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Welcome to joker4eva76’s page.
Contributor score: 25

Comments ...

 +4  (nbme22#15)
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lCdou loas use hte t'setipna age to kmae eth dneiafrfeli.t Age is a krsi ocfatr eretlda ot besrta cnerca (ommnoc ni sueplposntoma-a nowem, lsesun sert'he a trisyoh of brtsae ncearc in the ml.y)aif

tyrsiFciobc nacgesh dna aodrmsafnboei aer ylslauu ocmmon ni nlapuapoesmer .owmen

No shgiardec n,oedt os t'is ton an arindatltuc poi.lmaalp

yotsubato  Intraductal papillomas are also under the areola +5

 +7  (nbme23#4)
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ehT eotinqsu tesm is irsdbcgien a mitlooinardch esidaes, cihwh ooncmyml neepstr iwht cclita oicdisas. erheT is an ecaesrni in nbarcaoie fmrso fo nergey opdtoricnu sy)olysl(cg.i hTe iirtcanohmod are ,ftauyl so hyet ntca’ eus teh dne poctdur of oylygssicl prv(et)auy ni TCA. nadtIse yeptravu is nhustde erov nda is ueds yb HLD (cetlaat heyesgedndo)ar ot etagrnee apuve.try

Ae:dsi eallcR atth HLD seus AHDN nda setarenge DA+.N ecfnDcyeii of LHD nca ldae to sslo of teenaegrnoir fo AND+ nda hinsitib sgiycll.oys

drdoom  ... pyruvate is shunted over and is used by LDH (lactate dehydrogenase) to generate lactate*. +3
chris07  It's hinted in the answer, but I would like to clarify: max O2 consumption is decreased because O2 is consumed in the Electron Transport Chain, which occurs in the mitochondria. With the mitochondria not working, the ETC cannot work, and thus there is less demand for Oxygen. +17
masonkingcobra  Mitochondria are the powerhouse of the cell +50
uslme123  Apparently ragged red fibers are the result of coarse subsarcolemmal or intermyofibrillar mitochondrial accumulations.. +2
mnemonicsfordayz  As @chris07 said, less O2 is being consumed in the ETC... but I also was thinking that the diaphragm is a muscle and if the mitochondria in her diaphragm are also not functioning, then she's not breathing properly and less O2 is being inhaled and therefore decreasing her oxygen consumption. Is that totally off base or am I just grasping at straws here? +

 +4  (nbme23#13)
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sihT is tneevtearieprs fo ouka,kpeaill a aecps-ornercu sioenl of susmquao .lescl In rorde orf it to sprade ot sdintat seti,s it mstu srift avedni rhohugt the tmeseanb /bammrebce.nasousum uolCd eb ecufdnos hiwt roal yhiar palloeikkau whih(c alos is a etiwh atchp hatt llcaclasisy iseasr on the llraeat gu.oe)tn ,oveHerw aolr ryiha leiaolkkapu is ton r-ccrapeosuen and is onfet aodcastesi htwi EBV snocfiient ro epeplo atth are eeevsryl iommooeipru.dmsncm

hpkrazydesi  How did you know that this wasnt oral hairy leukoplakia? just from the picture? +1
nwinkelmann  To piggyback off of @hpkrazydesi, you ruled out oral hairy leukoplakia because the patient was seeing the doctor for normal health maintenance, i.e. not immunocompromised, I'm assuming. +2
dentist  @nwinkelmann thats correct! my time to shine. +

 +9  (nbme23#34)
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eegSni atf in hte tosol ldwou celu oyu in ot ehwerth ro ton teh trmnaeett enmergi is .rnokgwi egSnpiuplnmte itwh ipcaenarct zeynmse amens ahtt yuo hlsduo NOT ees rfo tfa in the ts.loo

Subcomments ...

submitted by mcl(579),
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neicS 'ryeuo siognl lal yoru irabcb tnoi ruyo eep, you wudol etpcex het pH to be eorm .nikllaea ,lsAo cenis htree is caeddsree +/+aHN ,ntptroia heter si lses simudo rsreobdbea nda hfteeorer eirsecnad osls fo efer uildf ot teh rui.en

joker4eva76  Why wouldn't this be similar to a Type 2 RTA where urinary pH <5.5? +1  
mcl  I can't remember exactly what the question was asking off the top of my head, I think it was asking about relative to normal? But I think you're right in that the alpha intercalated cells (AIC) can still dump H+ into the urine and acidify it to an extent. And, like in RTA2, I don't know that the action of the AIC would be able to overcome the bicarb and acidify the urine enough for it to be the usual pH, so the urine should still be more alkaline compared to baseline. Kinda sucks, pH less than 5.5 should technically be acidic but it's alkaline for pee. +  
mcl  JK, normal urine pH is around 4-8, but I guess they consider closer to 5.5 on the more alkaline side...? I guess I would go more off that the alpha intercalated cells can't completely compensate for the amount of bicarb in the pee due to the CA inhibitor, not so much the actual pH. +  
meningitis  Anhydrase inhibitors also affect the anhydrase inhibitors that are used in the AIC in order to excrete the H+. Here is a link: +4  
mcl  ohhhhhhhhhhhhhhhhhhhhhhh my god duh yes thank you <3 +1  
meningitis  Lol yw!! +