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Raise your hand if you were also thrown off by the normal heart sounds.
I think this question is poorly constructed. Cardiogenic shock would result in an INCREASE in SVR - this woman's BP is 70/40...
@jmd2020 low BP does not mean the SVR isn't increased — it /is/ increased! it's just that the heart is so effed up that even massively increased SVR is not enough to maintain good pressure
another way to explain: imagine you are losing blood volume at a constant rate (someone punched a tube into your aorta and draining you like a pig); at first, your heart would beat stronger (ionotropy) and faster (chronotropy) to maintain BP; at the same time, all your arterioles would constrict to maintain blood flow rates (and perfusion) to vital tissues ... but at some point you will have lost so much blood that all the ionotropy, chronotropy & SVR in the world could not save you or your BP .. your BP will plummet no matter what compensatory mechanisms your body has up its sleeve.
Jugular venous distension clued me into cardiogenic shock (heart isn't pumping well resulting in back up) vs the others listed, esp since obstructive shock isn't an answer choice
Ilioinguinal n. derived from L1 is mostly sensory supplying
skin of upper and medial thigh
root of penis & upper scrotum (males)
**mons pubis & labia majora (females)
it accompanies spermatic cord through superficial inguinal ring, great pic of this ^ @skuutnasty
how do we know when to transfuse?
I also thought about transfusing, but then thought that might cause iron overload since he's also getting iron supplements. I'm not sure if iron overload is a possibility w EPO. Please correct me if I am wrong
Transfusion is only indicated when hemoglobin is < 7g/dL
& this tx is usually reserved for critically ill patients
there are several UWorld questions about psychogenic ED with the answer being normal libido and normal nocturnal erections, idgi
Yeah NBME says its C, but I still think with a recent stroke you can't bank on normal nocturnal erections...
fatigue, difficulty sleeping and concentrating could be depression or hypothyroidism both of which can cause decreased libido
@djeffs1 when you say NBME say's it's C, how do you know that's the official answer? Did NBME post the answers somewhere?
in the versions I purchased from them they highlight the correct answer in the test review