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Welcome to pppro’s page.
Contributor score: 23


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 +2  (nbme22#13)
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forerofore  growth in cold temperatures seems to be the method of isolation of yersinia enterocolitica https://www.ncbi.nlm.nih.gov/pmc/articles/PMC275385/ https://jcm.asm.org/content/2/6/559 +

 +6  (nbme22#8)
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ttPanie sha HB.P eGvi halpa one aiatngosnt to educer omohts clsmeu cnticonarto dan eileerv cliyuftfdi irnguina.t

d_holles  lol i thought it was some kind of urinary retention problem and put H. +15
sbryant6  How is H wrong? Oxybutinin or tolterodine treat urinary incontinence by blocking M3 muscarinic acetylcholine receptors --> urinary retention. We're just supposed to assume they are talking about BPH here because he is old? +
jaxx  I agree. I picked "H" for that same logic. Does anyone know where we should have come to the conclusion that this was BPH? +
forerofore  they are telling you he's having "difficulty urinating", one of the clinical criteria for BPH is reduced urinary flow rate. this is not incontinence because they are not telling you he leaks at all, just that he pees "a lot" +12
drzed  Even if he was urinating too much, anticholinergics are contraindicated in the elderly (Beers criteria) +3
pathogen7  @drzed tI mean techinically alpha-1 blockers are on the Criteria too ... +1

 +0  (nbme22#37)
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 +6  (nbme22#43)
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fukprometric  why couldn't it be something cirrhosis related given his IVDU? I was thinking that the increased systolic pressure was a sign of portal HTN from cirrhosis so he'd also have a portosystemic shunt, but that was wrong +1
schep  I picked portosystemic shunt, too. Looking at the question now, I should have focused on the fact that he is IV drug user, has a fever and has signs of right heart failure (back up of blood into the liver) which makes me think endocarditis +

 +9  (nbme22#39)
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