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 +4  (nbme21#4)

Tennis elbow results in strain of the common extensor tendon and inflammation of the periosteum of lateral epicondyle.

Lateral elbow pain, often felt when opening a door or lifting a glass.

origins of the muscles that may be affected (all have extensor in the name so if you remember that you could get this question by elimination)

  1. extensor carpi radialis longus
  2. extensor carpi radialis brevis
  3. extensor digitorum
  4. extensor digiti minimi
  5. extensor carpi ulnaris

From the 100 most important Anatomy Conceptions PPT (St Matthews University)

 +3  (nbme21#26)

Idk if it helps but I got it using the Hot T-Bone stEAK mnemonic

Hot -> IL 1 (Fever)

T cell stimulation -> IL 2

Bone marrow stimulation -> IL 3

IgE -> IL 4

IgA -> IL 5

aKute phase protein -> IL 6

temmy  cyclosporine inhibits transcription of IL2

 +1  (nbme24#39)

Myogenic mechanism works in the afferent arteriole that supplies the glomerulus. When blood pressure increases, smooth muscle cells in the wall of the arteriole are stretched and respond by contracting to resist the pressure, resulting in little change in flow. When blood pressure drops, the same smooth muscle cells relax to lower resistance, allowing a continued even flow of blood.

Click the link to read about tuburoglomerular feedback as well. https://courses.lumenlearning.com/suny-ap2/chapter/regulation-of-renal-blood-flow/

 +0  (nbme24#50)

Pg 360 First Aid 2019

Internal Hemorrhoids

-Visceral innervation (no pain felt), Superior rectal a., Superior rectal vein (drains to IMV), Internal iliac lymph nodes


External Hemorrhoids

-Somatic innervation (they hurt), Inferior rectal a., Inferior rectal vein (drains to internal pudendal vein), Superficial inguinal lymph nodes

kateinwonderland  Above pectinate -V:sup. rectal v -> inf. mesenteric v. -> splenic v. -> portal v -internal iliac LN Below pectinate -V:inf. rectal v -> internal pudendal v->internal iliac v->common iliac v->IVC -superficial inguinal LN (FA 2018 p360)
sherry  Venous drainage above pectinate, most to the portal vein, some to internal iliac v via middle rectal vein. I think the real solid key here is that the clinical vignette suggests hepatic cirrhosis.

 +2  (nbme24#17)

Annular pancreas is an abnormal rotation of the ventral pancreatic bud. It encircles the 2nd part of the duodenum like a ring and narrows the lumen of the duodenum. If the pancreatic ring is tight enough to narrow the lumen enough, it leads to vomiting. The bilious vomiting implies the obstruction is distal to the Ampulla of Vater.

Other answers

Pyloric stenosis -> NONbilious projectile vomiting, olive-shaped mass in epigastric region

Esophageal atresia -> would be non bilious as well. usually neonates present with drooling, choke and vomit with FIRST feeding, this boy is 3 yrs old so it is unlikely.

Biliary atresia -> Fibro-obliterative destruction of extrahepatic bile duct, leads to cholestasis. Usually newborn with jaundice, dark urine and acholic stools because bile backed up.

Subcomments ...

Can someone please clarify the answer. Is decreased adherence same as decreased aggregation? Wouldn;t inhibition of the IIb/IIIa receptor prevent aggregation?

xxabi  I'm not completely sure...but I think its because its aspirin, and aspirin doesn't work on IIb/IIIa receptors. That's why i picked decreased adherence of platelets, figured that was the closest thing to decreased aggregation that still made sense with aspirin's mechanism of action. Hope that helps! +  
ihavenolife  Aspirin irreversibly inhibits COX which leads to decreased TXA2. TXA2 normally is a vasoconstrictor and induces platelet aggregation, so aspirin inhibits platelet aggregation by downplaying TXA2 not by interacting with IIb/IIIa receptor. (Source FA and UWorld) +6  
fallenistand  In this case, inhibition of COX-1 by aspirin will also reduce the amount of precursors for vascular prostacyclin synthesis, provided, for example, from adhering platelets https://www.ncbi.nlm.nih.gov/pubmed/9263351 +  
niboonsh  inhibition of IIb/IIIa receptor is the moa of a completely separate class of drugs - Glycoprotein IIb/IIIa (abciximab, eptifabide, tirofiban) +