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Contributor score: 82


Comments ...

 +7  (nbme24#32)
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oysspsrenu lmaengit ahs aavnior slvsees t;g--& riaonav rtaery + ertuer cna be eagdamd in ehopoomyroct

driaclna lgaemnti ash enrueti sssvele -&;gt- eieurtn ytarre + ruetre acn be dedgmaa in scortetemhyy


 +1  (nbme24#32)
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soupyssrne mnetliga sah irnvaao esslves -g;t-& turree can eb amaeddg ni motyopheorco

daalcnir agemlint ahs eitnreu esslsve t&;g-- eeurrt anc eb egaadmd ni ymteeotsrych


 +1  (nbme24#1)
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imroytccac enaiam sene( in loobd eamsr) = CRB secrrsrupo cna rogw ubt ont veidid

ovla cyscrateom e(nse ni olbod mr)ase = laotcbgaselim iaenam (fi ythe 'odnt shwo elorunihpt ntgaenthmrsoeip)ye

2B1 ash eicnugrool ypstsmom dan wlo ytomachemliln dcia lwehi fltaeo fiycideenc does ton

ealotf is abosdrbe in u,umjnej 1B2 ni ilmue

secu as of 12B ycfinieced = psueniroic naima,e stcetymoarg, aliel tcnresoie, ihsf pmtr,aewo i segnavm

)D auilefr of MTFRH ;-tg-& HTF iva( ahynlreetemtarsfs = 12B eifccidyen nad mtcocaicry neamai

)B 6DPG nfydiceeic = oomctrcyin aebescu fo rnic RCB unsoi;tdtcre tp uwdol ohws uvrialsaacrtn hseomiyls xs pitradeetpci by an ieiaxodvt seosrstr

)C igoooprytehpronpn xdoeais icndeyicfe = ocyiicrctm namaie cuaseeb of wlo hmee iehsssnyt

)A crde rertfnsnria = gihh efinrtir = aiaenm of nrcoich esiesda = oiymirctcc ameani scbueea of olw inor


 +0  (nbme24#6)
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aectu otniaeexcbra of FHC lasde ot dcdreeu OC ;-&tg- ceorlhvipemy paminho,retya ydob vepresiec ti as coyohlpviem (so yuo pxetce ghih H)AD onoomc"-[inst sareeel of DA]"H

  • tihs tp is lcilyancil emhciyovrple dae,em( ,srlae nedsdtied ekcn sniev)

  • urnie dohsul eb deaettronccn mU(sO &;0t01g sO/mkm)g sceeuab esndkyi ohsldu be nefi dan HAD is odgni sit o,jb jtus with bad fraiimootnn

  • fi reuni is tdieul, 'its nto FH,C 'tsi eigcoyhscpn (cna eb euacsd by hinspirzaheco ro ottausifci rie)dords

et'sl ysa seh 'watsn acyrz dna erlaly was gihvan HCF rebe o-acxtain tx wtih udietirc dan iudfl inoctrstrie as tehy -di;g-&td tnoe thta uoy acn loas sue atapnv sgurd fro tCee-HlFard ntecapmiryho ylvhmeapoire obklc( A)DH -&;t-g dlhosu ecsau the reuin ot be tleidu hhwci lliw reedcu hte hopervemayil dna eedcur satl ritpoosnre ot orctecr eth rnamoeyhipta

mrnoad baseetdi sipiidsnu edis ntoe for ypsiohneccg opy ilI(pdaiDs xd is trmplny,rariomanhe/ae lhpmayvioo,e udeilt eniru &g1mt/m;0slk0)O

  • can slao ues eth waert pvdnrtoiaei stte ofr a pt twih ualoiypr dna opidpalsyi

&;g--t if ineru ,scoetecnrtna si't chipecsngyo

-g;&-t fi it deos tno trtnaceo,nce vgie mseisorpdsen nda if ti tctocnanrees = tlnrcae ,ID soed ont reonacecnt = recngohnpei ID


 +9  (nbme24#45)
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AAD munaotti = mtousaaol eevsrseci CDSI

--2RLI mmaga cianh iatnuomt = LRX ICSD

R-2I-L hplaa hiacn )C25D( = -Tgre u;ndtysncfoi ascso twih ayitnoumtuim s.ep M,1DT SM

aFs nigdal ()CD59 tmuoiant = no T lelc sastpopio in igaevnet silteceon ni himtyc aldumle = cirn oactcnuriil fo -aesigclnrtfe ptyylhocem = oaniemtmuu foyvlpethiolrrpimea nyoerdsm


 +0  (nbme24#30)
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pei = ohrcootyhaemcopm of rlneaad luamled = deipiosc HrNPP HTT = suaqmuos lelc acrmnocai fo lgnu pslu( )erhsto = Vayo miceIlParmehcap = oonnneuirceerd tecarncapi uromt erctysero= rradhiae HA[WD yarw(te d,iaarrhe yoalipahek,m rlhac]adoyih


 +9  (nbme24#4)
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A = NC III

B = CN V

C = NC VI

D = CN IVI

E = NC IVII

F = CN X


 +4  (nbme24#36)
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hrmpa cssaeu of edllp-uidcin ehspaigsoti = o,pnhphstesbisoa tyeialnesccrt, ,DNsSIA n,ori staopismu chlrdoie

ntpipahoshsbsoe MAO = ndbi paydtrehaitxo to uecrde stscoetola tiiayvct e(dus in otiposo,eossr getaP saeised of oben, oegtsesenosi p,cftreeaim aharecclmpiey adn mset to )ebno

oisprosestoo rpahm

  1. Ca/V+ti2 D ntppiloaenuetsm rsl(xp)ayphoi

  2. sasnthosoehpbip - EMDsA = tihase,gpois ,NOJ taycpali laroefm sssrte aecusrrft

  3. eliltsapu TPH noasalg pe)at(taidirer = noly eon ttah rnic bone wthogr si(emstautl slboet)otssa --g;&t nrttanesi hymeaepliccr,a saol ricn kisr fo oosaaecstmor d(nto evgi ot etgap dz of nbeo ro ayn eaccrn )pt

  4. MSRE (aeoielxnrf = taitaongns ta tbssare nda tse,uru SAONGTI ta noeb = no ncir isrk of tnleraodeim as.bpu.aiprthy.le tisll ncir skri fo rlmbeo)mbishotmo

  5. madeuosbn abm( anigats RLAKN ..ie iimmsc OG)P

  6. rreayl alocctinni

sunshinesweetheart  IGNORE ALLLLL MY OTHER POSTS lol I just learned text boxes. brb will continue helping no one/jumping out a window +1

 +0  (nbme24#36)
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ahmpr sesauc fo ldup-lnedici iapgeishtso = oshnpiest,poashb sn,rieeyttaccl sS,ADNI ,inor tapmsisou hdeilocr

ssabsphpnooehit OAM = bind prxihaeyotatd to ueerdc eoscoaltts ttyivaci se(du ni s,rtoiopeosso aPetg edasesi of bo,en gsoiseotnsee ,femirtecpa heyemlrciaapc dan mset to ebon)

sosireopoost aprmh

  1. a/iC2tV+ D ilnupsntaoteemp ysoxhppr(a)il

  2. aosnbpsitehohsp - etllsuaip HTP naloasg retpdai)t(aier = ynol oen tath rinc boen whgrto aml(setiuts sto)eslsbota &t-;g- attsnenir r,apiecmayelhc olsa irnc krsi fo tsaomraoeocs (ntdo gvei to petga zd of boen or yna ccnaer )tp

  3. ERSM r(inxleoefa = snoagntait ta aerstbs and uustre, TISNOGA ta oneb = on ncri kisr of nereaolmidt pispeah.b.ryua.tl itsll ircn srki of rmooehbsmiobmtl)
  4. beonumasd mab( snitgaa ALKNR ..ei mciims GOP) - ayrelr accntiinlo
sunshinesweetheart  GOT IT IN LIST FORM #procrastinating +

 +0  (nbme24#36)
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hrpma uecssa fo leu-didplnic ghpeassitoi = ptoasophsbeihsn, eysltatier,cnc NAI,DsS ion,r ssimptuoa olderhci

psehtsohbsionap OAM = ndbi dartpyheiotxa to rudcee ostelctsoa citytiva e(uds ni oteop,osroiss taegP aesdsei of ,oben enseissoeotg tre,amepfic yarcpimlceeah nda mets to ne)ob

torspoiosose pra1hm. 2aiV/t+C D pisuntmeonelapt p)(lhr2iapys.xo sisnohpbestahop - eitpasull TPH soganal (redti)eiaatpr = olny eno ttha cirn bneo wtrgho silmtteu(sa lsooatsbe)st -&g-t; tietarnns aaphe,yrlecmic aosl incr rsik fo msaoecrsooat o(tdn eigv to ategp zd fo oben ro ayn rnaecc t)p.3 SREM (lieaxeonfr = nsoaianttg ta sebrats nad us,utre INSGATO ta enob = no cinr srki fo rlionameetd .b.pelpruhsytai.a illts ncri skir of io).mmosbe4hrobmtl banmedsou bam( iagsant RKALN ei.. scmimi P)OG - eryral anlnocctii

sunshinesweetheart  ha I am bad at using websites and can't make this a list that doesn't transform into a paragraph :( sorry +

 +0  (nbme24#36)
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amhpr sesauc fo dinui-cdplle ehgioissapt = oanhphsostbpse,i lesecanicrt,ty DNI,ASs io,nr oausmitps erlhdcoi

noptheasisphsbo OAM = nidb ahrtxaopideyt ot uceerd tsosceatlo ivcytita eu(sd in iesoporstoso, taegP dsesaie of bo,en soeitssgeeno ifrpaecemt, clrcaimaypeeh and tsme to )eonb

ooprtoesssoi phar m- VC/t2ai+ D ituelmenspopant phirlsxpy-)oa( epao-hos stpihnsb auetllsip HPT naaolsg petrt)di(iarae = oyln oen htat nicr eobn hrtogw ustletm(ais stlssa)tobeo &tg--; tatnesinr ye,ccapmlrieah sola icnr ksir fo taomsrsecaoo otnd( iegv to geapt dz of nobe or ayn crcnea )t p- MERS eai(xlrfeno = tagstaonin at saesrtb and ue,ustr GOTIANS at enbo = no cinr rkis fo riedemloatn tbalph.i..uaeysrp sltil ricn srki of sem-roblom mito)hb odbaenums (abm antagsi NKLRA e..i sicmim -)P OG elrary iocitnlacn


 +3  (nbme24#38)
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p 916 AF 2901 - oohsciygpli seachng in encapyrng

cnir ,OC imen,aa tap,iubghirocaelyyl eohnltiinrve,yapt nirc iyspoills and taf ztiinoailut to esvperer clugsoe nda AAs orf teh bbay


 +9  (nbme24#46)
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some ufn tscfa 4 u heso to erlu tou hte orngw nss:ware

arcuteA lcunsue aak alr“iufuinnbd lscunu”e = yahitamcolph nsPrc.l eecuustoj dpiaenrocimg enonusr ot errnaito pauitiytr lgand -;&-gt hnsbiiit RL.P enO of het 4 aimn ndaemiop phtaywas of het ian.rb ronclPtai olsa geisv eebdkcfa dan nri mpaedino nieertcos vai iths ywhatap p[ 487 FA 1]029

Ftrloan otrcxe = nooaodemiilgdr [p 514 AF ,9]e1ra0r2 sowl wogg,rni iredf egg a,peacpnera mya eprents tiwh esiruzse

yiaurtitp amdeano p[ 154 FA 0 1-]92 arpitlemBo inoi-hpa eam otsM yoomcnml a anlaopcomrti ail(rahspepy fo ottsplhcor)a - :Meal ercd ,iiolbd yelr nttifii - eaeFl:m rcaelthogra,a ereahraomn (PLR eevnigta ecdefkba on aapitochlmyh RH )n-G Can oals ese irlayhapesp fo mosrposhtoat G)H( -&;g-t oa,reglmacy gntgsiami ro csttrocoiproh t&g;-- uhgCins seasdei

PRFP = ni rcheag of eey ogvcnteoaesnetumj/m egaz [p 053 AF 12-9]0 A koerst by eth lrsbaai eyrrat fo auicrrcl iswlli will lead to ssol of or,tlzahoin btu nto irecvlta eye esomvntem


 +0  (nbme24#7)
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prl"i"hspu si a stfgtnrraui wrod ehre but tyhe eyk si NUVSCAERO ACLAUVSR E.SLNCANH toPr nwie siant ni gtrsue rbewe nda nsloma achtp sko"r(t b"tei) rea btho alft ssi,eoln nto a ih.amgmoean

sunshinesweetheart  outcomes: stork bite/salmon patch will regress by 5-6year old or persist into adulthood; strawberry hemangioma will regress by 3-6 year old; port wine stain will regress or persist but it'll be associated with the sturge-weber stuff see the mnemonic pg 513 of FA 2019) +
sunshinesweetheart  oops correction on port wine stain outcome: "lesions become a deeper purple, and angiomatous bleeding papules and soft tissue hypertrophy often develop. Because of the propensity of these cutaneous lesions to persist and grow, treatment of cosmetically or functionally impairing port-wine stains is recommended during infancy to prevent the soft tissue and bony changes" from the link kateinwonderland posted above +

 +3  (nbme24#10)
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okol at FA 2109 g.p 216

in a sGna,iaus %66 aer wthiin 1 DS nad 9%5 tnwhii 2 SD

hsit is hhig diyle af


 +1  (nbme24#3)
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uot of itryso,uic hwy rea STA dna ATL ?hhgi is taht anisyg hte RITN edus aws deasnoidien chhiw edl to ctriatneipsa ?olas

krewfoo99  AST and ALT will not be elevated in pancreatitis, they will only be increased during liver damage. NRTI causes hepatoxicity (although FA 2018 states NNRTI causes hepatotoxicity, NRTI could also be an option considering the two classes are similar. The hepatoxicity will cause an increase in ALT and AST +




Subcomments ...

submitted by neonem(571),
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Pg 194 ni FA 8120 (loyeruNgo tmaoayn ;a&mp oyyolihgsp t)no:cies 3 ulssmce cleos eth aw:j ,aetrssMe sMpoa,lirte edaliM doegir1tpy selcmu sonpe het a:wj rLealat tigro eydpLLA aer eivtadnner by igiaenmtrl veen,r V3oenMmi:n c sM' hcumn sleoc( het ,jw)a 'sL ewrol ll(eaxoo/senr the a)wj

sunshinesweetheart  p 495 in FA 2019 +3  
mnunez187  p 507 in FA 2020 +  


submitted by brethren_md(90),
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lscsCia eples aeanp ni het n.etptia aosCtnsei fo tanibgreh suaces urtnolanc ohiyaxp and mstcsiye isdpseuencd/ryhonrhmytha/tnrie dheat nac .seirtsp aOP2 is rmanol druing yad nda drcsedeea dirgnu pseoseid nad at hting. ilaClylcass nees in Obsee etaispnt cush sa the tatpien in hte snoqeuit sm.et

tinydoc  Caused a cessation of breathing rather than a ↓ in lung volume although a patient could develop an obesity related restrictive lung disease thats not whats happening with this question. +2  
sunshinesweetheart  p 665 FA 2019 +1  
syringomyelia1  p 679 FA2020 +1  


submitted by sajaqua1(533),
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yrraiPm oeenpitrnv is na eviact spte akten ot ehda ffo ro iettiamg a asi-sdee khtin of toaanisicvn.c nI hist ,ecsa it is lyetlfsie miifcndaioto e)execri(s to hple -0043 ryae lod woenm ehtigw( neiragb xceriees acn teaimtgi ospsseo,ioort bnefteis fo bocerai escr.ex)ie

Sdeyocan iterpvenno si lreay edoncttei fo a sasede,i miroonptg lyrae tiv.tnrnoeien hTsi oducl enucil nistgh ikel VHI isettng eevyr 6 ,tmnsoh ro or aalnnu mmogra.aphym

iyTrreta viretntnneio is prhayte imgina ta ercndiug ls,antoiipcmco aoinwgll rl,saepe or nmiigrvop oi.fctnnu nbcAstiene romf lcloaho aym eb here sbceuea fo unebsatsc suaeb lesobp,mr or eesbuca osme eagadm opsryeviul deno yb clolhoa nntoac eb revtepn.de ralSlymii rfo a lwo trraebcdayoh teid ew yma eb tiatginmgi hte fetcfes on mabsietoml taht eahv ladraey been endo.

sunshinesweetheart  p 269 FA 2019 +  
motherhen  [P]rimary= [P]revention [S]econdary= [S]creening [T]ertiary= [T]herapy +3  
rockodude  almost picked alcohol because that may lead to fetal alcohol syndrome, relevant to women of childbearing age, but regular exercise made more sense. complete abstinence of alcohol is a little extreme for a general recommendation +  
jurrutia  Abstinence from alcohol is a form of primary prevention, because alcohol causes many bad outcomes. However, exercise is more important. +  


submitted by famylife(93),
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oT ulre uot ADSIH e:pty Suer"m ostipsaum octanrtoinnec reyalngel nairmes dcuah.negn Mvmoteen fo tpamsiuso ormf the tlclelrraauin aspce to the lualalecexrrt ceasp evetpsnr ltinuaolid yaohkli.mpae As honrgdye nios emvo lilyrl,uralnecat hety aer exedhangc ofr pmuotissa ni order to anainmit otinyalutr.r"leecet

ewi6yrnc-iah-teimsi:tefo-c.drhlsuasane--p6n/ei-ametpsec8/cnpo4satwar-s-3e2oas0hmfudmodesc/efao/wpo5mls-wmwreuroirs.deestinott-ri-dh3n-tvppoe8os/-r

usmile1  Does anyone know if SIADH is associated with hypertension? I don't think it is due to the body's response of downregulating aldosterone, but if someone could verify that I would appreciate it. +  
sunshinesweetheart  @usmile1 pg 579 FA 2019 = BP can be normal or high in SIADH +  
usmlecrasherss  in SIADH GOLJAN says you have diluteonal hypokalemia +  
tyrionwill  SIADH -> excessive ADH -> water retention -> atrium excretes more ANP, ventricule excretes more BNP -> water is excreted more. So that is why not too much plasma volume increment, resulting mostly normal BP. +  


submitted by m-ice(340),
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sQtunoei si acialybls snagik hwat rea eth easbsstutr dues eth stirf tspe in ehem .yssnhstei In htat ,epts ylecgin dna ccynilsu oCA rae ocmiednb ot amek vielunniilmcao iacd.

sunshinesweetheart  p 417 FA 2019 +3  
drschmoctor  p 425 FA2020 +  


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rhamp sasceu of -ueipcllidnd tsshoaeigpi = shpo,sstbpenahio tlcasyeeic,tnr sAIDN,S i,orn imoautssp rhlceiod

hahebonpssipost MAO = dnib itxorehyaapdt to euedcr sstoatlcoe ttaiyicv s(due ni oeoroptssis,o eaPtg ieesdsa of n,obe seoetnsgsoie ar,ceetpimf lyeahircacepm nad mest ot e)bon

sssooeitproo prmah

  1. 2/aitCV+ D ttmelpoieansupn hayposlp(x)ir

  2. hsboistapsohepn - DEMsA = ,gsapshoieti O,JN lyatiapc erlfamo estsrs scrueftra

  3. pltulasie PHT solgaan tredia)tp(arei = nloy eon atht ircn ebon ohrwgt lut(misesat talbstes)oos &;t-g- niettnars a,lecmyieracph sloa cnri iskr fo tocaeoamrsso dnt(o iveg to pegat zd of onbe or nya nercac t)p

  4. MERS oinraxf(ele = gnatntoisa ta strabes nda setu,ur OTINSGA ta eonb = no ncri sikr of eoidelatmrn yuh..patilaepb.sr ltlis rcin rsik of bhiotrm)sbemmloo

  5. sbemoduna b(am ignstaa NLRAK i.e. immcsi GOP)

  6. rreayl lonctancii

sunshinesweetheart  IGNORE ALLLLL MY OTHER POSTS lol I just learned text boxes. brb will continue helping no one/jumping out a window +1  


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ahrmp uescas fo ieudn-dllpci eitihspaosg = bsoatnhosphies,p iltecnaeycstr, N,DIsAS nor,i psimtauso rlohdeci

sohhobapnetsisp MAO = inbd teptyioxhdraa ot cerdue ssolettaco cyittaiv (deus ni pso,seotsoiro tegPa idesaes of oe,bn eeegstossoni arimtpe,ecf craeiayhepmcl dna emts ot )ebon

tsoisooorspe mpahr

  1. 2/it+VCa D uitoptnmeealnsp h)osaiyr(ppxl

  2. oshpanpetsbisho - sletpaliu HPT gnaasol p)ariadie(etrt = nylo one thta icnr nbeo towghr la(smistteu )soeaslsbott &;-t-g neinttrsa lceyr,mhaaceip aosl incr ksir of mseoocartosa (tdno vgie ot tgape zd of noeb ro any crcnae p)t

  3. RMES fnr(eoilexa = tnsgtainao at tbaessr nad rtseuu, TGNSOAI ta oebn = no rcin skri fo enetiadmolr iaehsyltp.p.rb.au sitll icrn irks fo mishmbe)olbmrtoo
  4. oumnseadb bma( ngstaia LKARN ie.. simimc O)PG - raylre ilcoanctni
sunshinesweetheart  GOT IT IN LIST FORM #procrastinating +  


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pmhra uescas of ilelnpddui-c hiiossgptae = ,sapbphisoostehn rnyeitc,easctl s,SIADN rn,io piomsstua iorhdlec

atipssheobnshop AOM = indb tarhyeidtaopx to eurecd lotsasteco iityctav edu(s ni iso,potsseoro Pegat isdeaes of n,boe eotngsseesio meap,rifetc cleamhyrpaeic dan smte to eob)n

osooriteopss .r1hapm aVti/2+C D ltepntuismapone 2lp) ihro.(yapsx oohnstbhsppasie - tualselpi THP loagnas )taaiierrp(ted = ynol neo ttah ncri eonb thorwg sutlse(mtia osaoetsslt)b t&g--; esnraitnt clr,iycaeamhpe slao cirn irks of tossoaaemorc td(on geiv ot apgte dz fo nboe ro nay arccen tp).3 ERMS naloree(fix = tniaogsant ta bsarste dna sut,reu OSNITAG ta bneo = no inrc riks of eatmdonlrei ptbryhiu.sea.lap. llist icnr kisr of mib oml)ombe.trosh4 uabndemso b(ma gtasina KLRNA .i.e iismcm GO)P - rralye ntiicoancl

sunshinesweetheart  ha I am bad at using websites and can't make this a list that doesn't transform into a paragraph :( sorry +  


submitted by drmomo(18),
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why ntc'a ti be exlcu ouiqts?om byaem hcwairueer ciatfbonr sraiif?slia

sunshinesweetheart  diff presentation - that's elephentiasis +3  
sunshinesweetheart  plus filariasis isn't the same as microfilariae +  
avocadotoast  @sunshinesweetheart wucheria bancrofti shows microfilariae on blood smear. Filariasis in the name is referring to the microfilariae +1  


submitted by drmomo(18),
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hwy a'tcn ti eb xucle qm?otsoiu mbyea aecwrerihu riotfcbna aiiilf?assr

sunshinesweetheart  diff presentation - that's elephentiasis +3  
sunshinesweetheart  plus filariasis isn't the same as microfilariae +  
avocadotoast  @sunshinesweetheart wucheria bancrofti shows microfilariae on blood smear. Filariasis in the name is referring to the microfilariae +1  


submitted by medstruggle(12),
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hyW si it otn roianva locilfle c?elsl I uhoghtt hte emealf olnaag fo eorStil adn diegLy is scr/gnalthaaoeu sl.elc

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +38  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +18  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


submitted by medstruggle(12),
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Why is it otn aainrov cllielfo s?lelc I tutgohh het eeflam alngao fo teoilSr dan egidyL is uhosrceanag/lat .ecsll

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +38  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +18  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


submitted by neonem(571),
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siht atitenp ahs taytspoimcm itorca sitsosn.e sThi nac eb neifetiidd by eth rcavnelritu pthoepyyhrr o(t eocpstenma fro diacsnree lotfnucian aoraldetf rfom n-nnlimpoctoa oritca )l,evav cmidsolytis rumurm nad eth lncoatoi ta eth alornm atrico .aare

ePr tUTepDao on aniicllC sfaetatsmnoini fo rctoiA :oetSnsis

isz"ziDnse dan yecnops — enSpyco rcucos sa a sgpnetenri opmtsym in rleaxpiomaypt 01 ncprete of ensaptit iwht pmytoascmit rvesee AS r(o tploayerxmiap 3 epentrc fo lla aespittn htiw eserev SA) []3. eTreh rae eveasrl poopsdre txpeniasoaln rfo inletraeox szdneszii )soryeenpp(c ro scynpeo in npasetti hitw ,SA htbo of wcihh etrflce eerdsdace brarecel fu.enpsori -reixEecsidcuend sdatioavloni in teh rscepeen fo an bicttrnouos whit efidx adiccar puottu acn uslert in poosnte.iynh"

guillo12  What does "fixed cardiac output" signify? +1  
usmleuser007  "fixed cardiac output" might mean that with the stenosis (ie. narrowed aortic valve) there is a limited or rather reduced cardiac output. Exercise would not increase cardiac output because the stenosis is caused by a mechanical (physical) rather than a biochemical process. Therefore, At any given moment the heart can not increase its output no matter how forcefully it contracts. +8  
fallot4logy  why not option A?arterial compression ? +3  
sunshinesweetheart  @fallot4logy LVH does not lead to coronary artery compression. only reallyyyy rarely will pulmonary artery dilation cause coronary artery compression. plus that would cause angina but probably wouldnt decrease cerebral bloodflow to syncope. her murmur + LVH point us toward aortic stenosis which does cause those --> fixed CO +2  
drpatinoire  @fallot4logy LVH can cause coronary artery compression, but typically leading to coronary ischemia after exercise (i.e. stable angina in this patient). The question is asking what leads to her syncope. Syncope actually means her brain is lacking blood supply abruptly. +5  
rainlad  how do we rule out mitral valve prolapse in this case? +  
spow  @rainlad murmurs at the right upper sternal border are aortic in nature. Mitral murmurs are heard at left 5th intercostal at the midaxillary line. +1  
jj375  Also, nobody mentioned the "prominent left ventricular impulse". I kinda get thrown off by these. Anyone have thoughts? Google was telling me it is from a hypertrophied ventricle so I'm thinking her aortic stenosis causes the LV hypertrophy and an impulse. Is this the correct line of thinking? +  


submitted by yotsubato(1032),
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moAlyid A : esne in iochcnr fmlitanmoyar icn,ooitsdn poindstoei fo liomady in stiessu

2B :iulorolnigmcb saecitaosd wtih ERSD dna ngol etrm ilsiadsy

Neaofmtrneuli entopir: mFor teh tnoeoeskyctl fo rosunne n(i hhetayl vduainl)isdi

iinnrPe:els esdostciaa whit ilifaalm ihazereslm aedises

sunshinesweetheart  neurofilament also seen in neuronal tumors i.e. neuroblastoma +  


submitted by xxabi(259),
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ntSet hsrsobmtio sv si.t-eossnre tSnet ossrobhtmi is na ceuat soionculc fo a naorcroy yrtaer s,ttne whihc nfeto sseultr in eacut rnoayocr ynemd.ors Cna eb ntpvedree yb luad lpttleaeanti hprteay or ntuglirgd-ue .ntesst n-tssiosRee is eth lgdaura rnniagowr of hte tntes mnlue due ot inometailn e,iptlofrnaoir rnstliueg ni nliagna mysmpo.ts

sunshinesweetheart  so just to clarify - it's the "symptom-free for 3 months" that rules out thrombosis? +6  
hpsbwz  It's moreso that at rest there's no changes, but during exercise there is. Like the pathophys of stable angina. +6  
suckitnbme  I think it's more because of the 2-month history of PROGRESSIVE angina sx with exertion. This points to a chronic process rather than an acute event. +  
alienfever  Drug-eluting stents prevent re-stenosis (rather than thrombosis) by releasing sirolimus which by blocking cell proliferation. +2  


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urh"pislp" is a rfnusitratg wrdo eerh tub htey key is RUACNSOEV SLUCAARV HC.NEALSN ortP nwie naits ni sretug ewber and oslanm ptcah osr"tk( )bie"t ear otbh falt ,ossleni nto a ieaahmn.ogm

sunshinesweetheart  outcomes: stork bite/salmon patch will regress by 5-6year old or persist into adulthood; strawberry hemangioma will regress by 3-6 year old; port wine stain will regress or persist but it'll be associated with the sturge-weber stuff see the mnemonic pg 513 of FA 2019) +  
sunshinesweetheart  oops correction on port wine stain outcome: "lesions become a deeper purple, and angiomatous bleeding papules and soft tissue hypertrophy often develop. Because of the propensity of these cutaneous lesions to persist and grow, treatment of cosmetically or functionally impairing port-wine stains is recommended during infancy to prevent the soft tissue and bony changes" from the link kateinwonderland posted above +  


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uphls"pri" is a nagirufsttr rdwo ehre utb ethy key si VASRNEUCO ARASLCVU HECSNL.NA Ptro niwe ansit ni tursge ebwre adn nmosla hatpc ro"tks( "te)ib are both lfat olessin, ont a hmga.oemian

sunshinesweetheart  outcomes: stork bite/salmon patch will regress by 5-6year old or persist into adulthood; strawberry hemangioma will regress by 3-6 year old; port wine stain will regress or persist but it'll be associated with the sturge-weber stuff see the mnemonic pg 513 of FA 2019) +  
sunshinesweetheart  oops correction on port wine stain outcome: "lesions become a deeper purple, and angiomatous bleeding papules and soft tissue hypertrophy often develop. Because of the propensity of these cutaneous lesions to persist and grow, treatment of cosmetically or functionally impairing port-wine stains is recommended during infancy to prevent the soft tissue and bony changes" from the link kateinwonderland posted above +  


submitted by neonem(571),
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ackL fo 18CD (AL-1F rtngi)ine no gopaehtysc is het uceas of luceeyokt hneoadis dceecifniy ptye 1 (D).1LA Sneci cgthaopsey keil hserptlunoi adn eamocgashrp n'cat egt tou fo eth ,dbmreloaots htey rae skutc ni hte d,lboo henec het olueksicsoty iwht BWC ocntu g;t& 00100., niSec eth uektyecsol rae scktu in teh o,bdol tehy cant' tuomn na fcviefete uinemm rsoeepns gntsiaa eraa.icbt

sunshinesweetheart  also for completeness, LFA-1 is an integrin that binds ICAM, so LAD1 results from a defect in tight binding +1  
avicenna  FA 2019 - PG 117 +  


submitted by happysingh(45),
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,so hte yKe rswod atht on oen si gmntenoini : acinugommitnc oerupcsahhyld

het apyphhtos oesg liek stih :

na imaltoaymrnf tenisgt ,..i(e asahudcribno goere)hhmar ldeiy sbifosri / sragrnic of teh aidhcrona lnrogiauntsa &=gt; rmipdiae SFC gienraad

hte yek soiptn / ccntpoes yhet rae tgriny to tste rhee : .1 do uoy wkon tahw ntncigcioamum pdhyoahsluerc thu(iwot meht iltgnle you ehots odws)r .2 do uyo konw tswh'a eht soyotyalhpihgop o(f iminoccmtnuag arelphocuhdsy) is ?

potentialdoctor1  Exactly. To add to this, communicating hydrocephalus can be subdivided as follows: Normal-pressure hydrocephalus: Chronic/gradual decrease in CSF reabsorption at arachnoid granulations, usually due to calcification due to aging. CSF accumulates slowly, so ventricles are able to widen without causing an important increase in intracranial pressure. Symptoms occur due to compression of periventricular white matter tracts ---> Wacky, wobbly, wet High-pressure hydrocephalus: Acute decrease in CSF reabsorption at arachnoid granulations, usually due to inflammatory state in the subarachnoid space (eg, meningitis, sub-arachnoid hemorrhage). CSF accumulates suddenly, causing an acute-onset increase in intracranial pressure +7  
sunshinesweetheart  not to take away from your perfect explanations, but if it were a woman with neck stiffness and fever (rather than circle of willis rupture) that could lead to increased CSF production, right? I think that's the only case where CSF production would increase. Also I think decr absorption in arachnoid granulations in that situation as well so it'd be a shit question +  
peqmd  If anyone like me also got "decreased absorption in choroid plexus", as their wrong answer it's because the choroid plexus doesn't "absorb" it produces. +9  
alienfever  FA 19 p510 +2  
alienfever  If anyone chose F, communication hydrocephalus is caused by decreased absorption and not increased production. FA 19 p510. +1  
an_improved_me  So she has a leaking aneurysm for how long.. gets it repaired, and then within 2 days has an inflammatory response that leads to decreased CSF absorption at arachnoid granulation... Is it the bleeding associated with the aneurysm causing it? The surgery? I'm inclined to say the latter, given that it happens coincidently after the surgery, and not for however long it was leaking beforehand. Thats what tripping me up. +  


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hyW ton lniaclci talr?i Tyeh oulcd opertr a arer dveeasr eetcff ni eshpa 4 nicalcil iltar ?ghitr

sunshinesweetheart  there's no control group. it's just a case study. x3 +2  
sunshinesweetheart  plus clinical trials at that stage would have had tons and tons of participants (and, most importantly to rule out all the answers, control group) +  
servage  I totally thought it was phase 4 of a clinical trial as part of post-market surveillance. Smh. +  
loaloagubba  For phase 4 they report to the said findinds and adverse to the FDA via a portal not to a journal. +  


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hWy otn llniicac il?tra eTyh oducl terpor a rrea dvresea tfefce in hapes 4 laciicln artil rhg?it

sunshinesweetheart  there's no control group. it's just a case study. x3 +2  
sunshinesweetheart  plus clinical trials at that stage would have had tons and tons of participants (and, most importantly to rule out all the answers, control group) +  
servage  I totally thought it was phase 4 of a clinical trial as part of post-market surveillance. Smh. +  
loaloagubba  For phase 4 they report to the said findinds and adverse to the FDA via a portal not to a journal. +  


submitted by m-ice(340),
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hTe pattein endse idmlcae tetnainot laimteydm,ie iwchh iislmnetae itbagonin a rctuo ro,edr ro tarrsifnrgen .reh A uensr osed not heva the mase nianigtr adn ciquisfatloina as a hysicn,aip so it lwdou be ipiterpnporaa to ska htme to anieexm the iepnta.t ngsAik hte hoptlsai nhicapla ianga oculd be pn,proaiitpear dan lodwu teak moer em.ti eofTrhee,r het ebst oponti mnoag tsohe given si to aks teh etatpin fi ehs lliw lolwa htwi hre dbahusn .rnestep

sympathetikey  Garbage question. +60  
masonkingcobra  So two men is better than one apparently +29  
zoggybiscuits  GarBAGE! ? +1  
bigjimbo  gárbágé +4  
fulminant_life  this question is garbage. She doesnt want to be examined by a male how would the presence of her husband make any difference in that respect? +12  
dr.xx  I guess this is a garbage question because what hospital, even small and rural, does not have a female physician on staff. NBME take notice -- this is the 2010s not 1970s. https://images.app.goo.gl/xBL4cK31ta7nG4L39 +9  
medpsychosis  The question here focuses on a specific issue which is the patient's religious conservative beliefs vs. urgency of the situation. A physician is required to respect the patient's autonomy while also balancing between beneficence and non-maleficence. The answer choice where the physician asks the patient if it would be ok to perform the exam with the husband present is an attempt to respect the conservative religious belief of the patient (not being exposed or alone with another man in the absence of her husband) while also allowing the physician to provide necessary medical treatment that could be life saving for her and or the child. Again, this allows for the patient to practice autonomy as she has the right to say no. +16  
sahusema  I showed this question to my parents and they said "this is the kind of stuff you study all day?" smh +26  
sherry  I totally agree this is a garbage question. I personally think there is more garbage question on new NBME forms than the previous ones...they can argue in any way. I feel like they were just trying to make people struggle on bad options when everybody knows what they were trying to ask. +  
niboonsh  This question is a3othobillah +5  
sunshinesweetheart  this question is really not that garbage....actually easy points I was grateful for... yall are just clearly ignorant about Islam. educate yourselves, brethren, just as this exam is trying to get you to do. but yeah I agree there should be an option for female physician lol +5  
drmohandes  I think this NBME24 is a waste of $60. On one hand we have these types of questions, that have 0 connection to our week-month-year-long studying. On the other hand we have "Synaptobrevin" instead of SNARE, because f*ck coming up with good questions. +12  
myoclonictonicbionic  @sunshinesweetheart I actually have studied the religion tremendously and there a clear consensus among all Muslims that in the case of an emergency, it is completely allowed to have someone from the opposite gender examine you. I think this actually represents how ignorant the exam writers are of Islam. +11  
korahelqadam  All it takes is one NBME question concerning muslims for the Islamophobia to jump out I guess +  
sars  This is a very fair question. I agree with sunshinesweetheart above. That is all. +  
wrongcareer69  Garbage question +  
alimd  well we should wait for the question "if a man shouts I CANT BREATHE with a police knee on his neck, what is your next step? Ans- wait 8 minutes." +1  


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naC dyybona nplaiex isth oe?n I utp tpeaeder setts ebecaus I duamses na laore-y-38d anmwo is na uasulnu oigmcrhadpe rof ishyis.lp

m-ice  83 might seem an uncommon age, but we don't know for sure her sexual history. She only recently (8 months ago) started showing some signs of mild cognitive impairment. She has all these results implying that she has syphilis, so the most likely answer is that she has syphilis, so we should speak to her privately about her sexual history. The tests don't necessarily means she got syphilis very recently, it's possible she's had syphilis for a while and never got treated. +5  
mousie  I understand that she could possibly have syphilis but I also put repeat tests because I know there are a few things that can cause false positive VRDLs but if she also has a + RPR does this make a FP less likely? And also if she has mild cognitive impairment you still discuss with her not her daughter correct ...? +4  
m-ice  This definitely could be a false positive, but before we want to consider it to be a false positive, we should talk to the patient about it privately. Assuming that it's a false positive before asking the patient about it could delay treatment of her syphilis. There's a chance she didn't want to disclose her sexual history in front of her daughter or maybe she was embarrassed or didn't think it was important to mention. And you're absolutely right, she only has mild cognitive impairment, so we most definitely should talk to the patient alone without her daughter first. +4  
seagull  She has dementia. She doesn't have the capacity to determine her own care (23/20 MME). I feel the daughter should have the word on the care since Grandma likely doesn't have the capacity to understand her actions. +5  
sajaqua1  From what I remember, dementia is typically a combination of impaired memory *and* impaired thought processes. There is nothing to indicate that the patient has impaired thought processes, and the memory impairment is only mild. The patient can still reasonably said to be competent, and so her private information should be discussed with her alone. +12  
yotsubato  Elder care homes or elderly communities actually have a high rate of STDs. Turns out, when you put a bunch of divorced/widowed adults together in a community they have sex. +11  
yotsubato  Additionally, you should respect the privacy of a competent adult with "Mild memory" impairment. I know I could have mild memory impairment considering the crap I forget studying for step 1 +13  
drdoom  @seagull dementia ≠ absence of competence -- the two are separate concepts and have to be evaluated independently. see https://meshb.nlm.nih.gov/record/ui?ui=D003704 and https://meshb.nlm.nih.gov/record/ui?ui=D016743 +3  
wowo  also important to note, d) repeated tests is also incorrect as the microhemagglutination assay is a confirmatory treponemal test (along the same lines as FTA-ABS) https://www.uofmhealth.org/health-library/hw5839 +5  
sunshinesweetheart  also.... I think we can assume that "repeated tests" means repeat VRDL, not "additional tests to rule out false positives" +2  
imtiredofstudying  the entire point of this question is that when you see an STD in an unexpected demographic (children, elderly), THINK SEXUAL ABUSE +  


submitted by m-ice(340),
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usmleuser007  I knew the disorder and its pathophysiology. But sometimes the answer choices are so wordy or colorful that you still get it wrong.... +21  
sunshinesweetheart  I got this one right but now upon review I'm having trouble ruling out hereditary spherocytosis ("abnormal cell morphology") answer choice. It helps that the dark urine is in the mornings, but is it officially ruled out because of her age? like this is obvi an acquired mutation if someone's 33? +  
krewfoo99  @sunshinesweetheart Hereditary Spherocytosis is a autosomnal dominant condition. The patient in the question stem has had dark urine since the past 2 months (acute presentation). Since spherocytosis is hereditary, it wont be present as a acute condition +6  
sexymexican888  @sunshinesweetheart Spherocytosis results in extravascular hemolysis (spleen) so no weird colored urine (due to intravascular hemolysis) as is seen in PNH (complement destroy RBCs in blood vessels) +  


submitted by jkan(23),
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sunshinesweetheart  ugh, I feel like a child could misuse their insulin by accident without proper supervision. Totally thought she had T1DM and not enough guidance on how to use the meds. annoying +3  
peqmd  I couldn't rule out if the child was trying to get swole and had a shady dealer. +3  
alwaysdivs94  Sorry, where doesn't it talk about insulin abuse in the question? I thought she was administered for an acute exacerbation of heart failure? +  


submitted by m-ice(340),
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sunshinesweetheart  I got this one right but wasn't exactly sure how to rule out 'translation'. I guess just because we're talking about a gene i.e. trasncription and not miRNA i.e. post-translational modifiers? +  
sars  Hox (homeodomain) genes code for homeodomain proteins which are specific transcription factors (bind to enhancers, making these activators). They promote transcription of certain genes involved in development. Thanks so much +1