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submitted by hungrybox(831),
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etGra iedov I euds ot eranl thsi etiarlma.

  1. eTreh rae 3 rjoma eypts fo ud:grs psrepu at,i(mlsustn) sdrowen )ensdspst(rea, nda .hgnascleoiuln
  2. niorHe si na ii.opdo sipdiOo ear enor*s.dw
  3. oresDwn do htwa ti ssondu kl.ei yThe uasce w"ond" pmsm:syot rasddeeeoiectds/na ntieyax adn( suth biaearohlv tiiiinhi)dobn,s toisryerapr droni.ssepe
  4. Thsu iawrlawdth lliw euacs eth opepos:ti pntreorathcca,yesadiiynh/ ty.xanie
hungrybox  *other downers: alcohol, benzodiazepines, barbiturates +2  
nwinkelmann  THANK YOU! for the link to the video. this is one thing I've ALWAYS struggled with. +  
qball  I get that this is a good rule of thumb to help narrow down between alcohol and heroin, BUT is still not enough to answer this question. Some key features for depressants (downer) is alcohol (if we are talking mild withdraw) - tremors , diaphoresis and delirium (heavy withdraw) . For Heroin - Dilated pupils, yawning and lacrimation are key exam findings. +1  


submitted by soscrying(8),

at my uni, we learnt that at lower GFR, loop diuretics still work. That's why you should use them in renal failure. Thiazides would not work with a GFR of <30.

qball  Dang, you actually learned something at your school? Lucky. +9  
lowyield  At our med school they teach us that Thiazide anti-HTN function is primarily from it's direct effects on vasculature rather than it's diuretic effects. Somehow directly affects the vasculature which is not well understood but this is linked to why Thiazides have greater efficacy in African American Populations. That's kinda why i figured it wouldn't be the best diuretic in this case. +  
brotherimodu  lowyield but interesting +  


This is a picture of Giardia lamblia… caused by drinking contaminated water with cysts.

Multinucleated trophozoites

Rx -- Metronidazole -- forms toxic free radical metabolites in the bacterial cell that damage DNA = BACTERICIDAL

qball  This is testing our knowledge in a FAIR way. Why cant there be more questions like this instead of them trying to trick us, have poorly worded questions or have us pick the least shitty answer. End of rant. +1  


submitted by sahusema(125),
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The Dadeoinnis uyg in teh ITRN csthek si hioldgn a saapcnre pgneos.

qball  Sir Dan, my boi. +5  


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bnuomMsare miGreoephtorillsnu is ;ciprtoNhe YLNO RENIOTRAIUP si in hte vgitenet

tI ac'nt eb NGPM sucebea MGPN si cehitiNrp ithw sioelpsb cehpNoitr

theOr oiscceh aer itdieleamn yb Relan Bioyps

hungrybox  agreed "granular deposits" rules out MCD (the only other nephrotic syndrome) because MCD is IF (-) +2  
cooldudeboy1  could someone explain why the other choices are ruled out by biopsy? +  
arlenieeweenie  @cooldudeboy1 PSGN does have a granular immunofluorescence, but there is no previous illness or hematuria mentioned so you can rule that out. Goodpasture is classically linear IF since they're antibodies against the GBM. IgA nephropathy is mesangial IF so it would deposit more in the middle. Minimal change wouldn't show anything on IF +2  
qball  I know First Aid states MPGN as a nephritic disease but I think it can present as nephritic or nephrotic syndrome. https://emedicine.medscape.com/article/240056-clinical. Of course, the renal biopsy helps give it away but I wouldn't be so quick as to rule out MPGN +1  
taediggity  Totally agree w/ you Qball... I thought MPGN too, but I think Penicillamine makes it Membranous Nephropathy +  


submitted by drdoom(686),
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eTh nysshtise of yivtlrual lla ponresti )tN-;pt(deRgAipem& rocscu in the tolsapcmy.][1 as’thT ehrew lal rseosimob dse,ier tarfe lal. i,seooRbms cihhw ear ostylm jstu RrNA /(3~2 NRAr + 31/ ritn*e,po by ,tgwhe)i rea slmsbeead in het unlecus tub yonl od teirh tsffu cneo yhet egt ot the my.laptsoc

roF a toerinp to eaelv tis noirilag wonhotem fo the sctolyo nda cbemoe a tieersnd fo eth eucsuln o,r ,yayyyysy teh diaseplomcn ctmreui,ul it ednes ot hvae a ltitle ngitrs fo anmio aidcs ihchw sthou “I oelgbn ni hte lc”nsueu! or I“ olbgne in the dansmeploci ”leituc!umr

otrsPine limtelaytu dnestied orf eth ER nncotia an imlavaiugneitny endma stnrgi fo mniao casdi onnwk as a“snlig n”eec,esqu h,iwhc ofr teh puressop fo het Setp ,1 si wlaasy at eth mrt-iN.uens The glnsia qecnesue tlsle orthe scyicootl ,nrepiost !y“He keTa me da(n teh estr fo eht pdtipee fo chiwh I ma tra)p to teh E!R”

nI hte cebasen of thsi lanisg, a onpreit illw nerima ni sit etlfua”d“ ohme of eht scotloy.

orr;eHsqe&su a enci hacecstmi gnohwis teh lowf fo nesritop ofmr iainlit snhsiteys to fnali ttdni:soniesa


nnEtseod

  1. Te“h snityhess of yilaluvtr lla nptrosie ni eth ecll bsgeni on orbisemos in eht cso”yotl. (nEatlessi llCe glByoio, Aslerbt et ,.la 04,21 p. 94)2

*If oyu alrlye nwta uyor midn wo,bln nosridce atht neve teh tpenrio suinubst atth make up thta /31 of a iboeroms ear elshsvtmee niyaltili ntsdziyshee ni hte tcosloy; tler,a hyet rea setrpatndro bakc onit hte ucusnle avi het enlcrau eo.pr

qball  Awesome explanation. Now explain it to me like I'm 5. +5  
drdoom  All baby peptides are born in the cytosol. But some baby peptides have a birthmark at their N-terminus. The birthmark tells a special mailman that this baby needs to be delivered somewhere else. If you chop off the birthmark — or erase it somehow — the mailman never knows to take baby to its true home. The end. Now go to sleep or Santa won’t bring your presents. +27  


submitted by hayayah(1000),
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eth aytoirjm fo borcna exidoid elmulcoes are erradci sa tarp of het obneairbcat effrbu steys.m nI stih s,tseym canbro xeddiio siseduff toni the CB.Rs caoCinbr eyrnasdha )(AC inwiht CsRB cqiyukl ercsovtn the orcban ioxiedd noit ccironab iacd (.)3HC2O Crcoanib idca si an nlasbtue niimdeeeartt lmeueocl hatt yelmtimiade deiaisotcss toni oantarbcibe nsoi O()H-3C nda rgohyend )H+( .sion

Teh wyenl nidyzshstee eicbntabora oni si atrnsrpedto uot fo teh BCR tnoi teh maalsp ni eexhgnca rfo a ilhcoerd nio l)C(;− htsi si dlclea eht dhcroile f.ihst nWhe teh doolb casrhee het sl,gun het obnaerbacit ino si dtpenosrart kcba tnoi eth BRC in hnexcage rfo hte odlehric o.ni eTh +H ino eitsdcsaios omfr het hboenlgimo dna nbdsi to eth earbanctibo .oin Tish uodrecsp hte ariccbon daci teriaein,dmte ichwh si rtecevodn back toni onarcb odiedix touhhrg eht cemnztaiy oncait of AC. hTe abconr doeixid odecdurp is eexdepll gouhthr teh ulnsg ngirdu ix.otahlaen

hungrybox  Amazing explanation. Thank you!! +1  
namira  in case anyone wants to visualize things... https://o.quizlet.com/V6hf-2fgWeaWYu1u23fryQ.png +4  
ergogenic22  CO2 is carried in the blood is bound to hemoglobin, known as carbaminohemoglobin (HbCO2) (5%), dissolved CO2 (5%), bicarb is 90% +3  
pg32  Nice explanation, but can anyone clarify how we know from the question that we are measuring HCO3 rather than dissolved CO2? +1  
qball  @pg32 This question is asking about what accounts for the LARGER amount of co2 and the HCO3 buffer is about 85% of this transport and dissolved C02 is about 5-7%. https://courses.lumenlearning.com/wm-biology2/chapter/transport-of-carbon-dioxide-in-the-blood/ +1  
teepot123  fa 19 pg 656 +1  


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It idsa it wsa tfala ot almes ni eotu,r nda eth enouitsq seakd tauob leiv norb srg.fonifp cnieS the elasm aetr’n egibn bonr ni hte trfsi pce,la I dsai 0%5 eseamlf nad %0 .eslma

hungrybox  fuck i got baited +28  
jcrll  "live-born offspring" ← baited +13  
sympathetikey  Same :/ +  
arkmoses  smh +  
niboonsh  why is it 50% females tho? +2  
imgdoc  felt like an idiot after i figured out why i got this wrong. +1  
temmy  oh shit! +  
suckitnbme  This isn't exactly right as males can still be born as evidenced by individuals III 6,9,11. This basically an x-linked recessive disease. A carrier mother can still pass her normal X chromosome to a son (50% chance). It's just that the other 50% chance of passing an affected X chromosome results in death of the fetus in utero. Thus all males actually born will not be affected. +2  
makinallkindzofgainz  @suckitnbme, Correct, but if you're a live-born male, you 100% for sure do NOT have the disease, so the chance of a live-born male "being affected" is 0. +3  
spow  @suckitnbme it's not X-linked recessive, otherwise every single son would be affected and therefore have died in utero. It's X-linked dominant +2  
qball  Jail-baited +  


submitted by est88(16),
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isRbea riVus obdie)v(hdirara

,vFere itpiehls,eanc ogdionrl



submitted by hayayah(1000),
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LPHLE medsnor:y EvaHymlli eet edsos Lvrie eoyLnew zsm lal.tsPete

A saiiteannftom fo eesvre aeapicrempls. oBlod rasem owssh sysoittc.cshe anC dael to IDC and htpicae tsmocabpmsaulshraeau Ž eurtrpu Ž eseevr shp.enoinoyt

mambaforstep  FA 2019 pg 629 +1  
qball  One thing I find odd with this question is HELLP is a manifestation of severe preeclampsia but she has had an otherwise unremarkable pregnancy. Shouldn't she have hypertension/edema in regards to her pregnancy beforehand? +  
demihesmisome  Pre-eclampsia, if not severe, can be entirely asymptomatic. +1  
misterdoctor69  Her blood pressure is 164/102, which qualifies her as having preeclampsia. +  


drdoom  great schematic. +  
qball  Just to add, the ovarian artery branches from the aorta as well. +1  


submitted by lnsetick(86),
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  • PionAcer = royu iprmats mlels kile an APE
  • ceRUnMe = te’serh no MOOR ni ryuo arse sceni rt’heye lulf fo wxa
  • C-YCeRnE = enhw you iE,ceCser yrou eposr aer iYnCgR
  • BueocSEas = mSEuB is nPSigEE out fo rouy spore
hungrybox  as an ape i'm offended +19  
dr.xx  stop being an ape. evolutionize! +6  
dbg  as a creationist i'm offended +11  
maxillarythirdmolar  Also, Tarsal/Meibomian glands are found along the rims of the eyelid and produce meibum +  
snripper  So why is it apocrine? The dude is EXERCISING when playing football. +1  
qball  The question asks about "the characteristic odor" i.e. body odor coming from the APEocrine glands. The Eccrine glands secrete water and electrolytes. +  


submitted by sahusema(125),
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cR.asaeo An tymofrmanila acflia ikns isrdeodr dcecetirazhra by rahtouemytes aplpesu nad tlepsuu ubt no domconee.s yMa eb taidoassce with afialc inshulgf in ssenoepr to arexltne tsiimlu (ge, cllo,oha )a.eth

qball  https://en.wikipedia.org/wiki/Rosacea#/media/File:Rosacea.jpg for that quick picture. +1  
drdoom  and many, many more: https://www.google.com/search?q=rosacea&tbm=isch :) +  
icedcoffeeislyfe  FA2020 pg 477 +  


submitted by gabeb71(37),
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heT ialpourtbces u,elcms chhiw is eon of hte cmsselu tath emrspioc het pvleic foolr dan alpys na mrpanotti erol in hobt faelc cnneoinetc and aifetceo,dn si yniloatcl tecranctdo dan initmsaan hte aotacnelr gelna ta .tser

reeh si a cri:teup ewphlhpa-ect-oteneh-oai-w.0pa-c2m5culrmvcw---o-4o3t-mo-e1r-nsoer-.g8tnlod-oronfultt-vob-fctl/s-ce//9dhsha.ith4ika-n6rohssftum7t:urot_ef_prwu-ostces-tahtret

gh889  How do you differentiate this from hypertonicity of the internal anal sphincter? +1  
gh889  nvm. im dumb lol +  
qball  Uworld Q ID 17004 +  
focus  @gh889 I made the same mistake... fecal INCONTINENCE meaning she CAN pass stool-- in fact, way too well... more than we want. Hypertonicity of the internal anal sphincter would cause constipation-like symptoms. +2  


submitted by sajaqua1(472),
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nI na ydlrlee aettipn ithw olaesdit adeeltev aelliakn assoheahptp nro(aml esurm iluamcc adn oa)hhsetpp sPgt'ae isedsae fo oebn udhols eb at eth tpo fo het ialne.fedrfti shiT esasied is eud ot goldinytuesar fo coslstaociet and ieltbsaocsto aytciv;ti rifts an liianit tootseclas vhctryeipitay a,hsep nhet dreecisna boossalett iyivtcat rfo a tem,uxir neht soltceossat n"uubo"tr ngieald ot rnnolivatiemorzaie- nda teiclrcos nbeo lsu.apqe nI atoddni,i htsi can acrtee snrreoetvuoai usnhst in teh sbnoe ihcwh daseescre ietss,nacer genilad ot ghhi puuott cdiaarc lieuarf (a rmiaisl pblorem nca easri in inaorvesreuto siutasfl rfmo dloob iysdl.sia) On ohoylsitg it lliw vahe a "micao"s trtpea.n

A-) Anlmauyers noeb t-scy gyallre a trcupod of thtcpaeiyrvyi of tacoo,lsstes this urcosc oerm netof in het bslmi, dan hsows a tiscyc aepcs twih lbkilnooal-e iliodant. B) -Aamogicnsora mcagaoroinsa fo eth nbeo is n lmatso ryupel itcyl nosi.el yhTe ccoru mero eqtnfuleyr ni gnoruye people. )C Nicain defyiicen-c I nac nfdi iothngn uaobt tbivinam B3 eycfiencdi ngvilovin n.oseb B3 ctidecfnie ertsuls in raplgela, hwti hte sslaicc rTeeh s'D- dtemitirsa ahs(r acnckele on C34C/ e)tedmr,oma nit,mdeea nad erh.ridaa E) mea-taOsrcoos dounF latmos euxielcvsyl in nouyerg pep,loe htsi oenb htogrw sruocc ta teh towgrh pael,t tyarrlcauipl ta teh xmarpiol edn fo het ia,tbi ltadis ned fo hte ,mefru or xorlpmia ned fo hte msuehur n(i eht nolg nseob around royu eknse ro ta uyor soulres.dh) It oswhs a ragel, dsloi ggionwr smas taht yma sraei eth itremoueps ni a tnusbsur 'onsaemCptnatr/d l.rgianet F) satrticPo acnoiarcm- erra orf igenb neo of, if nto the noyl eacttastmi bneo ccrane htat is ulprye o.oaseltcibst

alexb  Great explanation, except that there was a question in NBME 22 in which the prostatic carcinoma was osteolytic. One of the commenters here looked it up and apparently it's like that 30% of the time or something. So I guess you would have to use the high output HF, normal Ca, high ALP, and mosaic pattern to "play odds" as Goljan would say. +1  
qball  At least they were nice enough to put Paget disease because I had no idea what osteitis deformans is. +1  
drzed  USMLE seems to be moving away from using eponymous names... so it's a good idea to see if there is a descriptive name for diseases. For example, they don't use the word "Wegener" anymore if you have noticed, since it turns out that guy was a nazi. So now they call it by what it is -- granulomatosis with polyangitis. +2  


submitted by hhsuperhigh(24),

"His friends believe there may have been drugs at the party", period. lmao...

aisel1787  ahahaha +  
qball  What a snitch +6  
bend_nbme_over  Good thing they were at the ED cause that friend is gonna need some stitches +  


submitted by yotsubato(841),
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oS rfo ianCdad ew nca seu

lsoeAz aoce)ul(nozlf (nbtiihi Y40PC5 tny)edoieltmha

rpiAothemnc B ro(pe tronafomi in aglnuf clle ambmre)en

aCpgfuonsni ve(petrn oinrngisckls fo ebta alncugs in lelc lawl)

or tynisaN fro oalr or lhosaegaep escsa oer(p mfnatiroo)

isTh oetqunis is anyisg ttah hse si tgnkai na ORAL grdu to teatr aidndac giani.svit

opirhmtecAn si IV

nsoaifuCnpg is osal VI

os 'erwe tfel with aelzso

lsAezo tbiinhi tehsysins fo ogosetlrre yb ibntghiiin PCY 045 ahtt vrotcsen ooearlslnt ot ese.orogrlt

qball  Nystatin does treat vaginal candidiasis but is TOPICAL. +1  
thotcandy  Nystatin is NOT for esophageal candidiasis, Swish and spit, not swallow. +2  
staghorn  Me - picks Metronidazole -_- +  
alexxxx30  @thotcandy...actually you can swish and swallow nystatin for esophageal infections (per Sketchy micro candida sketch) +2  
turtlepenlight  I have seen that on the wards so I hope it works! +  
fexx  and my smartass picks amphp B +1  
avocadotoast  Please no one give a poor girl with a yeast infection amphoterrible +2  


submitted by wired-in(62),
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ctainneeanM dose arulfom si s(Cs × Cl × a)ut ÷ F

rwehe Css is tsdettaa-sey atertg pslaam cno.c of ,rudg Cl si ,aneecalcr uat si gesdao arnivlet ma;p& F si libvblaata.iiyoi

tehNrei agoeds anetlrvi nro ilivababtlyaoii is nivg,e so rgiognin thsoe ;pm&a niulggpg in eht mbesunr eurlfac( to eotrnvc itnus to :/m)gk/dgya

( =12 u/Lmg × 1 /0m0g01 gu) × 09.(0 kh/grL/ × 0010 /Lm1 L × 42 /1rh d)ya
= 9.252 gkga/d/ym

.ichw..h 'snti yan of het anrwse ocicehs eisltd. ehTy must hvae dednrou 0.90 Lhgk/r/ ot 0.1 ,hLrgk// dan nodig so sevig yxcalet 828. mgk/gya/d o(ihcce )C

lispectedwumbologist  That's so infuriating I stared at this question for 20 minutes thinking I did something wrong +56  
hyoid  ^^^^^ +11  
seagull  lol..my math never worked either. I also just chose the closest number. also, screw this question author for doing that. +7  
praderwilli  Big mad +9  
ht3  this is why you never waste 7 minutes on a question.... because of shit like this +8  
yotsubato  Why the FUCK did they not just give us a clearance of 0.1 if they're going to fuckin round it anyways... +15  
bigjimbo  JOKES +1  
cr  in ur maths, why did u put 24h/1day and not 1day/24h? if the given Cl was 0.09L/hr/kg. I know it just is a math question, but i´d appreciate if someone could explain it. +1  
d_holles  LMAO games NBME plays +1  
hyperfukus  magic math!!!!! how TF r we supposed to know when they round and when they don't like wtf im so pissed someone please tell me step isn't like this...with such precise decimal answers and a calculator fxn you would assume they wanted an actual answer! +1  
jean_young2019  OMG, I've got the 25.92 mg/kg/day, which isn't any of the answer choices listed. So I chose the D 51.8, because 51.8 is double of 25.9......I thought I must have make a mistake during the calculation ...... +6  
atbangura  They purposely did that so if you made a mistake with your conversion like I did, you might end up with 2.5 which was one of the answer choices. SMH +2  
titanesxvi  I did well, but I thought that my mistake was something to do with the conversion and end up choosing 2.5 because it is similar to 25.92 +1  
makinallkindzofgainz  The fact that we pay these people 60 dollars a pop for poorly formatted and written exams boggles my mind, and yet here I am, about to buy Form 24 +12  
qball  Me after plugging in the right numbers and not rounding down : https://i.kym-cdn.com/entries/icons/original/000/028/539/DyqSKoaX4AATc2G.jpg +1  
frustratedllama  Not only do you feel like you're doing sth wrong but then that feeling stays for other questions. sucks so baad +  
fexx  'here.. take 50mg of vyvanse.. I just rounded it up from 30.. dw you'll be fine' (totally doing this with my patients 8-)) +1  
cbreland  I was so close to picking 2.5 because I thought I did a conversion error. 5 minutes later and still didn't feel comfortable picking 28.8😡 +  


submitted by sympathetikey(1027),
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evliBee sith qtoeuins is gefrirren ot Vlesaicr ssLsiniaaeimh.

gabeb71  The give away is the Fever, Pancytopenia, and Hepatosplenomegaly after being bitten by an insect and developing the sore. +8  
tallerthanmymom  I got this question directly after the other visceral leishmania question and it made me second guess everything I thought I knew. +4  
qball  Don't forget they like to infect macrophages. +  


submitted by welpdedelp(203),
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It saw a yept IV NSH i,cetanor hchwi sadel twhi T slcel nad taht swa hte lnoy nwrsae ttha had t cells ovdvnel.i

yogi  Poison Ivy/ oak /Sumak +  
qball  Uworld Q ID 1133 +1  


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A sbrmoatonl si na rmeimaut ,RBC os ti's eeelvtad in tsaets of idaensrce pi.emeshositao

sympathetikey  Don't mind me. Just sippin my dumb ass soda over here. +51  
someduck3  The term "Normoblast" isn't even in first aid. +31  
link981  NBME testing your knowledge of synonyms. Have to know 15 descriptive words of the same thing I guess. +15  
tinydoc  I wish they would stop making it so every other question I know the answer and I can't find it among the answer choices because they decided to use some medical thesaurus on us. +15  
qball  Metamyelocytes = Precursor to neutrophils Siderophages = hemosiderin-containing macrophage aka heart failure cells +7  
llamastep1  Theres a UWorld question about Parvovirus B19 that mentions "giant pronormoblasts" that helped me make the connection +5  
fexx  I got it right but would it hurt them to put RBCs? Medicine is hard as it is. No need to make the exams more complicated. I doubt my pt is ever going to as me if his/ her normoblasts are going to increase if they go hiking in the mountains +3  
nerdstewiegriffin  I can guarantee you this Q was written by some sadistic PhD examiner +2  


submitted by lfsuarez(134),
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hsTi iptntea tepsnsre htwi a lasml elcl ciamorcna whchi is rvey moomcn fro para ipenloscat semdyr.nos nI sthi seca het ncacer is insgauc DS.HAI mncolieclDeey si a eieattcrylnc canbiitito htta si aosl edsu ot ratte IHDAS

gabeb71  To add to ^ It is widely used (though off-label in many countries including the United States) in the treatment of hyponatremia (low blood sodium concentration) due to the syndrome of inappropriate antidiuretic hormone (SIADH) when fluid restriction alone has been ineffective. Physiologically, this works by reducing the responsiveness of the collecting tubule cells to ADH. The use in SIADH actually relies on a side effect; demeclocycline induces nephrogenic diabetes insipidus (dehydration due to the inability to concentrate urine). +13  
qball  And for you Sketchy people Demeclocycline is in GI/Endocrine ADH one with the bicycle and that "vaptans" are first line. +2  


submitted by rainlad(20),

my approach to this question was to eliminate all the answer choices that mentioned specificity or sensitivity, since the data here did not provide information about any sort of screening test.

that left me with two possible answer choices: I eliminated the one about consistency of other studies, since no other studies were mentioned in the question stem.

not sure if I oversimplified things, but it led me to the right answer!

makinallkindzofgainz  this is exactly how I reasoned through it. Were we correct in our line of thinking? We'll never knooooow +  
qball  But will you ever know on the real thing? +1  
drdoom  but will you ever know in real life? you may do the right thing (given time constraints, & information available), but outcome is bad; maybe you do the wrong thing, but the outcome is good (despite your decision). how to know the difference? +3  


submitted by guillo12(42),
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V"P is a oalcpistne ca)(nllo obdol orsedird tiwh uomountoas ninE-Oddet(nPe)pe dtoerhyir afeip.rrltoion eecuBas fo eth excetsein fo a eientagv bfckeade ahmnei,scm teh sisryherooctt in PV -utlnoeasgwerd POE ditocrpuon nda utrlsse in olwbe alnrom uemsr EPO lve.les nI otcr,ants na dnPeEO-vir schroyrettoysi ecetishrrcaaz ydacorsen shy,oiscettyror nda tish nioitnocd yam be ioasdatces itwh iteher hihg or alrnom umser EPO s"ellv.e

p/lc(n1liliwl8wt8e3/n9dhw1ircmot-)apiocS-.y2te600r4uge6/01tgr/xcoe6/sst:af5.

qball  For those that want to know what total red cell mass means in polycythemia and PV read the first paragraph in this article. The hemoglobin and hematocrit do NOT inform you of the total red cell mass. +  


submitted by mousie(179),
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rhaeloC = lacFe enneLaiasgirol/or = egaoalLln oemunp = ON pesonr ot rosnep yoln yb olhanianti of trieabac tdeomatnnaic re/wLmyae t = ckit tnoiolgcc Mcini/ebea = hrgsina yerriotrspa nda ttohra oscsnereti a(liasv ro .tsip) ynGle,rela ti steak loesc f(ro ,mpaexel iguhcgon or )isgniks ro thygnle cacttno ot pdsare teshe aciebrat )CD FCRM/(S = ckti etib

smc213  Also, when Meningococcal meningitis is treated ... close contacts are also treated prophylactically whereas the others typically are not. There's also a subunit vaccine for n. meningitis due to high infectivity rate especially in crowded establishments. +6  
dentist  So, Cholera is also p2p but Mening is more likely? +1  
usmlecharserssss  in cholera people to water => water to people +  
qball  Remember the fire sprinklers from Sketchy for M. Meningitis. as respiratory droplets are the easiest to transmit from person to person. +  
drschmoctor  but the poop water comes from people so.... +1  
llamastep1  Respiratory dropplets is easier than fecal-oral tho +1  
lowyield  Can also reason that n. meningitidis is common in college students because they live in close quarters which suggests high rate of transmission even amongst immunocompetent individuals +1  
peridot  I can see why fecal-oral can seem like person-to-person transmission. What helped me reason it was that in countries with lots of cases of cholera, the primary reason is lack of water sanitation. Even when you google cholera, you get pictures of people collecting dirty water and how the WHO is aiming to reduce cases of the disease by improving water sources. Therefore it's more of a systemic/environmental problem rather than the fact that one person accidentally touched another person's poopy parts and then transmitted it to their own mouth, making this less of a person-to-person thing, especially when compared to another answer choice such as Meningococcal meningitis. +  
bbr  To add, think of the water in cholera as a reservoir. The bug is going to hang out there between infecting another person. In meningitis it seems we are going from 1 persons saliva to another. Without much of a reservoir inbetween. (might be using the word reservoir incorrectly). +