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Comments ...

 +0  (nbme24#42)

I could be wrong.. but the normal ANC (absolute neutrophil count) ranges from (1,500 to 8,000/mm3) this patient is way below the normal ANC range, thus a GMCSF could help boost neutrophils which are granulocytes!

mgoyo89  I think there are two questions with this answer!!I was so scared :(
trichotillomaniac  yep ---not IL-2 bc that stimulates Tcells and NK cells- I think I blacked out when I answered this question

 +0  (nbme24#30)

Why is it that the pulmonary capillary wedge preesssuree is increased? on pg. 307 of FA 2019 it says it can be increased or decreased :/

giggidy  Depends on where the infarct is I guess? Crackles in lung base means increased left sided pressure and therefore PCWP. At least that's how I thought of it.

Subcomments ...

can someone explain why this is not transduction? Last nbme I said conjugation and got it wrong for transduction.. this one I say transduction and its conjugation.

pseudorosette  I would say because this happened between two bacteria, but in transduction what causes the acquisition of bacterial resistance is coming from a bacteriophage, which is a virus that infects bacteria, but that is never hinted at the question! +  
medpsychosis  Quick Overview of the involved topics and answer choices that are relevant in this question: Transduction: Involves phage, cleaves DNA and takes a part with it as it is packaged. Generalized is when is happens by accident. Specialized is an excision event. Transformation: bacteria takes up naked DNA around it and incorporates it therefore becoming "transformed" e.g. (SHiN) S. Pneuma, H. Influenza type B, and Neisseria. Transposition: Jumping from one location to another within same bacterial organism (e.g. from chromosome to plasmid) Conjugation: Above mentioned plasmid gets transferred from conjugal bridge from one bacteria to another. +5  
wowo  FA2019 p130 +  
zbird  Easy here...first both are G-ves which likely have a sex pilus and if cultured together as in this case transfer their plasmid. Transduction need phage. Transposition is exchange of genetic material inside the bacteria b/n the dna and the plasmid or vv (FA2019) +  

How do you know he has an incarcerated inguinal hernia and not fecal impaction?

sattanki  So as far as I understand, you don’t really get a bulging, defined abdominal mass with fecal impaction. Much more likely to see this with a hernia. +2  
xxabi  Fecal impaction can be palpated in the abdomen, since it'd be accumulating in the rectum and colon, not the groin. Hope that helps! +5  
pseudorosette  a little late but they also mention that the mass had bowel sounds hence it was an incarcerated bowel! :) +2