NBME Answers : lolmedlol's page

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submitted by dragon3(12),

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lolmedlol i think neutrophils (in addition to lacking granzymes and perforins which are used to kill viruses and fungi) dont recognize intracellular things; viral antigens needs to be processed and presented on an MHC for the lymphocytes to recognize +6

usmile1 also neutrophils are only seen in acute inflammation. This pt has longstanding inflammation which is associated with monocytes, lymphocytes, macrophages, plasma cells. +4

usmlecrasherss Neutrophil come and goes quick like day or two , after that rest of immune cells take care +

submitted by seagull(1392),

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hWta a ribeletr etcu.rpi eThy tehy crvdeoe up aprt of ti whti sln.ei FWT

sympathetikey Agreed. +10

catch-22 Start at the pontomedullary junction and count from superior to inferiorly (or medially to laterally): VI, VII, VIII, IX. +3

yotsubato I looked at the left side (cause the nerves arent frazzled up). Saw 7 and 8 come out together nicely. Then picked the right sided version of 8 +11

lolmedlol why is it not H or I on the right side; the stem says he has hearing loss on the right side, so the lesion should be ipsilateral no? +2

catch-22 You're looking at the ventral aspect of the brainstem. +10

catch-22 ^Also, you know it's the ventral aspect because you can see the medullary pyramids. +1

amarousis think of the belly of the pons as a pregnant lady. so you're looking at the front of her +4

hello which letter is CN IX in this diagram? +

miriamp3 there is no VI nerve. That's the thing. The VI nerve should be in the angle between the pons and the medulla. Parallel to the pyramid. It goes V then VII and then VIII. I make the same mistake and I thought it was the picture but there is no VI par in the photo. They know We count from superior to inferior. +

jesusisking Don't G and H lowkey look like VII and VIII? I chose H b/c of that +

ljennetten G and H are CN VII and VIII on the left side, while this guy has right sided hearing loss. CN VI is not labeled in this photo, but is the smaller nerve that arises medial to CN VII and us cut most of the way up the pons. +1

prolific_pygophilic Mother Fuckers took this with a disposal camera then deep fried it. What is this grainy ass picture +1

soccerfan23 There's over a million pics of the brainstem on the internet and of course, the NBME picked the worst quality, most blurry one for this Q. +

submitted by bubbles(66),

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lolmedlol i believe you get peripheral vasoconstriction and central vasodilation in the first stages of shock, which would cause stasis in the capillary beds, which would mean decreased capillary hydrostatic pressure, despite interstital hydrostatic pressure going down as well. https://www.sciencedirect.com/topics/medicine-and-dentistry/vasoconstriction and amboss shock description +1

trichotillomaniac https://derangedphysiology.com/main/core-topics-intensive-care/manipulation-fluids-and-electrolytes/Chapter%201.1.8/response-haemorrhage-loss-1l-blood +

trichotillomaniac ^ this type of question is really hard for me to conceptualize. the link above walks you through it step by step with pictures. Theres not much of an explanation in FA. +

trichotillomaniac Overall is has to do with osmotic vs hydrostatic pressure. osmotic pressure stays the same and hydrostatic decreases. Hydrostatic pressure is the pressure pushing fluid out of the capillary and in the setting of blood loss this would decrease in efforts to keep as much fluid in the intravascular compartment as possible +2