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Welcome to pparalpha’s page.
Contributor score: 84


Comments ...

 +0  (nbme22#5)
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aCn smooene lpaees axpenil ywh ti odulw nto be ycglengo ?pdteeilon I htoguth eht eniotuqs asw kgitlna abtuo het bWgaurr e.mnn.he.poon so wyh not wneorkbad of gcnleyog ot goelc?su

I sgues it wluod ont lienaxp hte edmea?

hello  Glygocen stores are depleted within 24h. This person has signs and symptoms of longterm nutritional deficiences. +2
raffff  it would not explain the edema, yes +
drzed  Also the warburg phenomenon has to do with cancers preferentially taking up glucose; there is no indication that he has cancer. +
haydenelise  The first sentence says that he has lung cancer. +2

 +7  (nbme22#8)
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ringoccAd ot :nBB

Clravcei bri si na olmansuao erxta irb frmo hte ht7 vcrleaci b.eveerrta peoelP itwh ihst ear ta srik rfo oahitccr totleu orsdmeyn aa(k ssiomnecorp of resven dna svselse ttha aeelv eht a.hxotr Tihs ocsucr oveab teh tsfri rbi dna bihdne teh vlciaelc.)

ialniClc uefestar leindcu:

1) aalcbirh xlsuep jyinru us(hc sa kKuplme s,aylp hhwci si a ewlro upslex )niyruj

2) oVusne iomespsocrn

)3 rraieAlt scmorisnpeo

*nA pttamnori amlioacnta ateerclor teh eacsnle giaenlrt iratr(eon se,elnac lemidd ese,nalc vabeo teh tfirs r)bi

llamastep1  The cervical rib is underneath the brachial plexus, the pressure of the backpack compresses these nerves causing the pain https://lh3.googleusercontent.com/proxy/m6FASqomZvlebUu8MoUePvFzMXP7u8vgEnT0VamRq3Wij_sOH7gtJTfK1L9LCeOgsq-O6Rpxd_Z0mhjL +1
rockodude  link didn't open for me +1

 +5  (nbme21#21)
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tibiihnnio fo obmclutriue atirzenpoyioml → iiithibsn istpsoachgyo fo raute ,rtycssla lyetkouec ntitacavio dna ,rmioaigtn dna llce xomsehca.ti

teepot123  fa 19 pg 476 +

 +3  (nbme21#47)
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The uianinlg part fo hte nsueqoti ptsino you to a a ofmlrea ieharn

raFelom eria:nh oconmmnu ptye fo ainliung erhn,ai in ichhw atmaln-dobiarin tstcneon (in htsi aesc teh malsl wobe)l tierhaen ntoi eht lrmeofa aclna ohrhtgu eht moaeflr girn

Teh ia:emg aaltuogn:sirnt cmicesih iocenrss fo enstnoct nwhtii eht einhar asc sa doolb fowl is omrdoeiscpm ued ot einnrioccarta iedcur(rbile aeolfrm aherni deu ot eatrppd irnaeh sctntone in henira )acs

oS, ni t:hosr roemfla irnhea acn laed ot a tcnimcopolai cledal atainoercrnci hcwhi nac dlea ot nasalutronitg

madojo  Femoral hernia's are more common in women, i don't think this was a femoral hernia, either way any type of hernia can under strangulation. +

 +1  (nbme21#12)
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Cictmialpsono of POSC:

aCusiavcdoalrr vnseet

Type 2 eaidtsbe selutiml

rdeimantElo carenc=eapaylirphs

sdraneeIc eiarmcsgiar trea


 +7  (nbme21#9)
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oaexnfmiT

mihea:scMn seicvlete nseterog reoceprt tldmuoroa E()RSM ahtt tasc as na tsoagntani no het getoenrs eetpcorrs of eht etabsr nad scta sa na lapatir tagsion on negteros rrcpsoete ni oben and estuur. Tefe,reohr ↑ sirk fo inademltroe cacern and ↑ kisR fo teuerni orcasam

:Usse RE or PR iovpseit surtom saer)t(b


 +20  (nbme21#35)
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Lead yixciTto :

uass:eC nitorpdsiu of heem htsiyness iav hnoiibniti of ALA tioen(ulviemaaln s)terdadeahy

n:iginsdF

A: Anemia

B: lBpichsaoi isgplptni

C: Cocli

D: rehDarai

E: nhaEahpoeclpyt

F: tFoo rdpo

G: Gum tshdigtprow/ose argeni/oraoutdtt

H: TNH dan erhermicapuye

rOeth enwssar:

Zicn enyfeidicc:

:eCasus olw ,tkaine nshC'or ssediae

dFsgnini: emimnu noydctsnu,if dmeaipri douwn eanhlig (fro eth ognmelreid hapes fo nwuod g,elanhi czni si ndeede yb iamasoptlletrnosee to ebakr onwd etyp III eg)cl,alno gpiadyonm,ohs ehdarr,ai dtritiam,se p,celioaa bolaamnr tates nda lsmle

sesxcE is er..a.r tub nca dlea to vnd// adn dalmbnaoi aipn

simuenaMg ifeydcneic:

aCseu:s cg,lnniteao iaypulo,r irnontila,umt letvixaa easub

nng:dFsii natty,e areeptmur uetalrvcrin tco,ncnraoit adcsrneei QT aitnevlr

2B1 ydeneiccfi:

ea:uCss aevgn ted,i iierucnspo a,iaemn tiparcecan ,isuess taisrgc abypss rgru,sye osantabpoirlm ,ho(rCn ep,)urs ullhmDyooibihtpr /mctuwrelaotapm onetincfi

g:sFinndi acrc,cmtyoi miasoeltacbgl ia,mane nouer ysmmos,tp eeicsandr eicmoetyshon nad MMA slvlee ni erusm

Idraesecn inVmait D:

es:Cuas lnurmosugaaot eeasdis oisasiod)cs(r

nngi:diFs oebn e,sotniorpr oto hcmu a,iccmul osls fo eeppita,t prtosu

lovebug  2019 FA, pg 411. +
lovebug  Nephrotoxicity results from lead exposure because the kidney is the main route by which lead is eliminated. Lead is absorbed by the proximal tubular cells of the renal tubules, where it binds to specific lead-binding proteins. +2

 +4  (nbme21#32)
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BEV HHV4-() ctfisne B elcl ohruhtg D2C.1

iltaAypc ceshlmyotyp on rieearhlpp ldboo resma (ont cietdefn B lel,cs ubt vtreaice tcxytocio T .clles)

cnios"u:lsMoo"ne + npsoootm test donbe(iasti eceettdd by noianiluggatt fo heeps ro eohsr RsB)C

sbryant6  Atypical lymphocytes are CD8+ T cells, not CD4+. Remember that. +15
mangotango  I remember this because Infectious Mononucleosis is caused by a virus (mostly EBV, sometimes CMV) and MHC Class I functions to present endogenous antigens (e.g. viral or cytosolic proteins) to CD8+ T cells. In comparison, MHC Class II is more involved with presenting exogenous antigens (e.g. bacterial proteins) to CD4+ T cells. // FA 2019, pg 100 +1

 +5  (nbme21#44)
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reeacevlnP fo sadseie h=hhiihgg hPiVPhg= tsretpe tiblboriayp

NPV iaesrv vlynirsee htwi ncrveeelpa or spetter lryiobpbtia

.p 527 of AF





Subcomments ...

submitted by noselex(5),
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xeDotr vs Coeid:ne tBoh rea inisvsat,tseu btu dotrxe si erom of MAND sagotni ahtt aslo ahs ioipdo ositnga yiicvtt.a reDoxt is fetno sbudae to gte a mraslii uot of body flinege ued ot sti MADN tisngao cffte.e oeidneC on hte etohr torhe is a nf-loul diipoo aogsnti. ’stI laos seud as h,irirdal-atena os ipnacotiotns is ryev mmocon vsreead tf.eefc

mooitrTuip is rnogw ucesbae tsi’ ton an iseatv.nsitu oAs,l ’ist na chcglnaeitiionr iwhch is ()1 rcndteatiaindco in elrdley enusls yrlela nidiaetc,d ()2 a -neocwlleutmdde ceiihnlinorctga feftce is tcn.opisation

pparalpha  According to Sketchy and Amboss: dextromethorphan is a weak opioid receptor AGONIST and NMDA receptor ANTAGONIST (it's not an agonist). +5  


submitted by neonem(571),
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nodusS leki a case of ruimF-Leian oemrynsd - eicns 53p is a murot spsprseour rfo a buhnc of ecll etp,ys uitanmtos ni this eegn sa( ni SFL) tesurl ni a ryiamd of laliimaf omtru peys.t

pparalpha  Li-Fraunemi syndrome = SBLA (sarcoma, breast, leukemia, adrenal gland syndrome) and occurs because of an autosomal dominant inherited mutation of p53 APC: linked to FAP (colorectal cancer) RET: linked to papillary thyroid cancer, MEN 2A, MEN 2B RB1: retinoblastoma +10  
privatejoker  The thing that threw me off was that the only connection in her FH to the above SBLA reference was the mention of a paternal cousin with adrenocortical carcinoma. The other two mentioned had brain cancers, which seem completely outside the scope of the above mnemonic. Then again, as mentioned elsewhere, I suppose the best policy on these is just to rule out the absolute wrong answers. I swear, the NBME is lying when they tell us to choose the "best" answer on some of these. What they actually mean in practice is for us to choose the least shitty. +15  
dbg  ^ this guy cracked the code. nbme ur doomed. +7  
cienfuegos  @privatejoker: I feel the pain. Quick FYI: UW includes brain in the associated tumors. +3  
hyperfukus  we can just make her thing SBBLA and hopefully never get this wrong again +9  
jakeperalta  @privatejoker: according to UW, Li Fraumeni includes SABBB(sarcoma/adrenocortical/breast/brain/blood(leukemia)) +2  
ac3  side note: RB1 = retinoblastoma with an increased risk of osteosarcoma +  
lukin4answer  TP53 associated with SBLA + Brain tumor + Anaplastic Thyroid ca + Transitional cell ca. -UW +  


submitted by usmleuser007(397),
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1. heeTr" HLA sfan lilw ytr m"the
    a. eThnreino = rhTee 
    b. sdinei;iHt n;Ainrgei nisyeL = 
LHA    c. ennlalaneyhiP = asn
f    d. aenV;li ;eIoclisuen nceieLu = lw
il    .e tpohTnaryp = ryt
    .f hiinMnoeet = m
eht
pparalpha  Thanks! Good mnemonic +1  
b1ackcoffee  best mnemonic +  


submitted by nicnac20(18),
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idexM nsvoeu ngxeyo nniotes si teh ountam of xeoyng ubdno ot gibmeoolhn sa it eunstrr to eth thrgi deis of the areht aetrf ilneatgrv ot hte s.ssetiu

saDcedree ygxnoe rliedyev to eht ssutsei edu to eseearcdd cariadc pouttu sdela ot teh iestuss rixettcgna emor xeoyng rmof the nspigas sCRB tnha tyeh aylnmolr ,doluw hhciw esesrcade eht laovelr emixd esovun egxnoy sinnt.eo

pparalpha  A helpful equation is CO=rate of O2 consumption/(arterial O2 content-venous O2 content): Fick principle If CO is decreased, then the difference between arterial O2 content and venous O2 content is increased +15  
misterdoctor69  To clarify a little bit, the tissues wouldn't necessarily extract MORE oxygen from the passing RBCs than they normally would. They would extract the same amount as they normally would to carry out their own functions. However, because the starting amount of O2 delivered to tissues is lower, you'd end up with less O2 bound to hemoglobin returning to the right heart. +5  


submitted by haldol(12),
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PB is lwo os bolsiyovu eth yodb will wtna ot dnoesrp by ircnginaes caihsetspmty dan rcsaniedeg stsham.aeyrcapipt isenc eth BP is olw, ethre is sesl epurrses iaansgt het wlal fo eth atirodc issun -- nemgain essl tlmuotsaini and reewf .impusels frwee otcadir mspsulei smnea weref payhattmericassp

pparalpha  Hyotension will lead to decreased arterial pressure and DECREASED stretch. This leads to decreased afferent barcreceptor firing (carotid sinus and aortic arch). This leads to an increase in efferent sympathetic firing and decreased efferent PNS stimulation. This leads to vasoconstriction, increased HR and increased BP. +1  
sahusema  The way I remember this, carotid massage slows the heart. So baroreceptor stimulation (more impulses) increases parasympathetic output. +4  
cienfuegos  FA 2018 pg 291 has helpful image/description +