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submitted by keycompany(269),
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ptvalonrnyeHeiit rsaeeced aPC.2O tClenar eremesoccoprht sendrpo to wlo aP2CO yb tnacsntoovgriics lbrereac lobdo .sselves

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B) aitlrrAe looBd OP2: OP2a cnhsgae in posnerse to eacdesdre P2,AO P,OI2 or fuoiinfs.d hTree uolwd be no caehgn in OP2a guinrd hlveintoepytrnai hlelato.cre)iyt(

C) iAtrlae uersrseP: eDscaered OPa2C si idstaaesoc wiht ncroiacotnt,sviso hhcwi wluod ensceiar bdloo .psreesur

)E reCblera isTesu Hp wduol ecesirna due ot oyipsrrtera .loassaikl

keycompany  EDIT: Via the **Haldane Effect**, not the Bohr Effect. +  
impostersyndromel1000  excellent response +  
teepot123  fa 19 pg 489 +  

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lePase can ouy ydlikn harse MBEN 22 nad 23 nuioetsQs hwit me . I lyno ese eth arssewn btu I do ton heva teh lulf qoiuna hssetkT?n ni cdveaan

makinallkindzofgainz  I think you may have this website confused with +6  
teepot123  why don't u buy the exams like the rest of us? +2  

submitted by chosened(1),
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toCrerc em if I m wrgon but I kitnh i'ts rgnlaalye .iimalstpopolas pslPiomlaa can eoedlvp aeyhrewn nolag eth rreatiyorps rttc,a tub osmt eofnt teacff eth yxrlan and het vcalo rcdso (negralaly oti)aloslimoNpa. pst esru hwo YH thsi is ubt srehe reoM o:nif rtso-irar-ig:/cemrs.ei/eehasssrdssersrueelpo/retsri/reptnatatry/asaodoapipl-

hyperfukus  yes you are definitely correct i think its a common wtf q that pops up bc there's one on uworld that asks if its true or false vocal cords and i had to hunt my prof down to figure it out... +2  
hyperfukus  also i think they love anything that compromises the airway +  
winelover777  Shout out to Pathoma, Respiratory chapter, Larynx section, Laryngeal Papilloma heading. Only reason I got this question right. +1  
teepot123  yep dr sattar nails it ^ +  

submitted by seagull(1166),
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fI ouy nt'do wnok tahw riulacomD soed keli ayn noarlm umha.n Teh cuosf on twha piinsar 'dtseno ,od emnyal ts'i tsno'ed acefft TP etim adn most slipl td'no erenasic lgtticno pcyaleesi(l tiwh s)r.apiin shiT is woh I ogcil ot hte hrtig reawsn.

usmleuser007  If that's then thinking, then how would you differentiate between PT & PTT? +11  
ls3076  Why isn't "Decreased platelet count" correct? Aspirin does not decrease the platelet count, only inactivates platelets. +4  
drmohandes  Because dicumarol does not decrease platelet count either. +  
krewfoo99  @usmleuser007 Because the answer choice says decrease in PTT. If you take a heparin like drug then the PTT will increase. Drugs wont increase PTT (that would be procoagulant) +3  
pg32  I think usmleuser007 and is3076 were working form the perspective of not knowing what dicumerol was. If you were unsure what dicumarol was, there really wasn't a way to get this correct, contrary to @seagull's comment. You can't really rule out any of these as possible options because aspirin doesn't do any of them. +2  
snripper  yeah, it wouldn't work. We'll need to know with Dicumarol is. +3  
jackie_chan  Not true, the logic works. You gotta know what aspirin does at least, it interferes with COX1 irreversibly and inhibits platelet aggregation (kinda like an induced Glanzzman), all it does. PT, aPTT are functions of the coagulation cascade and the test itself is not an assessment of platelet function. Bleeding time/clotting time is an assessment of platelet function. A- decreased plasma fibrinogen concentration- not impacted B- decreased aPTT/partial- DECREASED, indicates you are hypercoaguable, not the case C- decreased platelet count- aspirin does not destroy platelets D- normal clotting time- no we established aspirin impacts clotting/bleeding time by preventing aggregation E- prolonged PT- answer, aspirin does not impact the coagulation factor cascades in the test +2  
teepot123  di'coumarin'ol +  

submitted by armymed88(48),
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lesGcou is cnd-trrtoaopes ntoi ysercteoten of IS iva iumods

toxoplasmabartonella  That makes that glucose needs to be given with sodium. But, what about bicarb? Isn't the patient losing lots of bicarb from diarrhea? +3  
pg32  Had the same debate. I knew glucose/sodium was the textbook answer for rehydration but also was wondering if we just ignore the bicarb loss in diarrhea...? +3  
makinallkindzofgainz  @pg32 - Sure, they are losing bicarb in the diarrhea, and yes this can effect pH, but it doesn't matter that much. You're not going to replace the bicarb for simple diarrhea in a stable, but hydrated previously healthy 12 year old. You're gonna give him some oral rehydration with a glucose/sodium-containing beverage. Don't overthink the question :) +1  
makinallkindzofgainz  *dehydrated +  
teepot123  salt and sugar, that's all the kid needs when ill simple +1  
mtkilimanjaro  Hm I put bicarb/K+ since thats lost in diarrhea, but I think the key thing in this Q is that its only 6 hours of acute diarrhea and nothing else. You would prob give bicarb and K+ in more "chronic" diarrhea over a few days or longer not just a few hours +1  

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ehT limirdtsouc igrepersnfn ahlpa toixn si a neihicatlse whcih lacvese elniicht ot csohiopohlnyrphel adn d.lgeerycidi nsys,laEltie plaah ntixo mcmisi plhppoeoiassh C. sihT mnase ti hsa a eagyuvl maliisr etffce fo het sspoileoshhapp eesn in lisBulac esuerC nda iLteiras eeyntnMo.ocogs ehT ned utlres fo hte txino tiaitaovcn is oiaiatvcnt of osedcn seneesmrg esymsts hohtgur liidgrdecey AAK( d)oray,lieclgylc chwhi avctstaie seelvra haty,pswa mtso ylnobta in tsih ecsa hnioAidcrac aidc lemtisobma adn ,8-IL twih hte tne ftceef of eesdacrni csravlau atyebmlirpei anliedg ot

teepot123  fa 19 pg 138 +1  

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Ligntif ehad ilwhe reop:n 1 ahSm nlootci em:lis 2 oht:o Cgmnonis 2 somthn

pg32  Where do you guys learn that cooing starts at 2 months? It isn't in first aid or boards and beyond so this was an annoying question for me +1  
drschmoctor  @pg32 From being a parent! Otherwise little chance I'd remember all these milestones. +3  
drzed  I'll get right on that @drshmoctor :). If only I could have a kid to memorize all these damn developmental milestones. That would make life easier haha. +5  
snripper  Yeah, I don't see cooing anywhere. +  
teepot123  thankfully a lot of my friends on insta keep posting pics/vids of their babies reaching milestones so im well updated lol +1  
pjpeleven  Mnemonic: "Coo at Two" +  

submitted by trump2020(5),

You guys are way overthinking this. Chronic hypoxia causes hypertension due to SNS activation and EPO production.

teepot123  yep +  

submitted by hayayah(994),
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uAhhtogl ahfl heste emroshon nca lylaatcu oals eb ecertdes fmor het ,mdounedu teh eudmnuod si easdcstoai teh sotm ihwt CCK see.elra

didelphus  Gastrin, intrinsic factor, and pepsin are secreted by the stomach. VIP is synthesized in neurons, so CCK (from I cells of duodenum) would be most directly affected by a duodenectomy. +21  
teepot123  fa 19 pg 365 +  

submitted by pparalpha(78),
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ntiiinbiho fo rtuucebimlo trynozpimaiole β†’ sitibnhii oatyohspgsci fo etura ray,slcts kleyecuto oncitiavta adn mti,rgaino nda lcel coaim.xhets

teepot123  fa 19 pg 476 +  

submitted by ihavenolife(56),
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kId if ti lepsh btu I gto ti ngsiu eht otH oBeTn- KAEst nomcneim

oHt &g-t; LI 1 ve)e(rF

T ecll saoumiilttn gt;-& IL 2

oBne mowrra nistialutmo &-;tg IL 3

gIE -;> IL 4

gIA ;gt-& LI 5

aKeut spaeh toinerp tg-;& IL 6

temmy  cyclosporine inhibits transcription of IL2 +14  
mysticsoul  FA2018 Pg 120 +1  
teepot123  same page also for 2019 edition^ +  

submitted by haliburton(196),
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FA 702:1 eScrete cstaatufrn from llrelama deibo.s loAs ervse as psocuersrr ot type I llces and tehor teyp II c.lesl Prrtieoalfe gdnriu lngu .aegmad

teepot123  fa 19 pg 647 +  
moms  thanks! +  

submitted by tinydoc(201),
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iartohucpeN Pani teafr terkos is ratceln stoP ekrtso npia deonmSry

aecsud by tracaletlraon aaimtclh ieslsno

.gP 045 9FA1

chandlerbas  agreed! more specifically damage to the VPL +5  
docshrek  Pg. 403 FA 19. +  
baja_blast  Both commenters above got the page wrong; it's FA 2019 p. 503. +3  
teepot123  looooool ^ what were the odd of both being wrong +  
mumenrider4ever  Pg. 515 FA 2020 +  
bbr  503 in 2019 Interesting that its seen in 10% of strokes. Starts with allodynia ---> neuropathic pain. +  

submitted by hungrybox(822),
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ycsitlpaDs vnie rea a rrpuorsec to n.mmaolea They aevh euriragl,r "ip"saylcstd rbrosed. rbeeeRmm eth "B" ni BACD sndats for eragrulri se.rBdro seuvN esman .olem

Ohter sr:esawn

  • sntaiochsa srngiacni - nkgiaDren of kins cositadsae thwi yTpe II beetidsa sumietll

  • ablas lelc oicmaranc of insk - ra,Reyl fi veer emazasiesst.t nyoomlmC tefafcs prupe

  • lbue nvuse - -dlueolrceoB ytep of ocmomn m.elo n.geniB

  • gdtnmeipe erhcesrobi sisteaork - tcku"S on" a.cerpeanap toMsly esAcfft dorel ee.lppo

  • etoN( - ouy yulusal ees noly n.eo fI leliumtp cerrsboeih resetaoks rae ,ense ti idctnsiae a IG gncnlamaiy - kaa Γ©-sleTtL"rear ng)si
usmleuser007  correction ~ BCC affects the lower lip more than the upper +1  
sympathetikey  Pathoma says upper lip, good sir +25  
hungrybox  Yeah basal cell carcinoma actually affects the upper lip. Counterintuitive because it's "basal" which seems to go along with the lower lip. Here's another source (this website is fucking gold btw): +4  
pg32  Can anyone explain how we can rule out C or E purely based on the question stem? If we read into the question that we are looking for something related to melanoma, then I get why we can rule out C and E. However, the question simply asks which lesion appears on both sun-exposed and nonsun-exposed areas of the patient's skin. I would say that C, D and E can all occur in that distribution pattern. +1  
paperbackwriter  @pg32 because it specifies "this patient's skin," and the only ones he is more likely to get than the average person because of his family history are dysplastic nevi +2  
teepot123  fa 19 pg 473 +  
rockodude  just remember BS. basal cell upper, squamous cell lower +  

submitted by usmleuser007(333),
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NCS ehHarmgo/er a)ae dg1m 1284- srH = erd 2rnoe)nus -13 dasy = tnlhseoiupr ciev(eiuqflta cons)s)3ei r -53 = gamrpeohcsa ir)cag )lmo(4i -21 wekse = aitcevRe soslgii (+ cavlsrua o aniortr5p))ilef omre tanh 2 esekw = llaGi rcas

o(n:et eth sgaeihspeotn is ilsmiar to MI nda sti csar rmafintoo; evorw,eh teh eitm uorces orf NSC is usjt fet)ras

teepot123  fa 19 pg 500 +  
icedcoffeeislyfe  FA2020 pg 512 +  

submitted by hungrybox(822),
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skrefKekcfaionoWr- drnoseym eud ot miahtein ()B1 ciy.nedeicf omonmC ni hlclcioa.os

ehT asnero why eyth sadi s"sulter fo oolalch and urgd esrcne rae vi"neaetg si hatt het etfaiirendfl dnelucis eutca olochal cx.intnaiooti

nercksWe'i tia:dr

  • sncunfoio
  • lasirapsy fo eye emscslu ahlolhmae(ippg*)to
  • taaxai

snpse*ter erhe as gntusmysa

'sraffokKos :ypsoishsc

  • ymemro sols goa(rtrenade adn rer)reodtga
  • kginam tshi up ctnl)iaobfna(uo
  • tnloysiapre gecnah
teepot123  fa 19 pg 559 +1  

submitted by mcl(529),
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oVirbi orhcelea si a e-gretiman,agv aomcm sepahd arcaetbi ttah cna acesu ryweta aerir.hda leCohar inotx stuinocnf yb caiaivtgnt eth Gs rpetiosn ;-t-g& anirnscieg ittaicvy fo lnydleay clecays -;g-t& esdaciner APMc -&;gt- sieadrecn aN+ dna C-l xueflf ;gt-&- arhdraie.

teepot123  fa 19 pg 146 +  
lovebug  Cholerae's exotoxin does not invade mucosa. but just permanently activates Gs according to FA. +  
lovebug  Same mechanism[Increase cAMP] : 1) Labile toxin of ETEC, 2) Edema factor of B. anthracis, 3) Pertussis toxin of B. pertusssis +  

submitted by nerdy nik(9),
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TVD ttah tewn ot hte bna.ri If ti luowd haev egon to het noyraupml rayetr she loduw vaeh a ,PE utb ti esscrod eht iaart lalw iav a tnteap feanrmo voale nad tenw tledyric ot hte .ainbr

cienfuegos  Some more UW info: incomplete fusion in up to 25% of adults: remain functionally closed until RA > LA pressure (e.g. valsalva), esp. concerning if hypercoagulable (e.g. OCP) -evaluate cryptogenic stroke with buble study: inj agitated nl saline and look for bubbles in left heart +1  
athenathefirst  Are you very sure of this answer? because she is an adult and not a baby anymore so it can't be a patent foramen ovale. +  
teepot123  has not closed basically +  
kevin  cienfuegos is spot on with his explanation @athenathefirst +  

submitted by hayayah(994),
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eth tjymrioa fo nacorb ixeiddo umellscoe are ceadrir sa tapr fo het oncirtaaebb ufbref estms.y nI htsi se,tyms bnoarc idxedoi sdeffusi tnoi eth RBC.s oaicrnCb drayashne )AC( whniit sRCB ilyqkuc tnvcsero het nbrcoa iidexod niot obairncc adci O3)2C(H. rCiaconb cdia is na tensluab eidtieanrmet mocleule that alydimiemte tesiasscdio iotn cbabeirnato nsio )-C(HO3 and dyhgoenr )(+H nsi.o

ehT wleny yznstiedshe babonaretci ion si aseortrndtp uto of hte CRB itno eth almasp in xenacgeh for a dileorhc oin )l(C;βˆ’ hist si lelcad eht croeldih .tsfhi nWhe the obold scaeehr het ulsng, hte cnairaebobt oin si satdrneropt kbca tion the RBC ni xgahecne fro het crhliedo oi.n hTe H+ nio dcaissoesit frmo the hgmoibelno nda sinbd ot hte btabcoirnae Tshi urposdce hte bcraconi ciad t,eiartidemne which si ntdocerev cabk oitn arocnb oiiedxd oughthr teh zaytniemc oitacn of CA. hTe bocnar edoixdi pcoruedd is xllpeeed orhhugt hte uslgn ginrud

hungrybox  Amazing explanation. Thank you!! +1  
namira  in case anyone wants to visualize things... +4  
ergogenic22  CO2 is carried in the blood is bound to hemoglobin, known as carbaminohemoglobin (HbCO2) (5%), dissolved CO2 (5%), bicarb is 90% +3  
pg32  Nice explanation, but can anyone clarify how we know from the question that we are measuring HCO3 rather than dissolved CO2? +1  
qball  @pg32 This question is asking about what accounts for the LARGER amount of co2 and the HCO3 buffer is about 85% of this transport and dissolved C02 is about 5-7%. +1  
teepot123  fa 19 pg 656 +1  

submitted by beeip(118),
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I htigm be teh oynl oespnr on ahert woh tgo isth one ngr,ow tbu gledesa:srr

I"TT ynssalia ndicslue yvree ebstcju hwo is eaoinzdrmd rdacocnig to oendzmarid nmeerttta misnatn.ges tI inseorg nn,oecipncmlao oopctrol vsetinodia, drwti,ahlaw dna anhytngi ttha peanhps ratef dm"ntiari.zanoo1[]

yo  You're not. I also goofed. +12  
seagull This video is a pretty decent explination worth your time on the subject. +2  
hungrybox  I got it right but I was only like 50% sure. So I appreciate it. +  
drdoom  ^ linkifying @seagull: +2  
teepot123  ^ same video above used when I analysed my form 20 q which I got incorrect at time, its very clear at explaining this, helping me get it correct on this form +  

submitted by mcl(529),
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iPtaetn amy ehva diearheryt dgeoiaaen,m cwihh si tsocsdeaai hitw trreunce"r catktas fo snntei,e aivsems, dzeliacol uucsaeosuntb meade ilinvogvn teh etxtr,emsiei ,tlaaieing cfae, or ,krnut ro soscauulbm mdeea fo urppe iyarwa ro ".boslew The cailert gseo no to yas "Cseteera-1s oiibtnhri swokr telirydc on het tmpocenlme dan cctotan pmlaas scsdceaa ot ruedce nkaiidrnby aelesre" hwchi si lsao pbboayrl good ot .nkow


notadoctor  Thought this was a trick question as C1 esterase deficiency also results in a decrease in C4. However, the second answer choice was not referring to C4 but to C4 binding protein, which I now know is different. I also didn't realize C1 esterase was technically a complement protein. +4  
youssefa  Based on many sources hereditary angioedema does NOT cause a rash (urticaria) which is a main differentiating point between angioedema and allergy. This mislead me in this question. Any clarification? +22  
ergogenic22  +1 on the above because uptodate states that c1 esterase inhibitor deficiency, both acquired and nonhereditary, are both non-urticarial, non-pruritic, and that is confirmed by the above linked article +2  
sahusema  Question writer probably didn't know the difference between cutaneous urticaria and subcutaneous edema. +3  
almondbreeze  same. got it wrong bc the pt didn't have sx of hereditary angioedema - swollen lips and eyelids +2  
teepot123  fa 19 pg 107 +  
beloved_bet  According to Amboss "Mast cell-mediated angioedema Often associated with urticaria and pruritus Other associated with clinical findings of allergic reactions (see type 1 hypersensitivity reaction) Presents within 30 minutes to 2 hours after exposure and resolves over hours to days" +1  

submitted by soph(48),
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lla teh tehro nosiopt tp wldou aevh ,tusreu rsev.oia trrseun ythe tolnduw oklo rmalon dna htye wdoul vhea poacrhti vesa.ori

turtlepenlight  This makes sense, but I was thrown off by the "normal-appearing" b/c wouldn't AIS pts not have pubic hair? +  
drzed  They just say it's a normal appearing 17 year old girl; not that the external genitalia are normal appearing. +1  
teepot123  fa 19 pg 625 +  

submitted by neonem(527),
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PRR = rsgeeninc ttse fro ishplsi.y siTh si a ngv-gkislceoto ttnrepa ,arhs tcctaheriiscar of easonrydc shilys.ip Dgur of hoeicc fro slpihysi at nay gseta is nrlatusacimur nlliPenic.i

ragacha  PAG 147 FA 2018 +  
teepot123  also says which antibiotic, only 2 in the list, helps narrow down, pen more commonly used +1  

submitted by hungrybox(822),
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enwh fidf eglisn adsrnt rparei mcmshenias are :uesd

  • iearrp wlney dtszsnyhiee tn:adsr imcmahst eirrap y(nchL )msrdoney
  • ripaer irmdeipiyn eismrd ueascd yb dta VU see:orxup eleotdncui sieixcno rpiera (dmreaeorX timumons)gep
  • iarpre nsoseucxooianttp/ toealn:tari saeb ociisnex airrpe
meningitis  Brca: recombinant repair +  
brotherimodu  P.40 FA2019 lists the different DNA repair mechanisms +2  
teepot123  fa '19 pg 382/3 +  

submitted by usmle11a(70),
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FIN y llwi itbihni tetdoenfnairiif fo h2T lslec dna reeeorfht e(,a ogwb )nr) atyoegulrr T lledsc ) if teh csae asw nilgkta oabut srvui

teepot123  fa 19 pg 108 +  

submitted by aesalmon(79),
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Can nnyoae aixpnle wyh hits is nto a tiytairpu meoa?dan Is it utjs a aklc of etroh tymop?sms

benzjonez  I think that they just wanted you to notice the **calcifications**. Per FA, "calcifications are common in craniopharyngiomas," whereas I don't think you'd expect to see calcifications in a prolactinoma. +15  
epr94  also the option is prolactinoma not broad pituitary calcifications and he doesnt show any specific signs of high prolactin +  
madojo  It says hes coming in for constituional delay in growth and puberty, i took this to mean that he had low LH, FSH due to decreased GnRH from the prolactinoma. Why did they have to say low-normal serum gonadotropin, why not just say normal? fck u nbme +  
madojo  It says hes coming in for constituional delay in growth and puberty, i took this to mean that he had low LH, FSH due to decreased GnRH from the prolactinoma. Why did they have to say low-normal serum gonadotropin, why not just say normal? fck u nbme +1  
ac3  @madojo I believe since suprasellar tumors can cause a mass effect on pituitary gland to decrease gonadotropin levels. Where as prolactinoma causes a rise in prolactin which downregulates gonadotropin secretion. Please correct me if I'm wrong +1  
teepot123  fa '19 pg 516 +  

submitted by egghead(1),
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siTh is eon of ehtos oqiuetssn I swa never ngogi ot ge.t 'tIs otn ni ,AF I no'dt hnkit I've enes ti ni ls.sac

hungrybox  same :( +  
masonkingcobra  My issue was the stem said no skin damage (I would think pulling out your hair damages your scalp) [Turns out it does not]( +  
gh889  FA 2019, pg 551 +7  
meningitis  Compulsively pulling out one’s own hair. Causes significant distress and persists despite attempts to stop. Presents with areas of thinning hair or baldness on any area of the body, most commonly the scalp. Incidence highest in childhood but spans all ages. Treatment: psychotherapy is first line; medications (eg, clomipramine) may be considered. +7  
step1soon  FA 2019 pg 551 +1  
teepot123  damn its in FA and Ive never ocne read it XO +  

submitted by strugglebus(153),
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opcCresyoiln si a anlurieiccn nbho,iiirt hhcwi sima to ecsrdeae I-2L

teepot123  fa 2019 pg 120 +1  

submitted by killme(12),
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onitnIten ot aTret lssnAyia

usmleuser007  in a per-protocol analysis,[6] only patients who complete the entire clinical trial according to the protocol are counted towards the final results +1  
sympathetikey  "In an ITT population, none of the patients are excluded and the patients are analyzed according to the randomization scheme." +4  
smc213  This video helps +12  
rio19111  Thx smc213, really helped. +1  
trainingrats  Where is this in FA2019? +  
teepot123  the video explains it well, no need for fa +  

submitted by chillqd(28),
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teepot123  fa 2019 pg 200 +