invite friends ⋅ share via emailtwitter
support the site ⋅ become a member ⋅ unscramble the egg
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 
Welcome to atstillisafraud’s page.
Contributor score: 150

Comments ...

 +8  (nbme24#28)
unscramble the site ⋅ become a member ($36/month)

aersDtimy ( sola, akiiseaydoisndd dna niennttoi )torrem is aretlal ceue.rmllbe (E.)

tiaxAa is a ropelmb htiw hte tcnealr ceullberme (D) or at salte shtat het etsb I cduol ocme up .twih

ronald-dumsfeld  I actually think D is pointing at the Flocculonodular lobe. See here: So a lesion at D would present with Nystagmus +3
urachus  flocculonodular is medial (central). but yes it'll have nystagmus and truncal ataxia +

 +45  (nbme24#35)
unscramble the site ⋅ become a member ($36/month)

kanhT yuo MNEB orf hte ighh lauiytq ep.rucsit It saemk etshe sexma rsstse rfee and eajye.nbol

sympathetikey  Feels bad man. +2
zoggybiscuits  Those Sclera sure look blue. wow. +11
yotsubato  the same girl shows up on so many NBME exams its not even funny. Its just like that poor kidney that's cut in half that shows up in all kidney questions. +9
aneurysmclip  I turned my brightness up and down 2 times to make sure it wasn't my brightness messing with the sclera. I'm declaring it, NBME stands for "Naturally Bad at Making Exams" . +3
peqmd  $60 a pop and no competitors...That's what happen when there's a monopoly. +3
peqmd  Actually they used their best software to generate images. You might have heard it before, it's called MS Paint. Quite legendary. +3
feochromocytoma  It feels like they cranked up the contrast and saturation on a normal eye to make it look "blue"... +4

 +52  (nbme24#42)
unscramble the site ⋅ become a member ($36/month)

I like tihs teqnuios cabeuse it rsdmien me hatt mirensexa ntihk sjocbet cna istxe ni 2 isnsimdn.oe

 +4  (nbme22#11)
unscramble the site ⋅ become a member ($36/month)

nmnPiNkc-aei Dessiae ptrseens twih entlam araiednttor, liidp danel (mofa ellsc) ni beon wroarm dan errhcy der ospt on mua.lca No openhamlsnisiegy srtselu ni lbiupud of nhlpimgisneyo chhwi bildsu pu ni aergshmao.pc

meningitis  "Pick your **Big** **Foamie** **Zeibra** nose with your Sphinger" Choose options with the letter I. SpIngomyelin, Sphingomyelinase, bIgorgans (hepatomegaly etc), zeIbra bodies, Foam cells +1

 +5  (nbme22#38)
unscramble the site ⋅ become a member ($36/month)

ereiPm sah no usantrcatf

ntiAnesiogn II - deernagte in ohopymalvie

Dioypmaltil einhcilt aak ioylihidpslpalndpeayolhicohmtt ungl unftsacrta

napsodtolisPhtyoilhi hpta,oebsh54psi- aka IP2P qG eptrcore whtpyaa

Peaonsyidltrhpeshi -nlevdvio ni riicstnni iotsappos nhwe edepxso no xurlaetclrela sraesucf

lheniomgySnip - eospmcso mlyine nda osal ahs rloes in lsgani trocsuditn,an Ltiecin:h ipelnynomgShi orita g&;2t ctnsieadi rauemt etalf lgnus.

endochondral1  how are we supposed to know that dipalmitoyl lecithin is the same thing as dipalmitorylphosphatidylcholine +5
qfever  FA 2019 page 647 Pulmonary surfactant is a complex mix of lecithins, the most important of which is dipalmitoylphosphatidylcholine (DPPC). Also: Screening tests for fetal lung maturity: lecithin- sphingomyelin (L/S) ratio in amniotic fluid (≥ 2 is healthy; < 1.5 predictive of NRDS) +9

 -8  (nbme22#48)
unscramble the site ⋅ become a member ($36/month)

etonQius si ingksa tbauo eulnstaacdpe sogirnasm eitnincfg DGC at.setpin c.oEil si salo ceeasdatln.pu naC nnayeo dpnaxe on ?hits

keycompany  Step pneumonia is the most common pathogenic organism in CGD, and the most common cause of pneumonia, otitis media, meningits, and sepsis. While CGD are at an increased risk of encapsulated E. coli infections, however, they are at MOST risk for S. pneumo. This is kind of just a memorization fact that you need to know about S. pneumo. +
keycompany  Sorry english is clearly not my shit, but you get the point +
biliarytree220  CGD is susceptible against catalase-positive organisms (FA 109), of which S. aureus is the one to look out for. It's not about encapsulated organisms, like I had it confused in my head. +6
.ooo.   You are completely right about E.Coli being encapsulated and is also a CAT+ organism and patients with CGD would have an increased risk of infection for both S. Aureus and E. Coli. How you narrow down the two is the most common infections are S. Aureus and Aspergillus (FA 109 like mentioned above) and also using the pneumonic "Cats Need PLACESS to Belch their Hairballs" (FA 128) Nocardia, Pseudomonas, Listeria, Aspergillus, Candida, E.Coli, Staphylococci, Serratia, B cepacia, H pylori +6

 -1  (nbme22#25)
unscramble the site ⋅ become a member ($36/month)

ntisamHei ecssua alcraypil ratrleario oldintia reeda(ces neacdisret(caes)serin suerprse in the alypralic sebceua efsrnefet rmeian the msea s)iez Hieasntmi saol isasrecne lcalpayir li.eebmyatrip

 -4  (nbme22#23)
unscramble the site ⋅ become a member ($36/month)

oAbismguu qsoetinu utb ni sceebau it is alery cokhs, etehr si ont ghnueo tiem ot titvacae the RASA ot ecsaneir ndyiek usnfroi.ep

makinallkindzofgainz  This is not an ambiguous question. It makes perfect sense. +3

 +5  (nbme22#31)
unscramble the site ⋅ become a member ($36/month)

gethiW olss - itknh iepHaecaotmr crynan - SDAHI orfm masll lcle ugnl Enma eedcrca + VJD - SCV emyosrdn

peridot  I was thinking lung cancer secreting SIADH, resulting in hyponatremia. But because the question asked specifically about the cause of the facial edema, I put hyponatremia (answer choice C). I was wondering how you guys were able to differentiate between C. hyponatremia and E. lung cancer? Thank you! +1
mannan  The first thing that crossed my mind was SVC syndrome from the cancer obstructing the R brachiocephalic vein preventing venous blood from returning to the heart (and staying in the facial area). Also I assume Hyponatremia would be equivalent to decreased body volume so there wouldn't be edema. FA Renal physiology section has a good chart on what happens during electrolyte imbalances (hypo and hyper) +1
mannan  @peridot +1
peridot  I was thinking that hyponatremia would be more loss of osmotic pressure --> edema, but I definitely see the argument for a mass that's simply blocking blood flow. Thank you! +

 +11  (nbme22#15)
unscramble the site ⋅ become a member ($36/month)

nAgikyllta setnag reho(mmtrnah)eilce te(h rhote gsrdu teldis rae icueltombur sotrih)nibi nrciaese eth skri fo ALM.

keycompany  Additionally, AML is the only answer choice that has multiple blast forms (myeloblasts, promyelocytes, etc.). ALL is characterized by a single blast form (lymphoblasts). +25
seagull  CML has blasts too but they tend to favor mature forms. +4
kash1f  You see numerous blast forms == AML, which is characterized by >20% blasts +4
keycompany  The answer choices are all of lymphoid origin except for AML and Hodgkin Disease. We know Hodgkin Disease is a lymphoma (not leukemia) and would present with lymphadenoapthy. So the answer must be AML #testtakingstrategies +12
impostersyndromel1000  @atstillisafraud thanks for mentioning the merchlorethamine increasing risk for AML, i was trying to make a connection with the drugs but couldnt. Had to lean on the test taking skills just like key company +1
sweetmed  Procarbazine is alkylating as well. +
pg32  @keycompany how did you know the phrase "multiple blast forms" meant literally different types of blasts and not just many blast cells were seen? +3
castlblack  this link says CLL has 'large lymphocytic variety' under the picture of the peripheral smear. I am not arguing against you, just researching here +

Subcomments ...

unscramble the site ⋅ become a member ($36/month)

Mtsa eslcl eaa,tgnrudel pcoiurgdn eisnmiath icwhh tttsacar hnioiosp.lse The ryael tgsae fo an elriclga nertocai si atsm elcl imtaeed,d utb hte late saget i(niglcndu ucmus intocupdo)r si tiedmdea yb ieo.pnissolh

atstillisafraud  Thanks for a good answer. This question made me feel like I was taking T21 pills +14  
medguru2295  Thank you- I was really thinking this question had 2 correct answers... of course my dumbass picked Mast cells. +2  
ajss  where do i find this info?? +  
paperbackwriter  @ajss pg 112 of first aid 2019, under type I hypersensitivity. Immediate --> mast cells releasing histamine and tryptase, late--> eosinophils and leukotrienes recruited via chemokines +2  
graciewacie9  Wow, i missed the fact that the question is asking for the RESULT of the reaction, NOT the cause of the reaction. Mast cells cause the initial reaction, eosinophils would be the result of the eosinophils. *facepalm +1  
greentea733  @graciewacie9 SAME UGH +  
lba9587  Pathophys (as far as I understand it)...Mast cell degranulates, thus the phospholipid bilayer et. Al are left behind and needs to be degraded. Who comes in? Our good friend eosinophils, as they contain Major Basic Protein (responsible from breakdown of expired mast cell). Note, you can tie this in to the delayed Leukotriene effects of an allergic rxn, as the bilayer is also broken down by arach. Acid. (See this link to support my credibility +  

submitted by beeip(116),
unscramble the site ⋅ become a member ($36/month)

ybniaIlti to laeteev het aatlep uegssstg agdmae fo hte asgvu .nevre

.F CN( )X

atstillisafraud  I guess F is the vagus nerve. Thanks to NBME I am also training to become a mind reader. +24  
seagull  Thanks to the NBME I have crippling depression +29  
drdoom  bonus cadaver diagram via @mcl +2