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Welcome to prostar’s page.
Contributor score: 2

Comments ...

 +0  (nbme17#0)

In contemplation stage, the person is ambivalent about his thoughts. He knows both pros and cons of something. (as in our case)

 +0  (nbme17#0)

I just wanted to add that N- glycosidases involved in capsule synthesis - is for Cryptococcus neoformans.

 +0  (nbme17#0)

I just wanted to add that Helix-loop-Helix is an example of a DNA binding motif.

High hydroxyproline and multiple disulfide cross-links are for collagen protein.

 +0  (nbme17#27)

This is Allergic contact dermatitis. Type-4 HS reaction. Most commonly in this case is due to poison ivy.

 +0  (nbme17#0)

For the sake of completeness, this is paraneoplastic cerebellar degeneration due to breast cancer- Anti - Yo antibodies. (FA2019 Pg229)

 +0  (nbme17#27)

think this pedigree is for X-linked recessive disease. since the disease-causing allele is 1. and in the case of X-linked recessive diseases, only one allele is enough for causing disease in MALE.(evident by II male). And in the case of FEMALES , two alleles are needed. evident in this pedigree ( II female)

 +0  (nbme17#0)

just want to add this is Stanford type A (proximal)

Subcomments ...

submitted by bingcentipede(218),

A premature infant does not have mature surfactant levels until week 35. Being born at 28 weeks, his type II pneumocytes are not fully mature yet/haven't produced enough yet.

Type I and II pneumocytes line the basement membrane. Type I (C) are squamous, and type II (D) are cuboidal.

E: alveolar macrophage B: RBCs A: capillary endothelial cell?

jj375  Here is a labeled diagram that may help! A) Capillary endothelium B) RBCs C) Type I pneumocyte D) Type II pneumocyte E) I kinda think these are alveolar macrophages +2  
j44n  did anyone else think D was trying to show a lamellar body that ID's a type II pneumoyte +  
j44n  my bad i meant B**** +  
i_hate_it_here  I sure did +  
prostar  Lamellar bodies are not visible in this magnification. They are viewed in Electron microscopy. +1  

submitted by cassdawg(957),

The description cooresponds to rhabdomyolysis which is excessive breakdown of skeletal muscle tissue that can lead to excessive release of myoglobin into the blood which causes myoglobinuria and kidney damage. Rhabdomyolysis can be precipitated by overexertion (such as a triathalon) and commonly presents with weakness and muscle tenderness and may also present with shortness of breath due to fluid buildup in the lungs.

Rhabdomyolysis will present with elevations in creatinine kinase as well as myoglobin, but it is the elevated myoglobin which causes the symptoms and acute kidney injury as seen in this patient. Creatinine kinase elevation causes no toxic effects, even though it occurs, as reported here.

Here is another article about rhabdomyolysis as it is not covered in depth in First Aid.

j44n  I went with my gut on this just base on the physical exam. But they did have elevated Hemoglobin in the urine as well and I know Dr. Golijan said you cant get that after a marathon. Does anyone know why hemoglobin is wrong? +  
prostar  hemoglobin is due to the breakdown of RBCs, not muscles. +  

submitted by cassdawg(957),

The big hint here is EXTREME respiratory depression which is characteristic of opioid overdose, so he should be given naloxone. [FA2020 p570 has drug intoxication and withdrawal syndromes]

bingcentipede  And he was also taking codeine, a mu opiod agonist. So naloxone would be able to reverse the codeine specifically. +1  
schep  Flumazenil-GABA antagonist, used to treat benzodiazepine OD Fomepizole-competitive inhibitor of alcohol dehydrogenase, used to treat ethylene glycol and methanol OD hemodialysis-can be used for severe lithium ODs, not sure what else propranolol-nonselective beta blocker; not sure if it treats any ODs in particular +2  
deadbeet  The HR made me waste way too much time on this question. Don't think tachycardia is the norm for opoid OD. +2  
prostar  the reason for increase HR is hypotension(and the reason for hypotension is opioid induced mast cell release- histamine-vasodilation) +1  

submitted by lpp06(27),

Hemorrhoids are dilatations of arteriorvenous plexuses in the rectum. Blockages on the arterial side will not cause the plexus to fill while venous thromboses will cause a back up of fluid.

Clues for hinting which vein are the location at the anal margin and that he was in extreme pain. External hem's will be painful, pointing towards inferior rectal as the answer since it drains below the pectinate line where external hem's are found.

skilledboyb  anyone know how to rule out middle rectal vein thromboses? +  
prostar  it is just that when both are in option go for inferior rectal vein. this is more apt. or else both are correct. +  

The two possible answer choices related to concentric hypertrophy of the left ventricle are mitral insufficiency and aortic stenosis. Concentric hypertrophy in an older individual is not likely due to familial hypertrophic cardiomyopathy, ruling out the answer choice of mitral insufficiency. You are then left with aortic stenosis causing the hypertrophy of the heart.

prostar  even if mitral insufficiency would be the case, that would cases chronic high preload, causing eccentric hypertrophy. hence the only option is correct for concentric hypertrophy- aortic stenosis(another cause is hypertension) +