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Laxatives would cause an anion gap metabolic acidosis due to loss of bicarbonate in the stool. You would see hypokalemia though as seen in this question.
it took me a lot of time choosing between laxatives and diuretics and at the end I choose diuretics. but I didn't realize that the only thing I had to do was check if were a anion gap or not.
Why would laxatives cause anion gap MA? Isn't it similar to diarrhea?
The above comments are incorrect. Diarrhea is a cause of normal-anion-gap metabolic acidosis (D in HARDASS from FA). Laxatives are wrong because they would lower HCO3- but in this scenario it is high. The low K+ and Cl- fits either case though.
Well color me surprised. I was completely thrown off here.
@almondbreeze go to the cardiovascular pharmacology you will see a draw of lipid lowering agents and you will find niacin en two places ++one on the adipose tissue and the second one in the liver by the vldl production. in the text in the same page is also mention it FA 2018 pg 313.
I still don't quite see how C corresponds to those 2 processes...
@titanesxvi because the dx is CHF
I get why crackles are more likely in CHF, but wouldn't it also cause whispered pectoriloquy, if fluid allows better transmission of sound?
Someone please help me with this (always trips me up): PTH causes increased vit D production in kidney... are we assuming the increased PTH can't catch up with the kidney failure? Is it the level prior to PTH compensation that they want? D:
@paperbackwriter what it works for me ;;;; is find the first abnormality so CKD low calcitriol (no D vit) ---> is gonna increase PTH ---> the kidney are not working (chronic, they don't tell u recently- you can;t revert a CKD so the kidney never going to catch up) --> increase inorganic phosphorus.--> always start with the problem. I also use this for celiac and types of shocks. start with the problem, and trust yourself.
@miriamp3 thank you! I will try out your strategy next time!! :)
I thought renal insufficiency -> inability to reabsorb phosphate at PCT -> decreased phosphate?
@haozhier if you are deciding to think that he had a ATN because of the 4 weeks.. then he should be by now in the recovery phase(polyuria, Bun/cr fall) But he is with HF and his urine output has progressively decrease. So AKI prerenal HF Bun/cr >20. the only one is D. Don't get confused with the rest of the information.
I thought the same thing so chose C as well!
Start at the pontomedullary junction and count from superior to inferiorly (or medially to laterally): VI, VII, VIII, IX.
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
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?
You're looking at the ventral aspect of the brainstem.
^Also, you know it's the ventral aspect because you can see the medullary pyramids.
think of the belly of the pons as a pregnant lady. so you're looking at the front of her
which letter is CN IX in this diagram?
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.
Don't G and H lowkey look like VII and VIII? I chose H b/c of that
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.
Mother Fuckers took this with a disposal camera then deep fried it. What is this grainy ass picture
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.