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Also the patient is on anticoagulation
The question shows the labs/findings prior to the surgery, not s/p GU surgery. I think your explanation is still valid though physiologically because maybe the tumor is compressing the ureter, causing a post-renal AKI. Still agree ureter damage from GU surgery is mega high yield.
Yes but how do you know that the placenta is not retained?
also, since she has metastatic cancer and is cared for in a home, we're assuming she's at end of life care, therefore managing pain is more important than any side effects the opioids could have
so for NBME, 47 years is OLD?? This is vague, if they're going to make people choose between haloperidol and a benzodiazepine, shouldn't they actually make the ages in more of a spectrum?
Thanks for this! but i think you meant to write cataract instead of glaucoma
The clinical picture fits strangulated inguinal hernia and SBO better.
Probably Zenker's diverticulum instead of achalasia, but barium swallow still valid.
depression-like symptoms, bradycardia, 1+ DTRs make hypothyroidism more likely than the other answers!
ischemia of the kidneys can cause intrinsic renal failure - w/ a BUN/Cr <15
This is parvovirus/Fifth disease in a child ("slapped cheek" appearance). Viral illness, will run its course.
Yes for newborns specifically Rh incompatibility is more likely and also much more severe (see pg 405 FA 2020). ABO incompatibility would produce only mild jaundice and is actually quite common.
in addition i took the description of baby being edematous to mean hydrops fetalis, which Rh incompatability is associated with
G6PD causes hemolysis in response to oxidative stress (infection, foods, meds, etc.) which seems unlikely in this case. It also is not as severe as this case. Abnormal synthesis refers to thalassemia or sickle cell. Sickle cell doesn't present at birth due to high HbF levels. Alpha thalassemia could cause hydrops as well but would likely present in utero, so would have been detected during the pregnancy.
Yes. See comment for more.
I believe it is acute pancreatitis secondary to hypertriglyceridemia from the cholecystectomy. Could be wrong, but thats where I went with the increased amylase, although not specific for pancreatitis, and epigastric pain in an acutely ill patient.
Two most common causes of acute pancreatitis are gallstones and alcohol, so in this patient who had a cholecystectomy and does not use alcohol, we would think of other potential causes such as hypertriglyceridemia, hypercalcemia (this patient has normal calcium), steroids, autoimmune pancreatitis, post-ERCP, drugs (diuretics, IBD drugs, anticonvulsants, etc.)