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neels11
and there's no mass in the scrotum, whereas testicular torsion will have that "bag of worms" feel (along with a lack of cremaster reflex)
testicular torsion usually happens in a younger age group
+1 2019-06-22T01:54:55Z
medpsychosis
@neels11 I would like to clarify a piece of information. I believe you are confusing Varicocele with Testicular Torsion. Varicocele will present with "bag of worms" feeling. While the absence of cremasteric reflex is a sign of testicular torsion.
+1 2019-06-25T04:29:39Z
johnson
This is the classic "loin to groin pain" of nephrolithiasis.
+ 2019-07-24T16:06:58Z
johnson
Also - you're almost NEVER referring/passing on a patient with the USMLE.
+1 2019-07-24T14:55:59Z
colonelred_
Catecholamines activate the Na/K pump, which will drive K inside.
+5 2019-05-21T09:43:23Z
trazabone
Read online that catachelamines are released following tonic clonic seizures. Besides that, BP of 180/100 could indicate that catecholamines are circulating.
+1 2019-05-28T22:18:28Z
fulminant_life
This mechanism is why giving albuterol for hyperkalemia works
+4 2019-06-23T15:52:48Z
nbmehelp
Why does this guy have increased catecholamines tho
+ 2019-07-19T06:47:50Z
johnson
His SNS activity is seriously increased --> increased catecholamines.
+ 2019-07-24T14:28:37Z
nbmehelp
Why is his SNS activity increased? Is the BP literally the only hint?
+ 2019-07-24T21:28:10Z
youssefa
Alcohol withdrawal creates a hyper- catecholaminergic state + Seizures do that as well.
+1 2019-07-25T07:40:44Z
water
My best guess is that withdrawal puts the body in a state of stress (same for seizures) and with stress you have release of catecholamine which we'll see in the BP and the hypokalemia.
+ 2019-07-29T13:50:57Z
rhsteps
isnt this considered physician assisted suicide?
+ 2019-07-22T16:25:07Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:02Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:17Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:23Z
rhsteps
isnt this considered physician assisted suicide?
+ 2019-07-22T16:25:07Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:02Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:17Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:23Z
rhsteps
isnt this considered physician assisted suicide?
+ 2019-07-22T16:25:07Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:02Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:17Z
johnson
No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well.
+ 2019-07-24T14:13:23Z
johnson
yep - supposedly, ethanol is used when a hospital/facility doesn't have fomepizole.
+ 2019-07-24T01:19:45Z
usmlecrasherss
Drink vodka man , either way you're dying
+ 2019-11-27T00:46:47Z
fulminant_life
I just dont understand how that is the cause of his altered state of consciousness. Why wouldnt altered affinity of oxygen from HbA1c be correct? A1C has a higher affinity for oxygen so wouldnt that be a better reason for him being unconscious?
+3 2019-06-22T20:29:07Z
toupvote
HbA1c is more of a chronic process. It is a snapshot of three months. Also, people can have elevated A1c without much impact on their mental status. Other organs are affected sooner and to a greater degree than the brain. DKA is an acute issue.
+1 2019-06-28T22:42:41Z
snafull
Can somebody please explain why 'Inability of neurons to perform glycolysis' is wrong?
+1 2019-07-16T12:43:19Z
johnson
Probably because they're sustained on ketones.
+1 2019-07-23T22:09:45Z
doodimoodi
@snafull glucose is very high in the blood, why would neurons not be able to use it?
+1 2019-07-27T18:15:19Z
soph
@snafull maybe u are confusing bc DK tissues are unable to use the high glucose as it is unable to enter cells but I dont think thats the case in the neurons?
+ 2019-07-29T21:57:39Z
drmohandes
I thought the high amount of glucose in the blood (osmotic pressure), sucks out the water from the cells. But you also pee out all that glucose and water goes with it. That's why you have to drink and pee a lot..
+1 2019-11-22T16:33:49Z
titanesxvi
Neurons are not dependent on insulin, so they are not affected by utilization of glucose (only GLUT4 receptors in the muscle and adipose tissue are insulin dependent)
+ 2019-11-27T15:07:58Z
How do you distinguish this from testicular torsion? Is it just because it started in the left flank?