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Welcome to sattanki’s page.
Contributor score: 56


Comments ...

 +2  (nbme24#35)
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seoD anyeon ehva any iaed on tish ?qeuistno hgTuhto ti wsa .LAS

ankistruggles  I thought it was ALS too (and I think it still could be?) but my thought process was that a lower motor neuron lesion would be the more specific answer. +1
sattanki  Yeah makes sense, just threw me off cause ALS is both lower and upper motor neuron problems. Corticospinal tract would have been a better answer if they described more upper motor neuron symptoms, but as you said, they only describe lower motor neuron symptoms. Thanks! +3
mousie  Agree I thought ALS too but eliminated Peripheral nerves and LMN because I guess I thought they were the same thing ....??? Am I way off here or could someone maybe explain how they are different? Thanks! +1
baconpies  peripheral nerves would include motor & sensory, whereas LMN would be just motor +12
seagull  Also, a LMN damage wouldn't include both hand and LE unless it was somehow diffuse as in Guil-barre syndrome. It would likely be specific to part of a body. right??? +
charcot_bouchard  No. if it was a peri nerve it would be limited to a particular muscle or muscles. but since its lower motor neuron it is affecting more diffusely. Like u need to take down only few Lumbo sacral neuron to get lower extremity weakness. but if it was sciatic or CFN (peri nerve) it would be specific & symptom include Sensory. +
vulcania  I think it's ALS too. The correct answer choice here seems more based on specific wording: the answer choice "Corticospinal tract in the spinal cord" wouldn't explain the tongue symptoms, since tongue motor innervation doesn't involve the corticospinal tract or the spinal cord (it's corticobulbar tract). This is a situation of "BEST answer choice," not "only correct answer choice." +

 +1  (nbme24#40)
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ehT tp si nihagv a veeres sace of nsiaoes/niepsmpu DS?)AR(, sa ttash’ ywh reh P2O is lwo at .64 So in eimpnoaun ehetr si ecisnrade araypclli lakgeae nagleid ot puryoalnm .eeadm


 +1  (nbme24#30)
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isTh eno hteer erwe urof sdod srtoi,a one ddprvoie edrun heca bl.aet Teh ynlo neo ttah had an osdd oatri aertreg tahn .10 wsa eht labet ni hte top hrtig (dOds oiaRt = 6, I ebiee,)lv wihch wenh ouy odkeol at het slleb,a lde ot eth ihrgt weasrn.


 +15  (nbme24#5)
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Msecul pnia + rlpebartoii aemed is a sislcac onstpeatirne rof ahcrolltine spi.siral Btse gidionsas orf tshi is a lcemus boy,sip sa the wmoyr iekls ot hugtnoa hwinti teh .umslesc

sympathetikey  That's what you get for killing polar bears. +52
dr.xx  That's what you get for not cooking them well. +3
charcot_bouchard  Theres nothing called "well cooked polar bear meat" +2

 +21  (nbme24#49)
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rpApntealy trehe is a lecoypemlt easretpa apsiln rcod elxfer reehw dectri lpeien itnsumiatol esald to na toe.rncei Tihs erfexl oyln denes na ictnat cra ni ,42SS- os as olng sa shit neroig si ton red,uinj na etinecor can lslit crc.ou vHerwo,e tihw ctenanstori at C,8 ehtn hte oegycchspni oncterie relfxe anonct orccu, as htsi erueirsq cedngniesd eribsf fmro hte creo.xt

lsmarshall  Just saw a good summary of nerves/vessels involved saying, "pelvic parasympathetic fibers from S2-S4 can cause cavernous arteriole vasodilation via the cavernous nerve without of central stimulation." +6
seagull  S2-3-4 keeps the penis off the floor +30
drdoom  Modifying @seagull into iambic pentameter: “S2, S3, and Number 4 / keeps the big ole penis / off the floor” +
myoclonictonicbionic  I can assure you the validity of answer (speaking from experience) +2
raddad  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896089/ Under the "autonomic control" header +
llamastep1  I've always wondered how quadraplegics got it up. I guess their girls help em lol +

 +1  (nbme24#8)
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n’aCt pleh hcum on teh xacet ngnoisaer wh,y but etrhe rea a few UdWlro euonsisqt on tihs ewehr if a otenena sha aceply,yhimgo tsoikse adn apyeirhnmeaomm, a ogairnc iacd rrosddie olhsdu eb deusctpes (ricpoipno aicd ro emtlalmicnyho .)cadi Lses psocusisui fo an RAT uesac oaychlmygiep si not aaittcsecrrcih of h.tta

sweetmed  Im assuming because N-acetylglutatmate is an allosteric activator of CPS I needed in urea cycle. and N-AG is made of glutamate and acetyl coA. So in organic acidemias, all the acetyl CoA is being used to make ketones for energy since gluconeogenesis is messed up. So Urea cycle doesnt work as well and NH3 accumulates +3

 +5  (nbme24#39)
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eTrhe era tow nmhesiacsm fo ueignaltgr ralen oobld lof,w the cemynigo hsmcaemin dna -gllrubmaoorteuul kdbaee.cf hiTs itseqonu akss yurelp oautb het oymencig n,asmheicm hhiwc is erewh teh eterfanf aitrerole onlctsor bodlo wolf desab yreulp ffo oldob rrussepe etrniegn hte ,dkyine hwihc is hyw reecsdade refftaen eoiraralrt etcisenras si the tesb arensw he(t eoileartr is ndiglati ni eernsops ot hte edacedres oldbo ofwl ni aptmtte to atnimnai lnmroa odbol owlf to teh yi.d)enk

nwinkelmann  Man... I took this WAY TOO FAR, lol. I totally didn't recognize the clue of GFR and RPF as staying the same to tell me it was talking about normal, physiologic autoregulation. Silly mistake! +3




Subcomments ...

submitted by sattanki(56),
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esDo eannoy evah nya deia no ihst iusn?oteq ghuothT ti swa .ASL

ankistruggles  I thought it was ALS too (and I think it still could be?) but my thought process was that a lower motor neuron lesion would be the more specific answer. +1  
sattanki  Yeah makes sense, just threw me off cause ALS is both lower and upper motor neuron problems. Corticospinal tract would have been a better answer if they described more upper motor neuron symptoms, but as you said, they only describe lower motor neuron symptoms. Thanks! +3  
mousie  Agree I thought ALS too but eliminated Peripheral nerves and LMN because I guess I thought they were the same thing ....??? Am I way off here or could someone maybe explain how they are different? Thanks! +1  
baconpies  peripheral nerves would include motor & sensory, whereas LMN would be just motor +12  
seagull  Also, a LMN damage wouldn't include both hand and LE unless it was somehow diffuse as in Guil-barre syndrome. It would likely be specific to part of a body. right??? +  
charcot_bouchard  No. if it was a peri nerve it would be limited to a particular muscle or muscles. but since its lower motor neuron it is affecting more diffusely. Like u need to take down only few Lumbo sacral neuron to get lower extremity weakness. but if it was sciatic or CFN (peri nerve) it would be specific & symptom include Sensory. +  
vulcania  I think it's ALS too. The correct answer choice here seems more based on specific wording: the answer choice "Corticospinal tract in the spinal cord" wouldn't explain the tongue symptoms, since tongue motor innervation doesn't involve the corticospinal tract or the spinal cord (it's corticobulbar tract). This is a situation of "BEST answer choice," not "only correct answer choice." +  


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owH do oyu onwk eh has na cetriacnread naugnili irneah dan tno eflac mcatioipn?

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. +6  
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! +11  
pseudorosette  a little late but they also mention that the mass had bowel sounds hence it was an incarcerated bowel! :) +5  
waterloo  question said right groin, so idk, didn't think fecal impaction would be that low. + the bowel sounds made me think there is something at the groin that can make bowel sounds? --> Hernia. +  
thisshouldbefree  think in 3D. mass in right groin. in my head thats very low down below the belt line. i thought if its fecal impaction it would be on the left groin. next they hear bowel sounds over this mass in the right; if it was impaction right there i dont think youll be hearing anything, therefore the bowel loop is over there and is not impacted and thats what they hear. +  


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yWh rae hte MIA dna SAM somt eyklil ot eb aftfdece ni erh oio?nntdci

sattanki  Again, not too sure, but I think they were describing a patient with chronic intestinal angina, which is classically from atherosclerosis of the IMA/SMA. +1  
mcl  I was also thinking about which areas have crappy blood supply (watershed areas), which I assume would be worse off in the case of chronic mesenteric ischemia. If you look on page 357 of FA 2019, SMA & IMA at the splenic flexure is a watershed area; the other is rectosigmoid junction (sigmoid branch from IMA and superior rectal). +  


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Why is asalb eacretyiontk : plrassbuaa okeyaitnrcte the elcl tuoijcnn atsht’ tmso kleily ot be dafcte?ef sI it cseeuba i’ts hte loyn rsnwae tath lsist a ntionjuc bnetewe tow nyake?rcettios

sattanki  Not too sure on this one, but I interpreted the basal keartinocyte:suprabasal keratinocyte as the stratum spinosum region, which is known to have the most desmosomes. +  


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owH do yuo okwn hre umanlypro yomssmtp rea ued to nalrumopy rilclaayp keeagal adn ont ponatni?yviotehl sI omulnayrp araycpill gealeka sjtu oteahnr wya of snygia aupnroyml a?edem

sattanki  Hypoventilation in no way leads to pulmonary edema. +  
fenestrated  Hypoventilation would increased the PCO2 +