnlu at salet two ymrrpai eesslsv era ducedcl .o"bnmo/.o.nk.//t7nwss.gwhc8Nlh/0b:w/BpvK34i4oti

llrClteoaas ewenbet ASM and AMI erna hte epncsli rflxeue inegdMr(ean rinMeetsce ry)ret.a eherT si loas lelalcarto ebtewen eilaCc yerrtA nda MSA acPra(cidaetdleoonun )cdara.e

yas,Llt I nkow htta heetr si a 3cm- cetaict oaart ufond no ,CT tub an tiacro unmersay dwolu ont pruoedc tshee op.ystmms vEne fi uyo thohtug htta the tssmpyom ewre edu to hte AA,A yuo cuold slilt tge to eth trccero wnarse fi ouy use 4h'dmes1af nieoasg.rn

honey-crusted lesion  Great explanation! There's also a slide about this in the 100 Anatomy Concepts pdf but doesn't go into as much detail as this explanation. Thanks! +
djtallahassee  Good explanation but I think an AAA would be more likely superior mesenteric and hepatic. the SMA and IMA are more than 3 cm apart (L1 to L4ish), Triple A affecting both would be very large. I blew this question because I saw 3cm and jumped to AAA, didnt even see it was a sclerosis thing. Put the two closest arteries and moved on +

 +2  (nbme24#33)
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maoPalilp iusvr cusaes mlatopaoisiPsl in nn.tifsa Grwoth ni ovcal rsc=do ewak ,cyr erahsoens,s dt.rrois

moxomonkey  ain't nobody got time for that +4

 +18  (nbme23#43)
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ePr WOU-DRL ncoraeoAmnacid is tasesoidca /w lnug srgianrc ldarete ot rolgaunmtosua ,asisdee dlo DCPO h)cocnri( dna gaeamd ued ot rerrentuc aunieopmn.

arcanumm  Here i was thinking i was being clever by not being tricked by distractors when metastasis is more common... +5

 +2  (nbme22#16)
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lsAmto tog krecdit by thsi oen eceasub oeorsacoamts lsao susace iosacsteltob saoeOtrsacmo tsmo mmclonoy astzsiteaems ot lsgnu hgot.uh

impostersyndromel1000  This was in pathoma, he said prostate cancer causes osteoblastic lesions and "the board examiners really want you to know that". also following the potential site of mets helps choose the answer +1
snripper  Also, osteosarcoma is less common in the elderly, more common in males <20 y/o (per F.A 2020) +1

 +1  (nbme22#41)
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eRpurtu of nlrypomau elbsb ear a mmnooc cuaes of nsstneuaopo onerautpohxm in ngyou dltau esaml ttha rae tlla nda I konw sti' aols ocitessdaa thwi oksgi,nm but rdgnee adn obdy uaihsbt emsdee leki eth roem kelyli arsnew erhe icnes hte tatpnei si a nyuog emla.

Subcomments ...

submitted by bubbles(63),
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Cna esomnoe uodlc anlpxei ot em ohw hsit si llcnuuyeqvoai setuourb cloiessrs isdtpee N1-F nda uerbStee-gWr olsa sieeprgtnn wtih insk osnel,is oypdpgneeihtm m,aclseu dan rss?uezei

nAd enigisndocr teh nvgeteia mliayf syoir,ht I oulwd hvea dessuma that a sodcaipr uimttoan (like )SW luwdo be orme .ky.e.lli

cocoxaurus  This question was tricky! Tuberous sclerosis= Hypopigmented= Ash leaf spot (The skin lesion in NF is Hyperpigmented- Cafe au lait and in Sturge Weber it's a port wine stain (also not hypopigmented). I'm assuming that the SINGLE raised flesh colored lesion is a Hamartoma (The angiofibromas in NF1 are typically multiple). Although both Tuberous Sclerosis and Sturge Weber are both associated with seizures, I used all the other stuff to narrow it down to the correct answer. Also, don't forget that there is Incomplete penetrance and variable expressivity in Tuberous Sclerosis. So I think the lack of family history of "seizure or major medical illness" was there to throw us off. +18  
bubbles  Thank you! :) I thought I really knew my congenital disorders, so I was a little annoyed when they trotted this question out +7  
pg32  @cocoxaurus I believe the single raised flesh-colored lesion is actually a Shagreen patch, which helps you arrive at TSC as the diagnosis. +1  

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hyrerwveeE I odufn tTDUap(eo dan sevrale preap)s dsia teh nskiomg si teh sbgeigt sikr cotarf rfo oueatnnossp etnomaourxp,h with dyob uaishtb dna eedrgn gienb a reelss Am I tjsu mltpyeeolc utsdgnesirnnimda hte qeuotn?si

imresident2020  Yes smoking is a risk factor but not the best option among the choices given. Check FA, it says that it occurs more in tall thin young males. Smoking isn’t even mentioned. Tall & thin males are more at risk because they have more negative intrapleural pressure. Check Uworld for this. +  
drdoom  You have to think about this using the concept of CONDITIONAL PROBABILITY. Another way to ask this type of question is like this: “I show you a patient with spontaneous pneumothorax. Which other thing is most likely to be true about this patient?” Said a different way: Given a CONDITION [spontaneous pneumo], what other finding is most likely to be the case? Still other words: Given a pool of people with spontaneous pneumothorax, what other thing is most likely to be true about them? In other words, of all people who end up with spontaneous pneumo, the most common other thing about them is that they are MALE & THIN. If I gave you a bucket of spontaneous pneumo patients -- and you reached your hand in there and pulled one out -- what scenario would be more common: In your hand you have a smoker or in your hand you have a thin male? The latter. +  
cocoxaurus  Rupture of pulmonary blebs are a common cause of spontaneous pneumothorax in young adult males that are tall and thin. I know it's also associated with smoking, but gender and body habitus seemed like the more likely answer here since the patient is a young male. +1