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Comments ...

 +2  (nbme22#37)

This is internuclear ophthalmoplegia. In INO you would see impaired adduction during horizontal gaze due to a lesion of the ipsilateral MLF. However, since the MLF is not involved in convergence, the affected eye is still able to converge normally.


 +0  (nbme22#29)

How are you able to tell that the CT slice is not at the level of duodenum?

zelderonmorningstar  I think the small intestine narrows as you go along, so jejunum would most likely intuss into the duodenum.
yotsubato  Duodenum is fixed to the retroperitoneal wall, and also has lots of named vessels attached to it, along with the pancreaticobiliary duct and ampulla. It cant really intussuscept.
gh889  You should also know that the duodenum is almost purely on the right side of the body

 +24  (nbme21#3)
  • APocrine = your armpits smell like an APE
  • ceRUMen = there’s no ROOM in your ears since they’re full of wax
  • EC-CRYne = when you ECercise, your pores are CRYing
  • SEBaceous = SEBum is SEEPing out of your pores
hungrybox  as an ape i'm offended
dr.xx  stop being an ape. evolutionize!
dbg  as a creationist i'm offended
maxillarythirdmolar  Also, Tarsal/Meibomian glands are found along the rims of the eyelid and produce meibum

 +3  (nbme21#16)

I just remember Sattar saying MVP tends to be asymptomatic. Also, I think the kid complained specifically of coughing, and that made me really lean away from MVP.

yo  he also has a family history of asthma. that's shit is genetic. +1 for asthma.
yotsubato  Cheif complaint is SOB during exercise with coughing. Mitral valve prolapse is not going to do that so I picked asthma as well.

 +0  (nbme21#24)

I don’t think it was cavitary; I think that was just the bronchus. I think abscesses tend to be smaller, and wouldn’t affect the surrounding parenchyma much. I wasn’t super confident in picking squamous cell carcinoma, but I did know that squamous cell carcinoma tends to be a centrally-located lung tumor.

fallabella4  Squamous cell carcinoma of the esophagus presents itself as an raised plaque with ulcerations




Subcomments ...

submitted by oznefu(7),

I get she doubled her levothyroxine dose because of fatigue. I get that TSH is decreased. But why is free T4 decreased and free T3 increased? Wouldn’t both free T4 and free T3 be increased?

lnsetick  she doubled her triiodothyronine not levothyroxine, so she took a bunch of T3 -> feedback inhibition of TSH and therefore decreased T4 +3  
oznefu  D’oh didn’t even read that just assumed it was levothyroxine. Thanks! +1  


submitted by _pusheen_(1),

How can you tell that the ankle fracture is eversion?

lnsetick  Because there is avulsion fracture on medial side from deltoid ligament and fibular fracture on oppostie side, this is classic for an eversion. +1