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I don't see where it says that gout is associated with kidney stones. Gout is more commonly caused by underexcretion than overproduction, yes? And this patient has renal insufficiency, yes? So if anything, they have LESS uric acid in the urine and are LESS likely to have stones. It's the reason they have gout to begin with (because it's out of the urine and into the blood).
This answer would make sense if the gout was due to overproduction but there is no evidence of that here. This isn't a very good question imo. Please lmk if I'm missing something here.
uric acid stones...
hyperuricemia may cause kidney stone if urine turns to be acidic or condensed. so I think this question is asking a general possible complication.
I think that what they were trying to ask was what could also occur due to the predisposing factor that led to gout. The patient was on a loop diuretic which can lead to hypovolemia. Kidney stones and gout occur more frequently when the substrates are able to concentrate in low volume.
furosemide and acetazolamid---> Nephrolithiasis!
thank you! it was the wording of the question which got me!!
I think there were two possible ways of approaching this.
The first was by appreciating that the tumor cells ( which release Growth Hormone ) would express growth hormone releasing hormone receptors GHRH receptors - GHRH uses the Gs signalling pathway ( Net effect an increase in cAMP from the increased activity of adenyl cyclase )
The second and more straight forward approach
From the stem of the question already they told us we are dealing with an overactivation of the G alpha stimulatory subunit .
If the GTPase aint working ( meaning it cant be inactivated ) , the effect would be an increase in the activity of adenyl cyclase
well I know you guys probably thought its a jam kinase because of somatotroph adenoma. we know growth hormone has a jar/ kinase right? but the question was really sneaky and mentioned that there is a G alpha s subunits protein!! that should remind you that Gs activates adenylyl cyclase to increase CAMP. the key world was Gs (and I didn't think about it cause I just saw somatotropin adenoma)
where in FA2020 will I find reference to this? I'm still at a loss ;/
m0niagui, Just Get this GHRH (Gs)cAMP ---->GH(Jak/STAT), And you can check all of them on the "Signaling Pathways of Endocrine Hormones"
C - Pons - CNs 8,7,6,5, likely result in "locked in syndrome" or complete loss of motor function on LEFT side + RIGHT sided facial features. Decussation occurs in medulla
Sorry if im mistaken, Isnt A) Somatosensory?
Yes i think A should be somatosensory. Primary motor cortex would be present in the precentral gyrus
A is primary motor. A and the gyrus at right side of A compose the paracentral lobule.
Mucus hypersecretion --> Induce airflow limitation in COPD
"potential risk factor for accelerated decline in lung function"
Cigarette smoke impairs both the phagocytic and respiratory burst function of neutrophils!
Macrophages-->activated by cigarette smoke extract to release inflammatory mediators
COPD--> alveolar macrophages and neutrophils are defective in their antimicrobial functions.
Macrophages from COPD patients--> show reduced phagocytic uptake of bacteria.
"Streptococcus pneumoniae and nontypeable Haemophilus influenzae"
I Hope This Helps...
Can someone explain why the other choices are incorrect?, Thanks
I got it wrong and put the lacunae one, I wasnt sure if hematopoietic stem cells could occur from the mother as well. If it had any other cell line i wouldve picked it. For the others: this lady has a partial mole, which has fetal parts. A complete mole has NO fetal parts. Both mole types have cyto, syncytio, and villi. Thats how I ruled those ones out
Agreed! It's along the lines of those marathon runners who collapse questions. Nothing but water for 24 hours = getting rid of too much sodium.
are we just going to ignore the diarrhea for 3 days? what is its significance
Temmy, We aint Ignoring the Diarrhea, Actually the most likely electrolytes to get lost with it is sodium> chloride> potassium> bicarbonate... Plus the Water intoxication -> HYPONATREMIA
Because glucose is not an electrolyte, it does not conduct electricity in solution. The question is asking "Which of the following electrolyte abnormalities".
I solve it like this: So age is 70 (already, nothing we can do to change it), is asking about a predictor of success in the Rehab process (So basically, what this patient did in matter of activity, life style, etc. to have a Good rehab process). So From all the answers the, Activity level is the most likely choice because of the, increase in Bone density(Specially Weigh bearing) and OsteoBlastic activity.
But bu that logic: just like you can't do anything about age, you also can't do anything about activity level BEFORE the fracture right...?
Agreed -- went with E. Coli like a dingus, just because I didn't associate DIC with S. Pneumo. Thought it was too easy.
Isn't E. Coli also an encapsulated organism? What makes Strep pneumo more likely in this question just because its the more common cause?
Pseudomonas aeruginosa is encapsulated as well. I think the right answer has to do with DIC but why?
The only reason i found was S. pneumo is more common, I went with Pseudomonas because of the "overwhelming sepsis" :(
Everyone is correct about the Encapsulated microbes, but this is one of those of "MOST LIKELY",
and by far the most likely is S.Pneumo>>H.infl>N.Mening. (omitting that patients with history of splenectomy must be vaccinated.
Gram negative are more common in DIC my friends
Correct me if I am wrong, but I am pretty sure that E. coli is NOT a common cause of pneumonia because it must be aspirated to enter the lung. Thus, only patients with aspiration risk (e.g. stroke, neurogenic conditions) would be at a chance of getting E. coli pneumonia.