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Misoprostol is indicated for prevention of NSAID-induced peptic ulcers (FA 2019 pg 393). Omeprazole is better for treatment
Why is pulmonary hypertension incorrect?
PEEP allows the alveoli to remain slightly open with exhalation to prevent atelectasis. Pulmonary Hypertension is going to be related to vascular changes (instead you might see shunting of blood in areas of poor ventilation)
Chancroid is described as an ulcer.. whilst in this question they mentioned "vesicles". Pretty much only herpes is vesicular
They mentioned ulcers too. I chose chancroid as well, couldn't find a clue to rule it out. Also thought "discharge" was pointing you towards a bacterial infection. But guess I'm wrong :)
I think NBME/USMLE writers make the assumption the patient is in America unless specified otherwise. Chancroid is not common in the US. If the question stem mentions a developing country, then chancroid can make your differential list.
for chancroid, there may be a mention of inguinal lymphadenopathy
Also with chancroid questions they want you to differentiate it between chancroid and syphilis, (eg. Painful vs. painless) and is usually described as a much larger ulcer that is painful (not vesicular as in this question)
Also believe that chancroid does not presents with systemic symptoms like in this vignette.
*same goes for saccular aneurysm, which also is usually 2/2 trauma
In the question stem there is no indication of trauma so it would be hard to just assume that
see my comment above for marfan syndrome. might help
pg. 47 on FA got the good visuals!
COPII* proteins are needed to coat vesicles from the RER to Golgi. "Two(COPII) steps forward; one(COPI) step back."
Anterograde goes RER -> Golgi -> Lysosomes/Secretory Vesicles -> Plasma membrane
and I thought large lysosomes due to lack of enzymes to degrade
The size of the lysosome is not affected by the presence or absence of protein, but its function is compromised (eg. protein is getting stuck in the RER)
I hope this helps to whomever was lost like me
Null mutation: A mutation (a change) in a gene that leads to its not being transcribed into RNA and/or translated into a functional protein product. For example, a null mutation in a gene that usually encodes a specific enzyme leads to the production of a nonfunctional enzyme or no enzyme at all.
Ashkenazi Jews have a higher risk of inheriting the BRCA1 and BRCA 2 gene mutations, just another tip!
BRCA1/BRACA2 are involved in the repair of DNA double stranded breaks
DNA Mismatch Repair: Lynch Syndrome (MLH1, MSH2)
DNA Nucleotide Excision Repair: Xeroderma Pigmentosa