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 +0  (free120#13)

The inferior thyroid artery (branch of the thyrocervical trunk) irrigates the posterior thyroid, including the parathyroid hormones.


 +0  (free120#17)

Myeloperoxidase is the only one actually involved in making free radicals. Catalase makes H2O2 into water, Superoxide dismutase eliminates oxygen radicals, LDH makes lactate (no role in bacterial killing), and NO synthase, makes NO.

b1ackcoffee  I thought SOD also comes (second) after pathway (making h2o2) to make HO—Cl
mdmofongo  Now that I took a look at the pathway again you are right. Knowing this I’d say that free radicals of O2 still have a chance to cause some damage, as where Hydrogen peroxide just serves as a intermediate for free radical formation. Thus SOD deficiency leaves some bactericidal action but MPO leaves none?




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submitted by mdmofongo(0),

Myeloperoxidase is the only one actually involved in making free radicals. Catalase makes H2O2 into water, Superoxide dismutase eliminates oxygen radicals, LDH makes lactate (no role in bacterial killing), and NO synthase, makes NO.

b1ackcoffee  I thought SOD also comes (second) after pathway (making h2o2) to make HO—Cl +  
mdmofongo  Now that I took a look at the pathway again you are right. Knowing this I’d say that free radicals of O2 still have a chance to cause some damage, as where Hydrogen peroxide just serves as a intermediate for free radical formation. Thus SOD deficiency leaves some bactericidal action but MPO leaves none? +  


Calcium is low while PTH is high. It’s primary hyperparathyroidism (not secondary). Ans is branch of IJV.

mdmofongo  You’re right, how weird. But I guess following the Hx there is no other way to approach it? Not a fair question I would agree. Also the inferior thyroid artery does branch off of the thyrocervical trunk. The superior and middle veins of the thyroids drain into the IJV. +  
b1ackcoffee  I got that it must be some vein, I just didn’t know the tributaries. Oh well, anatomy fucks me again! +  


Any good material for this and lymph node drainage in general? Is this common knowledge or low yield stuff?

mdmofongo  I got this question right thanks to the 100 high yield concepts of anatomy pdf, learn the lymph node drainage from there and you will be all right. +  


confused why this is not autonomic dysfunction or hyponatremia due to sweating and why is this orthostatic hypotension?

mdmofongo  This one is tricky and come downs to choosing the “best” option. I can see why you were confused. However do note that in an autonomic dysfunction you will never present tachycardia as this patient does. I guess the key here is seeing how her BP normalizes once she is laying down? Sorry, this one is a kinda unusual presentation of Orthostatic hypo. +  
mamed  Not sure if this is correct thinking but how I got this right was: 1. She is hypovolemic 2. Likely retaining salt so water follows (ADH or just renal dynamics in general). This is how I ruled our hypokalemia and hyponatremia 3. If she is hyponatremic b/c sweating then why wouldn't she also be hypokalemic? so both have to wrong because both can't be right 4. Volume depletion ==> orthostatic hypotension +  


I am wondering which parasite is this actually? --

mdmofongo  The clinical presentation sounds like a GI parasite, which are transmitted via fecal-oral route, so ingestion of soil would be the most sensible answer. All the other routes are of parasites with more severe or systemic infection. +  
b1ackcoffee  @mdmofongo I know this. But which parasite is this? +  
drblu92  The parasite is most likely Trichuris trichiura (human whipworm). Trichuriasis is often asymptomatic and adult forms can reach 2 cm in length (visible with naked eye). A lot more common in tropical areas but there have been cases in the southeastern US (ex: Kentucky). All other GI worms would present with either a fever or a cough. Treat with mebendazole or albendazole. +2  


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