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Contributor score: 6

Comments ...

 +0  (nbme21#8)

Ppl remember that if you get shit face drunk, wait a day and then take a ETOH screen, its not going to be positive. Don't necessarily rule out alcoholism if an ETOH screen is negative

 +0  (nbme21#50)

This is showing demylination/disruption (presumably from the spinal cord injury) of the fasciculus gracilis at the level of the lower thoracic cord. You can tell this is the thoracic cord because of the presence of the intermediate horn and the smaller ventral horns. It is the lower thoracic cord (below T5) because there is only one dorsal column.

We have only enough information to conclude lower leg involvement so loss of sensation to vibration over both feet is the best answer.

Subcomments ...

9 lb isn't that big of a baby... I made it out okay. Definitely should've made the baby bigger to make the answer more clear

swagcabana  More than 8 lbs is by definition macrosoma +  
nifty95  Shawn Carter was born December 4th Weighing in at 10 pounds 8 ounces He was the last of my four children The only one who didn't give me any pain when I gave birth to him And that's how I knew that he was a special child +5  
an_improved_me  Legend +  

submitted by notadoctor(159),
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aneurysmclip  Nbme back at it again +27  
pg32  Is it still considered idiopathic pulmonary fibrosis is it appears to have been caused by an atypical pneumonia? +1  
zevvyt  Why not Sarcoidosis? Wouldn't Sarcodosis also be a chronic inflamation with fibrous thickening? +2  
swagcabana  UIP is a better answer. Sarcoid is a leap in logic, usual interstitial pneumonitis is textbook histological definition of idiopathic pulmonary fibrosis. The biopsy has no mention of noncaseating granulomas and the clinical picture is not consistent with an inflammatory process. You have to focus on the better answers, try not to get caught up in the "why nots?" Calling this sarcoidosis is like someone coming in with prototypical asthma and jumping to eosinophilic granulomatous with polyangiitis. Sure its a possibility but its definitely not likely. +6  
mangotango  I picked “diffuse alveolar damage” with Pulmonary Fibrosis in mind but these are actually key words for ARDS :/ +3  
zevvyt  thank you swagcabana! Very good explanation and strategy! +