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Welcome to cathartic_medstu’s page.
Contributor score: 28


Comments ...

 -2  (nbme24#29)
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aoPthma Ch 1, of .3

ylSwlo lineepogdv aihmisce (ei etihcl)srroossae eadls to tphorya ahwesr,e ectau easmiihc (ei erlna yrater use)bmol ruslets ni .yrniju

usmlecrasherss  i picked fibromuscular dysplasia and have zero regret, i just did not pay attention toward the word of proximal.... +3

 +3  (nbme23#29)
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BFA UGT

socruetF is ot eAlsdaol B sa lGeocsaat si ot Ulrydi seafLsnae.Tsder ra to tphpaehos p.oeinedtl

roucniFsketa def nda tclniaGsaekoa fed rae r.idkne

FA 2810 gp 80


 +1  (nbme23#48)
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I aemc rhee tujs ot eard hte otncemms

MJ at hte veoim eetsrtha naetgi noocppr meme

azibird  Same! +

 +5  (nbme23#8)
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bllataLeo = -thblloa-a"e"l"ap"

omrF thceSky

nArdew aYgn ofr ndprietse. is it 05 htcaesrrca yet?

anjum  RIP Yang gang +

 +0  (nbme22#7)
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gOncira :ED anmolr obl,idi areedsedc naunltcor eceoisntr

ehgosynPcic :ED sdeacrdee diob,li rnolam ctlnunrao etrinsoec

toG t.i


 +0  (nbme22#7)
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Ntunoarcl ilpnee ectueemnsc rmemeauestn lh(pyalprohga) is a tets hatt eearssum anestoposnu inhglyt tesorcnei in etelriec yidsnocufnt lay(pirrim emfdpoerr ni a seple toyrr.lb)aoa stI' fulues ofr ingditneartffie btwneee ocnragi mofr ngyechsopci telcerie .tyudfinnosc

etgnVite dibrcssee a ysisolbp esepdsder atptien ;g&=t ogpicshynce clireete fiuntcnoy.ds eSnci ti is ont na nairocg ecsua fo ,DE untnraocl etnreoics oldwu eb nm.oalr rgaciOn lieitseogo of ED ndeliuc ougnecnrei or s.vuarlca

obdiiL atpr ucssoenf me rhee. oiLbid esnma uxales ediesr ro ttae.iepp I saw inhkntgi necis she' nmcogi ni ot etg ED ekc,edhc it stiedacni sh'e iptetape rfo esx si nghueo taht it aemd ihm egt ti hekcc. So ioidbl uodlsh be rola.nm Ayn l?hep


 +9  (nbme22#45)
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h5p.w3:twm0//.1p0tp0g2s/w4/5af1p.tr03ahf/ol/a

^^^a eulbufiat bleat taht hsosw ftcsafe no oteecrlleyt leslve in vxatslaie vs seiidrcut vs ivintmog.

nrcdiocgA ot het l,eatb sti drha ot etll rdeuciti vs laviteax sabue by urmse toletclrseey .noale eTh rinue eectsoyrltle lwoud ryaklemd fifder in htat ituderic wlli heav direnasec C//KaNl nad aexsaltiv uowld llofow eth eiostppo etrnd dar.de(ecs)e Hweeovr, twih the fcta thta BNU si engasniric dna atth ew cna eltl teehs'r a laobmetic alkassoli ihwt ytearsrorip diioassc ietmaocn,pnso we can etb no tricseiud revo tas.lvxaie

ATERX NOFI morf het lbtea in het lnik :veaob

:nVtoimig K[ edc] [Cl ce]d [H3CO ic]n Hp[ nci]
xea iaLv:st [K ecd] lC[ icn ro ecd] O[3HC cde ro i]nc [Hp cde or cn]i
s t:ciDeuri K[ ed]c C[l d]ec [H3OC nc]i H[p cn]i

In rnuei fro v,moignit /CNK/al iwll all be renIsddceea iuenr ofr tliaxvea ,ubase /aKN illw be csere.daed Cl is olmarn or n.s eIaeeddrc irune for edcurtii bsea:u aC/K/Nl will all be daneriesc

nrdew(A ngaY rfo einPrd)set

nootnootpenguinn  The last sentence is nice touch!!! +2

 +2  (nbme22#38)
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anC emooesn tcrecor ym rningosea he:er

I aws tngikhin petsiiov yrwiaa esrreusp wlil nrieaecs elvralao ieavnltntio adn sceedrea xoiyhap dueincd youmalrnp osocnnsriiv.ctaot Ts,uh VR faert loda ulodw eesacedr ;>= omer adrlope to LV adn eomr craciad tuut.op Thne wnt'ldou PB e?dsecrea

nAy leph si rceapatdp.ie n.Tksha

pg32  I just thought of it as follows: he has high BP due to pulmonary vasoconstriction as well as widespread sympathetic activation (as if he is being partially strangled all the time, because he basically is). Increasing oxygenation will relax his pulmonary vasculature and decrease sympathetic stimulation throughout the body, leading to a drop in blood pressure. +1

 +1  (nbme22#35)
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tcruPie wssoh dietald rtreeu nda elrna elvisp

hriocnC EYPLOhinepstir oyelp( = elvsp)i l;&t= rtceurner pisdseoe fo uAtce eeopsylnhrPiit =t;&l ITU

hTis tpnatei lkilye has eviluroetescar elxerf agndile to enrrecurt .IsTU


 +0  (nbme22#35)
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uceirPt oswsh tdidael eturer dan narle ilpvse.

oinhrcC LEOPYprihetsni (elypo = isl)vpe t&l=; nterceurr edoipsse of eAtcu lPeynsriotheip ;=t&l UTI

hsTi einattp ilyekl hsa eelrvuosriceat xrlfee nagdlei to ncererrtu T.sIU


 +4  (nbme22#44)
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iSuorper dmeroshoirh dl,obo reInifro iersdmhoohr m.btosroh aywlsA beermrme htt.a

-nojlGa





Subcomments ...

submitted by nwinkelmann(292),
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ePr tmlonog.ieoplhnsocay

Lelaaupkiok = irsk fcroats dulecni amel drenge, -0047 aseyr dlo, msgknio, Wehti tphac or lepauq, 5 mm or erm,o on oral ucsoum nsrmembea htta tcoann eb oremved by pi,ncrsga nto due ot anteroh iesdesa eintyt shcu as lehnic splnua ro acisndsdiia dan nto evrerdse yb rovealm of tsnririat adn slneoi tsum eb icesdrndoe puncsrecoear nitlu opnrev s.iohrtewe aiPngnltearm lieons rtianamosftrno oudlw aled ot noaviins fo hte u.csbuaoms

Moric = isaVre hyllaosglociit fmro ,staiohnsca srktohe,rpseiya ayldspsia ro oacnciamr ni tsui itaeacos(ds ithw ypchoystelm adn .gahopeamrc)s hTis icertal paxnlsie it cmhu rtbtee and hsa eu:picrts 6rdp1rtie:ttsvescav#emeca6ii.m/m/ieldon78c-epeaw/e04ho4/c.. Beasd no sith eliartc adn hte pt,esiruc dI' say the htosi isedl ni eht tsuneqio si at etals eomatedr sasmouqu plsadi.ays

Hyiar kpaoueLilak = Wti,he outlnnecf acshpet of ffyful )(hriya casoum, iraebll,ta olang lalerta euog,tn nda sitsaoedac iwth +HVI nptetasi A(SDI aym perapa wthini 2 - 3 aer)sy utb cuytalal eud ot EBV etionfinc

Htosi = tcHaeikrtroeyp arlo mosacu ude ot pinlgi fo ekattcrio smaqusou time,iuphel rdoywC tyep A nrnlaeutirca nos,nuliics Blaonlo escll twih argmiontina fo acntroihm lauce(nr ;enbgda)i EVB ntrpees ni lacer llesc of ponsisu ayre,l bevlaira yosiio,klotsc dupmessiproe addiaCn enciifon,t huiwtto ytoaafrmnmil ensorep.s

moFr tpiusecr nd(a thsi edoi:v hhpveu6ub:1ot/.tq/s8/xutSyIK mptmetisa 2:,2)1 riyha keukoilpala sha a htgliyl tdsnaie band fo leslc a"lobln sle"lc ni the sttmrua umsopins whihc si erweh eht VEB silve. It lsook much eftedrfni tanh teh ostih iesld honws in teh e.qunotis

yb_26  great explanation, thanks for sharing! +  
cathartic_medstu  on point +  


submitted by oznefu(22),
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’mI hvniga turbleo uesnadntdigrn yhw hsti si a tbeert coiche hnat tegaP esd,aies pesceilyla wiht het ecsnaierd ?PLA

zelderonmorningstar  Paget’s would also show some sclerosis. +4  
seagull  ALK is increased in bone breakdown too. Prostate loves spreading to the lumbar Spine. It's like crack-cocaine for cancer. +26  
aesalmon  I think the "Worse at night" lends itself more towards mets, and the pt demographics lean towards prostate cancer, which loves to go to the lumbar spine via the Batson plexus. I picked Paget but i think they would have given something more telling if they wanted pagets, histology or another clue +1  
fcambridge  @seagull and aesalmon, I think you're a bit off here. Prostate mets would be osteoblastic, not osteolytic as is described in the vignette. +17  
sup  Yeah I chose Paget's too bcz I figured if it wasn't prostate cancer (which as @fcambridge said would present w/ osteoblastic lesions) they would give us another presenting sx of the metastatic cancer (lung, renal, skin) that might point us in that direction. I got distracted by the increased ALP too and fell for Paget :( +1  
kernicterusthefrog  @fcambridge, not exactly. Yes, prostate mets tends to be osteoblastic, but about 30% are found to be lytic, per this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768452/ Additionally, the night bone pains point to mets, and Paget's is much more commonly found in the cranial bones and appendicular skeleton, than axial. This could also be RCC mets! +  
sweetmed  I mainly ruled out pagets because they said the physical examination was normal. He would def have other symptoms. +4  
cathartic_medstu  From what I remember from Pathoma: Metastasis to bone is usually osteolytic with exception to prostate, which is osteoblastic. Therefore, stem says NUMEROUS lytic lesions and sounds more like metastasis. +5  
medguru2295  If this is Metastatic cancer, it is likely MM. MM spreads to the spinal cord and causes Lytic lesions. It is NOT prostate as stated above. While Adenocarcinoma does spread to the Prostate, it produces only BLASTIC lesions. +