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Welcome to pelparente’s page.
Contributor score: 16


Comments ...

 +2  (nbme18#19)

I believe this is rotavirus which is a common cause of fatal diarrhea in children. I think "wheel-like shape" is technically a buzz word for rotavirus, but I didn't know that. Yes, there is a vaccine, but it requires 2-3 shots giving within a month starting after 6 weeks of age so maybe this child isn't completely immune yet. Once you get to rotavirus you just need to know the rest and I linked the video below on how I remember all the viruses.

https://www.youtube.com/watch?v=Df_qAFF58Ec

cheesetouch  Rotavirus is the only dsRNA virus and is important/unique from that. +
overa  the vaccine is orally administrated +

 +1  (nbme18#28)

G-protein coupled receptors bind to GTP in the activated state and to GDP in the inactivated state. So inhibition of the GTPase keeps the receptor from turning GTP to GDP and thus it remains constitutively active (this is what tripped me up). Now that we know the Gs protein is overactive, then we know everything downstream is overproduced. Gs activates adenylyl cyclase which turns ATP to cAMP and thus cAMP is increased. No need to even know anything about Cholera if you understand the biochem.

Otherwise, you can remember that Cholera toxin over activates adenylyl cyclase and thus releases Cl- resulting in H2O loss.

I think about it as kind of like the opposite of cystic fibrosis, so in this case, the increased secretion of Cl- leads to less Na+ absorption and thus less H2O absorption (H2O efflux).


 +8  (nbme18#39)

If it ain't broke don't fix it. The patient is showing improvement and there are no signs of developing drug resistance or unwanted side effects, so maintain the patient on her current therapy.

Typical antiretroviral HIV therapy regime is:

3 NRTIs OR 2 NRTIs AND 1 NNRTI OR 1 Protease inhibitor OR 1 Integrase inhibitor

In this case the patient is on 2 NRTIs (emtricitabine, tenofovir) and an NNRTI (efavirenz)

nbmeanswersownersucks  and here comes my dumbass that read the lower CD4 count as his newer labs (instead of old) and was trying to figure out why his drug combo wasn't working.... +11




Subcomments ...

submitted by iguzman2(3),
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nt'erA M1 rcotrpese ndufo ni hte riabn and rea nilbsosepre for mitnoo esic?nkss

m-ice  M1 receptors are for sure the major muscarinic receptor type found in the CNS, but M3 receptors are the muscarinic subtype involved in vomiting controlled by the CNS. This is definitely a random fact, but I think they also wanted you to eliminate all other options. Targeting the sympathetic system (options A and B) won't make a difference. NMDA receptors are a major receptor throughout the CNS, but they're not a target of antihistamines, and neither are serotonin receptors. We know that antihistamines target histamine and muscarinic receptors, but the H2 histamine receptor is responsible for gastrin secretion in the stomach, so the answer must be antagonism of M3 receptors. +5  
dorsal_vein  ^ First generation antihistamines definitely antagonize serotonin receptors within the CNS, which can cause weight gain and increase appetite. However, this plays little role in motion sickness. +12  
mumenrider4ever  That is confusing because scopolamine (anti-muscarinic used to treat motion sickness) is an M1 receptor antagonist +2  
pelparente  So according to amboss scopolamine is a nonspecific antiemetic. I think Sketchy probably just confused everyone. https://www.amboss.com/us/knowledge/Antiemetics +2  
osteopathnproud  I had @m-ice logic down to H2 and M3, then from base knowledge, I was like H2 gastrin secretion or M3 contraction of smooth muscle like bladder... stomach stuff is for me so H2... I do not know how you can get this question without knowing that M3 has to do with motion sickness +  


submitted by match95(48),
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nealdIh esetaicthns ttah heav low agbsdol:o ipoirattn dnefcl/iefiobocto byllitousi ilevsods in obodl oerm .sileya orfreTehe, reeht is SESL sga neddee ot eatstaur oldob -- kaa rfetsa stiautnaor fo lbood. hiTs alsde to tsreaf sntiartaou of ira.bn

ldr;t wlo lostubliiy ;-g-t& tsafre nteso -g;-t& fersat ceroyver

pelparente  great answer; just to add to it. Lipid solubility determines potency, not onset/offset (that is determined by blood solubility as stated above). The more lipid soluble the more potent the drug. The more lipid soluble the drug the higher the oil:gas partition (directly proportional to potency) and the lower the MAC (inversely proportional to potency). Source: Boards and Beyond General Anesthesia Neurology +2  
cbreland  I really went down a rabbit hole on this one... Convinced myself that it had something to do with mask v. IV anesthesia even though I haven't seen/heard that anywhere. Taking step in a week🙏🏼 +  
jer040512  I thought a low blood:gas partition coefficient meant that it has a low solubility and therefore DOESN'T dissolve in the blood that easily. +2  
dhpainte22  Think onset/offset is about blood solubility and potency of drug higher with higher lipid solubility so low blood gas coefficient has faster onset and recovery. +  
jurrutia  Just to drill point home further: consider halothane, high lipid solubility (so high potency) and high blood solubility (slow onset). If you want fast onset, low solubility is the key. +  


submitted by lae(19),
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petoatdu ysas ti can uaces nylo cesiltyoto oenlssi ,oot dna esubcea ti ayss os"mt liekyl" dna tabser cnecar si teh tmos ocommn enracc in w,noem it is rsbate ...

pelparente  Yah ^ this is why I put breast over thyroid. +1  


Where do you get off selling peoples comments I understand you built the platform but charging $5 a month for something that was built by users that thought it was free for everyone. You should be ashamed of yourself.

blueberriesyum  People are going to move to a different platform now that this isn't free anymore. +1  
azibird  Oh shit, is that what's happening? Someone explain. I was wondering why there are so many questions missing, is that related? +  
thisshouldbefree  @azibird i dont think the missing questions is related to that as i dont think ppl would delete them +1  
drdoom  @thisshouldbefree after you pass a certain score threshold, you can add missing questions via a form on the main exam pages +  
pelparente  Yah it sucks that they are charging now, but I'm assuming they have to pay hosting fees for the website. It is basically going to cost you at most 10 bucks for your dedicated period, which isn't terrible, and good on them if they make a bit of money for having this idea. That's capitalism. I would love for it to be free, but please don't delete your comments if you posted something... I still need to study and these answers don't seem to be aggregated anywhere else. @not_greedy_like_you make another website that is free then get this content on there and create competition so they have to go back to free in order to have anyone on here if you feel so strongly. +