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i like the way to remember acd but there is no bacterial etiology in Rheumatoid arthritis is there?
The body recognises chronic inflammatory states as infections
Ferritin is not the "iron delivery trucks", that's actually TRANSFERRIN (transfers iron to liver and bone marrow). Ferritin is the STORAGE form of iron in the liver and bone marrow. In anemia of chronic disease, there usually is an inflammatory process going (whether infectious, auto-immune [as in this case of Rheumatoid Arthritis], or cancer). During inflammation, the body releases IL-6, which releases hepcidin. Hepcidin downregulates ferroportin channels in the gut and on macrophages; therefore you absorb less iron from the GI and iron is trapped in macrophages (ferritin) and cannot be used for RBC production. All this causes INCREASED FERRITIN, decreased TIBC (if ferritin goes up, TIBC goes down and vice versa), and decreased serum iron levels and TIBC saturation (the bone marrow will suck up all the serum iron to make RBCs because it cannot make use of the iron stored as ferritin).
as per goljan, selenium is involved in glutathione peroxidase
selenium has a role in glutathione peroxidase. excess selenium = garlic breath, hair loss, and nail changes, might see peripheral neuropathy. deficiency (pt on TPN) = dilated cardiomyopathy
would require a a large sample size to see if there is a true difference
This question is bogus. CI does not always increase with decreased sample size or vice versa. Four readings with small variation would give a narrower CI than 10 readings with greater variation. The only thing you can be certain about by adding more samples is that the CI will most likely change, but which direction is uncertain.
Recall the formula for 95%ci
Mean +/- 1.96* (SD/sqrt(samplesize))
@claptain The point you made is relevant in studies involving random data. But in case of this question, the data being collected is in fact the diastolic BP. We take several readings of BP to rule out white-coat hypertension and have as accurate reading as possible. In this case, taking more readings will actually narrow down the confidence interval. The readings here represent physiological parameter, which wouldn't vary veryyyy widely in an individual.
@claptain i was thinking the same thing but ended up choosing the increased because alot of NBME seems to reward the more simplistic answer than the overthinking answer