welcome redditors!to snoo-finity ... and beyond!
NBME Answers

Block 1/Question#1
A 28-year-old man comes to the physician because of a 1-year ...
Schistosomiasis

Block 1/Question#2
A 14-year-old boy is brought to the emergency department ...
Common fibular (peroneal)

Block 1/Question#3
A 24-year-old man comes to the office because of a 2-day ...
Hair follicle

Block 1/Question#4
A 14-year-old girl is brought to the physician after her ...
Acting out

Block 1/Question#5
A 24-year-old woman comes to the physician for a follow-up ...
Vascular endothelial growth factor

Block 1/Question#6
A 63-year-old woman comes to the physician 1 day after the ...
Calcium pyrophosphate

Block 1/Question#7
A 55-year-old woman with small cell carcinoma of the lung is ...
Filgrastim

Block 1/Question#8
A 37-year-old woman with right lower extremity edema is ...
P2 louder than A2

Block 1/Question#9
During an experiment, a Southern blot analysis is done by ...
Gene rearrangement

Block 1/Question#10
During a clinical study examining the effects of exercise, ...
Total peripheral resistance

Block 1/Question#11
A 26-year-old man is brought to the emergency department by ...
Arterial baroreceptor firing rate: decreased;
Systemic vascular resistance: increased;
Pulmonary vascular resistance: increased;
Systemic capillary fluid transfer: absorption


Block 1/Question#12
A 17-year-old boy is brought to the emergency department 30 ...
PCP (phencyclidine)

Block 1/Question#13
A 26-year-old woman is brought to the emergency department ...
Pouch of Douglas

Block 1/Question#14
A 14-year-old girl has had nausea, intermittent diarrhea, and ...
Microscopic examination of the stool

Block 1/Question#15
A 40-year-old woman comes to the physician because of a ...
Sertoli-Leydig tumor

Block 1/Question#16
A 45-year-old woman with systemic sclerosis (scleroderma) ...
Diffuse interstitial fibrosis

Block 1/Question#17
A new blood test to detect prostate cancer is evaluated in ...
Prostate biopsies of men with test results equal to or below 5 ng/mL

Block 1/Question#18
A 62-year-old woman comes to the physician because of low ...
Decreased osteoclast activity

Block 1/Question#19
A 26-year-old woman is brought to the emergency department 3 ...
Serum HCO3-: decreased;
Arterial pH: decreased;
Blood PCO2: decreased


Block 1/Question#20
An investigator is studying the incidence of the common cold ...
Decreased macrophage activity

Block 1/Question#21
A 63-year-old man is brought to the emergency department ...
Hypercoagulability from advanced malignancy

Block 1/Question#22
A 35-year-old man comes to the physician because of pain and ...
Separation of endothelial junctions

Block 1/Question#23
A 4-year-old boy from Brazil is brought to the physician ...
Apoptosis

Block 1/Question#24
A 33-year-old woman comes to the physician because of a 2-day ...
Inactivation of cellular p53

Block 1/Question#25
A 27-year-old man is admitted to the hospital 45 minutes ...
Adenylyl cyclase

Block 1/Question#26
A 30-year-old man is admitted to the hospital for evaluation. ...
Crohn disease

Block 1/Question#27
A couple comes for preconceptional genetic counseling because ...
50%

Block 1/Question#28
A healthy 22-year-old man participates in a study of glucose ...
Glycogenolysis in the liver

Block 1/Question#29
A 63-year-old homeless man is brought to the emergency ...
C5a

Block 1/Question#30
A 16-year-old boy is brought to the physician because of a ...
Escherichia coli

Block 1/Question#31
A 16-year-old boy is admitted to the emergency department ...
Hemopneumothorax, not under tension

Block 1/Question#32
A 20-year-old woman comes to the physician because of a ...
von Willebrand disease

Block 1/Question#33
A 2-year-old boy is brought to the physician for a well-child ...
Trinucleotide repeat expansion

Block 1/Question#34
A 31-year-old woman with type 2 diabetes mellitus comes to ...
α-Toxin

Block 1/Question#35
A 10-month-old boy is brought to the physician because of a ...
Mediation of cell entry via a fusion protein

Block 1/Question#36
A 17-year-old girl is brought to the emergency department 15 ...
β2-Adrenergic agonist

Block 1/Question#37
A 30-year-old woman, gravida 2, para 0, aborta 1, at 28 ...
Formation of antibodies to RhD

Block 1/Question#38
A 52-year-old woman begins pharmacotherapy after being ...
Metformin

Block 1/Question#39
A sexually active 23-year-old man with multiple sex partners ...
Antigenic variation

Block 1/Question#40
A 17-year-old girl is brought to the physician by her mother ...
Hypogonadotropic hypogonadism

Block 2/Question#1
A 49-year-old woman comes to the physician for a follow-up ...
HDL-cholesterol: increased;
Triglycerides: decreased


Block 2/Question#2
A 15-year-old girl comes to the physician because of a ...
Stimulation of the sebaceous glands by androgens

Block 2/Question#3
A previously healthy 40-year-old man is brought to the ...
Pericardium

Block 2/Question#4
A 55-year-old man is brought to the emergency department ...
Blood pressure: 85/60;
Pulse: 120;
Jugular venous pressure: increased;
Pulsus paradoxus: increased


Block 2/Question#5
A 54-year-old woman comes to the emergency department because ...
Decreased metabolism of codeine to morphine

Block 2/Question#6
A 14-year-old girl with a 9-year history of type 1 diabetes ...
Countertransference

Block 2/Question#7
A 23-year-old woman with bone marrow failure is treated with ...
Immune complex deposition in tissues

Block 2/Question#8
A 25-year-old man is brought to the emergency department ...
Ribosomal assembly

Block 2/Question#9
A 42-year-old woman comes to the physician because of ...
Thyroid-stimulating hormone: decreased;
Total thyroxine (T4): increased;
Free thyroxine: increased;
Thyroid-binding globulin: normal


Block 2/Question#10
A 29-year-old woman is prescribed carbamazepine for ...
Metabolism

Block 2/Question#11
Over 1 year, a study is conducted to assess the antileukemic ...
Open-labeled clinical trial

Block 2/Question#12
A 64-year-old man with non-Hodgkin lymphoma comes to the ...
Vincristine

Block 2/Question#13
During an experiment, drug X is added to a muscle bath ...
Cholinesterase inhibitor

Block 2/Question#14
A 42-year-old man comes to the physician for a follow-up ...
The patient's perception that the physician is uncaring

Block 2/Question#15
A 72-year-old woman comes to the physician because of a ...
Echocardiography

Block 2/Question#16
A 14-year-old boy is brought to the physician for a physical ...
Normal development

Block 2/Question#17
A 5-year-old boy is admitted to the hospital because of a ...
Inability of leukocytes to kill intracellular microorganisms

Block 2/Question#18
A 22-year-old woman contacts a medical student and asks if he ...
He cannot date her because she was once his psychiatric patient

Block 2/Question#19
A 73-year-old woman comes to the physician because of a ...
Vitamin B12 (cyanocobalamin)

Block 2/Question#20
A 45-year-old man comes to the physician because of right ...
Infraspinatus

Block 2/Question#21
A 54-year-old man comes to the physician for a follow-up ...
Amygdala

Block 2/Question#22
A placebo-controlled clinical trial is conducted to assess ...
Significant findings can be reported with greater confidence

Block 2/Question#23
A male stillborn is delivered at 32 weeks' gestation to a ...
Pulmonary hypoplasia

Block 2/Question#24
A 33-year-old man undergoes a radical thyroidectomy for ...
Branch of the thyrocervical trunk

Block 2/Question#25
A 42-year-old man comes to the physician for a follow-up ...
Na+–Cl− symport inhibitor

Block 2/Question#26
A 55-year-old man comes to the physician because of a 2-week ...
Basement membrane

Block 2/Question#27
A 24-year-old man is brought to the emergency department 40 ...
Foramen ovale

Block 2/Question#28
A 55-year-old man who is a business executive is admitted to ...
Splitting

Block 2/Question#29
A 3-year-old boy with chronic granulomatous disease is ...
Vancomycin

Block 2/Question#30
An otherwise healthy 45-year-old man comes to the physician ...
Elaboration of proteases and urease with local tissue destruction

Block 2/Question#31
A 10-year-old girl is brought to the office by her mother ...
It is a polymorphism

Block 2/Question#32
A previously healthy 40-year-old woman is brought to the ...
Thrombotic thrombocytopenic purpura

Block 2/Question#33
A 17-year-old girl has never had a menstrual period. Physical ...
Androgen insensitivity

Block 2/Question#34
A 12-year-old girl is brought to the physician because of a ...
Decreased activity of UDP glucuronosyltransferase

Block 2/Question#35
A 47-year-old woman comes to the emergency department because ...
Annular pancreas

Block 2/Question#36
An 8-year-old boy is brought to the office by his mother ...
Adenovirus

Block 2/Question#37
A 36-year-old man with profound intellectual disability is ...
Omental bursa (lesser sac)

Block 2/Question#38
A study is designed to evaluate the feasibility of ...
Case series

Block 2/Question#39
A 56-year-old man comes to the emergency department because ...
Uric acid crystals

Block 2/Question#40
A 62-year-old man comes to the physician for a follow-up ...
Type I pneumocytes: decreased;
Type II pneumocytes: increased;
Fibroblasts: increased


Block 3/Question#1
Six healthy subjects participate in a study of muscle ...
Fatty acid oxidation

Block 3/Question#2
A 72-year-old woman who has smoked 20 cigarettes daily for ...
Timolol

Block 3/Question#3
A 54-year-old man comes to the physician because of episodes ...
Third-degree atrioventricular block

Block 3/Question#4
A 15-year-old boy is brought to the emergency department by ...
Olfactory nerve

Block 3/Question#5
A 42-year-old woman comes to the physician for a routine ...
Parathyroid gland

Block 3/Question#6
A new severe respiratory illness caused by a newly identified ...
Avoids the concern for reversion to virulence

Block 3/Question#7
A 72-year-old woman comes to the physician because of a 3-day ...
Aspiration

Block 3/Question#8
A 25-year-old woman comes to the office because of a 6-month ...
Cyclin-dependent kinases

Block 3/Question#9
A 72-year-old woman is brought to the emergency department by ...
Area labeled 'C'

Block 3/Question#10
A 4-year-old boy is brought to the physician because of slow ...
Calcium: decreased;
Inorganic phosphorus: increased;
1,25-dihydroxycholecalciferol: decreased;
Erythropoietin: decreased


Block 3/Question#11
A 42-year-old woman is brought to the emergency department ...
Infraorbital

Block 3/Question#12
A previously healthy 24-year-old woman who is a college ...
Lubiprostone

Block 3/Question#13
A 32-year-old man is brought to the emergency department 30 ...
Membranous

Block 3/Question#14
A 2-year-old boy is brought to the office by his mother ...
DNA virus

Block 3/Question#15
A 46-year-old woman with active ankylosing spondylitis comes ...
Tumor necrosis factor α

Block 3/Question#16
During a study of renal glomeruli, a healthy animal kidney is ...
Increased hydrostatic pressure

Block 3/Question#17
A 67-year-old woman is brought to the emergency department 30 ...
Syndrome of inappropriate secretion of ADH (vasopressin)

Block 3/Question#18
A 23-year-old woman comes to the physician for genetic ...
The patient's DMD carrier status is uncertain because of random X inactivation

Block 3/Question#19
A randomized controlled trial is conducted to assess the risk ...
0.2

Block 3/Question#20
A 35-year-old woman comes to the office because of a 3-day ...
Explain that the patient does not need the MRI and that it is not appropriate to misrepresent her examination findings

Block 3/Question#21
A 6-day-old breast-fed boy is brought to the emergency ...
Galactose 1-phosphate

Block 3/Question#22
A 14-year-old boy is brought to the physician because of a ...
Infectious mononucleosis

Block 3/Question#23
In a cohort study of elderly women, the relative risk ratio ...
Statistically significant overall increase in risk

Block 3/Question#24
A 12-year-old boy is brought to the physician by his mother ...
Patellar ligament

Block 3/Question#25
A 22-year-old woman comes to the office because of a 3-day ...
BK virus

Block 3/Question#26
A new test to detect the presence of malarial antibodies by ...
95%

Block 3/Question#27
A 30-year-old woman comes to the physician because of a 2-day ...
The second CFTR mutation was not detected by the testing obtained

Block 3/Question#28
A 52-year-old man is brought to the emergency department 30 ...
Increases nitric oxide concentration

Block 3/Question#29
A technician wants to determine whether cytomegalovirus (CMV) ...
Polymerase chain reaction

Block 3/Question#30
A 16-year-old boy comes to the physician because of a rash on ...
Carditis

Block 3/Question#31
After being severely beaten and sustaining a gunshot wound to ...
Reassure the patient that her chance of becoming addicted to narcotics is minuscule

Block 3/Question#32
A 51-year-old man comes to the office because of a 6-month ...
Submental

Block 3/Question#33
A 31-year-old woman comes to the physician because of a ...
Lifelong persistent infection

Block 3/Question#34
A 57-year-old man receives radiation therapy for a squamous ...
G1

Block 3/Question#35
A 55-year-old man comes to the physician for a routine ...
Increased peripheral vascular resistance

Block 3/Question#36
A 53-year-old man comes to the physician because of a 6-month ...
Superficial inguinal

Block 3/Question#37
A 59-year-old man is brought to the emergency department ...
Hypovolemic

Block 3/Question#38
A 2-week-old newborn is brought to the physician for a ...
Normal reflex response

Block 3/Question#39
A 14-year-old boy is brought to the office for an examination ...
Normal findings

Block 3/Question#40
A 65-year-old man is brought to the physician by his daughter ...
Substantia nigra

Recent comments ...

... benwhite_dotcom made a comment on free120/block1/q#1 (A 28-year-old man comes to the physician because of...)
 +1  upvote downvote
submitted by benwhite_dotcom(36)

Schistosomiasis is a parasitic worm particularly endemic in Africa (Egypt, in particular, comes up the most on questions) that is most associated with chronic cystitis. Calcifications of the bladder wall are essentially pathognomonic. Chronic infection is associated with an increased risk of squamous cell carcinoma of the bladder (as opposed to the usual urothelial/transitional cell).

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
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submitted by benwhite_dotcom(36)

Hot tub folliculitis, it’s a thing. Classically pseudomonas.

... benwhite_dotcom made a comment on free120/block1/q#4 (A 14-year-old girl is brought to the physician after...)
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submitted by benwhite_dotcom(36)

And the answer is, acting out aka “being a teenager.”

... benwhite_dotcom made a comment on free120/block1/q#5 (A 24-year-old woman comes to the physician for a...)
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submitted by benwhite_dotcom(36)

VEGF is a major tissue growth factor activated by injury, cytokine release (infection, inflammation) and hypoxia that promotes angiogenesis and also increases vascular permeability (hence the edema). This increased permeability aids in the movement of proteins and white blood cells to the site of injury.

... benwhite_dotcom made a comment on free120/block1/q#6 (A 63-year-old woman comes to the physician 1 day...)
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submitted by benwhite_dotcom(36)

Pseudogout is caused by positively-birefringent rhomboid calcium pyrophosphate crystal deposition. Most commonly affected location is the knee. Contrast with gout, negatively birefringent, big toe. A differential for both to keep in mind is septic arthritis.

... benwhite_dotcom made a comment on free120/block1/q#7 (A 55-year-old woman with small cell carcinoma of the...)
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submitted by benwhite_dotcom(36)

Filgrastim is a granulocyte colony stimulating factor (GCSF), which are drugs used to increase white blood cell count in patients with leukopenia. Leucovorin (folinic acid) sounds like it would also be right, but it’s used to prevent bone marrow suppression in patients taking methotrexate. Darbepoetin (like erythropoietin) is used to stimulate red blood cell production.

... benwhite_dotcom made a comment on free120/block1/q#8 (A 37-year-old woman with right lower extremity edema...)
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submitted by benwhite_dotcom(36)

The left-sided system is much higher pressure than the right side, hence the aortic valve closing is usually louder than the pulmonic valve. A P2 louder than A2 means that the pulmonary arterial pressure is significantly elevated.

... benwhite_dotcom made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
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submitted by benwhite_dotcom(36)

Southern blots are commonly used in immunological studies, as the southern blot allows for the study of DNA alterations. What is normally one gene configuration related to immune globulins in most tissues demonstrates multiple different bands in the bone marrow, indicative of gene rearrangement. This is basically how we create new antibodies. Reactive processes are polyclonal (multiple bands); leukemia, in contrast, is monoclonal (single band).

ali  I still don’t understand this one. Could you provide a better explanation?
benwhite_dotcom  The cDNA tag is tagging a constant region common to immunoglobulins, so it normally only finds the one band corresponding to that particular gene (the bands travel different amounts due to their differing size/weight). In the bone marrow sample, that gene has rearranged itself, so the cDNA clone instead tags multiple different genes that are of different sizes on the gel (each one has that same constant region the cDNA is tagging, but with different stuff around it such that the restriction enzyme has cut it up differently). I’d be happy for someone to step in and do a better job on that explanation.
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
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submitted by sugaplum(43)

This question is asking about VDJ rearrangement which happens in the bone marrow. The genes are all chopped up because the B cell is trying to generate a unique combination for its receptor
simple concepts... odd wording

Chapter 3 of "how the immune system works" - awesome book

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :(
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
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submitted by benwhite_dotcom(36)

Total peripheral resistance goes down during exercise as the arterioles supplying muscle and skin dilate.

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
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submitted by benwhite_dotcom(36)

The baroreceptors are stretch receptors (the more fluid in the vessel, the more they fire). So a patient with hemorrhagic shock will see a decrease in the baroreceptor firing rate. Activation of RAAS will result in increased vascular resistance (vasoconstriction) in order to maintain blood pressure. And capillaries, such as those in the kidney, will be primed for resorption and not filtration (no one wants to pee out good dilute urine when they’re dehydrated). Likewise, systemic capillaries will prefer to hold onto plasma and not let it leak into the interstitium (third-spacing).

... anu made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
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submitted by anu(1)

what about the increase in pulmonary vascular resistance ? doesnt PCWP fall in hemorraghic shock

... benwhite_dotcom made a comment on free120/block1/q#12 (A 17-year-old boy is brought to the emergency...)
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submitted by benwhite_dotcom(36)

PCP is a sedative-hypnotic and dissociative anesthetic that generally acts as a downer but can also cause incredible aggression coupled with pain insensitivity (the superman drug). Vertical nystagmus is a commonly mentioned physical exam finding.

... benwhite_dotcom made a comment on free120/block1/q#13 (A 26-year-old woman is brought to the emergency...)
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submitted by benwhite_dotcom(36)

The Pouch of Douglas is the space between the uterus and the rectum (i.e. the place where pelvic free fluid goes).

... benwhite_dotcom made a comment on free120/block1/q#14 (A 14-year-old girl has had nausea, intermittent...)
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submitted by benwhite_dotcom(36)

The “migratory serpiginous perianal rash” (ick) is classic for strongyloides, a parasitic roundworm acquired from larvae-contaminated soil. Strongyloides larvae can borrow (hence the rash) and can migrate to the GI tract and lay their eggs, which then hatch in the intestine and cause diarrhea. Treatment is Ivermectin (and if not, mebendazole/albendazole). Checking the stools for larvae is the most sensitive test. Parasite life cycles are gross.

benwhite_dotcom  As an addendum, I believe this is larva currens (https://en.wikipedia.org/wiki/Larva_currens) in the setting of strongyloides infection and not Cutaneous larva migrans. Strongyloides, unlike CLM, explains the diarrhea, weight loss, and not just the eosinophilia. CLM is generally limited to the skin and typically appears first in hands or feet (whatever touches soil) with perianal involvement being significantly less common. Stool studies are unnecessary in CLM, which is primarily a clinical diagnosis. The other information in the stem is there for a reason. See this nice comparison page: https://www.derm101.com/therapeutic/cutaneous-larva-migrans-larva-currens/introduction/
... benwhite_dotcom made a comment on free120/block1/q#15 (A 40-year-old woman comes to the physician because...)
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submitted by benwhite_dotcom(36)

Leydig cells make testosterone. Leydig cell tumors aren’t always physiological active, but those that are can cause masculinization. Granulosa cell tumors, on the other hand, sometimes produce estrogen (which can lead to precocious puberty in young girls but otherwise may be occult). Teratomas are oddballs that typically have fat, hair, teeth, etc. Thecomas will not be on your test. Ovarian carcinoid is highly unlikely to show up on your test, but if it did, it would likely present with a classic carcinoid syndrome.

sugaplum  FA 2019 page 632
... benwhite_dotcom made a comment on free120/block1/q#16 (A 45-year-old woman with systemic sclerosis...)
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submitted by benwhite_dotcom(36)

Pulmonary fibrosis (a restrictive pattern disease) is a major cause of mortality for patients with scleroderma. Logically, if the disease causes fibrosis elsewhere, it’s going to cause fibrosis in the lungs.

... benwhite_dotcom made a comment on free120/block1/q#17 (A new blood test to detect prostate cancer is...)
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submitted by benwhite_dotcom(36)

Sensitivity rules things out. It’s TP / (TP + FN). So in order to calculate the sensitivity of this test, we need the true positives (the 90 with cancer) and the false negatives: the patients for whom the test is negative but actually do have prostate cancer.

... benwhite_dotcom made a comment on free120/block1/q#18 (A 62-year-old woman comes to the physician because...)
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submitted by benwhite_dotcom(36)

Bisphosphonates work by decreasing osteoclast activity (thereby reducing bone resorption). “Increased receptor activation of NFkB ligand (RANKL) production” is the opposite of how estrogen therapy works (RANKL is found on osteoblasts, and its activation triggers osteoclasts and stimulates bone resorption).

... benwhite_dotcom made a comment on free120/block1/q#19 (A 26-year-old woman is brought to the emergency...)
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submitted by benwhite_dotcom(36)

Memorize aspirin’s unique acid-base effects: metabolic acidosis and respiratory alkalosis. Note, this is likely actual respiratory alkalosis, not simply normal respiratory compensation for metabolic acidosis.

mikerite  Based on the correct answer choice, the person is now in metabolic acidosis with respiratory compensation.
benwhite_dotcom  The correct answer choice is as listed above (all decreased). Note that whether metabolic acidosis is combined with primary respiratory alkalosis, which is an important teaching point I’ve argued the question writers are probably getting at, or even if just simple respiratory compensation for metabolic acidosis–both can have the same arrows. In this case, it’s not respiratory compensation. In ASA overdose, the respiratory alkalosis actually happens first. Ultimately, the metabolic acidosis dominates and the pH is almost always low. This mixed primary acid/base response to ASA toxicity is highly testable.
ali  How long till the respiratory alkalosis turns into a metabolic/mixed picture?
benwhite_dotcom  @ali 12 hours is a good number to memorize but it can definitely happen much earlier.
yoav  From what I understand, the metabolic acidosis only presents 12h post ingestion, while she is only 3h. What do you think?
benwhite_dotcom  @yoav, It can definitely happen earlier. It’s more of a by 12 hours (not only beginning then).
angelaq11  I'm beginning to think that they don't actually care about how many hours lapse after the ingestion, but if we actually know the unique acid-base disturbance. I chose the wrong one, again because I was foolishly thinking about those 12 hours postintoxication
charcot_bouchard  I think this is good rule of thmb in USMLE "a Right answer may or may not tick all the correct things but will NEVER have a wrong thing in it". So the ans choice we all chose has Bicarb inc. But this will never happen. at 3 hour we should have pure resp alkalosis with normal bicarb (as per uw). Or in this case decreased due to neutralization by organic salicylic acid. In Aspirin poisoning bicarb will nver increase.
elasaf@post.bgu.ac.il  Another important point- they probably gave her RR (30) to indicate that she is hyperventilating==> LOW CO2
... benwhite_dotcom made a comment on free120/block1/q#20 (An investigator is studying the incidence of the...)
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submitted by benwhite_dotcom(36)

Note that the question is not asking what cells fight URIs. The question asks what lab finding would be consistent with decreased immune activity (and thus the only choice that matches “decreased” with an immune cell is the best answer).

sugaplum  So I read Lymphocyte as leukocyte (because cortisol probably) so that is what I put. but cortisol does increase levels of neutrophils floating around in the blood right, I was going for stress demarg. Can't tell if i am thinking too hard about this.
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
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submitted by benwhite_dotcom(36)

Don’t let them blind you with this patient’s misery. The issue of the day is that he has a DVT. That’s why he came to the ER in the first sentence and what the ultrasound shows at the end. Patients with cancer are hypercoagulable.

... benwhite_dotcom made a comment on free120/block1/q#22 (A 35-year-old man comes to the physician because of...)
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submitted by benwhite_dotcom(36)

Endothelial tight junctions’ permeability is increased in response to injury and inflammation, allowing migration of white blood cells and friends to the site of injury.

... benwhite_dotcom made a comment on free120/block1/q#23 (A 4-year-old boy from Brazil is brought to the...)
 +2  upvote downvote
submitted by benwhite_dotcom(36)

Endemic Burkitt lymphoma can happen in Brazil as well as Africa (jaw lesion, puffy face). The photomicrograph is demonstrating tingible body macrophages, a type of macrophage containing many phagocytized, apoptotic cells in various states of degradation.

... nwinkelmann made a comment on free120/block1/q#23 (A 4-year-old boy from Brazil is brought to the...)
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submitted by nwinkelmann(75)

In case anyone is curious about the other terms: I think apoptosis and necroptosis are fairly recognizable, but I had no clue what symptosis, ostosis, and oncosis were. Symptosis = ischemic cell death. Ostosis = bone formation (duh! why didn't I remember that, lol). Oncosis = emaciation.

... benwhite_dotcom made a comment on free120/block1/q#24 (A 33-year-old woman comes to the physician because...)
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submitted by benwhite_dotcom(36)

p53 protein is the quintessential tumor suppressor (it activates apoptosis). HPV carcinogenesis is caused by insertion of the virus into host DNA that produces a protein which binds to an essential p53 substrate, functionally inactivating p53 and preventing its apoptotic cascade. Transactivation/TAX is how HIV and HTLV cause cancer. c-myc translocation causes Burkitt lymphoma.

claptain  Just to add to this, HPV can also inactivate Rb via E7 viral protein.
... benwhite_dotcom made a comment on free120/block1/q#25 (A 27-year-old man is admitted to the hospital 45...)
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DI is an important complication of some skull base fractures and can be treated with DDAVP. You probably remember that this works via the activation of aquaporin channels, but these are moved from intracellular vesicles to the apical membrane surface as a result of a DDAVP-mediated increase adenylate cyclase via a stimulatory G protein that increases intracellular cAMP.

... benwhite_dotcom made a comment on free120/block1/q#26 (A 30-year-old man is admitted to the hospital for...)
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Crohn’s: skip lesions, fistulae, strictures (and the unnecessary transmural involvement on histology).

... benwhite_dotcom made a comment on free120/block1/q#27 (A couple comes for preconceptional genetic...)
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The mom will pass on her deletion in 50%. The father will pass it on in 100% (because both of his copies are affected). Therefore, the child will automatically have at least one deletion and will have the double deletion in 50%.

... benwhite_dotcom made a comment on free120/block1/q#28 (A healthy 22-year-old man participates in a study of...)
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Approximate fasting physiology timing: the post-absorptive phase (6-24 hours after a meal) is dominated by glycogenolysis. Gluconeogenesis from 24 hours to 2 days. Then ketosis.

... benwhite_dotcom made a comment on free120/block1/q#29 (A 63-year-old homeless man is brought to the...)
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The arrow is pointing to a neutrophil (multilobed nucleus): main fighter of the immune system in acute inflammation and bacterial infection (such as aspiration pneumonia). C5a is a chemotactic factor for PMNs.

... benwhite_dotcom made a comment on free120/block1/q#30 (A 16-year-old boy is brought to the physician...)
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While E coli is normal gut flora, your body would prefer it stay intraluminal.

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