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free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 
Welcome to icedcoffeeislyfe’s page.
Contributor score: 25


Comments ...

 +0  (free120#32)

I think this is a Meckel diverticulum presentation!

alinton  Agreed-Confused b/c Meckel Diverticulum is legit the classic example of a choristoma (p. 221 FA 2019) Maybe they're thinking gastric mucosa is a more specific answer? Idk +1

 +0  (free120#37)

Is the decrease in baroreceptor output due to the body adapting to the hypertension?

azibird  Apparently. "Baroreceptor activity is reset during sustained increases in blood pressure so that in patients with essential hypertension, baroreceptor responsiveness is maintained." "It is a universally accepted phenomenon that vascular baroreceptors reset to operate at higher pressure levels in hypertension." Okay, so they can reset to normal levels, but wouldn't this patient already have undergone their reset? Why would the receptors further decrease? I thought that eventually their LV would hypertrophy and fail, leading to decreased stroke work. https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000160355.93303.72 https://pubmed.ncbi.nlm.nih.gov/3042363/ +1
azibird  From Costanzo Physiology: "The sensitivity of the baroreceptors can be altered by disease. For example, in chronic hypertension (elevated blood pressure), the baroreceptors do not “see” the elevated blood pressure as abnormal. In such cases, the hypertension will be maintained, rather than corrected, by the baroreceptor reflex. The mechanism of this defect is either decreased sensitivity of the baroreceptors to increases in arterial pressure or an increase in the blood pressure set point of the brain stem centers." +6
mangomango  Hypertensive heart disease causes concentric LVH - impaired diastolic function, preserved ejection fraction +

 +0  (nbme18#46)

This question is worded extremely poorly-- Basically I looked at it as if 1) the twin studies showed that it was 50% genetic 2) the other studies only found loci accounting for a small percent of that heritability

Based on 1 & 2 you can get to the answer


 +0  (nbme18#16)

ADHD--> sxs in 2+ settings--> school, and ER for skateboarding injuries Tx= methylphenidate

yourmomsbartholincyst  Could someone explain the significance of the skateboarding injuries? Is this some part of ADHD that I'm missing? +

 +0  (nbme21#50)

Check out FA2020 pg 508 Put simply--> myelin= black --> color of the normal white matter no myelin= pink --> color of the normal gray matter and the damaged area

Dorsal columns= vibration, proprioception, pressure fine touch F. graciLis= Lower body F. cUtaneous= Upper body


 +0  (nbme19#0)

HIT!

In heparin induced thrombocytopenia IgG Ab are developed against platelet factor 4 leading to thrombosis and thrombocytopenia

FA2020 pg 436

cbay0509  thank you +

 +2  (nbme19#0)

FA2020 pg 48

retrograde transport= dynein

anterograde transport= kinesin

REaDY? AttacK!


 +0  (nbme19#8)

FA2020 pg 612

HOX genes are implicated in segmental organization in cranial-caudal direction

transcription factor coding!!

mutations cause limb problems; isotretinoin leads to increased HOX expression


 +0  (nbme19#26)

FA2020 pg 88--Lysosomal storage diseases

fts= AR, progressive neurodegeneration, hepatospenomegaly, cherry red macula, foam cells

deficienct enzyme= sphingomyelinase (a lysosmal hydrolase)--> build up of sphingomyelin

" No man picks his nose with his sphinger"

increased incidence in AShkenazi Jewish population


 +2  (nbme17#35)

The pt presents with IBD sxs

sulfalazine= combo antibacterial and anti-inflammatory that is used in IBD and is assoc w/ orange discoloration of body fluids


 +4  (nbme17#9)

The pt has sarcoidosis via the classic demographic association and the b/l hilar adenopathy

in sarcoid you get increased ACE and you also get hypercalcemia due to increased 1-alpha-hydroxylase (via acitvated macrophages) which leads to increased vitamin D

FA2020 pg 676


 +3  (nbme17#16)

Inhalant intoxication= slurred speech, disturbed gait, drowsiness

Inhalant withdrawal= headaches and irritability

usually will present with rash around nose and mouth too

FA2020 pg 570

mittelschmerz  So mad I second-guessed myself on this. Its always PCP or huffing glue smh +
bingcentipede  Think I had UWorld question on this. Apparently in this age group (teens), inhalants like glue are the first drugs they try. Only ever seen this on It's Always Sunny but w/e +

 +0  (nbme17#2)

increased PTT + hemarthroses + easy bruising = Hempophillia A which is a deficiency of Factor 8 and is XL recessive (ie why the mom's brothers have it)


 +2  (nbme17#36)

The prednisone will induce T cell apoptosis (FA2020 pg 120)

cheesetouch  FA2018 p120 +

 +1  (nbme17#11)

Holosystolic murmur--> think mitral or tricuspid regurg Based on the location (APTM) the murmur is heard over the "T" area

furthermore, murmurs that increase in intensity upon inspiration due to increased venous return to the RH are RIGHT SIDED

FA pg 290 and 291

waitingonprometric  Dr. Ryan said, "rIght sided murmurs increase with Inspiration" and "lEft sided murmurs increase with Exhalation" --> always helps me! +6

 +1  (nbme17#19)

Asplenic and sickle cell pts are susceptible to encapsulated organisms such as strep pneumo.

Knight is holding the sickle in the sketchy!

waitingonprometric  Other bacteria that splenectomy patients are at risk for are Hemophilus influenza and Neisseria meningitidis +1

 +3  (nbme17#34)

FA 2020 pg 425

Porphyria cutanea tarda-- defect in UROD in the heme synthesis pathway that causes photosensitivity and blistering

bingcentipede  Most common porphyria, too +2

 +2  (nbme17#45)

late onset CAH w/ 21 hydroxylase defiency--> excess androgens (increased facial hair and irregular menses, etc), salt wasting (low BP), increased 17-hydroxyprogesterone is key

11B problem= HTN and excess androgens 17a problem= HTN and decreased androgens 5a reductase converts testosterone to DHT 3B-hydroxysteroid dehydrogenase is involved in steroid synthesis earlier in the pathway

bingcentipede  If you see HYPOtension in a CAH question, it's gotta be 21-hydroxylase! +1
bingcentipede  My special friend just gave me a mnemonic for this that I did not know. If the 1 is the 1st digit (11, 17) = hypertension. If there is a 1 in the 2nd digit (11, 21) = virilization. +1

 +3  (nbme17#5)

First aid 2020 pg 511-- brain lesion in the subthalamic nucleus = contralateral hemiballismus





Subcomments ...

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FA 2810 P.( 5)86

icedcoffeeislyfe  FA2020 pg 676 +  
lovebug  and FA2019 pg 662: Vit.D usually activated in Kidney. but They can be also activated by Macrphage like this case. +  


submitted by usmleuser007(333),
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SCN ehe/roarHgm dame )g1a 1428- rsH = red enunsor)2 13- sdya = etplhnusiro laveuiicetf(q )s3r scneoi) 5-3 = poashacergm mc4il()oagi )r -21 eswke = cieavetR sisolig (+ cauarsvl inopoa)tf) i5lrer orem hnta 2 kwsee = llaGi sacr

ne:to( eht hispnatseoeg si siimral ot IM and ist rcsa ramonftio; w,oeerhv het temi ucrseo orf SCN is utjs ar)stfe

teepot123  fa 19 pg 500 +  
icedcoffeeislyfe  FA2020 pg 512 +  


submitted by haliburton(196),
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sith is a vicrelac pinlas dcor t.secnio het ntueeac uussiclcfa si ttcina )(EU obrvitian adn oinepoc,triprpo ubt the iehtw insocte is het lceiagr ulufcicssa L)E( dan is dga.dema I tknhi het lteaalr nrpitoo hatt si vuenen is tjus u/ftltaartricana.

arezpr  thorax section +3  
guillo12  How do you know the gracile fasciculus is damage?!?! +2  
cr  which parte of the image its damage?, the pink? or black? +  
usmile1  the pink park yes +2  
d_holles  If you look at https://en.wikipedia.org/wiki/Gracile_fasciculus#/media/File:Spinal_cord_tracts_-_English.svg you can see that the closer to the center = legs, while further away = arms. +3  
hyperfukus  i still don't see where the damage is lol! FML +  
hyperfukus  i finally figured it out lol that was a slow moment i hope im not this slow on step yikes! +  
angelaq11  @hyperfukus I had the same problem at first, marked it and then came back. If you remember, in the spinal cord the white matter and gray matter are "reversed" compared to the brain. That said, if the butterfly shaped region (ie, the gray matter) is colored (in this case) lilac and the rest (ie, white matter) is blackish, the only thing that is actually abnormal, is the region where the dorsal columns are, because it stains just like the normal gray matter. After that, you have to think about which fasciculus is damaged, the gracilis or the cuneatus. The gracilis is medial while the cuneatus is lateral (picture someone with glued legs and open arms). Hope this helped +10  
azharhu786  Gracilus Fasciculus = Graceful legs +  
icedcoffeeislyfe  Check out FA2020 pg 508 Put simply--> myelin= black --> color of the normal white matter no myelin= pink --> color of the normal gray matter and the damaged area Dorsal columns= vibration, proprioception, pressure fine touch F. graciLis= Lower body F. cUtaneous= Upper body +1  


submitted by h0odtime(44),
  • R Lower quadrantanopia = C/L Parietal Lesion/MCA via Dorsal optic radiation.

  • If top quarter was gone, then it would be C/L temporal lesion via meyer loop.

drzed  the dorsal optic radiation is also known as "baum's loop" +  
icedcoffeeislyfe  FA2020 pg 542 +  


submitted by mcl(529),
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shiT is a pttyre doog gfuire isognhw teh onrnsivcoe fo eamrnbme hpiipssphodol to niadriccaoh ckle/noieieastrud .ect

dkealcBo of XCO zemney yb ifeournpb elsstur ni crddseeae tucdirpnoo of pssgonatnaidrl H2 nda ,E2 lwehi gascuin het ercrpossur to k"bca up" dcn(saieer cchrnaiaodi aci)d. ,iTsh in tnr,u tulress in idsarceen picudnorto of neslokieur.te

icedcoffeeislyfe  FA2020 pg 485 has a figure that is helpful! +1  


submitted by sahusema(124),
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.aRscaoe nA amaoitnfrmyl aiaflc nksi rdidesor catederrazich by suroymtthaee epslupa nda eutslup tbu on docmes.noe May be csaiteoasd hwit clfaai hsguinfl ni sroenspe ot lexrenta imtsilu e,(g h,oalclo heat.)

qball  https://en.wikipedia.org/wiki/Rosacea#/media/File:Rosacea.jpg for that quick picture. +1  
drdoom  and many, many more: https://www.google.com/search?q=rosacea&tbm=isch :) +  
icedcoffeeislyfe  FA2020 pg 477 +  


submitted by aliyah(17),
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heT rhtgi eys'e rfenfeet nreevs aer nriwgko, sa lfte eey tisumtoilan ucsesa a eacnhg in eth rhtgi T heey.e rhtgi yee tpico .n adamge sesacu st'i tfeerfan .n ot be ddgemaa. It a'cnt cyrra oinf to ra,nib so rihtg and felt eey ac'tn nocttcirs ot gi.hlt

icedcoffeeislyfe  APD--> swinging flashlight test, light in the AFFECTED eye will result in dilation of both pupils inappropriately +  
cbay0509  thank you +