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submitted by karljeon(118),
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I 'otdn wkon fi htree is na qneutoia ofr ht,is tbu I lslcyibaa dppmue otu revye iinsviod srcosa eth baelt to teg 5%~ no gv.areea

ereH thye 0ae40:r / 6,000 = . 0602705 / 5,060 = .004305 0 / 535,0 = 50 .60300 / ,0055 = 0520905. / 48,00 = .2050

eTh avreeag of hseet s% ofr all the yares = .5 5.So%8 that's scole ueghon ot 5%.

seagull  good work. I found this question annoying and gave up doing those considering the amount of time we are given. +4
vshummy  Well just don’t include the intake year... because that messed me up.. +15
_yeetmasterflex  How would we have known not to include the intake year? From average **annual** incidence? +
lamhtu  Do not include intake year because the question stem is asking average annual incidence. The 4000 positives at intake could have acquired HIV whenever, not just in the last year. +8
neels11  literally didn't think there was an actual way to figure this out. but my thought process was: okay incidence means NEW cases. so the annual average at the end of 5 years would be: (# of NEW people that tested positive at the end of year 5) / (# of people at that were at risk at the beginning of year 5) <--- aka at the end of year 4 250/5050 = 4.95% also if you look at year 5: you'll see that the at risk population is 4800 when 300 new cases were found the year before. 5050 at the end of year 4 MINUS the 300 new cases at the end of year 4 should give you 4750 as the new population at risk. but notice that end of year 5 we have 4800. idk if that means 50 people were false positives before or 50 people were added but in incidence births/death/etc don't matter it's kind of like UWORLD ID 1270. assuming average annual incidence is the same as cumulative incidence this was just a bunch of word vomit. sorry if it was unbearable to follow +

submitted by brethren_md(90),
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euiqsRre ignkwon how to cclealtau na onain pga - lkoo it .up nI hist e,asc ti is a nmrlao onain gpa mbotaciel oiis.dasc Know eht meuonimnsc DPLEIUSM adn SHS.DARA aelRn lTuuarb ssciodia si het lyon aesnrw ocihec that is an exalmpe of a arnmol niano laoebmtci sais.idoc

mousie  Anion Gap: Na - (Cl + HCO3) = normally around 10-12 +3
seagull  good to know. I keep looking up the urine values but all it said was "varies", then I threw my computer and yelled "does that vary Mother F****ers. I do feel better now. +69
_yeetmasterflex  glad I wasn't the only one who got very pissed off at the urine values +4
fulminant_life  Usually the first thing I look at is whether or not the Cl- is high. Generally if the Cl- is high its going to be a normal gap +7
henoch schonlein  i think they gave you the urine values bc you can calculate the URINE anion gap which is (Na + K - Cl). In this case the Urine Anion Gap is positive (5). Boards and Beyond mentions that a positive UAG is due to Renal Tubular Acidosis Type 1 (inability of alpha intercalated cells to secrete hydrogen ions). just another approach to answer this q +19
270onstep1  Actually diarrhea is the "D" in "HARDASS"(reason why I was stuck between Chron's and RTA). Ended up getting it right with RTA.. +1
talha_s  So the reason this is not Crohn's disease is actually what BnB explains in Renal Tubular acidosis video. Anytime there is a Metabolic Acidosis with intact kidney secretion of H+, the URINARY Anion gap (Na+K-Cl) is NEGATIVE. This is because the excess NH4 that is secreted into urine is combined with Cl-. Therefore, in Crohn's disease and Type 2 Renal Tubular Acidosis, the urinary anion gap is NEGATIVE. In this question, the urinary anion gap is POSITIVE so this would be an example of Type 1 RTA because the kidney can not excrete H+. I got it right by chance, definitely did not understand it in this much detail when I was answering it lol +8

submitted by keycompany(311),
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This ttpinea has a m.xthoorenapu rlteeilvnayitpoHn is ont ougnhe ot cempeosnat orf eth valrelo scredaee ni ugln scaufre eraa.

_yeetmasterflex  Could the pneumothorax also cause less ventilation due to decreased lung surface, retaining more CO2 causing respiratory acidosis? That's how I got to the answer at least. +6
duat98  I think pneumothorax would increase RR because you're probably hypoxic. Also I'm sure when you have a lung collapse on you you'd be scared and that would trigger your sympathetic so your RR will go up either way. +3
kateinwonderland  Arterial blood gas studies may show respiratory alkalosis caused by a decrease in CO2 as a result of tachypnea but later hypoxemia, hypercapnia, and acidosis. The patient's SaO2 levels may decrease at first, but typically return to normal within 24 hours. (https://journals.lww.com/nursing/Fulltext/2002/11000/Understanding_pneumothorax.52.aspx) +1
linwanrun1357  How about choice C, --ARDS? +2
bullshitusmle  there is no bilateral lung opacities as you would see in ARDS +4
jesusisking  Was thinking some sort of infection b/c of the atelectasis so picked empyema but this makes sense! +
djeffs1  does it need to be ARDS to cause "diffuse alveolar damage"? +
makingstrides  Not only that, does having a collapsed lung affect the alveoli? +

submitted by gonyyong(109),
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Wsnt'a uers oautb eshro,t btu yapmomhrgam ofr reaelgn lnupooapit nis't mrdedemneco tliun 40

_yeetmasterflex  Also wouldn't mammography be secondary prevention since you'd look for asymptomatic disease already present? +23
suckitnbme  USPSTF recommends starting screening at age 50. 40 by patient choice if there's risk factors. +2
j44n  @_yeetmasterflex thats a good point i didnt think about that +