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NBME Answers

medicine
Question#1 (reveal difficulty score)
A 28-year-old man comes to the physician ...
SchistosomiasisπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 14-year-old boy is brought to the emergency ...
Common fibular (peroneal)πŸ”,πŸ“Ί

Question#3 (reveal difficulty score)
A 24-year-old man comes to the office because ...
Hair follicleπŸ”,πŸ“Ί

Question#4 (reveal difficulty score)
A 14-year-old girl is brought to the ...
Acting outπŸ”,πŸ“Ί


Question#6 (reveal difficulty score)
A 63-year-old woman comes to the physician 1 ...
Calcium pyrophosphateπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
A 55-year-old woman with small cell carcinoma ...
FilgrastimπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 37-year-old woman with right lower ...
P2 louder than A2πŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
During an experiment, a Southern blot ...
Gene rearrangementπŸ”,πŸ“Ί

Question#10 (reveal difficulty score)
During a clinical study examining the effects ...
Total peripheral resistanceπŸ”,πŸ“Ί


Question#12 (reveal difficulty score)
A 17-year-old boy is brought to the emergency ...
PCP (phencyclidine)πŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 26-year-old woman is brought to the ...
Pouch of DouglasπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 40-year-old woman comes to the physician ...
Sertoli-Leydig tumorπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 45-year-old woman with systemic sclerosis ...
Diffuse interstitial fibrosisπŸ”,πŸ“Ί


Question#18 (reveal difficulty score)
A 62-year-old woman comes to the physician ...
Decreased osteoclast activityπŸ”,πŸ“Ί


Question#20 (reveal difficulty score)
An investigator is studying the incidence of ...
Decreased macrophage activityπŸ”,πŸ“Ί



Question#23 (reveal difficulty score)
A 4-year-old boy from Brazil is brought to ...
ApoptosisπŸ”,πŸ“Ί

Question#24 (reveal difficulty score)
A 33-year-old woman comes to the physician ...
Inactivation of cellular p53πŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 27-year-old man is admitted to the hospital ...
Adenylyl cyclaseπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Crohn diseaseπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A couple comes for preconceptional genetic ...
50%πŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A healthy 22-year-old man participates in a ...
Glycogenolysis in the liverπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 63-year-old homeless man is brought to the ...
C5aπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy is brought to the physician ...
Escherichia coliπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand diseaseπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 2-year-old boy is brought to the physician ...
Trinucleotide repeat expansionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 31-year-old woman with type 2 diabetes ...
Ξ±-ToxinπŸ”,πŸ“Ί




Question#38 (reveal difficulty score)
A 52-year-old woman begins pharmacotherapy ...
MetforminπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A sexually active 23-year-old man with ...
Antigenic variationπŸ”,πŸ“Ί




Question#3 (reveal difficulty score)
A previously healthy 40-year-old man is ...
PericardiumπŸ”,πŸ“Ί



Question#6 (reveal difficulty score)
A 14-year-old girl with a 9-year history of ...
CountertransferenceπŸ”,πŸ“Ί


Question#8 (reveal difficulty score)
A 25-year-old man is brought to the emergency ...
Ribosomal assemblyπŸ”,πŸ“Ί


Question#10 (reveal difficulty score)
A 29-year-old woman is prescribed ...
MetabolismπŸ”,πŸ“Ί

Question#11 (reveal difficulty score)
Over 1 year, a study is conducted to assess ...
Open-labeled clinical trialπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A 64-year-old man with non-Hodgkin lymphoma ...
VincristineπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
During an experiment, drug X is added to a ...
Cholinesterase inhibitorπŸ”,πŸ“Ί


Question#15 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
EchocardiographyπŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Normal developmentπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A 73-year-old woman comes to the physician ...
Vitamin B12 (cyanocobalamin)πŸ”,πŸ“Ί

Question#20 (reveal difficulty score)
A 45-year-old man comes to the physician ...
InfraspinatusπŸ”,πŸ“Ί

Question#21 (reveal difficulty score)
A 54-year-old man comes to the physician for ...
AmygdalaπŸ”,πŸ“Ί


Question#23 (reveal difficulty score)
A male stillborn is delivered at 32 weeks' ...
Pulmonary hypoplasiaπŸ”,πŸ“Ί



Question#26 (reveal difficulty score)
A 55-year-old man comes to the physician ...
Basement membraneπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
A 24-year-old man is brought to the emergency ...
Foramen ovaleπŸ”,πŸ“Ί

Question#28 (reveal difficulty score)
A 55-year-old man who is a business executive ...
SplittingπŸ”,πŸ“Ί

Question#29 (reveal difficulty score)
A 3-year-old boy with chronic granulomatous ...
VancomycinπŸ”,πŸ“Ί


Question#31 (reveal difficulty score)
A 10-year-old girl is brought to the office ...
It is a polymorphismπŸ”,πŸ“Ί


Question#33 (reveal difficulty score)
A 17-year-old girl has never had a menstrual ...
Androgen insensitivityπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 47-year-old woman comes to the emergency ...
Annular pancreasπŸ”,πŸ“Ί

Question#36 (reveal difficulty score)
An 8-year-old boy is brought to the office by ...
AdenovirusπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 36-year-old man with profound intellectual ...
Omental bursa (lesser sac)πŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A study is designed to evaluate the ...
Case seriesπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 56-year-old man comes to the emergency ...
Uric acid crystalsπŸ”,πŸ“Ί


biochem metabolism
Question#1 (reveal difficulty score)
Six healthy subjects participate in a study ...
Fatty acid oxidationπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 72-year-old woman who has smoked 20 ...
TimololπŸ”,πŸ“Ί


Question#4 (reveal difficulty score)
A 15-year-old boy is brought to the emergency ...
Olfactory nerveπŸ”,πŸ“Ί

Question#5 (reveal difficulty score)
A 42-year-old woman comes to the physician ...
Parathyroid glandπŸ”,πŸ“Ί


Question#7 (reveal difficulty score)
A 72-year-old woman comes to the physician ...
AspirationπŸ”,πŸ“Ί

Question#8 (reveal difficulty score)
A 25-year-old woman comes to the office ...
Cyclin-dependent kinasesπŸ”,πŸ“Ί

Question#9 (reveal difficulty score)
A 72-year-old woman is brought to the ...
Area labeled 'C'πŸ”,πŸ“Ί


Question#11 (reveal difficulty score)
A 42-year-old woman is brought to the ...
InfraorbitalπŸ”,πŸ“Ί

Question#12 (reveal difficulty score)
A previously healthy 24-year-old woman who is ...
LubiprostoneπŸ”,πŸ“Ί

Question#13 (reveal difficulty score)
A 32-year-old man is brought to the emergency ...
MembranousπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 2-year-old boy is brought to the office by ...
DNA virusπŸ”,πŸ“Ί

Question#15 (reveal difficulty score)
A 46-year-old woman with active ankylosing ...
Tumor necrosis factor Ξ±πŸ”,πŸ“Ί

Question#16 (reveal difficulty score)
During a study of renal glomeruli, a healthy ...
Increased hydrostatic pressureπŸ”,πŸ“Ί



Question#19 (reveal difficulty score)
A randomized controlled trial is conducted to ...
0.2πŸ”,πŸ“Ί


Question#21 (reveal difficulty score)
A 6-day-old breast-fed boy is brought to the ...
Galactose 1-phosphateπŸ”,πŸ“Ί

Question#22 (reveal difficulty score)
A 14-year-old boy is brought to the physician ...
Infectious mononucleosisπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Patellar ligamentπŸ”,πŸ“Ί

Question#25 (reveal difficulty score)
A 22-year-old woman comes to the office ...
BK virusπŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A new test to detect the presence of malarial ...
95%πŸ”,πŸ“Ί



Question#29 (reveal difficulty score)
A technician wants to determine whether ...
Polymerase chain reactionπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 16-year-old boy comes to the physician ...
CarditisπŸ”,πŸ“Ί


Question#32 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#33 (reveal difficulty score)
A 31-year-old woman comes to the physician ...
Lifelong persistent infectionπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 57-year-old man receives radiation therapy ...
G1πŸ”,πŸ“Ί


Question#36 (reveal difficulty score)
A 53-year-old man comes to the physician ...
Superficial inguinalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 59-year-old man is brought to the emergency ...
HypovolemicπŸ”,πŸ“Ί

Question#38 (reveal difficulty score)
A 2-week-old newborn is brought to the ...
Normal reflex responseπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 14-year-old boy is brought to the office ...
Normal findingsπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 65-year-old man is brought to the physician ...
Substantia nigraπŸ”,πŸ“Ί




Question#17 (reveal difficulty score)
A 6-year-old girl is admitted to the hospital ...
MyeloperoxidaseπŸ”,πŸ“Ί

Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soilπŸ”,πŸ“Ί

Question#31 (reveal difficulty score)
A 23-year-old woman is brought to the medical ...
Orthostatic hypotensionπŸ”,πŸ“Ί

Question#18 (reveal difficulty score)
A 51-year-old man comes to the office because ...
SubmentalπŸ”,πŸ“Ί

Question#37 (reveal difficulty score)
A 50-year-old woman comes to the physician ...
baroreceptor outputπŸ”,πŸ“Ί

Question#32 (reveal difficulty score)
A 27-year-old man comes to the emergency ...
gastric mucosaπŸ”,πŸ“Ί

Question#7 (reveal difficulty score)
An asymptomatic 44-year-old man is found to ...
PetechiaeπŸ”,πŸ“Ί




Question#16 (reveal difficulty score)
A 12-year-old boy is brought to the physician ...
Upward gazeπŸ”,πŸ“Ί

Question#14 (reveal difficulty score)
A 52-year-old man comes to the emergency ...
Atrial fibrillationπŸ”,πŸ“Ί


Question#14 (reveal difficulty score)
A 46-year-old woman with 2 months of fatigue ...
Adverse drug eventπŸ”,πŸ“Ί

Question#27 (reveal difficulty score)
An 18-year-old is brought to the ED with 1 ...
TamponπŸ”,πŸ“Ί

Question#39 (reveal difficulty score)
A 32-year-old with 2 years of abnormal hand ...
Basal GangliaπŸ”,πŸ“Ί


Question#35 (reveal difficulty score)
A 65-years-old woman with asthma is brought ...
B. leukotrienes πŸ”,πŸ“Ί



micro antibiotics
Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί

Question#2 (reveal difficulty score)
A 43-year-old woman with type 2 Diabetesis ...
accumulation of acetaldehydeπŸ”,πŸ“Ί


Question#24 (reveal difficulty score)
A 47-year old man is brought to the emergency ...
AtropineπŸ”,πŸ“Ί

Question#30 (reveal difficulty score)
A 24-year old man is brought to the emergency ...
Sensation over the upper lipπŸ”,πŸ“Ί

Question#34 (reveal difficulty score)
A 38-year old woman, gravida 3, para 2, at ...
ACE inhibitorsπŸ”,πŸ“Ί

Crohn
Question#38 (reveal difficulty score)
A 30-year-old man is admitted to the hospital ...
Chron DiseaseπŸ”,πŸ“Ί

Question#40 (reveal difficulty score)
A 68-year old woman comes to the emergency ...
S. pyogenes (Group A)πŸ”,πŸ“Ί

Question#26 (reveal difficulty score)
A 45-year-old man is brought to the clinic by ...
AtrophyπŸ”,πŸ“Ί


Recent comments ...

... benwhite_dotcom made a comment on free120/block2/q#30 (An otherwise healthy 45-year-old man comes to the...)
 +22 
submitted by benwhite_dotcom(607)
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As aasyw,l ’its oatmls etetrb ot igrnoe the itpecrsu hnew e.sliopbs iTsh tnmneaelg sha a tpeicp ,uercl hcwhi ew wnok is ecuasd laiormdtepney by .H rolipy eo.nfnitci .H loypir rcoedpsu oatresspe adn tplrulriacay esru,ea wihch alolw ti to erinecas eht Hp of its lloca oimvtnrnene yb cligvaen urea noit mm,iaona ciwhh si xicto ot sarticg u.somac Teh etpciur ttdoessarnme H rlyiop, hchiw rae eievdtn wtih lrsiev nnsi.giat

joonam  Hey bro, thank you so much for your contributions on these free 120 questions. Your advice on test taking strategies for step 1 have been very helpful. +23
luciana  "Elaborated enzymes by H. pylori may also contribute directly to epithelial cell injury. Ammonia produced through urease activity may be toxic to gastric epithelial cells. H. pylori protease and lipase degrade gastric mucus and disrupt the phospholipid-rich layer at the apical epithelial cell surface, allowing for cell injury from back diffusion of gastric acid." https://www.ncbi.nlm.nih.gov/pubmed/9394757 +4
luciana  I got tricked :( Thought the damage was due to destruction of local somatostatin cells with increased gastrin and acid production... but this is actually the mechanism of duodenal ulcers development related to H. pylori But makes sense, so thats how the somatostatin producing cells are destroyed lol +6
drpee  "Hyperacidity and gastric ulcer development" is also sort of true, but this is hinting at the mechanism for DUODENAL ulcer development from H Pylori. Irritation in the stomach leads to G Cell hyperplasia, increasing acid secrection which causes downstream ulceration. +7
itsalwayslupus  Did anyone else pick the hyperacidity answer just because the correct answer had "local tissue destruction" in it? I figured that H. Pylori was non-invasive, so would not directly damage the tissue it is localized too +7
cbreland  @itsalwayslupus exact same thoughts over here +1
... sugaplum made a comment on free120/block2/q#31 (A 10-year-old girl is brought to the office by her...)
 +21 
submitted by sugaplum(423)
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caIens ynoean esel was itnnikhg het e:sma
I saw kctus eebwten isth dna arntaiv fo nnuknwo .gancfiinsice eHvowe,r naitvra fo wunoknn iifsnceganic is a esequcen tno a ngeils doniteeluc

nbme4unme  Thank you for explaining, I selected the unknown significance answer as well! +5
dhkahat  lol fuck this test +13
chaosawaits  Because knowing this will definitely make me a better doctor /s +
... imnotarobotbut made a comment on free120/block1/q#32 (A 20-year-old woman comes to the physician because...)
 +15 
submitted by imnotarobotbut(174)
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Tsih si a bad .teiouqns teeltPal gtgieogrnaa time ebngi oramn,l ok efni I nca ese .hatt uBt VWF seitzbaisl cofrta 8 dan uody' ese an nearseci ni PTT t(fsir enli ntex to WFV ni rFits .iA)d hWy si tehir TTP loarnm?

a1_antitrypsin  Totally agree, and they give you a slight increase in PT instead +1
mambaforstep  yeah but if they gave you an increase in PTT then Hemophilia A could have been a valid answer choice. so they prob showed a nl PTT to differentiate vWF dz from hemophlia A +1
drpee  VWD only sometimes presents with a slightly increased PTT. Don't let those anki facts steer you wrong... Plus all the other answers make no sense. Afibrinogenemia? That means literally no fibrinogin (PT and PTT would be infinitely increased). Hemophelia? Or vitamin K deficiency? Those are coagulation factor disorders so they would present with deep bleeding and large bruising. (Unlike platelet disorders, including VWD, which present with mucosal bleeding, petechiae, and heavy menses). VWD is actually the ONLY one that makes sense. +6
cbreland  I get why it's not afibrinogenemia (which is what I picked), but still don't understand how VWD is right. You have normal PTT and normal platelet aggregation (both of which should be abnormal). Is the only thing leading us to VWD is it being a primary bleeding issue? Again, my answer made no sense, but VWD in this context, seems way out there +3
osteopathnproud  I agree with you @cbreland once I noticed I had to bend lab values for any answer choice then in my head most of them were possible. I took a step back and answer with the most common bleeding disorder, vW disease. Funny thing is when I retook it to check my answers, I had time to overthink and got it wrong. +1
aakb  the anki facts never steer you wrong! my zanki cards say "Low vWF in von Willebrand disease impairs platelet {{c1::adhesion}}" (Gp1B binds to vWF) not platelet aggregation (GpIIbIIIa binds to fibrinogen). additionally it says you can have either a normal or increase PTT. in this case the PT is not increased. It is decreased a little, which I assume is fine esp w an INR of 1.0 +1
lebabs  Shut up +2
justanotherimg  i agree with @drpee , and we also need to keep in mind that hemophilia(x-linked recessive) wont be likely in this patient a 20 yr old woman +1
... benwhite_dotcom made a comment on free120/block2/q#21 (A 54-year-old man comes to the physician for a...)
 +15 
submitted by benwhite_dotcom(607)
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eFar = amlgydaa

atTh si lal I tdwnae ot ays but I usges thta si oto storh to eb eaedtccp by hte rofweb.m

... benwhite_dotcom made a comment on free120/block3/q#7 (A 72-year-old woman comes to the physician because...)
 +15 
submitted by benwhite_dotcom(607)
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heyT vahe sbdeercdi athw ouy saemsu is a aicslsc ecas fo nemi.auonp Bt,u PNA st’ni an rasenw chci.eo htWa the txen best ni?hgt heT esu!ca ldO arlfi peolpe nd(a icol)hclsoa vole ot etg anstiarpoi uanpni.oem RLL si eth tsmo conmmo ist,e cwihh yteh evah ridvopde t(nhak uy,o igb aclrvite o.hs)runcb yeTh eevn egav oyu eth nhti taht eth inettap sah cltifiudfyβ€œ nosgiw,”lawl hichw si odec fro pasraβ€œstie enwh s”aloign.lww

mannan  wrong answers: Smoking and emphysema are obstructive and more importantly air trapping disease processes and wouldn't really cause the dysphagia. The main vasculitis with lung involvement is We-C-ner granulomatosis that would also have nose and kidney problems - from SATTAR +1
... benwhite_dotcom made a comment on free120/block1/q#21 (A 63-year-old man is brought to the emergency...)
 +14 
submitted by benwhite_dotcom(607)
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Dnto’ etl tehm dlbin you itwh itsh itsa’eptn sy.eimr eTh susie of the ayd si hatt eh has a T.DV ’shTat hyw he cema to teh RE in the frtis ecnsetne dan thaw het duntrausol sswoh at teh n.ed astPiten wiht rencac aer auoery.bgelhalpc

focus  LOL best explanation possible. +2
... benwhite_dotcom made a comment on free120/block1/q#33 (A 2-year-old boy is brought to the physician for a...)
 +13 
submitted by benwhite_dotcom(607)
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irelgaF X si a GGC ttlncrueiedio eterpa oxnsiapen oirddesr hwhc(i ekli ’unntoitnsgH si a sett .ie)avofrt ehT alrntame unlce si the inht ot teh ieXdkln- trhac.eienin ui-kAmliets bvhoirsea and levaylitre lgear dhea rea oom;cnm ragel clssteite olny reaapp rtfea e.btpyur

cbreland  Also repeat expansions will get worse with each generation. I went with the learning difficulties and then uncle having issues that were not as severe to a child with issues within the first 2 years of life as being a signal of a triplet expansion +1
osteopathnproud  Fragile X syndrome is the most common inherited cause of intellectual disability FA20 pg 62. I just saw intellectual disability plus heritable = fragile X syndrome. +2
... benwhite_dotcom made a comment on free120/block2/q#26 (A 55-year-old man comes to the physician because of...)
 +12 
submitted by benwhite_dotcom(607)
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A enw grietbnisl esesaid ni an oerld sonerp is lpyicaytl ggnio ot be a sppumeihg stounie.q enTh uyo ujst vahe ot mmrrebee het fderecfeni wtneebe lsbuuol gdempiihop vs psihmuepg sagvuirl. ulBsoul mhogppdiei si ecrcerahidzta by eth sslo of smdhoesimmeoes ahtt nibd trekeaysntcoi ot het emsanebt mermbna,e ltreisngu in laulb bgi( )eiltrsbs in rasae fo conifrti e(Coich .)A sitatnPe hitw eusgpmphi sgrivaul olse ehitr semsdsoeom h(chwi nibd asektroynecti to aceh et,h)ro os atth tiher sikn si uspre ,brialfe hichw erutsls ni .lnuotaiecr tMhuo erclus era mroe cmoonm in VP.

drpee  Also question suggests a negative Nikolsky sign ("The blisters do not easily break"). This suggests BP over PV. +5
jbrito718  Dermal papillae= Celiac disease target +1
... benwhite_dotcom made a comment on free120/block2/q#10 (A 29-year-old woman is prescribed carbamazepine for...)
 +11 
submitted by benwhite_dotcom(607)
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aaienmrzeaCbp si a souoontir 0P5YC4 e,uicdrn os ouy hdsuol be ugisgesn btmmaeolsi on tmaetr htw.a Y504CP lsyap an tatrpiomn oler in tbho minaitv D atnoictiovbai nad ogtrdiaaend ni eht relv.i

mambaforstep  ahhhh i didnt know CYP450 played a role in vit D bioactivation/degradation. thanks! +7
mariame  Just to add: Vitamin D signal transduction system involves a series of cytochrome P450-containing sterol hydroxylases to generate and degrade the active hormone, 1Ξ±,25-dihydroxyvitamin D3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927478/ +1
... waterloo made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +9 
submitted by waterloo(105)
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oYu can ookl at thsi neuiostq aytiesg.tacrll

  1. uotShenr lobt t-&g;- so .NDA
  2. eyth aer sguin an sneueladonec to frenatsr t,isb tihs tenod's larely maen hginyatn to you .tye
  3. DANc is niborpg rfo selnig mlnoboltns-naigtimnocuu or.eign

'sThta aorimtnt,p aecseub now uyo nwko teyh aer gliookn at het sotnnatc onreig of olguoibimmnlun aka Fc fo eth yaehv nihc.a

So wyh si siht DNcA ttha eoncsde cF, ghntglii up nylo noce ni ohret sse,utsi ubt the ames cDAN tsghil pu itlleump etmsi ni nael 2 be(on rwmaro)? hisT si aebues,c at eht bneo wrraom aodmrn bmarcetnnoiio fo ghilt ro yheva hanci sucr,oc adn rou ADNc si rsetnpe ni ndeiftefr rmonda ictmiabnsono twhi lghti hsicna. Ttha sciifcpe cADN eeequcns thye desu nid'dt ncgahe webente eth uitssse ro enev inihwt teh obne marwo,r adn ti lliw lyon dinb ot eht eon gene uqseen.ce ehT actf it's tligighn pu mpluelit itesm eltls ouy that eth same cqeeeuns si e,nrepts ryou sqotinue is wyh os ynam m.esti

lAso a dsei ,tneo orhtusne bolts aer time ucgmnos,in os aslb sue htore dtohesm to do eth eams ihgnt kl(ei R),CP but tusnoreh oltsb era sitll het sbet nweh it csmeo to ciekgcnh mnmuolinoubgil and T llec ceproter eneg tmanagreerrne.

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einoaxAr desal to noochioaodtgrypp sdagoiyohp,mn sa eht doby azreelis ttah hte tslbpisioyi of nshngiuiro a tusef si rzoe and esvig up hte sterepe.n ’eeThrs a olt of poirtpusgn ad,ta btu eno uhsold usegs sith ersnwa ceno oyu rdea the odwr tβ€œngy”ams or( β€œβ€d.arenc)

sexymexican888  or "runner" +1
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hiTs hewol oqntesiu si on eth treniffed pyets of evethti.pyiyisnrs (.pg 131 9F21)A0

snpileiooh adtiugloenarn β†’ peyT 1 vnyitsietpersyhi samt( slcle ,elrya sthserhpoi/niesolo lrea)t

irddpsaewe ptisaoosp fo B ymetphyocls β†’ B typchysomle aer doevnlvi in ypTe 2 yteievtirihysspn. pdWdieraes apopstois dluow ont uoc.cr If a,ntnyhig B llcse dlwuo epaol?rireft

yieCtonk nsrcoeeit by ntarlau relkli lcels β†’ NK lslec ues orrfeipn nad rsaymzegn ot unceid opstapsoi in ytep 2 yenisityret.hvisp otN( reus if tehy trecese any aeerlvnt .tieoy.)nsck.

unmeim poexmlc poiesdtion in utissse β†’ suemr snsskcei pT(ye 3 tsnyei)viyrhpetsi

ncllyalopo c-phoTyylmte avcnottiai β†’ epty 4 ttsvpyrineeiyish

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heWn leepop go mi,acnpg uoy osudlh eb inkhgitn of otozcnio oininesf.ct nFu a,cft ewN ioecMx eslda the tonurcy ni essca fo gu.peal esY, taht p:aelgu inYaires estspi. hTe cuβ€β€œbboin prta of icobnbu gplaeu erfsre ot eth wnlleso endicfte dneso sb)(eob”uβ€œ ctaicacrtsehir fo eht si,eesad cwhhi ofnte ivoevln eth iognr b(buo is teh rGkee ordw for ng,iro woh kw?n)e. nI ihst esca, hy’erte soal sbcdingier a roniccte iteoelrrhpac enod. ilsasCc ntaetrmet is ihwt seocildisgnamyo, icwhh nibd ot eht 30s soiaolrbm nut.ibus eot(N atth ,Tuimaaler cdsaue yb toehrna imgenrgvae-at raaitbec clnaeFirlas elssrianut can netepsr lsmyliria ubt si oemr noommc ni eth i.emtwsd ess,Rerdlga teh wot rea foent mupdel ttgeorh,e eht boatiiminaclr emreattnt is iamrli,s adn eht ernswa in siht csea dlwou be eth .aes)m

ee(rF 01,2 0219 Uaetpd)

jbrito718  my dumbass didnt even think of the plague. This silly rabit actually thought francisella from the presentation and it was from there I came to the same answer. Thank god the mechanism for this answer was the same +1
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oT toehs wedgnorni wtah vollaaer rotioesipsn ,si it si a earr nlug isoerrdd cacdtrzhaerie by aboarmnl iuuccaoantml fo fc-nadvraistdeeurt otiseopiprnl hntwii eth alve.oli msSoetiem ti anc urcco erydcsaon to gunl nfetniio,sc htaoluhg luyauls it si na ouinmeutam o.rscesp

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ralO isecelv hi(nt it.hn) ienBirglst ialvcresu sieoln no het ndha. oN revef, ont pircti-ganx.paeo Tshi is eerpsH y(uo may erbmemre teinstsd ettggni epehtric twliwoh in yrou seuist,d iwchh si awht htis .i)s otsM osfkl get V1HS as nil,drceh hgtuho iyvblosuo nto all rae cisamyt.omtp HVS is a argel a,budnsleetd-rod rinlea ADN s.viur

jiya   why cant this be hand foot and mouth disease cause of coxsache +13
drachenx  Also thought it was Hand-foot-mouth an RNA virus but I did consider Herpes. Changed because I thought Hand foot and mouth would be more common. +1
llamastep1  Hand foot mouth usualy involves all 3 places (hands, feet and mouth/perioral area) and the lesions on the hand arent localized to just one finger. +5
aneurysmclip  Hand foot mouth disease affects palms and soles. ref: FA 2019 - 150 +5
raffff  wouldnt the history also be different for coxsakie +1
focus  I think this image is trying to show the "dew drops on a rose petal" sign on Hermes, the god of Herpes on Sketchy Micro +2
drpee  Google some images of HF&M disease. The small blisters look very different from herpetic whitlow. +2
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oimsodsygiAnecl ihchW( tnisihbi 0)S3 ear oucdlep ihtw llec wlal tvecai sagnte - e..g iii,Pnlncsle cyiVamocnn

hycetk(S Refrcenee on ylgdimcenosioA tk:eSch -eatBaacltm !m)bob!

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oppraxAtmie faignst spyhilgooy igmt:ni eth seobsttoirappv- aepsh 2-4(6 urhos rtfae a mlae) si meadotdni yb lnessggcyiy.olo ssoceuioegennGl romf 42 osuhr ot 2 a.ysd Thne .siseokt

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vno ldrabWnlei saeidse si by arf eth mtso momcon eteirhidn lgbdniee istdhs.iea lneeFtyrqu, hte ylon oablarytro molintbraay is cidseerna ldeenbgi time lr(iytaell you rickp eth niaeptt adn see hwo lngo it tesak mhte ot sopt de.bneg)il On e,tSp inbldege owmen eahv DWV. gneleidB yobs aehv ei.hmhioalp

winelover777  Agree. PTT does not have to be elevated to be VWD. +6
tulsigabbard  Welp. +1
tekkenman101  Except there's no laboratory verified bleeding time given, only aggregation which has to do with platelet-platelet interaction. +1
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eH has psrulbmya(e SV)R tcbooirh.ilsni VSR si an NAR vruis ahtt ntrsee het cell iav a fsoinu eprtino hhc(wi is teh etatgr of the rppotciyahcl lmoolnncoa ntdoiaby rugd zamPlai)iu.vb

aakb  I thought the fusion protein produces multinucleated giant cells. I thought RSV enters using the epithelial G protein? First aid literally says "All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells." +1
mariame  RSV F is a class I fusion protein that mediates fusion of the viral membrane with a host-cell membrane, a process that poses an otherwise insurmountable energetic barrier to viral entry. https://www.nature.com/articles/s41467-019-09807-5#:~:text=RSV%20F%20is%20a%20class,energetic%20barrier%20to%20viral%20entry. +1
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stJu to dda ot anix.oaeplnt nsrAew si ton loacegnnit dnelraa lsiperahapy, euebcsa pt sha mnlora astreb omedletepnv adn noarlm lnearxte teglaii.na stom nomocm ytpe do-lrxehs2ya1y fed odwul vaeh croupoesci perytub ro cratloli realng.emtne uosiQestn asys tetinap sah omnlar pgaenraip atnerexl niaale.tgi hda-oer1yx7alys fed dolwu eadl to usumaibog litniagae in YX dan in XX erteh lowdu be on aynoedsrc eulaxs dvenepltemo secueba ckal fo esx otseir.sd utB aig,an onteisqu ayss tp hsa nomalr bretas tleopvnmede and nleaxert ant.iaglie nI ealy1sdxrBy1oh- ,fde XX dluow vhea tiinarli,izvo ngaai ton picplelaab re.he

ceoartmdel apdlyassi wluod aveh orem rtsarcichatscei leki romabaln ,httee ohtre alabnrom sdinfngi ormf lcmateoerd l.aery

a hspyc ddiorser olcud owrth oyu ff,o eabym atptnie is ont eiangt gnoheu and is tno gavhni a ridpo.e tBu yeht disa aronlm feelam bydo ,uhibast os I ihtnk hatt eesms essl ilelky aedromcp to rneagond ints.tiseviniy

Sex eohmsomocr saisoimmc daem me htkni fo erTunr .dorSenym hrTee is a qieunu doby bitaush rfo rTnuer yoSemdnr so eamks shti a owrng rn.sewa

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No erailnot wbentee eth tuarim (P) wvsae dna the RSQ oecmxlp sanme d-hrdriegtee VA lcokb aak( poemtβ€œec”l trahe .)kbocl imSomacttpy eve(n a)atfl abciyardadr can us.relt onnCn”aβ€œ artlia svwae rae imtneonrp uguralj vusnoe npuosltasi that ccoru nehw teh iarta dna tivreelcn totcrnca slntaioleuusym ich,(hw of ,crseuo dn’teos lnyrolma hpan.)pe

jbrito718  also if you just pay attention to his pulse, it tells you that contractions are strictly ventricular, so no transmission is coming from the atria at all --> complete heart block +1
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CSN esmaiabois is ostm rtyolnosuio aescud yb aaiglreeN ,ifwelor ihchw I uoeregcan uyo ot meimreoz sa hte enniaigt-β€œbra m”oaaeb. Fodun in sfrwa-htree bieosd fo ewrta ikle opnds adn ,aksel it sha rthee fsmor: a yt,cs a eiohztpootr ,d)oa(imeb nda a liteebgaafll (.i.e sah tow .lale)lgaf ietnfncIo is via oofrlctay ecll oxsan rghohtu the oiirmrcbrf altep to teh bra.ni

mullerplouis  To add to this it causes Meningoencephalitis. Look out for confusion and brain signs mixed with signs of meningitis. Only a handful of organisms that cause both. +7
osler_weber_rendu  Am I the only one who thought portal of entry cant be through a nerve and just ignored all the nerves? +40
luciana  @osler_weber_rendu I thought the same... I knew it was through cribriform plate, but not that was actually through the nerve +12
paperbackwriter  @osler_weber_rendu yeah same here, otherwise would have been a much simpler question +2
melchior  In line with the thinking above, SketchyMicro teaches it as if it just passes through the cribriform plate, ignoring the nerves. Wikipedia says that it actually enters the nerves, then passes through the plate. +8
j44n  this is such an AWFUL disease, I worked in a hospital in south carolina where it happens A LOT and there's nothing at all you can do for them. When your cells go to phagocytose it it has an outer layer it sheds off like how a lizzard will sacrifice its tail when attacked by a predator. +3
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teSokr etdrriahzaecc by telf irpesihaesm dna htrig C1N2 sypl.a sersodC nigdsnif name a mtsaeibrn iolsne. igRht rsalpel)ait(i uoe,ngt ei-dtsdfel ertoarnllt(caa) aswsenke names eth xngiiet higrt hylsolapsgo rvene has enbe fcedtfea n(itihw eht trgih .dale)lmu C is het yiapmrd erewh the coplrtoinasic crtta unrs to rctnolo slumces pri(ro to het tecia)odsusn. siTh is nwkno sa eth meadil ayeudlrml yrdonems or Dneireje o.mrydnse

d_holles  It seems to me that the brain stem problems can all be answered using the Rule of 4s rather than memorizing the actual brain stem histology. +15
llamastep1  Yeah I think so too! With the right CN12 palsy you already know it has to be medial (factor of 12) and that would be enough to answer this question. The hemiparesis just confirms that its a medial lesion (starts with M). I know many of us like to really understand the concepts not just use these "tricks" but hey if it works it works. +5
tekkenman101  Except how do you rule out E? The hypoglossal nerve is damaged too and E is medial... +1
bgreen27  The way I ruled out E was by the hemiparesis, which pointed me towards the pyramids. +1
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teh xpioahy dna the lo"dbo apslme sraaepp bwn"or hldosu tpoin oyu tadrwso gmelemhn.otibioema

if uyo tawn a nfu oived omrf 19"-1"- htta taclyalu axlpines a lto fo :ti tvhLu=Qymm/FtsAlRawt0.wpecc?zwouobRhw-:/.t/

xmen  very nice videos +++ +1
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gLeyid cslel meak t.oroeseetnst Lgiyde clle motrsu e’atnr awlsay cgiaoshoyllip e,civta utb ehtos atht rae nac euasc n.aniilasomizutc rausaolnG lcle st,moru on teh htoer nhad, isotemsme cdeprou eoegrstn hhci(w acn dale ot opcsoeciur ubyeprt ni ynugo glisr tbu swhereoit aym be lccuo).t toasTemra rea ldlbadso ahtt tpyilclya ahev ,fta ,rhia ,ehtte .tce oehmTcas illw not eb no rouy t.est ianavOr onidcaric si ihgyhl ynilukel ot show pu on uoyr ts,et ubt if it ddi, it dwlou lyliek ertnpse iwth a salcisc cicradino y.ordmsne

sugaplum  FA 2019 page 632 +2
divakhan  because................"Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" NBME 24 -#13 Qs explanations/comments on this website, has led me to choose this answer! :D +19
zevvyt  divakhan, thANK you i was hoping praying that someone would have written that +1
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heT warro si tgiponni to a ruhtnlopie luil(bomedt )unue:slc niam etgrhfi of hte eunimm essytm in tceua nmtmioafalin adn ciltraaeb nenifotci uhsc( sa nrtoisipaa mu.ei)nanpo aC5 is a ccocihttema ocfart ofr NPs.M

ibestalkinyo  Other chemotactic factors include IL-8 and LTB4 +6
j123  Note: C5a is a chemotactic factor for many immune cells in addition to neutrophils. Also, C3a is a chemotactic factor for just eosinophils and basophils (not neutrophils) +2
cheesetouch  Q. What's so sexy about C5a? A. It's like Chanel No. 5 for neutrophils: they smell it and come running. +7
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lwlnoSawgi aicontmi fuidl is a tircailc tnoepcmon fo lgnu nlvdpee.tome estuesF ihwt sereev oodlorismnagiyh rae pglueda yb uranypoml iohap,slpay iwhch si teh sauec of dehat in eeftssu brno twih tPoter dnmyeosr reln(a egesa.)ins

mambaforstep  this is the second explanation that makes sense to me that I see downvoted. if you see something wrong and downvote, please explain! I want to know what im missing +4
abhishek021196  Maybe someone downvoted because in this question, there wasnt a mention of renal agenesis but rather urethral obstruction although that would lead to Potter sequence as well. +1
sexymexican888  Whether it was oligohydramnios or poly wouldn't they both cause pulmonary hypoplasia cause in the first you aint got no pee to swallow and in the second you cant swallow the pee? Only diff would be in oligo you get potters sequence bc compression +1
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ednArogn enittnsiiyisv is audecs by a dcviteefe edagnrno potcre.re DTH is lssnopbeeri ofr rtciegna lame igatnilea rguind atlef xuslea edmet.vopenl ehT tdfleua nauhm ernedg si elmae.f oS a eltngylicae leam ttpaien thiw telceopm endongra snetvnitysiii is tenyleraxl yecnlloyphtipa mefa.el caLk of nseorsep to dlearan eanorsndg ervpetns rhia tioamrfno igrudn yuertbp a).rahenedc(r

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The vfeapilteoirr hsaep of the mlatenrsu ccyel si oolcltdrne by lenidcyn-ceptedn skensai. T(sih asemk snsee sa pccenil-dndeetyn saskien vgenor ulitaryvl all lleulcar dvinsoii ni ioukretyac .)llcse

thelongshoreman24  Answer A shouldn't be confused with cAMP-dependent kinases https://www.wikiwand.com/en/Protein_kinase_A +3
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uJst baceuse she’ viagnh e)ttnrdep(uco exs sond’et aemn eh etsn’do hvae leimps siicenuoft lonceusomons.i heT exs lieipsm ’seh losa issngik meo!enos naPgshyitri + pyhlm nosed + gieautf = o.omn

titanesxvi  The triad of classic symptoms for infectious mononucleosis is lymphadenopathy (swollen glands), splenomegaly (large spleen), and exudative pharyngitis accompanied by high fever, malaise, and often hepatosplenomegaly (large liver and spleen) +3
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’mI ngiog ot otpni out atht a nrmaol tyahehl ikd twih on acacdir ihroyst or ptmsmsoy nda no mailyf iyorsht of usnedd crdiaac eathd orf a poer-psstr ysaiplhc si babrpylo gongi to aevh a einbng xeam on ramett hwat uyo iknth ouy a.ehr

the260guy  What a weird question. I could definitely hear a fixed split heart sound. And it was loudest over the pulmonic valve too which makes it even more of a dirty question. But I guess what I was actually hearing was an S3 heart sound. +15
wutuwantbruv  @the260guy I believe the splitting is being heard only during inspiration, making this normal physiologic splitting. Perhaps that's just my ears. +14
angelaq11  don't have adobe and couldn't download it, so I just chose whatever, but your explanation suddenly makes me feel dumb but grateful! Loving your tips! @benwhite_dotcom +1
blah  @the260guy Have to agree with wutuwantbruv. I interpreted this as a physiological splitting, had the opportunity to hear it in a newborn as well. +4
prolific_pygophilic  Definitely S3. FA 2020 pg 287 "but can be normal in children, young adults, athletes, and pregnancy" +1
dhkahat  I swear to god it wasnt just during inspiration but what the hell do i know +
jbrito718  I thought I heard a "LOUD S2" but thats what happens when you read FA 30,000 times. +
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D0C8 si osal konnw as 7.B isetuQno si knsgia if you wnok taht 8C2D sTel-l(c) rnteitsca hwti B7 CAP() sa a loytimoscaru-t glinas to taivaetc het -el.clT

ksoLo keli teh ciptuer is ndmgasrtitone cnocatt eirsadittm (ued to reh rnecet eus of wen rhai )edy cwihh si a eypt IV HSR

I luasyul bmeeremr ttah B7- si no eht Bclel- (na A)PC

melchior  Reminder: CTLA-4 on T-cells also binds to B-7, and the effect is opposite that of CD28 (inhibits T cell activation) FA 2020 pg 222 +1
mmizell  CD40L on T lymphocytes-> to CD40 on Langerhans cells is true association but doesn't answer the question because its co-stimulation induces B cell proliferation, not T cell proliferation. +2
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oFmr aatPomh .Ch 2 gp. 41: MOP eyedcicfni slstrue ni cvtdefiee csevnoroni fo 22OH ot CHOl. rdnIaeesc kirs for anCddai nnsifx (gthuhaol mots ptseanit )astapm.oyticm ilubretoN ailumttzore etst si oalrnm scbaeeu het rytiasrrpeo sbutr is alclayut lstil .tcinta ihTs titanpe sah naidacd ncitefnoi dna eydlade, btu stlil anc llki thspa ,a cwhhi iyemslgne oegs anolg wthi eth actf thta eth rersotiyarp tbsru is llist cntati, tub oituhwt POM it yam be henidedr a t.itlle

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iTsh rmow si rcsAsai. mrFo an fostniuiec sidseea rc:oodt

"eTh cuel si eht eizs- fi uoy nac ees ti omve nad ti olkos ekil an ehrat w,mor s’it saircsas! In rdit, iskd etg ti mfor kliginc rehit yitdr s!regnif eTh dltua okslo ilke na hrortmewa and ti aeuscs hte yomptsms beiredsdc htwi teh sotrw scsea ucsniag bloew costtirb.no"u

... hungrybox 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 hungrybox(1146)
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hrOte ssane:rw

esuoesbca dgaln β†’ ,ecna bCuetmciirtau ecnas mfly(rreo mPcpbarioitiureon n)sace

aeciponr danlg (kaa aswet d)glna β†’ eTh tubnsacse seredcte is irectkh athn einrcce swtae adn iorpveds nntrsiuet ofr rbtaceai no het :inks teh ascitbre'a otopiomdcnise fo tewsa is thaw teecsra het icrda dr.oo

reinecc dagnl β†’ dsue to eetescr fsfut idsnei the ybdo ei( avisyarl langsd, cacpienrta ndal)sg

edimsr β†’ emildd arlye of i.snk

melchior  To tweak the above a little, eccrine glands are more commonly known as "sweat glands," although sweat glands that are apocrine do exist in the armpits and perineal area, though they do not contribute to cooling. +4
acidfastboi  Per what @melchior said: "Eccrine glands are the major sweat glands of the human body, found in virtually all skin, with the highest density in palm and soles, then on the head, but much less on the trunk and the extremities" - Wiki +2
... sugaplum made a comment on free120/block1/q#9 (During an experiment, a Southern blot analysis is...)
 +6 
submitted by sugaplum(423)
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isTh nuieoqts is askngi obatu DJV rnaetenramreg ihhwc shpaepn ni teh ebno rw.moar The enges ear lla cdephop pu csueeba the B llce is rgnyit ot tegrneae a quneui mootciibann rfo its erotcrpe
l epmis ..os.epncct odd niowgdr

terCahp 3 of "owh het eumnim essmty rw"kso - omseawe bkoo

varunmehru  in the question stem, they are asking about a constant region. VDJ rearrangement is for the variable. It doesn't make sense :( +4
sallz  Both the constant (heavy chains) and the light chains undergo gene rearrangement. The heavy chain undergoes V(D)J random recombinations, while the light chain undergo VJ random recombinations. So gene rearrangement could work for both regions. +12
azibird  The constant region does not undergo recombination. That's why it's called constant. It's just right next to the variable region though, so they get expressed together as one protein. That's why the constant-labeled DNA region is variable length here. +4
chaosawaits  You're right that the constant region is not undergoing recombination. The multiple bands are not do to constant region rearrangement; it's due to the variable chain rearranging and then the cDNA probe that is specific to the constant region attaches to each of these rearrangements, since it hasn't changed +
... mkenerly made a comment on free120/block1/q#12 (A 17-year-old boy is brought to the emergency...)
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submitted by mkenerly(9)
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eIv' been ghatut atth nay dveorose eevgttni iwht a tepinat tiaulasnsg hte crtodo si a deda ergirn rfo PPC deu to irthe sogrg.isane

... 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(607)
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nheElatldoi titgh ’osjinnuct ptyimraeebil is scdraeine ni serospne to rjunyi dan ,mointianflam wialnlog romaigint of ithwe obold cesll dna sneridf ot hte eits of uny.rji

jesusisking  Thank you! +1
focus  Ugh I was thrown off by "disruption of vascular basement membranes" since it seemed similar to the correct answer but I can see how "separation" would be a normal, expected response of the body that is needed vs. "disruption" would be traumatic and abnormal... please correct me if I am wrong! +2
blah  @focus reasoning sounds right. I nearly picked that but the other choice sounded better. Just semantics. +4
aakb  um just to clarify I don't think the differentiating factor is the wording of separation vs disruption. but rather that the correct answer is separation of ENDOTHELIAL junctions meaning that the spaces between the endothelial cells get wider. vs the answer youre thinking of says the disruption of the vascular BASEMENT MEMBRANE (which is under the endothelial cells) gets disrupted. so meaning something literally broken through the blood vessel and made a cut in the layer beneath the endothelial cells that line the blood vessel Dr. Sattar from pathoma usually draws a basement membrane and a layer of endothelial cells sitting on top +4
... benwhite_dotcom 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 benwhite_dotcom(607)
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ncmEeid kirBtut aplhoymm cna pehapn ni rziaBl as elwl as Aarfic (ajw n,seiol pyffu afce.) hTe coritpropoaghhm si tneamoistnrgd iibtgnel bydo phacagmerso, a ypte fo capogmhaer gniantocni mnay azhgpcide,oyt iapoottpc clsle ni uvoasri stesta of nagridaoet.d

weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. (https://www.ncbi.nlm.nih.gov/pubmed/8247541) +2
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +5
jbrito718  composed of intermediate-sized lymphoid cells with a β€œstarry sky” appearance due to numerous reactive tingible-body macrophages (phagocytosis of apoptotic tumor cells). There is a characteristic t(8;14) translocation juxtaposing MYC to the immunoglobulin heavy chain locus in most cases. +1
... benwhite_dotcom made a comment on free120/block2/q#28 (A 55-year-old man who is a business executive is...)
 +6 
submitted by benwhite_dotcom(607)
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itigSlnpt si na urmimaet efdnees cismeanmh foent yeopdeml by tntaseip twhi erbodrneil nasloyiretp dserdo.ri hWne tils,pgint a eposnr fsail ot ese hrsote sa eclapab fo gnviah ohtb vieotsip and eneagivt usiliaqte; ta any niveg m,iet ’sti lal or gh.onnit

d_holles  Got this one wrong -- thought it was acting out. +2
cheesetouch  FA 2018 p539 the 'nurses are cold, doctors are friendly' example is what first aid uses too haha +1
... benwhite_dotcom made a comment on free120/block2/q#40 (A 62-year-old man comes to the physician for a...)
 +6 
submitted by benwhite_dotcom(607)
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ehT tinastpe’ rinhocc mlaorytfainm ntipoeimuns is liilkng off ihs unlg ranyhamcpe (demcopso lrmpyiair fo eytp I c)yeepsnmut.o pTye II opsme,nyucte in tdnaidoi to naimkg tua,ncasftr cna alcertipe in odrer ot leeparc yetp I yoctps,enmeu so heyt llwi eb iadcr.nsee rcohCni iaietslrntti ofltinmainma esltsur in osrfib,is ehcne na necriase in t.basrsifblo

len49  UW ID 666 has a great explanation. +4
melchior  From the UW ID 666 explanation, although type II pneumocytes normally differentiate into type I pneumocytes after proliferation, they do not differentiate in idiopathic pulmonary fibrosis due to altered cell signals and altered basement membrane, which is why type II pneumocytes are increased. +7
... em_goldman made a comment on free120/block3/q#15 (A 46-year-old woman with active ankylosing...)
 +6 
submitted by em_goldman(29)
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imaiRbtux ant(-CDi 02) si trrynleuc irdeunoggn lasitr for AS. My spaesr ignlgogo stju nwo shwso hatt iutabrmix lrbypboa olny sah a eoedtmar fet,cfe so oyabbrlp -eonslciden ot F-NiatnTa .arheypt yblbPaor.

faSe ot yas for sodbra ttha A:S NaFT t&g; DC20

cheesetouch  FA 2018 - rituximab p 430 -- - use for Nonhodgkins lymphoma, CLL, ITP, Rheumatoid arthritis TNF-a inhibitors - p 472: 1) etanercept for Ra, psoriasis, ankylosing spondylitis. 2) infliximab and other mAB for IBD, RA, AS, psoriasis +3
... thisquestionsucks made a comment on free120/block2/q#31 (A 23-year-old woman is brought to the medical tent 2...)
 +6 
submitted by thisquestionsucks(8)
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This neiuoqts is ankdi ac.hwk Rigth ,ayaw I lcduo eltl this was ecsdeeirie-dnuxc llespaco, iwhhc ehpsnpa eprtyt ontfe to n.unrres I kpecdi aiootmncu tsonicundfy sbueeca I i'tddn aleeirz tath tish is ieoscndred na ht"atsocitro pn"isyh.teono Artef a glon ,earc nrusner evah a edsereadc VRS mfro lla of eht obodl owfl ngogi to ssemul.c Oecn hyte osp,t oblod lsoo,p estn'do egt ackb ot the ol eoldon nad hyet c.plseloa tuB fsf I lslit itnd'd kipc tissahsroto beseauc I kinth fo odl pleoep. ukFc me

step7777  Not to mention orthostatics in the hospital imply a sudden change based on positioning. This patient didn't go from lying down to standing suddenly (just bitter bc I also chose autonomic dysfunction. +2
jbrito718  Hypokalemia would present with muscle weakness. Autonomic dysfxn is a decreased baroreceptor sensitivity so we would not see appropriate correction with elevated feet (over correction/hypertension would be seen). Isotonic saline would not correct hyponatremia, it would probably make it worse (dilution effect). MI would have different symptoms. +
... mes1717 made a comment on free120/block1/q#14 (A 52-year-old man comes to the emergency department...)
 +6 
submitted by mes1717(8)
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asddpWege-he poyhenstydi -&t;-g anler .inrcfat ydnKeis cveerie a gaelr mtoanu fo d'sybo cadairc tupot,u so teyh era a monmco stei of ifionarctn ude ot ileomb rmof rAtila .tiiarllbnifo

... benwhite_dotcom made a comment on free120/block1/q#3 (A 24-year-old man comes to the office because of a...)
 +5 
submitted by benwhite_dotcom(607)
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Hot btu tluliiosc,fli si’t a g.ihtn lalaisylCcs deamns.uoosp

medguru2295  I hate myself for overthinking this one. The first thought in my head was "hot tub folliculitis" but my dumbass didn't pick follicle. +15
hungrybox  @medguru2295 same bro same +1
yousif7000  wow, I thought this was scabies! +1
chaosawaits  @medguru2295 same bro. knew it was Pseudomonas, panicked after that and chose eccrine glands +
... benwhite_dotcom made a comment on free120/block1/q#8 (A 37-year-old woman with right lower extremity edema...)
 +5 
submitted by benwhite_dotcom(607)
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hTe etefl-ddsi smyset si mhcu rgeihh rpseeurs anht teh igrth ,idse ceehn hte iarcto vevla gisnocl si lyusaul uldoer tanh hte uoiclmnp vae.vl A 2P reodul hant 2A snaem ahtt eth ylaurnomp iralrtae rssrueep si gisninycaltfi devet.lae

topgunber  other answers choices such as peripheral edema and elevated JVP are nonspecific to right heart failure. Loud s3 (ken-tuck- EYYY) are more indicative of volume overload and pulmonary crackles/edema is usually due to a left sided heart defecT with backup of fluid into the lungs. +1
... benwhite_dotcom made a comment on free120/block1/q#10 (During a clinical study examining the effects of...)
 +5 
submitted by benwhite_dotcom(607)
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tlaTo rrpeilehpa stiansceer oegs nowd irdugn rseicexe sa hte soeaietlrr ugilynspp cueslm nad knsi eiltd.a

... benwhite_dotcom made a comment on free120/block1/q#11 (A 26-year-old man is brought to the emergency...)
 +5 
submitted by benwhite_dotcom(607)
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ehT orsobercearpt rae tsehrtc erpteorsc t(he remo lufdi in het eevssl, teh oemr tyhe i.e)fr oS a npeatti htwi cmihearhorg ksoch liwl ees a seradeec in het creaotboerpr ifnirg ar.et viiaAotctn of RSAA wlil rtslue in asrceined ulvcrsaa reenitacss (ntcoa)ootsnicirsv in odrre ot intnaima boldo peruse.sr dAn erl,iplasaic usch as ehtso in the ekyid,n wlil be edrpim ofr pooritnres nda ont fnarittlio on( eon stwan to pee uto godo itdlue iuren ewnh eh’tery ddrhdeey)t.a w,eeksLii eistysmc sraaielcipl iwll prefer to dhlo onto smalpa nda nto let it kale onti eth remitiitsunt pidga-is(c.rnt)h

tallerthanmymom  Another thing contributing to the increased SVR is increased SNS tone and decreased PNS tone. When BP is low --> Afferent BR firing decreased ---> Efferent SNS firing increases, and PNS decreases --> the inc in SNS tone stimulates a1 receptors ---> Inc SVR BUT, I don't understand what is causing the increase in the PVR because I always thought that inc SNS tone should be causing vasodilation in the lungs and that is why PCWP is decreased. +8
... benwhite_dotcom made a comment on free120/block2/q#19 (A 73-year-old woman comes to the physician because...)
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uSeatbuc cendobmi ginretaeodne rsivpoese(rg hpripearle oynsres adn mtoor so)ls si a late gins of B21 efeiccnd,iy hhicw is nmcomo in old .opleep On eax,sm a riigraetc ttaepin who ilevs loaen nda yam avhe a taeβ€œ nda astt”o tdei si lkeyil to aveh mvianit dfisiiecnc,ee ytaurallcipr of lfeoat nad B1.2

... ivypoison made a comment on free120/block2/q#24 (A 33-year-old man undergoes a radical thyroidectomy...)
 +5 
submitted by ivypoison(6)
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yWh hghi PHT 00/2pgml alonm(r ;)t&0l6t ?i ldhuos eb iyamrrp ria!mdyoiyrsoaphhpt

amm13e  i think with no proper Blood supply, the PTH cant sample the Ca2+ levels in the blood, making the gland secrete more PTH +6
castlblack  secrete pth into where? the lost blood supply it doesn't have? Also, there are no parathyroid glands because the dude had a thyroidectomy! +2
alimd  @castlblack maybe they left it hanging of the fucking veins))) +2


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