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This baby has abetalipoproteinemia. ("without Beta apolipoproteins"). Thus they will lack B-48 and B-100 and have absent levels of chylomicrons, VLDL, and LDL. Infants present with severe fat malabsorption and deficiencies of all fat soluble vitamins (ADEK). Lack of vitamin A renders them vulnerable to Retinitis pigmentosa and lack of VitE leads to spinocerebellar degeneration.
Muscle: Adductor magnus
Origin: Pubis, tuberosity of ischium
Action: Adducts the thigh at the hip
Remember, HOT T Bone Steak. IL-1 causes severe inflammation and is directly involved in the creation of the lytic lesion.
Positive staining for synaptophysin and chromogranin are immediate buzzwords for neuroendocrine tumors. Paragangliomas are the only type listed here.
Others would be small cell carcinoma of lung, carcinoid tumor, gastrinomas/insulinomas/etc, pheos, medullary carcinoma of thyroid.
Halides are the elements in the 2nd the last column of the periodic table (F, Cl, Br, I, etc). Defective MPO prevents conversion of H2O2 into HOCl (a hydroxy-halide) which is aka bleach and the most powerful antimicrobial our phagocytes can synthesize
Branchial cleft cysts typically occur due to failure of the 2nd branchial cleft to obliterate resulting in a persistent cervical sinus. Branchial cleft cysts will not move with swallowing and classically occur anterior to the sternocleidomastoid muscle
This one was a doozy. I think by saying "nerve studies show slow conduction velocity," they are referencing saltatory conduction impairment. Therefore they are asking us which channels are necessary for saltatory conduction - which would be voltage-gated Na+ channels.
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Klebsiella has a capsule and is spread through person-to-person contact (e.g. from patient to patient via the contaminated hands of healthcare personnel). "The bacteria are not spread through the air"
Seminal vesicles contribute fructose to the ejaculate. Decreased fructose concentration may indicate an ejaculatory duct obstruction.
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Diffuse alveolar damage = ARDS -> alveolar hyaline membranes
i was so confused by this question. is this because the rest are human antigens, so why would we have antibodies against them? but HPV is antibody toward E6 is foreign...?
So I think where I got tripped up is that she does, indeed, have multiple myeloma (so there will be increased serum IgG), but the thing that is actually causing her bones to show the osteoclastic lesions shown in the image is IL-1 (osteoclast activating factor). Weird wording. Thanks NBME.
I thought lytic bone lesion-->multiple myeloma-->hypercalcemia
but I suppose that calcium isn't involved in the process of creating the lytic lesion, that would be IL-1 and TNF
Why is this VSD? Is it just because she is 3 years old? I was stuck between MVP, VSD.
carbon monoxide inhibits the final step of ETC, cytochrome oxidase
Patient is obese with a BMI of 30 and a major risk factor for T2DM is obesity and high-calorie diet.
https://www.slideshare.net/csbrprasad/imn-csbrp-54556104 i found this link helpful. the atypical cd8+ lymphocytes are diagnostic for EBV
Diagnosis: strawberry hemangioma
Heme = blood -ang- = vessel -oma = benign mass
A benign tumor of capillaries, therefore the origin is endothelium
FYI since I didn't know the difference
Midline mass that moves with swallowing = thyroglossal duct cyst
Chronic EtOH induces CytP450. Acetaminophen metabolism yields NAPQI, which is highly hepatotoxic.
CytP450 inducers: CRAP GPS
Carbamazepine Rifampin Alcohol (chronic) Phenytoin
Griseofulvin Phenobarbitol St. John's wart
Colonic bacteria convert lactulose into lactic acid and acetic acid, which acidifies colonic contents. This leads to the conversion of ammonia (NH3), which is a weak base, into its nonabsorbable protonated form, ammonium (NH4+). Once protonated, the positive charge prevents ammonium from crossing cell membranes, keeping the molecule in the colon. As the levels of ammonia in circulation gradually declines, the symptoms of hepatic encephalopathy improve
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