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Welcome to xxabi’s page.
Contributor score: 248


Comments ...

 +34  (nbme24#43)
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ttenS sroshiobmt vs eest.rsn-soi tentS roisotmbsh is an auetc ccolosnui fo a rocayrno eatyrr tesnt, iwchh eftno teusrls ni uctea yocrrnoa doem.syrn anC eb vdtnpeeer by ulad pttlaatneile eahprty ro eg-inruutldg nse.tst -esssRiteno is the raagdlu raonirngw fo hte ettns nlume eud to motniinlea aefl,oiorntrpi ntugerlsi ni gnaialn ysptmso.m

sunshinesweetheart  so just to clarify - it's the "symptom-free for 3 months" that rules out thrombosis? +3
hpsbwz  It's moreso that at rest there's no changes, but during exercise there is. Like the pathophys of stable angina. +3
suckitnbme  I think it's more because of the 2-month history of PROGRESSIVE angina sx with exertion. This points to a chronic process rather than an acute event. +
alienfever  Drug-eluting stents prevent re-stenosis (rather than thrombosis) by releasing sirolimus which by blocking cell proliferation. +2

 +2  (nbme24#47)
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ARsB setlur ni the olinlgfwo egchs:an erscdiean inr,en nidscreea gAn I, cseianrde ngA II, aersecdde oelnatesdor and nedanuchg ndnarbikiy

famylife  ...and just to clarify, they directly inhibit the Ang II receptor (AT1) https://www.drugs.com/mmx/losartan-potassium.html +2
kpjk  I had a doubt- that wouldnt increased RAA lead to increased serum aldosterone as well. Now I understand that since the receptors are blocked- even the receptors to increase aldosterone secretion by Ang II would also get blocked... +2

 +11  (nbme24#45)
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nCieiaenrt naelraecc stilgylh sattsvireemeo GFR euecabs crtnineaei si traeyomeld edersect by CTP


 +9  (nbme24#18)
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ieeAstrr fo hte masircpet rdco - raecittslu a,. tduscu enefsrde .a, aecmricestr .a

roygbiv  https://i2.wp.com/obgynkey.com/wp-content/uploads/2017/06/A302767_1_En_1_Fig2_HTML.jpg?w=960 +1
roygbiv  Omg I keep adding comments instead of a post LOL +4

 +6  (nbme24#33)
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soMt noocmm csuae of aucte ttrptisosai in odrel mne is .E ,Cilo and nteh dmse.oanuPos

charcot_bouchard  Grandpa is monogamous. Sexual history was just to throw u off +11

 +7  (nbme24#2)
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trnSatgi ebta bekrslco befreo haalp kaoecldb ni maymcooprhthecoo is ncnedaritta.oidc taBe lsokecrb naccle uto teh saolorvydtai ffetce of earphpirel tae2-b nre,ocopserdat lepyatnltio aingeld to peoopsudn enedahrtrapploco-a siumaotlnti → vcisorosoatntcni → tvinerseephy ii.crss


 +8  (nbme24#23)
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EN is oeedtcvrn to IPE via P,TMN ichwh is cdeindu by toocri.ls

wowo  FA2019 p83 +2

 +3  (nbme20#13)
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normo-talneNep sttes ear iisvns,eet tub not pcisefic - PRR, RDVL


 +5  (nbme20#28)
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gwliSnlftoeh e  lc(.rh.lyo dp igee,c et tns oe→hmdie:ag)euesi icinasr ni eTe edcAtadsrpPdruoco a s+ eesTadnP Nade/eradK→ +cA uapp2mC+ ai→ cy ditfoison vuiftf aa+Nn d wtaer  toetihn  cel→l llslurligcanwe el

endochondral1  can someone explain how to cross out the other choices> +1
endochondral1  what is hydropic degneration and where do i learn about it? why is it not the loss of plasma membrane integrity? +1
shaeking  Endochondral1, I had the same question. I tried figuring it out and this is what I came up with. The CHF and congestion of the lungs is reducing the amount of oxygen getting to the renal cells. With hypoxia there is decreased aerobic resp in mitochondria with decreased ATP. Without ATPase Na builds up and water follows. As far as the loss of membrane integrity. I think it would cause cellular destruction not just hydropic changes. This is my best guess. +2
charcot_bouchard  Membrane damage is irreversible stage of cellular injury. if membrane is damaged cell is dying & it will shrink. or totally destroyed by inflammation. they are specifically asking hydropic changes ie cellular swelling. which is the 1st sign of reversible cell injury due to failure of Na/K pump +1
winelover777  @endochondral1 Chapter 1 of Pathoma. Also FA 2019 p207 describes hydropic degeneration without saying those exact words in the first bullet under reversible cell injury. +1

 +7  (nbme20#45)
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lmTeniar moletmnpeC -(C9C)5 iscenfeDicei icreasne ictelistispybu to enrucrret eisaeiNsr ma.icarteeb Ptieants tmos efton esrnept with cteuernrr imnngtie.is

lilyo  FA 2019 P. 107 Early and Terminal complement deficiencies. +1

 +0  (nbme20#5)
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Boars’c ip:ahaas evesxiepsr mo(ort i)paaahs thwi aamtsmirgma s(tp rewaa thta hyet ’ntdo emak ens)es - aera nirW’Aeec ks :aiaapsh cpiteerev nsy)eso(r pshaaai whti admeipir poeomsrnehcin s(pt lkac itns)gih

breis  Why would B be incorrect? I realize Broca is "technically lower" but A seems too low to be causing weakness of the lower 2/3 of the face? Am I missing something? +
shaeking  @breis B is incorrect because of the lower 2/3 of the face weakness. B isn't located on the motor cortex but in the premotor cortex, plus it isn't low enough for the lower two thirds of the face. https://thebrain.mcgill.ca/flash/a/a_06/a_06_cr/a_06_cr_mou/a_06_cr_mou.html https://www.sciencenews.org/blog/science-ticker/homunculus-reimagined +1
cienfuegos  @breis, per UW: "a/w r. hemiparesis (face & UE) bc close to primary motor cortex" +
almondbreeze  B is close to premotor cortex which is involved in learned or patterned skills & in planning movements. (i.e. two-hand coordination) slide 25/37 :https://www.slideserve.com/hal/the-motor-system-and-its-disorders +
almondbreeze  B is also close to frontal eye field; eyes look toward the lesion FA pg. 499 +
frijoles  I incorrectly picked C. When answering this, Broca's "broken speech" was my first thought, but I figured a lesion causing a facial droop would have to involve the motor strip so I prioritized that and chalked up the speech issue to dysarthria (I understand this is more of a "slurred speech" than broken, abrupt speech, but again, I simply misprioritized concepts.). So for the record, Broca area is part of the motor cortex? +1

 +2  (nbme20#24)
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ccieBly dhbalenar juiyrn nitalldotayir amsaged nlaru eenvr @ het hkoo fo the aameht eobn


 +7  (nbme20#3)
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siatSnt cdeeesar rolctlsehoe eh,nsisyts which ncierliytd attisSn idrtilnyce ueacs eersicdan LLD octerper xpsesirone no hysocpeeatt ecanies(rs LLD cnaraeecl mrfo lor.ciautc)ni

fatboyslim  SketchyPharm's "Statins" video explains this concept nicely and other lipid-lowering drugs +

 +12  (nbme20#8)
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I swa nrdue eht rnsismiepo taht tsih aws na ctaori nid,cosstei due to s"evere hetcs "pnai as lwel as het efals enulm ni het .aorta dnA NTH is teh #1 irks tfraoc rof tiaroc ntcsosie.di eSnoemo troccer me fi im' nogw,r but I ntihk ihst si ioatrc oietisscdn hraert athn aitorc murns.eya

chefcurry  I believe so, FA 2018 pg 299 +3
ergogenic22  It is dissection "extra lumen in the media of the proximal aorta" = "a longitudinal intimal (tunica intima) tear with dissection of blood through the media of the aortic wall" ... answer is still hypertension +2
breis  FA 2019: 301 +
pg32  First Aid says that aortic dissection causes widening of the mediastinum and is due to an intimal tear, so I thought it wasn't an aortic dissection. Can anyone help me understand why First Aid was wrong in this case? Thanks! +3
nephroguy  @pg32 The question stems states that there is no widening of the Aorta, not the mediastinum. Widening of the mediastinum is seen in dissection while widening of the aorta is seen in aneurysm. Also the intimal tear creates a false lumen between the intima and media. Hope that helps! +9
j44n  https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.312436 pictures worth a 1,000 character limit +

 +10  (nbme20#47)
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heT uanroidt fo notaci fo ucinlnSyloeichc si rtdieeednm yb sti mblmaeosit yb lasapm cesrhnteseao.il So fi eterh is aormlban laaspm oeaesenscrhlti odieus=pc)el,nosstheae(r ti lilw laed ot eedylad tmmoalibes of oilyccclhueinsn sa llew sa uriacim,mv hi,orne nda o.cnceai


 +7  (nbme20#13)
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rcnBoinhcgeo macoianrc = unlg cacern

atTh ebgin d,isa glun imccaonerdanoa cisicfayelpl si sdacesatio wtih icoyperthhpr optyrorasta,thheo ihwhc si a piestnaaolpcar dnseyrmo acdazrecrieht by lgiatid in,gclubb atlir,aagrh ointj oesi,sffnu and peisstsorio of arbuutl soben

luke.10  why not systemic scleroderma since i did this question wrong and i chose systemic sclerosis scleroderma , can someone explain that ? +2
kernicterusthefrog  My best guess answer to that @luke.10 is that: a) there's no mention of any skin involvement (which there would be in order to be scleroderma) b) Scleroderma shows pitting in the nails, not clubbing c) There would be collagen deposition with fibrosis, not hypertrophy of the bone at joints Saying that, I also got this wrong! (but put RA...) so I'm not claiming to "get this" Hope my thought process helps, though! +6
yotsubato  This is in FA 2019 page 229 +9
larascon  I agree with @kernicterusthefrog on this one, Bronchogenic carcinoma = lung cancer. Squamous cell carcinoma gives you hypercalcemia (new bone formation; maybe?), commonly found in SMOKERS ... +3
waterloo  the clubbing is the symptom that takes out alot of the answer choices. It's super tricky. +
jawnmeechell  Plus the patient has an 84 pack-year smoking history, super high risk for lung cancer +
veryhungrycaterpillar  FA 2019 pg 229 is all paraneoplastic syndromes. There is no mention of bronchogenic carcinoma in any of them. There is adenocarcinoma, but that is most likely in non smokers, not in someone with 84 pack year of smoking history. Why does he have 5 upvotes for referencing first aid here, what am I missing? +2
jakeisawake  @veryhungrycaterpillar sounds like bronchogenic carcinoma is a general term for lung cancer. You are right that if a non-smoker gets lung cancer it is most likely adenocarcinoma as non-smokers rarely get small cell. However, smokers can get adenocarcinomas as well. The oncologist that I shadow sees this frequently. Adenocarcinoma of the lung causes hypertrophic osteoarthropathy per 229 in FA2019 +2
mangotango  @verhungrycaterpillar @jakeisawake Adenocarcinoma is the most common tumor in nonsmokers and in female smokers (like this patient), so adenocarcinoma would still be the most likely cancer for this pt over the others. Pathoma Pg. 96. +3
fatboyslim  Apparently bronchogenic carcinoma is basically an umbrella term for lung cancer. Source: https://radiopaedia.org/articles/lung-cancer-3 +
lifeisruff  bronchogenic is another term for adenocarcinoma in situ according to pathoma +

 +23  (nbme20#46)
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lAos ofr setoh fo you owh ear ttllayo elluescs ilke e,m yirnaru ractt costtorunbi = seribuocvtt hroya.upt


 +2  (nbme20#33)
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eliB tlass hlpe vilsesdo enlgasolts ttha ahve romfed in het rlalbldda,eg duse ni tspaietn focratyrre to yesrugr ro erpefr to odiav i.t

xxabi  To add, bile salts are amphipathic which allows for the emulsification and solubilization of lipids in an aqueous environmen +4
md_caffeiner  To add more for people like me who dont even know what amphipathic means:, am·phi·path·ic /ˌamfəˈpaTHik/ (of a molecule, especially a protein) having both hydrophilic and hydrophobic parts +5

 +0  (nbme20#31)
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Vncai nda ntapl likdsalao inbd tulnB,-ibu cwihh hniitisb the tmriaonof or dsimlaysebs or iceusomtrb,ul eceery.vsiplt

md_caffeiner  Vinca is a plant alkaloid and it has vinblastin, vincristine, which bind β-tubulin and inhibit its polymerization into microtubules Paclitaxel hyperstabilizes and prevents breakdown, its not a Vinca alkaloid. (FA+Wikipedia) +1
md_caffeiner  What I mean is they are both derived from plants. +

 +7  (nbme20#7)
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shTi si a llhrtsoayosg udtc .csyt Teh soysgtalorl uctd yam istpres nad lsrute ni a alootgssyhrl utcd styc or(ngicucr ni delimni aren iydho nebo ro ta teh baes fo the tgne,uo) hsut iwll sascycliall emov up iwth wlnlwiogas or tuoneg .upnsrrooti

Teh aemonrf mecuc f(o het )euogtn si the orlnam trnanem of the ylasogslroth tduc

lilyo  I got it wrong though because the question clearly asks what does this structure (thyroglossal duct) DEVELOP from, not this structure eventually develops to form which structure. If it asked that then I would have picked option A but because it didnt that was the first option I crossed out. +15
misterdoctor69  It was a poorly worded question no doubt. But when they say "endoderm of foramen cecum" they're referring to the endoderm which is a primitive structure. The "foramen cecum" part is just a modifier that is added to describe what that endoderm would eventually become. +
lovebug  FA 2019, page 322page! +

 +2  (nbme20#47)
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D5E-P ihobtiirsn .(ge. ase,lnifild tila)dalaf rea edndtiica rof ED yb awy fo srnageicin dlobo fwol ni eth rscpou ermsvnocau (elebdal )D fo eht espni

dulxy071  I believe technically the answer would not be (B) as the corpus cavernosum isn't ACTED ON by PDE inhibitors ( per the words used in the question ) but rather simply fills as a result of PDE inhibitors acting on the internal pudis artery among many others to allow more blood flow into the corpus cavernosum for an erection +4

 -7  (nbme20#43)
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I ikthn its ahtt hte CI taendcoin teh urmnbe 0"" hihwc kemsa ti ltatiacsltisy igfnnitiscain

kernicterusthefrog  You're thinking about CI for a **mean difference** b/w 2 variables. This question talks about **relative risk**, for which 'strugglebus' correctly asserts that *a CI including 1 fails to reject the null hypothesis*. #funwithformatting +
xxabi  Ahhhh you're right, I definitely had them mixed up! Thanks! +1
xxabi  #biostatsisthebaneofmyexistence +3
conradfussurefake  So am I the only one giving no shit about CI and going straight to what they're asking about. My understanding of the question is that they're asking about the difference in cosmetic results of both the procedure which are described in the stem as the same. The study isn't about wound infection rate!! +
fatboyslim  @conradfussurefake In the beginning of the Q stem it states "A randomized clinical trial is conducted to compare WOUND HEALING and cosmetic differences...", hence wound infection will affect wound healing. But the because the CI contained the value of 1, it is insignificant. +1

 +4  (nbme20#33)
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edaL miet ibas si ucsaed yb lreya niotecetd nbgei soucndef twih casinered va.usirlv eyral tetocneid emaks it seme sa ugohht avsvilru hsa naec,rides tub eth nulraat yoirtsh fo het dasseei sha tno bnee ce.tdpmia





Subcomments ...

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aCn eoseomn lpease ayirflc teh was.ern sI deedsreac ednachree amse as eeardedcs oinag?atrgeg noWutdl; bnhiitniio of teh IIIbIaI/ rpocrtee epenrtv eag?tgnrogai

xxabi  I'm not completely sure...but I think its because its aspirin, and aspirin doesn't work on IIb/IIIa receptors. That's why i picked decreased adherence of platelets, figured that was the closest thing to decreased aggregation that still made sense with aspirin's mechanism of action. Hope that helps! +2  
ihavenolife  Aspirin irreversibly inhibits COX which leads to decreased TXA2. TXA2 normally is a vasoconstrictor and induces platelet aggregation, so aspirin inhibits platelet aggregation by downplaying TXA2 not by interacting with IIb/IIIa receptor. (Source FA and UWorld) +20  
fallenistand  In this case, inhibition of COX-1 by aspirin will also reduce the amount of precursors for vascular prostacyclin synthesis, provided, for example, from adhering platelets https://www.ncbi.nlm.nih.gov/pubmed/9263351 +1  
niboonsh  inhibition of IIb/IIIa receptor is the moa of a completely separate class of drugs - Glycoprotein IIb/IIIa (abciximab, eptifabide, tirofiban) +1  
t123  Bad question - TXA2 upregulates GpIIb/IIIa on platelets. So aspirin inhibits their expression. +1  


submitted by radshopeful(17),
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Tihs ttaneip ahs ecesedotadnpm etlf ahret rlueaf.i amiopncoDetsne rscocu eesbuca of teh shtare bitniaily ot peek pu tiwh damdne any nre.ogl siTh sadle to a eredasce ni VS ynaiml aeeusbc of a itnrlecatco issue hichw lsdae to a rcsedaee in CO (CO = SV x .)RH aty,lsL eth EVVDL lwli be caedsrede sucebea eht SV is decerades aelvgni moer olbod ni het telf elntrievc etraf tsysloe iensc it ocnant be pumpde frarwo.d poHe isth p!l!hes

xxabi  Great explanation - I think you have a minor typo, LVEDV will be increased* bc SV is decreased +15  
smoothie  More blood left in the ventricle after systole is LVESV. I thought LVEDV increases because more blood remains after systole and on top of that blood from left atria from diastole is now also added. +5  


submitted by xxabi(248),
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I khint sit ahtt het CI odtniacne het ebumrn "0" hhwic kesam it sailtactyitls tacnfninigisi

kernicterusthefrog  You're thinking about CI for a **mean difference** b/w 2 variables. This question talks about **relative risk**, for which 'strugglebus' correctly asserts that *a CI including 1 fails to reject the null hypothesis*. #funwithformatting +  
xxabi  Ahhhh you're right, I definitely had them mixed up! Thanks! +1  
xxabi  #biostatsisthebaneofmyexistence +3  
conradfussurefake  So am I the only one giving no shit about CI and going straight to what they're asking about. My understanding of the question is that they're asking about the difference in cosmetic results of both the procedure which are described in the stem as the same. The study isn't about wound infection rate!! +  
fatboyslim  @conradfussurefake In the beginning of the Q stem it states "A randomized clinical trial is conducted to compare WOUND HEALING and cosmetic differences...", hence wound infection will affect wound healing. But the because the CI contained the value of 1, it is insignificant. +1  


submitted by xxabi(248),
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I kinth ist atth eth IC dtcaeinno eht nrmueb 0"" hhwci maesk it tliascittlays iciingntnfsia

kernicterusthefrog  You're thinking about CI for a **mean difference** b/w 2 variables. This question talks about **relative risk**, for which 'strugglebus' correctly asserts that *a CI including 1 fails to reject the null hypothesis*. #funwithformatting +  
xxabi  Ahhhh you're right, I definitely had them mixed up! Thanks! +1  
xxabi  #biostatsisthebaneofmyexistence +3  
conradfussurefake  So am I the only one giving no shit about CI and going straight to what they're asking about. My understanding of the question is that they're asking about the difference in cosmetic results of both the procedure which are described in the stem as the same. The study isn't about wound infection rate!! +  
fatboyslim  @conradfussurefake In the beginning of the Q stem it states "A randomized clinical trial is conducted to compare WOUND HEALING and cosmetic differences...", hence wound infection will affect wound healing. But the because the CI contained the value of 1, it is insignificant. +1  


submitted by ameanolacid(24),
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otosAesrhielrsc si hte OTMS ncmmoo casue fo nerla tryaer o..tsewnsshii.t ismfucluorabr spsaaylid ingbe the DCNSEO otsm omnocm ceuas env(e gthhou ti is ngitptem to hcoeos hist iponot rcegoniidsn hte isnpate't pedigmaho)cr.

xxabi  Is there a situation where you would pick fibromuscular dysplasia over atherosclerosis if given both options? Thanks for your help! +5  
baconpies  Atherosclerosis affects PROXIMAL 1/3 of renal artery Fibromuscular dysplasia affects DISTAL 2/3 of renal artery +45  
gonyyong  Why is there ↓ size in both kidneys? This threw me off +3  
kateinwonderland  @gonyyong : Maybe because narrowed renal a. d/t atherosclerosis led to renal hypoperfusion and decrease in size? +1  
drdre  Fibromuscular dysplasia occurs in young females according to Sattar Pg 67, 2018. +10  
davidw  Normally you will see Fibromuscular dysplasia in a young female 18-35 with high or resistant hypertension. She is older has a history type II DM predispose you to vascular disease and normal to moderate elevation in BP +9  
suckitnbme  @gonyyong there's bilateral renal artery stenosis. The decrease in size of both kidneys should be from atrophy due to lack of renal blood flow. +3  
tyrionwill  1 year ago, she did not present any physical or Lab abnormalities. This means she must not suffer fibromuscular dysplasia, otherwise she must have presented renal abnormalities for a long long time, or even before DM-2. +2  
rockodude  a little surprised that atherosclerosis leading to bilateral renal artery stenosis and shrunken kidneys could happen that quickly after everything was A okay the year prior +  


submitted by lsmarshall(393),
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ehT" cxeta hsmceamni rfo trmore cinntoiud yb )egcβer2rd-ain( gsoatnsi si llits unwknno, btu trhee is mose eeecvdin htta er)dir(-eanβgc2 itagssno cta itcydelr no eucm..s.l roMe et,ynrlec orremt hsa neeb oedacrletr cloyels wthi lki.eaahmapy"o - HNI pcuiblioatn

iFrts idA tinsomen yirhorhmdipstye uginsac rometr omfr ier-rβgdance .asuiliottnm tI aslo esnimnot gβioansst-2 nucgsia moertr sa a dsei etf.cef rsitF iAd sola ionstnme s-sβno2iatg ingivdr psusatiom iont ,lecsl wihhc yma obtticenru ot .ertomr aTth ai,ds eorm alcscis mymspsto of mkhaalipeoy are dewi RQS nad edkpae T vaesw on E,CG tmhirhyas,ar adn scumle .wkneases

kioongL oadunr on the tetrenni olsko ielk if ythearp si oetcnindu the etrrmo rfmo a βos-atsig2n esvlsore mtreeovi.

xxabi  Sketchy mentions tremor and arrhythmia as side effects! +1  
drpatinoire  Hypokalemia is more associated with U waves, flattened T, muscle cramps/spasm, those symptoms you mentioned is more typical in hyperkalemia. (I guess you made a typo..?) +  


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How do oyu kwon eh sha an ectrdacnerai guinnlai herian dna ont lcfae ami?ncitpo

sattanki  So as far as I understand, you don’t really get a bulging, defined abdominal mass with fecal impaction. Much more likely to see this with a hernia. +8  
xxabi  Fecal impaction can be palpated in the abdomen, since it'd be accumulating in the rectum and colon, not the groin. Hope that helps! +13  
pseudorosette  a little late but they also mention that the mass had bowel sounds hence it was an incarcerated bowel! :) +6  
waterloo  question said right groin, so idk, didn't think fecal impaction would be that low. + the bowel sounds made me think there is something at the groin that can make bowel sounds? --> Hernia. +1  
thisshouldbefree  think in 3D. mass in right groin. in my head thats very low down below the belt line. i thought if its fecal impaction it would be on the left groin. next they hear bowel sounds over this mass in the right; if it was impaction right there i dont think youll be hearing anything, therefore the bowel loop is over there and is not impacted and thats what they hear. +1  


submitted by strugglebus(163),
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hTe CI aluve tcdionena ,1 iwhhc asnem thta tsi aniicitnginsf

sympathetikey  Correct. Per first aid: "If the 95% CI for odds ratio or relative risk includes 1, H0 is not rejected." +1  
xxabi  Ah that makes more sense, thanks! +  
drdanielr  Since the OR or RR is a ratio, if the two interventions are equal the ratio would be 1. So, if the CI includes 1, they are "the same" or not stat sig diff +  


submitted by usmleuser007(370),
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16nu5np3mi/0:.swo/mt.ht.b/p/dvb8whw.lengic

ieRlef fo brlttanciea pain asw dupcored ni six uhman stpetnia by nsilittoamu of ceotdseerl alyemenptnr nmipedtal ni hte tinreeacrlrvupi adn rtlauqapcdueie rayg m.ttare hTe velle fo tuiamnostli eiuffscitn to duinec apni irfeel semes not ot rltea the atuec ainp td.horshle asiceiItndminr prtiteeevi mlsontiauti coedudpr enleoarct ot ohbt rnpltosduicuodamiet- inap lirefe adn the liagnceas cniota fo tinrcaoc oic;iemandt tish ocsepsr loucd eb redeevsr yb nbneatecis mfor tiiusoant.lm om-ipedSautiruntolcd erfeil fo apni was dereervs yb elxnnaoo in iefv tou fo sxi iepts.nta eseTh tesrslu gsgtesu atht aastcoirfyts lnoliivaaet of tpsteinres napi in shmnau may be baidteno by tcneioeclr iaiml.tounst

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by usmleuser007(370),
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/t1/o5bm.lpw.3d0.n:/ipwhm6itgcvnnsuw8he/b.

feleRi of nittlacaerb nipa asw cdudepro ni isx hnmau pitetsan by uiisalnmtot fo eetlcosdre meylatnrnep aeidnplmt ni het nvrrarteiiuclpe adn eacaqutuipedrl yagr tr.amet Teh elevl of tumslinoita fefitsnuic ot cdeuin npai eierfl smsee ton ot aletr teh etcua ipan .sodrhtehl tiiincsrmIdena iivetrepte saumonlitti rpddeuoc nocertlae to btoh cetuspdtmlauono-idir aipn elierf and eht caaeslnig oitcna fo icactnor tna;mideico shit crsoesp udcol be eeresrvd by tseabeninc mfor nmi.oasliutt dcuttoeli-arinpuSmod ilfree fo inap swa rresvdee yb olnxoane ni fvie uto fo ixs snat.teip Teehs utrlsse tgessgu ahtt oiafcyrtstas anelivoalit fo tnrissepet pani ni msuhan amy be aonbdeti yb clerictnoe t.tilmusniao

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by strugglebus(163),
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uAto mdo eesisad era luyalus ehesuyrotzgo (or os ehty atnw su ot esua)ms

xxabi  How do you know is autosomal dominant? +3  
scpomp  Hereditary spherocytosis +  
fshowon  Isnt the mean corpuscular hemoglobin concentration increased in spherocytosis? Thats what through me off. +5  
charcot_bouchard  yes, would be inc in prev NBME. But this is batshit nbme 20. U have to identify spherocytes without central pallor in PBF +4  
charcot_bouchard  yes, would be inc in prev NBME. But this is batshit nbme 20. U have to identify spherocytes without central pallor in PBF +  


submitted by celeste(78),
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iramAoed,on a saslc III ntyiriahramcht rgdu, ahs liumeplt seffcet no mydirlaaco lrooetnipaiadz nad eziorlitraanop that keam ti na yeexrtlem efctefeiv imhnrirhttyaac r.ugd evoHw,er oorianemda is ssteaadoci wiht a nrbemu fo edis es,tcfef iigncnlud todryih tucyniodsfn (htob oy-hp dna it)hdmsieoh,rrpyy ihwhc is due to aeomdrnaoi's hgih eiodin onnttce nda tsi rcteid oictx fetefc on eht .toyhdri (etmt.audpcoo)

celeste  The "**iod**" part of am**iod**arone reminds me of it's high **iod**ine content. +8  
xxabi  I think of it as the trifecta - gotta monitor LFTs, PFTs, and Ts (thyroid) when on amiodarone! +3  
sinforslide  Also, the patient presented with Afib; this might've been caused by transient hyperthyroidism as a prelude to Hashimoto's. In this case, if you give Amio, you'd cause serious hypothyroidism! +  
fatboyslim  Always monitor LFTs (liver), TFTs (thyroid), and PFTs (pulmonary) with amiodarone +  


submitted by xxabi(248),
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ieBl sastl phle vsioldse atessglnlo ttah avhe dmfero ni eht rbaeladlgl,d duse ni ptaseitn ofetarrcyr to ugrreys or erfrpe ot odiva it.

xxabi  To add, bile salts are amphipathic which allows for the emulsification and solubilization of lipids in an aqueous environmen +4  
md_caffeiner  To add more for people like me who dont even know what amphipathic means:, am·phi·path·ic /ˌamfəˈpaTHik/ (of a molecule, especially a protein) having both hydrophilic and hydrophobic parts +5  


submitted by hayayah(1056),
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aPteint sah lrlmuadye cci.raonam nagnltaiM irortilopanef of arrluciofpalal ""C lcesl atth dprecuo cinlanoict nad heav eessth fo llcse ni na oyamidl rat.mso

xxabi  Just to add - patient likely has MEN 2A or 2B with the presence of medullary thyroid cancer and pheochromocytoma +13  
sympathetikey  @xxabi Was going to say the same thing. +  
dermgirl  The patient have MEN 2B (Medullary thyroid carcinoma + Pheochromocytoma) Page 351 FA. +