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Welcome to faus305’s page.
Contributor score: 7


Comments ...

 +0  (nbme18#10)

I think @beastaran1 has the correct explanation but I just want to say his kidney is "abnormally small and nonfunctional" which means that it is not being used. When the body doesn't use something (like a muscle) it atrophies. So tubular atrophy makes sense.

Atrophy = gradual decline in effectiveness or vigor due to underuse or neglect.

When a question seems wildly complicated and you have no idea what's going on, take a deep breath and explain it to yourself like you're five.


 +1  (nbme24#44)

Hi everyone I just came here to say that this was the last question on my NBME and I put a note on it saying "Zollinger-Ellison BOIIII" and then I selected plasma VIP as my answer choice because I'm an idiot.

We live and learn my friends.

dang90  LOLOL +

 +1  (nbme24#16)

Keycompany gave the quick, simple explanation.

but from a less-clinical perspective: If anyone has ever been "Lit-up" on the football field, or just generally ever had the "wind-knocked out" of them, you know that your breathing for the next 5 minutes is very shallow because it just hurts to breath too deep.

This girl broke a rib so likely can't breath very deep, so even though she is breathing rapidly the CO2 is likely remaining in her lungs and causing a respiratory acidosis.

Also, here is why the other answers don't make sense:

Amyloidosis & carcinoid - long term problems not related to a broken rib and acute presentation Empyema- "collection of pus" wouldn't form this soon and if it did the percussion would not reveal increased tympany. Pulmonary edema- percussion would not reveal increased tympany. PE- Could cause similar symptoms but percussion would not reveal increased tympany, and the x-ray and history of trauma tells you that this is definitely a pneumothorax.


 +2  (nbme24#1)

You know why I don't get chronic granulomas? Because I've got NADPH Oxidase. It makes OXYGEN FREE RADICALS THAT WIPE AWAY STAINS.

AND THAT'S THE POWER OF OXY-CLEAN.


 +0  (nbme24#8)

C tetani causes paralysis by cleaving SNARE proteins (e.g. synaptobrevin) and preventing the release of inhibitor neurotransmitters (e.g. GABA and glycine).

C botulinum causes paralysis by inhibiting ACh release at the neuromuscular junction.

To prevent from getting these confused (like I do sometimes): Think about why botulinum toxin is used in botox and not tetanus. Because we want the action to only work at the NMJ (so we want to inhibit ACh release at NMJ). If we used tetanus, something tells me it wouldn't work the same ~yikes~.


 +0  (nbme24#22)

So I guess now I know that this is Zellweger syndrome which is a disorder of biogenesis of peroxisomes. But would there have been a way to know this without knowing about this syndrome?

I guess if you knew that peroxisomes are involved in beta-oxidation of VLCFAs then you would've known why they are building up in the liver.

Can anyone explain why the hypotonia, jaundice, and facial problems occur?


 +2  (nbme24#11)

Was I wrong to just pick the only answer with the word nociceptor in it?


 +0  (nbme23#46)

Live Vaccines:

Salmonella Yellow fever MMR Rotavirus Adenovirus

Live vaccines that have killed versions: Sabin (the other polio vaccine) Influenza (intranasal)





Subcomments ...

submitted by neonem(554),
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rlCioepnoleebtne algne smas = aVlbteiusr monwacnsah A(AK iosuctac .m)eaunor veeriDd romf Swchann lle,cs hhicw are of lenrau stecr rnog.ii

yotsubato  Ugh. Of course they dont put schwann cells as a choice. So I pick oligodendrocytes like a dumbass +32  
subclaviansteele  Same^ +1  
madojo  Schwann cells = PNS Oligodendrocytes = CNS +3  
suckitnbme  NBME loves their neural crest cells +4  
wrongcareer69  How much do they pay these testwriters anyway? I can use a thesaurus too +2  
osteopathnproud  @suckitnbme they do love their neural crest cells, I have chosen neural crest cells for every single answer choice I see it in and I believe I gotten 90% of them correct, if something doesn't click or you don't know, I would keep neural crest cells as a very possible answer lol +  
faus305  AMERICA EXPLAIN +  


submitted by apurva(68),

Lol i thought trauma would hit more superficial structure than deep.. haha

cassdawg  Literally how I answered this question cause I didn't know what dysmetria was. Convinced myself of some version of coup/contrecoup that would injure this part of the brain and got it right for all the wrong reasons. Wish I could do that more often. +  
faus305  @cassdawg I did the same thing, lol. But I like to think that deep down we knew what we were doing. I knew the cerebellum was involved in balance and that this guy who just crashed his motorcycle would probably be having some balance issues. +  


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ysatiDemr ( oas,l asiseddinyoidak dan iennitnto tmeorr) si aalrtel .belmureelc ).(E

xaitAa si a olebmpr htwi eth lanectr lelcurmbee (D) or ta atlse tthas hte btse I dulco coem pu i.hwt

ronald-dumsfeld  I actually think D is pointing at the Flocculonodular lobe. See here: https://en.wikipedia.org/wiki/Flocculus_(cerebellar)#/media/File:Human_brain_midsagittal_view_description.JPG So a lesion at D would present with Nystagmus +3  
urachus  flocculonodular is medial (central). but yes it'll have nystagmus and truncal ataxia +  
faus305  Lesions of the lateral regions (cerebellar hemisphere) of the cerebellum affect the lateral body (dysmetria, fall toward injured side). Lesions of the medial region (vermis, floculonodular lobe) cause medial (truncal) ataxia. Oversimplified but these rules help me answer most questions about the cerebellum. +  


submitted by asharm10(22),

so his pitutary adenoma was removed, so prolly gonadotrophs were removed with it, so if you give gnrh it won't do anything as it can;t produce FSH/LH so you give fsh/lh directly to indce spermatogenesis and testo synthesis.

faus305  Yeah this makes a lot of since. The anterior pituitary produces FLAT-PiG (FSH, LH, ACTH, TSH, Prolactin, and Growth Hormone). Pituitary adenomas are most commonly prolactinomas in the anterior pituitary. He is just now noticing the effects of not having LH and FSH, infertility. So we need to replace those, aka give gonadotropins. +  


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ueeacsB ouy rea iue,nps s’eethr eisneradc erlopad oging kbca ot royu htear (no need to korw tngasia ytgirav, oyur obdol nti’s lgoopin ni yruo slge sa cuhm ireteh.) As a lstru,e APN is eecesdtr edu ot RA cse,ttrh negldai ot sisiured adn a untceorid fo oobld eluo.vm

urachus  When the person is lying down (supine position), gravitational forces are similar on the thorax, abdomen and legs because these compartments lie in the same horizontal plane. In this position, venous blood volumes and pressures are distributed evenly throughout the body. https://www.cvphysiology.com/Cardiac%20Function/CF017 +  
thelupuswolf  RAAS trumps ANP though, so the dec. in RAAS as said by colonelred_ is likely going to have more of an effect than ANP. +1  
lola915  If you have an increase in ANP wouldn't natriuresis occur and cause a decrease in blood sodium? +2  
mynamejeff  Because you are suprine, there's increased preload going back to your heart (no need to work against gravity, your blood isn't pooling in your legs as much). As a result, ANP is secreted due to RA stretch, leading to diuresis and a reduction of blood volume. +  
sars  This is a "read my mind" question and complete it in 1.5 minutes. Thanks +2  
faus305  @sars that is every question +  


submitted by krewfoo99(90),
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If uyo vree get foeusndc with eht igradma emr:mrbee

CN ,,3412, - diiCMnNrb a 7,8,5,6 - P CosNn 01,21911,, - aeldluM

eicSn yonl eon uurtecrts ni het armaigd si mginco uto of the umldael etnh it hsa be hte vusga veren

faus305  haha hey I do that +  


submitted by mcl(585),
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Bsuon carevad rdmigaa, kid yhw sith swa no ...p..tsn.ter.?ei....

drdoom  bonus cadaver diagram via @mcl +  
yotsubato  nurses +4  
faus305  Cause it's cute unlike the monstrosities they always put on the NBMEs +  


submitted by medstruggle(12),
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Why is ti nto oivraan lieflocl lselc? I ohgtuth het lefmea gnaalo of elriSto dan yedgiL si aotlauangr/cesh .lslec

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +7  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +37  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +17  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


well if that ain't my ex then I don't know what is

faus305  all my exes live in Texas like I'm texaspoontappa +1  
avicenna  I loved bad bitches its my fucking problem, bring em to the crib help solve them by doing uworld questions together! +  


submitted by beeip(123),
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hTe sbet I cna nudrsntae,d ehyert' egribnscdi eiatrlmodne aaryipehlps, a lrtues of exssce nsetoegr, a estirod orehnmo atht olttcranssae to eht lsuecun dan sdnib sti ntircapsrnito otcfar.

mousie  My exact thinking also! +7  
sympathetikey  Ditto. +  
meningitis  My thought as well but the answer says: "Binding of ligand to Nuclear transcription factor" and I thought to myself: "Estrogen Receptors aren't transcription factors.. they are receptors with Transcription Factor function that bind to the ER Element and recruit more Transcription Factors". Can anyone explain what I am missing? Am overthinking things? +  
criovoly  You are overthinking it, Steroid hormones receptor is found intracellular in the cytoplasm then they are translocated to the nucleus where they regulate gene transcription. HOPE THIS HELPS +4  
eve1000  Could this be due to the PTEN gene being linked to endometrial hyperplasia? +  
feochromocytoma  The question stem says it's glandular hyperplasia "without" atypia It's just due to increased levels of estrogen causing the hyperplasia +4  
faus305  This is a bunch of scientific mumbo jumbo +  


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iraclseV isassnlamehii sescua lahltnpemysoeeopag nad mtso ,mialtoytpnr oae.payipnnct tI si foten dfuon ni elpope woh visit the elddMi East nad is titsetdnram yb eth .dfnSayl yhW ddi NBEM tup 2 iiseaamLhn nqisestuo no ihts romf llo

stinkysulfaeggs  tell me about it... I got both in one block and started seriously reconsidering my answer choices! +11  
rongloz  I got both questions within 5 questions from one another! I was seriously doubting my answers haha +1  
faus305  Visceral Leishmaniasis affects about 0.001% of the world population each year so it only makes sense to have two questions on it. https://www.cdc.gov/parasites/leishmaniasis/epi.html#:~:text=For%20cutaneous%20leishmaniasis%2C%20estimates%20of,to%20400%2C000%20or%20more%20cases. +  
underd0g  How do you differentiate leishmaniasis vs malaria? I picked malaria because I thought, no way leishmaniasis is on here twice. But doesn't malaria also cause splenomegaly, fever and abdominal pain? is the key differentiator PANcytopenia? +  
faus305  @underd0g, correct no Pancytopenia in malaria. But also malaria probably would've said the patient was in Africa. +  


submitted by alexxxx30(44),

did anyone else have to reread this question several times? The jumping back and forth from "this happened before, 1 week after, 6 weeks after" then this happened today, then" this happened 6 weeks postop" gave me whiplash. Tell the story in order! haha

confidenceinterval  RIP anyone with a learning disability. I honestly think someone tried really hard to write something this confusing. +1  
faus305  Quentin Tarantino wrote this one +  


submitted by sugaplum(324),
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hTsi si soiuudicrl ubt I oudlc rvnee peke steeh airgttsh me esto ym i:mfaly
ycheA rnpdgaa reMenty
epo D cnuios VT hwit a ised o*H s(h'ow smnae rae jtus slai)iitn cNS
cUenl nad atnu pehaR nda saar oisu Cn bGbay laaysw gmcisrane -Na-NaaN
eo nrip rimdsen me fo het ocrlo elb,u so ucsol lscruuee

paulkarr  LOL. Achey Granpa Meynert. I'm gonna steal this from you. +  
abhishek021196  Achey grandpa Meynert = ACh / Basal Nucleus of Meynert Dope Cousin VT = Dopamine / Ventral tegmentum, SNc Uncle and aunt Raphe and Sara = Serotonin / Raphe nuclei(medulla, pons) Cousin Gabby always screaming NA-NA-NA = GABA / Nucleus Accumbens Norepi = Locus ceruleus. +1  
llamastep1  Amazing +  
mnemonicsfordayz  ACHey GRANDPA MEYNERT TREMBLES in the BASEment; DOPE cousin VT SNaCks DOWNstairs by the kitchen TAP; NANA GABBY ROCKS and ANXIOUSLY cooes...; "NENENENE... NENENENE...NENENE...NENE" to CRYING BLUE-eyed baby ELSIE; aunt SERO and uncle RAPHE DULLY PARK in the DOWNpour. CAPS = relevant info, lowercase = irrelevant. Includes diseases: DOWN, ANXIOUSLY, CRYING, DOWN = anxiety/depression; TREMBLES, TAP, ROCKS, PARK = movement disorder; GRANDPA = Alzheimer's. Note: ELSIE = LC = Locus ceruleus +  
mnemonicsfordayz  The extended "NENE" series is just for humor - shorten if you like ;) Also, ANXIOUSLY applies to both NTs in that sentence: GABA and NE. +  
castlblack  I use AChoo meynose +1  
faus305  I almost didn't even look at this review but then I thought "maybe someone has a cool mnemonic." and would you look at this. +  


I just realized there were solid arrows and dashed arrows in the image. Is there a significant to the dashed arrows vs the solid arrows?

faus305  The solid lines are the correct answers. lol jk but not really +  


submitted by haliburton(209),
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medlubtlse ash a ceni opiemncnu for the elklid :ecscavin

steR In ePeca ywlsa:A

Risaeb
fenaunIlz
lPoi o Sakl()
tiiesHtp a A

paulkarr  Also, the nice little puppet show from sketchy for those visual learners like me. +1  
makinallkindzofgainz  just remembered that MMR is a live attenuated vaccine +  
faus305  how could i forget that puppet show?! +  


submitted by hyperfukus(75),
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so dslhuo we ujts ispk e?shet zcu e'ethrs pobr 10 eorm i uovceld tnetgo teriw naigswt my file on iths oen

faus305  Don't skip it but flag it, give yourself 1 minute and 30 seconds or less to figure it out and if you don't then move on and come back if you have time. Questions like these are what I like to call "time wasters." I got it wrong because I selected 2.5 assuming I made a conversion error when I arrived at 25.9 as my answer. I think the lesson to learn here is that 28 is closer to 25 than 2.5 and NBME are evil people that know I'm not gonna make a conversion error. If you do math in a question and you are SURE you did it write, select the answer closest to the answer your math got you. +  


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esVracil alissmniiaseh ucsaes aespnoelphlmyoetga dna mots oanytlptm,ri pyeaoptin.can tI is neotf ufdno in oepple woh tiivs the ddeilM tEas adn is idmrtatsent by hte dnay.fSl Why ddi NBEM ptu 2 seLihmaani teinssqou on siht rfom lol

stinkysulfaeggs  tell me about it... I got both in one block and started seriously reconsidering my answer choices! +11  
rongloz  I got both questions within 5 questions from one another! I was seriously doubting my answers haha +1  
faus305  Visceral Leishmaniasis affects about 0.001% of the world population each year so it only makes sense to have two questions on it. https://www.cdc.gov/parasites/leishmaniasis/epi.html#:~:text=For%20cutaneous%20leishmaniasis%2C%20estimates%20of,to%20400%2C000%20or%20more%20cases. +  
underd0g  How do you differentiate leishmaniasis vs malaria? I picked malaria because I thought, no way leishmaniasis is on here twice. But doesn't malaria also cause splenomegaly, fever and abdominal pain? is the key differentiator PANcytopenia? +  
faus305  @underd0g, correct no Pancytopenia in malaria. But also malaria probably would've said the patient was in Africa. +  


submitted by nukie404(7),
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At irfst I wsa kihgintn ha!a Cdilh abues! utB I eguss wnmraio boens rea omer gtesisugev fo OI, tuhgoalh eth no iafyml xh ptar aws artehr hbel.

thotcandy  Literally had it on OI until I saw no family hx... Isn't it AUTOSOMAL DOMINANT? +2  
faus305  FA 2019 pg. 51. Yes it is autosomal dominant. This question is poorly written but the clues are "wormian bones" and multiple fractures. Pretty sure everyone on this page would've nailed the diagnosis if seeing a real patient instead of using three lines of text with two hints. Questions like this demonstrate how this test became a way of ranking people based off of minutia they know and not their clinical abilities. This is why step is pass/fail in 2 years. +  


submitted by gh889(117),
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lrtoKoeac si a ereleibvsr INDSA nevig V,I lal IAsDNS evha a rski of iittsiearltn hpir,esitn rlnea a,cehiims gactris rcules, nad catslpia n.maeia

teh sbet nwaers is alnre rilaufe b/c it si gvein IV dna sha less fo a echnac fo uiagncs rstgica reclus

tiredofstudying  I would also take into account that this patient has had HTN and T2DM for 20 years. His kidneys are probably shot. +5  
jackie_chan  @tiredofstudying 100%, thats probably why the mentioned it, if you didn't know wtf ketorolac was (I didnt) but i saw a long 20 year history of HTN, DM I assumed his kidney def could not be fully functional +  
faus305  I just ordered sushi from Japan. +  


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Teh ticimoduslr esengifnprr lhaap onxti si a eelsiihatcn hhicw asvlece ilhcetin to hrlhiopyncelposoh nad dceeiry.gild sEa,iyslenlt aahpl xnoit isimcm opaehsihlsopp C. Tihs senam it hsa a yuaevlg amiilsr etefcf of teh hppsepslhoasio snee in luiBlsac esrCeu dan etLarsii etMgncny.seooo heT ned sretul of hte niotx vaocitnait is ctovinaita fo esndco ssemnegre eymstss ghuroth geieicdyrld AK(A llelg,yo)ydcrica cihwh aesitacvt lsaevre atywaphs, mtos notyalb in htis eacs rAaiconhicd idac btmslaoemi dna 8-,LI iwht the ten eefftc fo casieedrn acusrlav timialeebyrp eidnlag to .dmaee

teepot123  fa 19 pg 138 +1  
faus305  alpha-toxin is also known as lecithinase. I got this right because I remembered the sketchy. That being said, can someone explain how this possibly received a "13.1 difficulty score?" It does not seem like that easy of a question. +  


submitted by anechakfspb(27),

Why couldn't it be retroperitoneal idiopathic fibrosis?

faus305  Idiopathic RPF is a rare fibro-inflammatory disease. It typically does not involve the adrenals, seagull is right in that this answer is just critical thinking, even if IRPF reached the adrenals it would likely harm their "configuration" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926988/). +