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 +0  (nbme20#29)

The way i look at this is the temperature.

A hypothermic patient will almost always present with septic shock because septic shock can present as both hyperthermia or hypothermia

Subcomments ...

submitted by hungrybox(1035),
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'Heser my orhcpapa eodno(tvw if wng:)or

afilgln on tutrtdscoeeh rma → uluaysl shodpcai


oasdichp elrbomp → napi in ataancomil unbfsfxo

os hent ti soeg to teh xtne tsmo monlomyc nidujer eobn ewnh yuo allf on an cedttseuotrh am,r ouyr ultnea

h(iwhc si hrtig xetn to teh ipdcoha)s

spaceboy98  Also, dislocation is most common in lunate, Fracture most common in Scaphoid +4  

submitted by apop(7),
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eTseh soaxlnpeitan naert e.gtar tI sndtoe llyear eahv ucmh ot od itwh SARA naiv.atcoit It ash latoms nreteghviy ot od htwi a onhmponeen elclad het lklaniea iet.d In nccihro imo,gvttin uyo loduw cxeept -Cl ot be owl dan K= to eb olw rlma(isi ot lba eslrtus in noesoem wtih oT semoaetnpc ofr the owl lC-, hte hcaotms sah an nartirepot chhiw xhecanseg Cl- ofr 3HCO.- o,eTrhefre C-l lwil be eelrinpesdh in het mh,atcos ewlih O3HC- wlil esicerna in hte do,lob ugiscna na .saklilosa nI aokcallti ,saetst the H/++K pirarontte lwli engib to ita,aecvt sitgnhfi +K TOIN ellcs aikop)amleh(y nad nriacisgne Hp. RAAS rypoalbb yspla a erol ni gminak eht yeoliphamak reosw tub het nlekliaa iedt is more ntrptmioa rhee.

spaceboy98  Isnt alkaline tide related to an increase in pH after meals? Your logic is on point but I'm not sure whether we can apply that concept here. +1  
kevin  concept can be applied here because we need to replete the Cl- in order to create HCl; the stomach doesn't care if Cl- is low in serum, only that Cl- is low in the parietal cells and so will pump out HCO3- in its expense +  

submitted by weenathon(40),

Diabetics get peripheral neuropathy from glucose damaging Schwann cells. For what I believe is an unconfirmed reason, T2DM patients tend to see parasympathetic autonomic neuropathy before sympathetic.

The hypogastric nerve carries sympathetic innervation to the posterior urethra and is responsible for ejaculation.

Inferior rectal nerve is a branch of the pudendal nerve that innervates the external anal sphincter and provides sensation below the pectinate line. A peripheral nerve problem with this nerve would cause the sphincter to remain relaxed and cause incontinence, not constipation.

Pelvic splanchnic nerves are parasympathetics (craniosacral outflow). If he is constipated, his rest and digest (parasympathetic) system is not working.

Perineal nerve is a branch of the pudendal nerve. It has both motor and sensory, is involved in the external anal sphincter, urethral sphincter, and is responsible for conscious sensation of the need to urinate.

Sacral sympathetic inhibits peristalsis, and contracts internal anal sphincter to maintain continence.

spaceboy98  Amazing man, thank you for this +  

submitted by hayayah(1078),
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otsM trseoctiirn szemney ndbi pimen.alsrdo

So ohtb CC'5GG or C'3CGG woldu vhae enbe aeabpeclct in hist iaernco.s

meningitis  Yes, correct. The 5'GGCC option could cause some confusion. +  
guillo12  I really don't understand the question nor the answer. Can someone explain it for dummies like me? +10  
whossayin  yes please.. I'm with guillo12 on this +  
sugaplum  @guillo12 @whossayin questions says you've created a new cut site, 1. look at the region on the sick vs healthy. The C to G is the change 2. Write out the sick "CCGG" from 5'3'- you could write out the whole thing, but the answer only has 4 letters, so being lazy here 3. write under it, its complement, the dna base pair. So "GGCC" 4. remember both strands are going in opposite directions when you write them out on top of each other. 5. So the bottom strand actually reads 5' CCGG 3' so that is the answer I hope that clears it up +51  
shirafune  To add to the palindrome part, many restriction endonucleases actually function as dimers. Each individual subunit usually has a nickase, so to create a double-stranded break in DNA, they must bind a palindrome so that each enzymatic domain creates a single-stranded break (thus a double-stranded break). +1  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +2  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +1  
ssbhatti  I think its due to the palindrome requirement? +  
bbr  Maybe I'm missing a part here, but the substrate that the enzyme will bind to will be the DNA. I went with the line that was from the questions stem, as it is the mtuated DNA will be recognized by the restriction enzyme. I didnt see the need to convert it into base pairing. Let me know what you guys think. +1  
uloveboobs  @bbr I agree. I'm definitely not an expert in these lab tests, but the question asks "substrate specificity." I was thinking that it would recognize the abnormal DNA; nothing to do with RNA. I didn't know about the palindromic preference of restriction enzymes, but I don't think there's any need to figure out base-pairing and whatnot here. (At least for this question it didn't work out that way!) +  
spaceboy98  sugaplum, I'd give you an award if this was Reddit +5  

submitted by fatboyslim(43),

I chose Aspirin. So aspirin is a non-reversible inhibitor of COX-1 and 2 which should decrease TXA2 levels, and according to FA 2020 page 485, TXA2 causes platelet aggregation and increases vascular tone...I'm guessing the overall combined effect of COX 1 & 2 inhibition will cause a net effect of either vasoconstriction or no change to vascular tone?

spaceboy98  Me too. i thought aspirin blocking off the TXA2 production would allow for vasodialation. +1  
kevin  This was a UWorld question. I originally thought the same, it's just cilostazol does the vasodilation and inhibition of platelet activation most directly +  

submitted by drdoom(884),
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Tihs hitmg be a moer ttueiiivn froawemkr fro gurd rliat pse.ash

shaeP 1 / sFitr you vige only to eatyhhl .lepeop uoY nctnao tets a nwe ptrheay no udlsidivani owh are adelayr c”ksi“. How wludo uyo itgdissuihn daesver gudr fcetef fmro coimpciolnat fo the iedsase? In het bnnegiing ouy lpimsy ehva to epvor ahtt het rdgu sn’oedt ascue oslbemrp in aomnrl ndalsdvi.iui Yuo ’ctan vorpe tath if oruy niiilat study cuedlsin rmnn“looa-n” ha.nsum

saePh 2 / ,oedncS ouy gvei nlyo to teh s.ick Tshi tlse uoy ot edemtrein if het gdur sah nya tbenief vwhsraeote in eht dninedet inuedce.a If it deos not evrpoid efi,bten ereht is on“ n”osear ot canaved ot het xetn .getsa

sePha 3 / ridh,T yuo tums verop htta eht rudg ton nylo soedrvpi a teeibnf utb si aytlcual trtebe tnah eht cnrrtue daans.trd -e-Htad“ae”odh( r;ltia onarmd dotlrcnelo )

hsPae 4 / If oyu apss the dirth seag,t oyu anc reaslee oyur drputoc to maekrt but stum vluires rfo nelormtg fcfetes ihcwh ucold otn eb edcrtaup by eth ar,eerli rh-roeasetsgt sapeh.s

spaceboy98  This is the kinda shit we need more of. Awesome explanation man, I wish they wrote FA like this +2  

submitted by madojo(177),
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onycpCoirsl is an rmosnesupmisnpuat atht koscbl T lecl toitnvcaai yb iiginnbhti I-,2L so ew wokn thsat nto h.gitr ypohpoldmeCiscah si an iaglkylant .taeng ubxcDniroio is an noaitumrt icintabtoi tath eaenrsget rfee asdrliac nad esscau skbrae in .AND uirro5oafc'ull si eictassoa hiwt iiepymndri esnysi.hst Lvienga ientiVinsrc iwhch si a tnspiealco ugdr htta rswko on iulmtbusoecr (thero udrgs taht od isth cceinohil,c il.cepaxtla

sA mdentneoi el,adyra eht lecl si ukstc ni eaeatsphm dan tnocan uerngdo eth eieponarst aspnaaeh. M ccyle etrsra is adsteciaos itwh icvirtnsnie dna cwhhi het cotitim nlsdpie cwhih si thaw aesatrspe eth emrocssmooh si nto or.fgimn

suckitnbme  The funny thing is that the image seems to show that the spindle did in fact form. +11  
spaceboy98  EXACTLY They showed the mitotic spindle is formed, so paclitaxel would be ok, but for vincristine, the damn thing would not even form +4