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Welcome to yogi’s page.
Contributor score: 11

Comments ...

 +6  (nbme23#17)
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TIP - Pltelate + bA geos ot plense - ydeLs - wLo tpl tencr.toufA csnpeytmleo - lyausul plt otunc reovmip nda hpearPeril olodb smaer owsh - JH ebidso sa a sgni of esanalip ( nuacelr mrtsenna in RCB uaysull omdreev yb .esn)elp fI ehrte asw na ssyrceoac lesnep ic(hhw saw nto nonluifatc hewn teh niam seplne asw wkinr)og illw take erov teh tonnuicf gardylaul - HJ beidso illw spiedapra and Plt atsrts ot ysle - ihwhc has nphpdeae in shit aecs neisrao.c

spow  But why are there no bite cells? Question stem states that there is normal morphology? That's why I didn't pick accessory spleen +2
makinallkindzofgainz  Bite cells are seen when splenic macrophages take "bites" out of hemoglobin precipitates in G6PD deficiency, which doesn't have to do with our question. This patient had a splenectomy 3 months ago, 6 weeks later showed Howell-Jolly bodies (asplenia), and then today now has normal erythrocytes (spleen is working again somehow = accessory spleen) +3
snripper  @spow Bite cells are associated with G6PD deficiency, not ITP. +1
srdgreen123  Main takeaway is the HJ bodies. They're seen pretty much whenever you have no spleen. So if they dissapear, that means another spleen-like structure has showed up +2

 +1  (nbme23#14)
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Q: piStl 1S ardeh erov tfLe entrsla rbredo - uirispcdt ra.ea irFst ecopnmtno of S:1A ? naynthig (CM ni RBBB) atth ecassu eydelad orsucle of pdsciutri lavev macdrepo ot alrtmi lavev- liwl esuca stilp S1 ithw aldeyed 1T nad aryle 1M dareh at cTriuispd ra.ea

Subcomments ...

submitted by welpdedelp(213),
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It aws a ypet VI HSN ,nrctioae wihch dsela hiwt T cslel dan htta swa the lnoy serwan htta dah t eclsl

yogi  Poison Ivy/ oak /Sumak +  
qball  Uworld Q ID 1133 +2  

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hWy esdo ottinleyham ucsae sols fo asnrcseeti ot AGTC ttciseinorr ndceeneuso?al Dsoe hits heav ot do whti nmeytalthio of U to ?T

methylased  GATC related to methylase --> +8  
sympathetikey  Dam methylase, alright +2  

submitted by seagull(1366),
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siTh attinep si ingrptip sbll.a ttBree od a dugr rnseec hciwh sseem o.osbivu

sympathetikey  When the answer is so obvious that you pick a stupid answer instead of it. DOH +36  
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