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Welcome to myoclonictonicbionic’s page.
Contributor score: 28


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iAr dan dlifu = ahyduroh.mpnrtoeox fI tath fduil is lbood p/s( nst,bia)bg i’st a ntomoeehpraoxuhm. acLk of asdenialmit ithsf nidetasic thta i’ts not rndue in.eotns

d_holles  @benwhite_dotcom how can it not be under tension if air is entering the pleural cavity? +1  
nwinkelmann  Because the stab wound isn't functioning like a flap, meaning the air can escape. The reason a tension pneumothorax occurs is because the wound acts as a flap, where on inspiration it is open and air enters, but on expiration is closes and traps the air. +10  
groovygrinch  Also if there was tension, there would be a mediastinal shift. +11  
t123  Also the gastric bubble is elevated, actually suggesting lower pressure. Mediastinum shifts require more pressure, but the gastric bubble confirms it. +1  
myoclonictonicbionic  I was overthinking and thought they're implying that the stomach bubble is the air-food level that was seen on the Xray. +3  
cheesetouch  umm air-fluid*^ lol +1  


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Ddi yeanon lees og nwod h:te she's snipevhyteo os bmaye 'leslh gte ahruewseot esniridhrecf mydsnreo cbeeuas ihnotng eles is kmgani eness to em ta hist ?poitn?? oteur -

rTnus ,tou rsveee rlaiaam nca cusae iosaaduacrlrcv lecalpos nad ooshtnieny.p

redvelvet  me too :( +1  
abigail  me three :( +1  
yex  Me four :-/ +1  
link981  Slowly raising my hand as well +1  
tinydoc  Sammmme +1  
bullshitusmle  same here!!!:@ +1  
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +12  
aisel1787  me five( +  
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +1  
alexxxx30  sammmeeeee +  
snripper  Dumbasses unite lmao +  
usmleaspirant2020  lol saaaaame! +  
usmleaspirant2020  lol saaaaame! +  
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +1  


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mCptenoeml si tmairnpot for reimogvn mimenu solpe,xemc so nseittpa ithw mclenetomp deesieniicfc 4-)1*(cc ear moer lykeli ot levdpeo LS.E 1Cq is a tetbre arwnes tahn nhta LMB )(D /cb eth LBM ptawhay is eitrggder by ebaiactr.

myoclonictonicbionic  Thats the reason I put MBL, because the question mentioned that it got worse when she went to the beach so I was thinking some sort of contact with bacteria may have exacerbated her immune system. +  
thotcandy  @myoclonictonicbionic i think that's just the typical SLE photosensitive malar/butterfly rash +1  
dna_at  FYI it is less to do with immune complex clearance than it is to do with clearance of apoptotic debris. The overload of apoptotic autoantigens contributes to loss of tolerance -> SLE. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764694/#S4title +2  


submitted by t123(20),

This question is really testing what the different types of diarrhea show. Key is "stool shows no abnormalities". In malabsorption, exudative, osmotic, and secretory diarrhea, your poop would be weird in some way. A motility disorder is the ONLY type here that would cause normal poop.

myoclonictonicbionic  How would stool be different in secretory or osmotic diarrhea? They state that he has loose stool which could also indicate osmotic/secretory diarrhea. I think they are trying to hint that he has diabetes for 26yrs therefore he has diabetes enteropathy and therefore motility issues +4  
takayasuarteritis  I'm with you on this. I think it's a myenteric nerve plexus issue from long-standing diabetes. +12  
drpee  Neuropathy makes sense for T1DM, I guess I just expected a motility issue to cause constipation rather than diarrhea... +13  


submitted by sammyj98(24),

did anybody else second guess the heck out this answer just because he's got a pH of 7.2 and he's hanging out in an outpatient clinic? I haven't done my clinicals yet but it seems like this guy would be struggling..

myoclonictonicbionic  EXACTLY... 7.2 for 6 months without any drastic symptoms.. that doesn't sound right +5  


submitted by sattanki(71),
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neppytralA eerth is a motlpecyle peraesat pnalis drco felerx wehre iedrtc ipenle tniutiosmla deals ot an rienoc.te sTih rxeelf noyl sdeen na tiacnt arc in S,S2-4 so as gnlo as thsi geroin si otn runj,die an nerciote acn slitl cuo.cr veHoe,wr hwti oirtnctneas at C8, nthe eht pinycgshoce ceoitren efxerl tnanoc urocc, sa tish irrseqeu edsidnegcn esrfbi from the retoc.x

lsmarshall  Just saw a good summary of nerves/vessels involved saying, "pelvic parasympathetic fibers from S2-S4 can cause cavernous arteriole vasodilation via the cavernous nerve without of central stimulation." +7  
seagull  S2-3-4 keeps the penis off the floor +37  
drdoom  Modifying @seagull into iambic pentameter: “S2, S3, and Number 4 / keeps the big ole penis / off the floor” +2  
myoclonictonicbionic  I can assure you the validity of answer (speaking from experience) +2  
raddad  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896089/ Under the "autonomic control" header +1  
llamastep1  I've always wondered how quadraplegics got it up. I guess their girls help em lol +  
jj375  This article is shockingly helpful. Scroll down to the 3 types of erections (psychogenic, reflexogenic, nocturnal) https://craighospital.org/resources/sexual-function-for-men-after-spinal-cord-injury +1  


submitted by m-ice(340),
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eTh tinpaet nseed meaildc ientnotat ditia,emlyem hciwh isatmienle gitobnnia a coutr drro,e ro grsfretrnani he.r A eunsr sdeo tno heva eth msae tnairing adn aonlacuiiftiqs sa a hnca,pisyi os ti wludo eb reaaipriopnpt ot aks mhet ot ixneaem teh tnatpie. igksAn het iasthplo hapnicla ainag odluc be aiiponretrap,p adn would atke mroe e.itm e,roThfeer the bste toinop ngoma oehst ignev is ot aks hte enittap fi ehs wlil allow whti erh ahudbsn erentp.s

sympathetikey  Garbage question. +60  
masonkingcobra  So two men is better than one apparently +29  
zoggybiscuits  GarBAGE! ? +1  
bigjimbo  gárbágé +4  
fulminant_life  this question is garbage. She doesnt want to be examined by a male how would the presence of her husband make any difference in that respect? +12  
dr.xx  I guess this is a garbage question because what hospital, even small and rural, does not have a female physician on staff. NBME take notice -- this is the 2010s not 1970s. https://images.app.goo.gl/xBL4cK31ta7nG4L39 +9  
medpsychosis  The question here focuses on a specific issue which is the patient's religious conservative beliefs vs. urgency of the situation. A physician is required to respect the patient's autonomy while also balancing between beneficence and non-maleficence. The answer choice where the physician asks the patient if it would be ok to perform the exam with the husband present is an attempt to respect the conservative religious belief of the patient (not being exposed or alone with another man in the absence of her husband) while also allowing the physician to provide necessary medical treatment that could be life saving for her and or the child. Again, this allows for the patient to practice autonomy as she has the right to say no. +16  
sahusema  I showed this question to my parents and they said "this is the kind of stuff you study all day?" smh +26  
sherry  I totally agree this is a garbage question. I personally think there is more garbage question on new NBME forms than the previous ones...they can argue in any way. I feel like they were just trying to make people struggle on bad options when everybody knows what they were trying to ask. +  
niboonsh  This question is a3othobillah +5  
sunshinesweetheart  this question is really not that garbage....actually easy points I was grateful for... yall are just clearly ignorant about Islam. educate yourselves, brethren, just as this exam is trying to get you to do. but yeah I agree there should be an option for female physician lol +5  
drmohandes  I think this NBME24 is a waste of $60. On one hand we have these types of questions, that have 0 connection to our week-month-year-long studying. On the other hand we have "Synaptobrevin" instead of SNARE, because f*ck coming up with good questions. +12  
myoclonictonicbionic  @sunshinesweetheart I actually have studied the religion tremendously and there a clear consensus among all Muslims that in the case of an emergency, it is completely allowed to have someone from the opposite gender examine you. I think this actually represents how ignorant the exam writers are of Islam. +11  
korahelqadam  All it takes is one NBME question concerning muslims for the Islamophobia to jump out I guess +  
sars  This is a very fair question. I agree with sunshinesweetheart above. That is all. +  
wrongcareer69  Garbage question +  
alimd  well we should wait for the question "if a man shouts I CANT BREATHE with a police knee on his neck, what is your next step? Ans- wait 8 minutes." +1  


submitted by studentdo(9),
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Teh rjoma tnomoi fo osaPs jomra si nfliexo fo p.ih sThi ttnaepi si dhel in gi"rid nioes,xent" echne he sedo not wtna ot lfxe. ssoaP is the nloy eusmlc on htis lsti ttah scteoncn teh uamlbsr to leowr xiteermyt "lodhs shi ghrti lwero yi"exetmtr

myoclonictonicbionic  The qstem said "lower extremity in rigid extension" which made it sound like extension at the knee joint rather than at the hip. Confusing wording +2  
j44n  if you lay on your back and kick your leg straight up this is lower extremity extension, hes doing that to prevent any weight being placed on his psoas, I know because ive had psoas problems before and you will do ANYTHING to keep your hip from flexing (like doing a sit up or pulling your knees toward your chest) getting in and out of a car was a nightmare +