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Welcome to thomasburton’s page.
Contributor score: 27


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submitted by bobson150(11),
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The inwgdor of tihs tensoiqu dnocfuse m.e sThi is gnskai w"hcih of ehset ssslvee is eht ihgh rueersps ye"ssmt tghri? oS eht ihgh prsurese ouipsrer cetlra is niagcsu drnecaesi rpuersse onit the oiienrrf ?rtelca

welpdedelp  Superior rectal comes from the inferior mesenteric vein which comes from the splenic vein --> portal veins Thus, this dude had cirrhosis so it would "back-up" into the superior rectal vein. FA 2018: p360 +13  
nc1992  Superior rectal not superior mesenteric. Took me a minute +  
hyperfukus  ugh am i ever gonna get these right EVER +5  
titanesxvi  why not the inferior mesenteric, since the superior rectal drains there +2  
thomasburton  @titanesxvi think it is because question says direct which is why superior rectal +2  
lilyo  thomasburton, so are they asking what vessels do internal hemorrhoids directly drain into? The order is Superior rectal vein--> Inferior mesenteric vein--> portal vein. +  
thomasburton  Yes exactly, so they do eventually reach IMV but not 'directly' +  
pg32  Also worded poorly because the varicosities are connections between the superior rectal and the middle/inferior rectal veins of the systemic circulation. So the blood could be in both the superior rectal vein and the middle/inferior rectal vein as that is what a varicosity is. +2  
snripper  You just gotta know indirect vs. direct hemorrhoids. In this case, it's an indirect hemorrhoid (superior rectal vein) because of the rectal bleeding. +  
jesusisking  @titanesxvi DrDoom explained it pretty well below: "Defining tributary: https://i.imgur.com/2zDxPbW.png Nice images make the term easier to recall. Smaller streams "pay tribute" to larger rivers (by flowing into them)" +  


submitted by hayayah(1056),
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He sah lfcea netciconenin os shi xerelnat rthisnepc si adm,geda hihcw si irteeadnvn yb teh uaneddlp .n )S-42(.S hTe peivlc cnhalsincp r,nevse whhic emditea teh enirtceo spcr,soe ear also 2S4S.-

thomasburton  Why could this not be dysuria? +2  
lilyo  I think that you are thinking about urinary incontinence. If we damage the pudendal nerve S2-S4, you can exhibit urinary and fecal incontinence since this nerve innervates both the urethral and the external anal sphincters. However since the pelvic splanchnic nerves also have roots that originate in S2-S4 a patient with pudendal nerve damage will also have impotence since these control the erection reflex. He wouldn't have dysuria which is painful urination. Most likely caused by a urethral infection or a blockade of the urinary tract. He would have urinary incontinence. I hope this helps. +16  
alexxxx30  dysuria is painful urination...if it said urinary incontinence then you'd be right. But decreased innervation wouldn't cause pain (that would mores be associated with UTI) +3  
peqmd  Another approach is fecal incontinence => parasympathetic nerve dysfunction => no boner +  
dul071  ahhhhh fucked up with terminology again thinking dysuria was urinary incontinence +  


submitted by keycompany(296),
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Tihs qieotusn si esgusii.dd htWa htey era leryla iskang is "awth is eth lsoe dtarmteneni of pceisse aluvsriv?" hTe oyln rnaesw si teh tilbayi to rct.apeore Beeascu DNA resayloPem sha iapfgrrn-eodo itcvy,tia eygrnop liwl be defeunfcat by ANR aeyslorsmPe ackl of peoir-dargnof civi.ytat

ls3076  the phrasing of this explanation doesnt make sense to me. +4  
ls3076  oh wait sorry i just read it again. So instead of proofreading how are errors handled with RNA? +  
thomasburton  Think the point is basically although errors with RNA polymerase make make the bacterium not very good at infecting or killing or whatever it does not affect replication as it is not used during replication! +5  
almondbreeze  common sense asked in a very very convoluted way.. +  


submitted by yb_26(243),
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  • igibndn to eht HMC cassl II eceprotr nad irgetrging the lraesee of tsoyeicnk - netregasisnpu

  • dnbiing ot eht oaneuucmrusrl tcniojnu and niotpnvree fo CAh alreese - unlbmtiou xtnio

  • ebkglcao of a GPg-indnbiT teipnor grinsluet nig teh cuuntaiocmla fo APcM - pssruties ntoxi

  • caebklog fo rietcnspyap iiininbtoh of nipals tmroo lrsexeef - nutesat tniox

  • etneornipv of oetinrp nesssytih by lgcnikbo ganloioten of eht oipeppdtely ihnac - rpehahdtii noi,tx nemduoossPa eoiuasnarg oixxteno A

thomasburton  Not sure I agree with the second one, M.O.A for botulinum is cleave of SNARE protein preventing pre-synaptic ACH release. Think the second one almost describes something like sux or some other deporalising nicotinic drug. +5  
humble_station  You are right but to get the muscle spasms, trismus & seizures it has to inhibit GABA & Glycine release from Renshaw cells Cleaving the snare proteins will cause paralysis +2  
texaspoontappa  tetanus->postsynaptic inhibition I believe +5  


submitted by hello(301),
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nac nmsoeoe psleae xenapli h?sit

thomasburton  My reasoning was BC>AC so this must be a conductive problem (which to me means something middle ear or out) so usually I think something blocking air flow or impeding the ossicles. You can rule out all other answers as they are all causes of sensorineural (AC>BC). +2  
madojo  Meniere's disease is sensorineural hearing loss with peripheral vertigo due to increased endolymph within the ear. +  


submitted by yotsubato(966),
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Was ti sjut me, or ddi e"ag at ntose in "sryae eaappr HIGRT vaebo the numebr fo teptani,s traerh htna het en.ma chiWh ncfeduos em for a gdoo 3 ntmi.seu

fulminant_life  Definitely was the same for me. I was so confused for like 5 mins +13  
d_holles  dude i almost didn't get the question bc of this ... i thought the age of onset was the actual age of onset (36) +7  
mellowpenguins  Are you serious. NBME strikes again with shitty formatting. +7  
yex  OMG!! Now I just realized that. Super confused and also thought onset of age was 36. :-/ +5  
monkey  what is 36 supposed to be? +1  
thomasburton  Think the number of people in that group +5  
paulkarr  Yup...was looking at it for a good 3 min before just doing the "fuck it..it's gotta be 99" +4  
arcanumm  Age of Onset is the Title of the table, which I didn't figure out until after exam was over. What terrible formatting. +3  


submitted by bobson150(11),
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eTh rgdinow fo tihs nqsitoue esdofncu me. iThs is knisga w"hhic fo eshet svleses si eth hihg srsreeup ymsse"t rith?g oS teh high rsueesrp priusreo ltaerc si agnsiuc niardsece rsrueeps noit teh nfriorie ca?tlre

welpdedelp  Superior rectal comes from the inferior mesenteric vein which comes from the splenic vein --> portal veins Thus, this dude had cirrhosis so it would "back-up" into the superior rectal vein. FA 2018: p360 +13  
nc1992  Superior rectal not superior mesenteric. Took me a minute +  
hyperfukus  ugh am i ever gonna get these right EVER +5  
titanesxvi  why not the inferior mesenteric, since the superior rectal drains there +2  
thomasburton  @titanesxvi think it is because question says direct which is why superior rectal +2  
lilyo  thomasburton, so are they asking what vessels do internal hemorrhoids directly drain into? The order is Superior rectal vein--> Inferior mesenteric vein--> portal vein. +  
thomasburton  Yes exactly, so they do eventually reach IMV but not 'directly' +  
pg32  Also worded poorly because the varicosities are connections between the superior rectal and the middle/inferior rectal veins of the systemic circulation. So the blood could be in both the superior rectal vein and the middle/inferior rectal vein as that is what a varicosity is. +2  
snripper  You just gotta know indirect vs. direct hemorrhoids. In this case, it's an indirect hemorrhoid (superior rectal vein) because of the rectal bleeding. +  
jesusisking  @titanesxvi DrDoom explained it pretty well below: "Defining tributary: https://i.imgur.com/2zDxPbW.png Nice images make the term easier to recall. Smaller streams "pay tribute" to larger rivers (by flowing into them)" +  


submitted by rogeliogs(9),
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iTsh oseiuQnt tis obtua tysiaorrepr brtsu

stniateP hwti HDPAN yiidhnncfoeirccec= ultnrgaoamuos aedsesi (CG)D

Enev hgouht npttsaei thwi GCD an'tc aemk rexiSouepd, hyet cna use ti romf het rbsecaati dan tovrcen it ot ablche LCHO nda kill eth traabsc.ie

BUT brecasita hitw cseaatla esnzemy iuntaelrze rehti nwo xuepeodsir dna ashtt wyh teh GDC niatpet catn' klil tm.eh

atsaealC tviposei rcseb:aait .S arueus - gAslpuiesrl

thomasburton  I thought E.coli was catalase positive too? Why can that not be correct? +6  
mb10  (FA 186) Catalase (+) microbes, especially S aureus +4  
makinallkindzofgainz  @thomasburton - because First Aid said so, so suck it +1  


submitted by usmile1(103),
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seod oyenan ownk wtha het rusrtetcu E is pinntgoi to?

thomasburton  Not sure looks like it might be free ribosomes or other such small cytosolic structure (I picked E too, thought B looked way too big!) +  
targetusmle  same here!! marked e thinking of it as a mitochondria +1  
msyrett  Glycogen Granules! They are not membrane bound and float freely in the cytoplasm. +4