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Comments ...

 +2  (nbme21#22)

The constellation of symptoms sounds like tuberous sclerosis. Cardiac rhabdomyoma is a rare benign tumor that is frequently associated with tuberous sclerosis.

tinydoc  Cardiac Tumors in adults -- usually myxoma Cardiac tumors in kids -- usually Rhabdomyoma ( ass. w/ Tuberous Sclerosis. ) --> its in the first aid rapid Review
tinydoc  Cardiac Tumors in adults -- usually myxoma Cardiac tumors in kids -- usually Rhabdomyoma ( ass. w/ Tuberous Sclerosis. ) --> its in the first aid rapid Review

 +1  (nbme20#3)

Sounds like a hypertrophic scar. "Hypertrophic scars contain primarily type III collagen oriented parallel to the epidermal surface with abundant nodules containing myofibroblasts, large extracellular collagen filaments and plentiful acidic mucopolysaccharides." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022978/

johnthurtjr  I think it may actually be a keloid, not a hypertrophic scar, as it expands beyond the borders of the original incision.
thepacksurvives  I believe this is a keloid; a hypertrophic scar does not extend past the borders of it's original incision, while a keloid does. regardless, the answer to this question is the same :)
breis  First AID pg 219 Scar formation: Hypertrophic vs. Keloid
charcot_bouchard  They give granulation tissue is a option which is type 3 collagen. so if it was hypertrophic scar it would be ap problem since its only excessive growth of Type 3. while keloid is excessive growth of both 1 and 3

 +4  (nbme20#20)

This sounds like Fanconi syndrome. The proximal tubular epithelial cells have a hard time reabsorbing filtrate, so you'll see a loss of phosphate, amino acids, bicarbonate, and glucose.

medschul  Wouldn't Fanconi syndrome also cause hypokalemia though?
yotsubato  Especially considering the fact that the DCT will be working in overdrive to compensate for lost solutes???
nala_ula  This question did not make sense to me at all. I knew it was Fanconi syndrome yet didn't select the obvious answer because it said "follow up examination 1 week after diagnosis". I thought it would already be in treatment... I searched (now) and it says that treatment is basically replenishing was is lost in the urine. So definitely the wording is like wtf to me
sugaplum  I was thinking since it affected the PCT that Na resorption would be affected as well? But I guess the other segments will pick up the slack?

 +4  (nbme20#24)

The adductor pollicis muscle is innervated by the ulnar nerve, giving this guy a difficult time holding a sheet of paper.


 +7  (nbme20#6)

While the lifetime risk in the general population is just below 1%, it is 6.5% in first-degree relatives of patients and it rises to more than 40% in monozygotic twins of affected people. Analyzing classic studies of the genetics of schizophrenia done as early as in 1930s, Fischer concludes that a concordance rate for psychosis of about 50% in monozygotic twins seems to be a realistic estimate, which is significantly higher than that in dizygotic twins of about 10–19% (ncbi.nlm.nih.gov/pmc/articles/PMC4623659/#ref3)

imnotarobotbut  How is one supposed to know this before having read this article?
imgdoc  This question falls under the either you know it or you dont category. It isnt in FA or Uworld

 +0  (nbme20#15)

Dextromethorphan is an opium alkaloid derivative. Dextromethorphan is a drug of abuse. The main risks associated with dextromethorphan are ataxia, central nervous system (CNS) stimulation, dizziness, lethargy and psychotic behavior. Less frequently with large doses seizures and respiratory depression can occur. Nausea, vomiting, constipation and tachycardia may also occur. (toxnet.nlm.nih.gov)


 +0  (nbme20#31)

Beta-Tubulin is a subunit of tubulin. Tubulin is one of several members of a small family of globular proteins. It is the major constituent of microtubules. There are two of most common members of the tubulin family: alpha-tubulin and beta-tubulin, and together their dimers form microtubules. (origene.com)


 +1  (nbme20#48)

Amiodarone, a class III antiarrhythmic drug, has multiple effects on myocardial depolarization and repolarization that make it an extremely effective antiarrhythmic drug. However, amiodarone is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism), which is due to amiodarone's high iodine content and its direct toxic effect on the thyroid. (uptodate.com)

celeste  The "**iod**" part of am**iod**arone reminds me of it's high **iod**ine content.
xxabi  I think of it as the trifecta - gotta monitor LFTs, PFTs, and Ts (thyroid) when on amiodarone!
sinforslide  Also, the patient presented with Afib; this might've been caused by transient hyperthyroidism as a prelude to Hashimoto's. In this case, if you give Amio, you'd cause serious hypothyroidism!

 +1  (nbme20#9)

If prostate cancer spreads to other parts of the body, it nearly always goes to the bones first (cancer.org/cancer/prostate-cancer/treating/treating-pain.html)





Subcomments ...

submitted by strugglebus(63),

You have negative Nitrogen balance in starvation (lack of protein) and positive Nitrogen in muscle building states (i.e. children/athletes)

celeste  Nitrogen Balance = Nitrogen intake - Nitrogen loss +1  


submitted by hayayah(343),

Down Syndrome Labs:

  • inc. nuchal translucency
  • inc. hCG
  • inc. inhibin
  • decreased AFP
  • decreased PAPPA
celeste  I remember this as Down Syndrome has high HI (hCg and inhibit) +5  
temmy  Thanks celeste. I'll remember Hi +1  


submitted by celeste(27),

Amiodarone, a class III antiarrhythmic drug, has multiple effects on myocardial depolarization and repolarization that make it an extremely effective antiarrhythmic drug. However, amiodarone is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism), which is due to amiodarone's high iodine content and its direct toxic effect on the thyroid. (uptodate.com)

celeste  The "**iod**" part of am**iod**arone reminds me of it's high **iod**ine content. +1  
xxabi  I think of it as the trifecta - gotta monitor LFTs, PFTs, and Ts (thyroid) when on amiodarone! +1  
sinforslide  Also, the patient presented with Afib; this might've been caused by transient hyperthyroidism as a prelude to Hashimoto's. In this case, if you give Amio, you'd cause serious hypothyroidism! +