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Welcome to nukie404’s page.
Contributor score: 7


Comments ...

 +2  (nbme23#5)
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thotcandy  Literally had it on OI until I saw no family hx... Isn't it AUTOSOMAL DOMINANT? +2
faus305  FA 2019 pg. 51. Yes it is autosomal dominant. This question is poorly written but the clues are "wormian bones" and multiple fractures. Pretty sure everyone on this page would've nailed the diagnosis if seeing a real patient instead of using three lines of text with two hints. Questions like this demonstrate how this test became a way of ranking people based off of minutia they know and not their clinical abilities. This is why step is pass/fail in 2 years. +

 +1  (nbme23#6)
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To msu ti pu, enev if uyo didnt' mmizeero teh hwelo moiutiznnmia albe,t sit' asey to mbreemre BHV utamnmniioiz is oend ta hbrt,i o,m1 o2m adn m6o oguyh.lr losA dedad atht eth ybab si of tEsa Anasi ,ecednt nad teh tcaf taht oehtr cnitenoifs no the tlis en'tar eeendrcs rfo ni teh sifrt alcep in -oelyalhihtgokn teinptas, I hintk 'its efas to deeucd VBH was eth srnawe rhee.





Subcomments ...

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nukie404  I wonder though, is it not possible for irradiated food to change in their protein structure, possibly somehow affect us? Some suggest Regardless I guess since it as irradiate with gamma radiation, there's no chance of the radiation staying in the food. In that sense I guess the answer makes sense but... +3  
dul071  "the 100" on netflix taught me this lol +  


submitted by shaydawn88(8),
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sI it eolair-lrnavta sdntesaruta besucae tsih eitpnat mtihg haev FH d/t .a ibf and elft ltraia &ng-nttegrmlea;e cin ihotastcdyr rr&-gsuteesp; aurtsendta upealrl ff?onusie

sajaqua1  Basically. +4  
medschul  Why can it not be arterial hypertension? +2  
meningitis  I think Arterial HTN is referring to Pulmonary Artery HTN which would be present in LT HF in the long run with RT HF and edema. Pulm HTN would cause a backflow, and doesn't really answer the question "explain the patients Dyspnea". At least, that's how I saw it. Hope this helped. +5  
sugaplum  the question has 2 murmurs, so does she have aortic stenosis too? i guess it is not relevant since it asked for what is causing her SOB +2  
nukie404  I guess pulmonary HTN would happen in response to increased pressure after the edema happens, and would cause backflow (to the RV) over pulmonary edema. +  
vulcania  There's a really great diagram in UWorld (QID 234) that explains what happens as a result of mitral stenosis. Very similar sounding to the patient in this question. +  
srdgreen123  @sugaplum, yes rheumatic heart disease can cause mitral and aortic stenosis. Rheumatic aortic stenosis can be distinguished from degenerative aortic stenosis by 1)coexisting mitral stenosis and 2)fusion of the commisures. +1  


submitted by chetzy(0),
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csenirea hp oshsw tsi nmsmgaeui uaimmonm posphthea lhycas.rtsp 3.7

bulgaine  The image shows a staghorn calculi which content is usually magnesium ammonium phosphate (can also be cystine but pH would be decreased not increased) and is caused by urease positive bugs that hydrolyze urea to ammonia leading to urine alkalinization (page 586 of FA 2019) +1  
nukie404  Patient also has a fever, suggestive of a UTI +1  
sigecapps  Why not calcium phosphate, also at high pH? I was between the two but decided on calcium phosphate because the images of staghorn I've seen seem to be more smooth and rounded. I guess should've gone more based on the pyelonephritis symptoms as well caused by the stone harboring bacteria. +1