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Welcome to usmle11a’s page.
Contributor score: 73


Comments ...

 +0  (nbme22#4)
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aconloorpetsni tsac as an dltseoaoenr antginasto hcwih eansm acrsednieg N+a imerypbieatl

j000  i think they're referring to triamterene and amiloride, not spironolactone spironolactone doesn't actually decrease Na+ permeability +
jackie_chan  @j000 It doesnt matter, spiro and triamterene/amiloride have a common effect of messing with ENaC. Aldosterone upregulates ENaC, spiro would inhibit that so in effect would decrease luminal permeability to Na in duct due to fewer ENaC channels; triamterene would block the channel directly, same effect. http://tmedweb.tulane.edu/pharmwiki/doku.php/potassium_sparing_diuretics +

 +0  (nbme24#50)
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.m./scninn/oelbtt/sh3/gh:l0mC2.w/wtrPii09Mwp/p9cav.7c

sasy thta rrmpahteooiyyls nda adiosisc etrla amntel ttsusa.

chwih sarercolet hiwt het htgir neswar

sp. i otg ti rwgon oto ):


 +3  (nbme24#6)
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het noly night deam em heosoc MAI and SAM is eth ctaf tyeh uplysp the inteetisn chwih si teh momcno tsei orf shiimcce neeesrmcti s.iaedse


 +2  (nbme24#38)
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ym yaw saw

VS S-D=VEVE

VED rcienases in enrycgnap edu to an sneaicer in alspma uolmev


 +4  (nbme24#24)
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usgy GV uwold snreow hwti asgotacel ,nsionuif erbmember ehty otdn avhe PG6ase chihw amsen they antc netrocv iathyngn ot lgsceou

tyrionwill  Yes, VG makes the liver into muscle, where all sugars (except glucose) can only be burned to lactate+glycerol(from glycolysis), ATP (from TCA metabolism, to give uric acid), and fat deposit (from glycerol+pyruvate going to FA+TG) to worsen the situation. Sugar cannot be made into glucose in liver for other tissues. +

 +0  (nbme23#35)
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ok teh ywa i odeolk ta shit ws:a

oyuer tno 100% seur she aws ataecktd orn od yuo wnat ot eb het seonpr lngitle eht dbshuan she na aettrcak so yuo evrmo:e B C

nlgiaolw mhi ni whit hte epant,ti gdo snwko ahtw taht ugy sah idhned with hmi alos ouy wlil amke a gehu ncsee : A

het nyol tnigh to do si be oicpdalmti as opelep nokw thye etrna oaldwel in eth tamentret reaa dna yb thta uoy rueass ehr yates.f

drdoom  The prevailing rule of American medicine (and law) is individual autonomy. No other person, professional or otherwise, is granted “default access” or privilege to another person’s body—that includes the physician! The physician must receive consent from a (conscious) “person” before they become “a patient”. In the same way, the person (now, the patient) must give consent before anyone else is permitted to be involved in her care—spouses included! +1
llamastep1  Alright we got it! lol +1
123ojm  B and C are actually wrong because they put the patient in danger for when she is discharged and has to return home. she probably has things she needs in their home (eg passport, money, etc) and if the husband knows she has told you about the abuse she is at risk of being killed. +

 +1  (nbme23#6)
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eht icdhl is spioatmtcmay uacbees hatisietp B is lotyms etnlis in tsiafnn eud ot oopr ptmcoeyyhl e.smtys otreh aedssies ouwdl prbyaolb shwo mroe ssomtymp


 +7  (nbme23#12)
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gyus chawt tihs : whtmo=yeo./uow.nuw?suovabucYtctwTtG:shs//Kp

ynaawy p.(s i gto it ro)ngw

A) dosspro-esnee = olcibgioal ilbials.uyitp ps. oswohme .ealqu B ) )C )E essivittn;iy D)gnwro ym r;wsnea nnciceotsys of hreot ditsseu ( it nwtsa ipapeld ot ethro emnctioum)si

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +
stemcellpsc  wouldn't D be also true based on this video? +

 +6  (nbme23#13)
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The edlaimc mrntiueeeqsr to abonit a pietrm avry by aet,ts ubt are lsluuay nidfoenc ot pceciisf seytp of lissiiidebat or .nitodiosnc ehTse as a nlegrea elur lnuidce hte esu fo nay esstsiaiv vedeic uhsc as a ac,ielhewhr hcscuetr, or ncae, sa wlle as a nsigims egl ro .ooft eomS astets aols inludec tcairne rvdcarlau,socai ,apni ro royrratspie .iinnotdcso Atoub lfha of SU tsseta )(26 denuilc sebnsndli sa a ifnuylgqai sbiytaidil agielnbn teh opsnre to iabont a abisiytlid gnrapki tiremp fro use sa a pasg,neesr dan 41 tessta ecdulin a ebldidas dhna as a qgfiynulia ii.ytlaibds uFro taests idenluc ssdafe,en adn owt ttssae gVa(iriin and ewN )Ykro ldcueni aelnmt ilssnle ro oedaetevlnmpl tbessdliiiai as nqugilafiy dslisitiebia

our ugy sues a ance .o..s

wbt i ogt ti wrong :) ecsua i ughotht ti is pu to het VDM

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV +4
peridot  I'm not sure if I'm being here or if the test question changed, but I don't see anywhere in the stem that says that the patient uses a cane? I even ctrl+F the word "cane" lol. I picked referring to PM&R specialist for full assessment cause I figured that another pattern is to always gather more info, but I guess that's not the case here T_T +4
azibird  It does NOT say he uses a cane. +2
sonofarathorn  I can also confirm that there was no cane involved. I repeat, NO CANE. +4

 +4  (nbme20#8)
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liaelelnog : ryev nmoocm in cnavdead ega, ,OCDP pemssropeniudmus etipnsat nda " ggoni abkc romf a ecdirnees "lhla hwich bboayprl had a imnentoaadtc XA ymsset aa(yblcils fits ryeve noe in eht Q)

nedao X : wulod ptneers thwi iuicsjnctv,otni hartto inap . f..lu ur:svi ont reonveey tgo the sisdeae VSR: no hlcernid rpst e emo:nup luodw egrtat a ergarl lonptaiupo of lythaeh plepoe sa lwle.

bharatpillai  why would they say that the only people who didnt get affected by the disease were people on steroids (lupus nephritis and severe asthma) couldnt have been rsv since it causes croup in children. strep pneumo would cause fever and other systemic signs. i went for adenovirus because uworld says most common causes of copd excacerbation are viral infections... +2
brbwhat  I went for adeno forr the same reason. I guess the MAIN HINT is that this is not a copd exacerbation. Since people without prexesting copd also had pneumonia, also people with copd exacerbation will have different presenting symptoms, here it was told, that we are told that dx was penumonia. People with copd exacerbation wouldn’t be diagnosed with pneumonia if it was an adenovirus infections. +1
j44n  adenovirus doesnt cause pneumonia its just makes the current COPD sx worse +
j44n  the SLE and asthmatic patient were both considered slightly immunosupressed or theyre just more likely to get something (SLE pt= your B cells are too busy making Ig's to kill your kidney, and the asthmatic is on corticosteroids that aopotose your t cells) but they're not COPD patients so the pneumonmia wont be as severe, all in all legionella causes really really bad pneumonia in COPD patients and less severe (pontiac fever) in those with mild immunosupression +

 +13  (nbme20#19)
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?s2qkawbcop:uA6me/Ehvc0p.Yu-ttth=w/wwt.Ayo/

ygsu hist idove spnaxlie olat


 +5  (nbme20#31)
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ok heer is owh i bkeor ti odw:n a) wnrog caesebu tosm escsa dlwou eavh emso sikr racotf "ldo efemla .)b".. le")dco"tid drenu sesruper ti nac tbrus nda fyalrnk it si dinetmnoe ni FA sa a yrev cnmomo s.D eac)u i tkihn it dowlu dene emgnoihts leki a erporisto otacidslino fo .e )pih udwlo lprsboby otn cseua enuor S $S


 +2  (nbme21#9)
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i ddi hte

(5-o31c.Hx) 8+ 2+-

it shuldo 2CO ahtt si twa herhgi ahtn onapotcemins icnidtinga edxmi

nhoerat ayw si het ↑ ↓ yaw


 +13  (nbme21#15)
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ok i tkhin i ahve a rthyoe in esardrg orf st:ih

teh wlhoe uredorecp is oden ot creaeeds hte atplro HT.N whchi aesmn teh tnuhs ulsohd be aotrpl to imsycets aonigdiv the lr.iev

)a tphaeci ytsimse)c( to inf enicphr ( ycesmsti ) ; )oBn ciecoilol (lartpo ) ot nif ensicrmte t(orl)ap ; o)nc eiscpln r(a)polt tfel ealnr )cyss;etmi( e)syd rieprous creispatig sy)ctes(mi ot inirerof grpiacties )sceimty(s ; eoN) ueirrspo ecratl l(rtpao) to rsuerpoi netiermsc ( potalr) ; NO

whossayin  You’re a legend. Good theory man, makes memorization a whole lotta easier! +
lovebug  2019FA, 359pg. +

 +0  (nbme21#21)
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uy!s!g

het toqiseun ndtsoe ays htta eth 005 tgo uecrd, so ti wlli eb 0020 woh rae ta .isrk


 +1  (nbme21#23)
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FNI y wlil tinbhii odetfinifienrta fo T2h lecls dan rfreoeeht (e,a ow )r)bgn rurgtayole T l)les dc if het csea swa kgantil botua uisvr

teepot123  fa 19 pg 108 +

 +0  (nbme21#45)
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i ddi iths hhtorug litoe:niainm

c,a and D cnrtiisi;n T↑PT noyl

)B hcwih si luatlcya eht 2;PIP doeivvln ni qG galnnsigi


 +4  (nbme21#28)
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ok uysg dna i qetou ormf egmr.sbcitse/oaasicospotenh-u:e1/hpscelte/2lwirr/s.4dtowome/t0ptwitf

09"% ahev an tedfinelibai itenecg tmoatniu CO L 11A dna LOC 2A1
esu cas mlaraobn elgnlaco ircnks-iolsgn via a cyielng utttsbnsuioi in the nlrlcgaoepo muelloce "

hcwhi amens that OI has a iyglcne ttusonbsitui nad heferort its eaubln ot ormf a adoeryncs teruu.rutcs





Subcomments ...

submitted by usmle11a(73),
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gysu whtac htis : Yupscohow/t.sw=thte?yuGm:nuwvo/Kucsawb/o.tT

awnayy sp(. i ogt it wrgn)o

)A ssesnpeeood-r = cobiolalig u.iislapbitly p.s ohmeosw qual.e B) )C )E eiiiytntvs;s w Dgnor) my re;snwa iysncsontec fo reoht ditusse ( ti tsnwa plpaide to otehr icmesmunot)i

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2  
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +  
stemcellpsc  wouldn't D be also true based on this video? +  


submitted by usmle11a(73),
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gysu hcatw hsit : c.tuGawsu/wo.twT/o/o?hy=YventmwpsutoscKu:hb

ynaayw s.(p i ogt ti nrwg)o

)A edsesooepsrn- = abgooiclli auiplt.syibil s.p seoomhw .aeqlu B ) )C E) seyin;tsvtii )gnDorw ym arsew;n nnoeciysstc of eohrt euidsts ( it ntswa paledip ot ethro ommiiesn)cut

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2  
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +  
stemcellpsc  wouldn't D be also true based on this video? +  


submitted by usmle11a(73),
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eTh dlicame menireureqts to inotab a imrpte vayr yb ,tsaet but are luluyas oinnefcd ot fipcsiec eystp of edtlbiiaisis or insot.condi eeshT as a eangrle urel nilcedu teh sue fo any iavssesit veidec cshu as a erliach,hew hc,csrute or ca,ne sa ellw as a msgisni leg or too.f meSo asetst oasl iecludn niceatr uarcv,rsadcailo ain,p or respaiorytr o.iidscnnot uAotb fahl of US tsesat 26)( eicudnl nsbseidln sa a ylguiqnaif ldiabitsiy anelbing the ponsre to aintob a dysabiitli gkanrpi eirmtp rfo esu as a sregasp,en adn 41 sattse encildu a adelsbdi nhda as a iqignaufly daytiibils. rFuo aestst icdnleu aef,sedns adn owt ssetta ig(niariV dna ewN oYrk) ncdueil nlmtae nslesil ro ovnalledpeetm isadiliteibs sa uqnilgyafi iiessditlabi

oru ygu esus a aenc ..s.o

bwt i tgo ti rgown :) cseua i hhugott ti si up ot het MDV

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV +4  
peridot  I'm not sure if I'm being here or if the test question changed, but I don't see anywhere in the stem that says that the patient uses a cane? I even ctrl+F the word "cane" lol. I picked referring to PM&R specialist for full assessment cause I figured that another pattern is to always gather more info, but I guess that's not the case here T_T +4  
azibird  It does NOT say he uses a cane. +2  
sonofarathorn  I can also confirm that there was no cane involved. I repeat, NO CANE. +4  


submitted by imgdoc(132),
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ihTs nquisteo si sainkg taobu the snuilin orecrept strioyen iksaen wpyah.ta So tkea ti fmor ereh,t

  1. The ntyhoiprshlopoa of eht SIR ttvaseaic a ainsgl snuaitrnocdt asceadc htat asdle to eth nioivactta of etroh sanikes as lelw as nsiottpicarnr asrfcto hatt tedimea eht canurliatrlle tceesff of nlusi.in aytcll/mipNruCocase linhgutts - yes verse(eilbr)

  2. Tnio/hnrereeeiSn nesskai are asol noknw to cerude teh aytivcit of ul.iisnn - eys ie)eb(srerlv

  3. inuUqiibt - additmee lioyrpsoset - no (ont vr)s,eeerlib nda laos lsinuni yoemlbctialla iceasnesr rnpoiet ntyshisse so it ne'tdos thcam hwat snluiin esdo yywnas.a

eorctrc em fi m'I orgn.w

usmle11a  i think youre correct cause ubiquitin mediated proteolyis is an irreversible step. +1  


submitted by cr(3),
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yhw nto dnicrseae ?efoyxhce,yl-rlioold2rccah5 whti eht emas clgio ouitbnrlha ipeaxnl +

usmle11a  i believe increase 25OHcholecalciferol indicates the storage capacity of vit D, which wont be affected in case of CKD. it goes like this, kidneys wont respond to regular PTH, loses Ca and cant execrete PO4, PTH gets made and tries to burn bone to produce Ca, resulting in elevated levels of Ca and PO4, Ca will bind the calcium and go to kidneys, yet same story all over. add to that the fact that 1 oh hydroxylase wont be able to function in a dead kidney. +1