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Welcome to targetmle’s page.
Contributor score: 7

Comments ...

 +1  (nbme24#6)

if the option had SMA and celiac trunk, would that be correct?

 +3  (nbme24#24)

Shouldn't we first address the issue by correcting her glucose levels by readjusting insulin and then see what are the problems?

am4140  This is what I picked and what I’d still pick in real life. The fact that her diabetes was controlled before doesn’t change the fact that it’s not controlled now... maybe we could change the insulin back to what it was after they get their family issues fixed, but the patient’s immediate blood sugar levels need treatment IMO. I’m just going to miss these questions forever, I think. +

Subcomments ...

submitted by hayayah(1077),
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Aceut tlsratiiietn rlane oiainl.amtnmf Pyraui llysalsa(icc esio)ipnhsol adn aazimtoe ucnogricr rfeat idomrtntaiains of rgdus atht tca as nphta,es gdiuncin seisiyhietvrpynt ,ge( ucies,rtdi DsI,SNA eiinnicpll iei,revtavsd ntopro ppmu ihoitis,rnb rnf,piiam onoinesq,lu soesl)aimdn.uf

hungrybox  But how is a 2-year history acute? +4  
jinzo  there is also " Chronic interstitial disease " +4  
targetmle  i got it wrong because there wasnt rash, also there was proteinuria, doesnt it indicate glomerular involvement? +2  
zevvyt  Got it wrong too cuz of that. But there can be proteinuria in nephritis, just not as much as in nephrotic syndrome. I guess that's confusing cuz this type of nephritis isn't grouped with the other nephritic conditions. +1  
lovebug  FA 2019, Page 591. +  

submitted by seagull(1567),
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hTis pienatt is ngpiitrp .asllb Bettre od a durg srneec cwhih eemss ou.vsiob

sympathetikey  When the answer is so obvious that you pick a stupid answer instead of it. DOH +43  
jooceman739  Funny thing I noticed is "he is alert and cooperative. He appears to be in pain" So he was so high that he was alert and cooperative during the basal ganglia hemorrhage +5  
yotsubato  @sympathetikey That fucking guy who drinks 2 six packs a day with liver failure got me like that. +1  
yogi  probably the "drug" have to be a stimulant or a hallucinogen which causes HTN & Tachycardia. +2  
charcot_bouchard  Lol. I got the right answer but took long time +  
goodkarmaonly  The patient's B.P. and pulse are raised + Bilateral dilated pupils = Most likely use of a stimulant Thats how I reasoned it anyways +  
llamastep1  Bilateraly messed up pupils = Drugs (most of the time) +  
targetmle  why is there basal ganglia hemorrhage? +  
dul071  Wait! doesn't it take like a week or two to get the results back!?!? i chose to measure catecholamine levels because that may be more timely. but clearly i'm wrong +1  
usmile1  basal ganglia hemorrhage is an intraparenchymal hemorrhage secondary to hypertension. according to FA, this occurs most commonly at the Basal Ganglia (FA19 pg 501) +1  

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If eht lriyontaabm asw hinegtmso oemr eifl ,eethgrintan lwn'toud teh srtfi cainot be to lalc hte precindatai?i I saw ,tniginkh imbl etymteixr gmthi aemn tgnmheois slee mreo sriusoe asw ipghnnape too t--&g; ende iencairpidat tihrg ywaa ot .dx

tinydoc  I thought about that but then I ruled it out as with the NBME ethics questions the answer is almost never to defer to someone else. The question doesn't ever tell you what type of doctor you are for you to be referring to a different more specialized physician. Also I assume that they think if there was something wrong you could handle it. +2  
llamastep1  Out of all the questions (UWorld,NBMEs etc.) I can only think of 1 question where you had to refer. +1  
targetmle  even i thought pediatrician should be called as after all, every newborn is screened by pediatrician and in this case, he had abnormality! i still wonder why would gynaec comment on that! +  

submitted by diabetes(28),
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cna ymoobdse aenplxi owh yernge pcdnutroio by gsolislyyc nsreda,iec sicne aeobcir sycslyolig purcedo 23 nte TeomArp,aPc ot 2 ten APT hruthog rbaeoicna soycislygl ?

diabetes  i think the stem should be "energy production by an anaerobic glycolysis " +3  
blueberrymuffinbabey  yeah that's the bit that tripped me up too. i get that there would be increased glycolysis in general to compensate for lack of TCA function but...the fact that it says "energy production by glycolysis" is kind of misleading/confusing. +  
thotcandy  technically, glycolysis is the reaction that happens in the cytosol that generates pyruvate and 2 net ATP. after that it's TCA and Oxidative phosphorylation, which occur in the mitochondria. By definition, glycolysis is anaerobic - which is why they hammer the fact that RBC undergo glycolysis only into our heads. +1  
thotcandy  technically, glycolysis is the reaction that happens in the cytosol that generates pyruvate and 2 net ATP. after that it's TCA and Oxidative phosphorylation, which occur in the mitochondria. By definition, glycolysis is anaerobic - which is why they hammer the fact that RBC undergo glycolysis only into our heads. +  
targetmle  i got it wrong because of this as i thought ATP will be decreased in anaerbic glycolysis, but proabably it was mainly 'glycolysis' is increased +1  

submitted by aneurysmclip(151),

anyone else get this wrong while the current coronavirus "pandemic" (acc to some sources) is happening? feeling reaaallll dumb rn

targetmle  yes because i thought they wont give ques on current coronavirus situation so early!! +  
adamventure  I thought to myself "damn it sure would be fuckin hilarious if Coronavirus was the answer".. turns out it was and it wasn't hilarious since I got it wrong. +52  
asdfjkl  no quotes needed for pandemic anymore :( big sad +13  

submitted by hopsalong(25),
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Tihs qsiueont ash a tol fo aswenr ooptn,si and yuo veirar ta tehoiiislphNrsa yb itnrhogw uto lla eth terho inoptso by htaw si nis.sgmi

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whoissaad  Great explanation. Always found it hard to differentiate between ATN and AIN due to NSAID use. This made it clear. Thanks! +4  
hyperfukus  yasss +  
dubywow  "occasionally writhes in pain" -- as a guy who has had a kidney stone, writhing in pain definitely hits the mark. Picture yourself knees on the ground, face on the couch, screaming incoherently while the paramedics are there because you can't control your own body movement and don't know if you're dying or whatnot from the canonball sized hole that (may or may not be) in your flank. Then imagine one of the paramedics is your premed study buddy. Never forget writhing and nephrolithiasis and premed study buddies. You will forever get this question correct in the future. +5  
bharatpillai  i swear to god ive done a similar question on the usmlerx qb and they answer was renal papillary necrosis. which is why i got it wrong :( +  
targetmle  i also remember that uw ques which got me this ques wrong. i think in that ques,patient sibling or he himself had sickle cell +