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But why are there no bite cells? Question stem states that there is normal morphology? That's why I didn't pick accessory spleen
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)
@spow Bite cells are associated with G6PD deficiency, not ITP.
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
Poison Ivy/ oak /Sumak
Uworld Q ID 1133
GATC related to methylase --> https://en.wikipedia.org/wiki/Dam_methylase
When the answer is so obvious that you pick a stupid answer instead of it. DOH
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
@sympathetikey That fucking guy who drinks 2 six packs a day with liver failure got me like that.
probably the "drug" have to be a stimulant or a hallucinogen which causes HTN & Tachycardia.
Lol. I got the right answer but took long time
The patient's B.P. and pulse are raised + Bilateral dilated pupils = Most likely use of a stimulant
Thats how I reasoned it anyways
Bilateraly messed up pupils = Drugs (most of the time)
why is there basal ganglia hemorrhage?
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
basal ganglia hemorrhage is an intraparenchymal hemorrhage secondary to hypertension. according to FA, this occurs most commonly at the Basal Ganglia (FA19 pg 501)