welcome redditors!to snoo-finity ... *and beyond!*

Contributor score: 5

School:

Comments ...

+4
(nbme23#38)

Informed consent should be obtained by a provider who has sufficient knowledge to give an accurate description of the intervention, the risk and benefits, alternative treatments and to answer all of the patient's questions

stinkysulfaeggs
Hate this question though... the first thing you would have to do in this situation is refuse to do what the resident asks you to do. Then you could accompany them....

Subcomments ...

submitted by happysingh(6),

so, the Key words that no one is mentioning : communicating hydrocephalus

the pathophys goes like this :

an inflammatory setting (i.e., subarachnoid hemorrhage) yield fibrosis / scarring of the arachnoid granulations => impaired CSF drainage

the key points / concepts they are trying to test here : 1. do you know what communicating hydrocephalus (without them telling you those words) 2. do you know what's the pathophysiology (of communicating hydrocephalus) is ?

potentialdoctor1
Exactly. To add to this, communicating hydrocephalus can be subdivided as follows:
Normal-pressure hydrocephalus: Chronic/gradual decrease in CSF reabsorption at arachnoid granulations, usually due to calcification due to aging. CSF accumulates slowly, so ventricles are able to widen without causing an important increase in intracranial pressure. Symptoms occur due to compression of periventricular white matter tracts ---> Wacky, wobbly, wet
High-pressure hydrocephalus: Acute decrease in CSF reabsorption at arachnoid granulations, usually due to inflammatory state in the subarachnoid space (eg, meningitis, sub-arachnoid hemorrhage). CSF accumulates suddenly, causing an acute-onset increase in intracranial pressure
+1

sunshinesweetheart
not to take away from your perfect explanations, but if it were a woman with neck stiffness and fever (rather than circle of willis rupture) that could lead to increased CSF production, right? I think that's the only case where CSF production would increase. Also I think decr absorption in arachnoid granulations in that situation as well so it'd be a shit question
+

submitted by tea-cats-biscuits(69),

Partial agonists have weak agonist activity on their own (thus in this case it causes HR to increase, b-adrenergic effect) but when an actual agonist is present (aka when you are exercising, you are producing NE and E that have full b-agonist effects), partial agonist actually have a mild antagonist effect (thus the heart rate decreases).

potentialdoctor1
Might be relevant to add that there are two beta-blockers that are actually partial beta-agonists (exert their blocking effects due to lesser effect when compared with endogenous catecholamines) ----> Pindolol and acebutolol
+

p-value refers to the probability of making a type I error (probability of having a false positive). When the 95% confidence interval does not include the null value (1 for ratio, 0 for difference), 0 < p < 0.05 (between 0% and 5% chance of having a false positive). However, when the 95% confidence interval includes the null value, 0.05 < p < 1.0 (between 5% and 100% chance of having a false positive).

Think of it as follows ---> If the 95% confidence interval includes the null value, then you have somewhere between 5% and 100% chance of being wrong if you conclude it is right. Conversely, if the 95% confidence interval does not include the null value, then you have between 0% and 5% chance of being wrong if you conclude that is is right