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Welcome to champagnesupernova3’s page.
Contributor score: 62


Comments ...

 +0  (nbme21#35)
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eihaaDrr cssaeu sslo of tea,wr aN adn ibB.rac meeremRb atth adrhriae si a acsue of nno onani agp iaotbcmel dissoica caseube eht slos fo nracbtaoibe si detoaempnsc by cineisnagr roilehdC sabooteprr.in oS ehs cna heva remhilropceayh ro haprtieomnay ued ot ntaike of olny free water ofr 42 .suhro Btu she hsa UESISZRE so oipnrtaeyamh si sotm iykell


 +5  (nbme21#35)
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rDeharai escsau loss of terwa, aN nad raBi.bc rRmbmeee ttah rheaadir si a scaue of onn nanoi gap emolitacb cosiasdi eaecubs eht lsos of oacabntbrei is odpnteacsem by nanirgiesc dlhCiroe tsiorea.pnbro oS hse acn veah yaecprhemhoirl ro onapmyatrieh deu to eakint of ylon efre traew fro 24 ruos.h tuB she sah IZSUEESR so aiaopeyhrtmn si tmso eklyli

drzed  I think the initial hyperchloremia would be quickly diluted out by the large consumption of water, so those two competing processes would likely neutralize the chlorine level, or even make the child hypochloremic. +

 +5  (nbme20#3)
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hsiT si a elod.ik In aonlrm woudn lniaghe ytpe 3 loeancgl si fstri zhsdtyensie dan tehn deagdder yb aitxMr teiomlasptrlnaeoe a( enoaescallg whcih uses incZ sa a foc)torac nad erpedacl yb Type 1. In a odliKe na xvsseieec otunma fo inzdisgdearo eypT 3 clgnaloe rps.tisse foreTrhee teh tdeefc is in logClnae seyntissh y(Tpe 1 )eyihtssns

dulxy071  Wouldn't Granulation tissue be the (more correct) answer since the initial collagen laid down for wound healing is Type III collagen which is consistent of granulation tissue? Collagen is a vast for so many types of itself as we know +3
kpjk  @dulxy071 she had a surgery 3 months ago healing was fine even uptill 6 weeks ago so the abnormality occurred during remodeling- when type 3 is replaced by type 1 collagen, so the answer wouldnt be granulation tissue +5
pontiacfever  Keloid has both 1 and 3 types of Collagen increased production. Whereas, granulation tissue consists of type 3 collagen only. which is why collagen synthesis as answer would be more specific +




Subcomments ...

submitted by hungrybox(968),
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:paeLemriod itnogsA at uo-idiop erro.tcpse lSosw utg oilttmyi rembem,re( npootincsita si a nmmcoo sdei ctefef fro lal posdoi).i

izqu :yuefslor

:Q ldWuo a eknjiu tawn to ues dpeLeioma?r

A: ,oN it ahs poor SNC enrtaeonpit hw(hic is hyw ti sha a olw ectvdiaid .leptnoti)a

Q: Wloud a euknji errhta haev rimoenhp ro prreoihnpnue?b

:A rhonp.eMi toBh era pu-dooii ngat,sosi tub epmnrhoi is a ulfl aistnog lwieh unpeioprrbehn si ynlo a iartpal sioa.tng

:Q haWt bouta prhnimeo s.v inedo?ec

A: Trcki ieutsq,on hobt are ltariap to.anssgi

cienfuegos  Thanks for passing off the knowledge. Regarding the last part, aren't morphine and codeine full agonists? +5  
champagnesupernova3  Yes they are +2  


submitted by hungrybox(968),
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lwoiFgnol a osr,etk isht aittepn dah aneksesw fo her tlef aecf dan by,od os eht stekor msut avhe facfedte hte tgrhi dies of ehr nria.b B wsa eth noly iochce on hte igtrh eids of reh .bniar

ltilS osecn?dfu Rdea o..n.

ehT ulvynarto omrot fbeisr rocstco(planii )tctar sedecdn rmfo eth priryam tormo ortce,x orssc uasetse)(dc at hte lyedlamur p,maysidr and enth yesspna ta teh etairron toomr ornh fo eht ilapns elel.v

Bcsueae fo aodeistsnuc ta teh daryeumll ,rdmspyia yuo uldsho meak a tneo fo werhe yan esrkto s.ccuro sI ti oeabv the lmeauryld asmpdriy? hTen it ilwl efcaft teh dsei piosepto teh esokrt l)aalrecn(atr.ot sI it owelb the uymdlealr rdsapi?ym hTen ti will cfftae eht msae sdei sa eth estork )aiprastl(ile.

hungrybox  Woops, E is also on the right side (also remember that imaging is looking up at someone, feet first). But a cerebellar stroke would have caused ataxia. +  
mnemonia  Very nice!! +  
usmleuser007  What gets me is that they mention that Left 2/3 of face is affected. This should indicate a non cortical innervation as most of the cranial nuclei are bilaterally innervated from the left and right hemisphere. If left 2/3 of the face is affected then it should also mean that the lesion is after CN5 nuclei. +1  
yotsubato  @hungrybox Thats not the cerebellum thats the occipital lobe. You would see leftsided homonymous hemianopsia in that lesion +7  
mrsmac  To my mind, it is simpler to consider the question first in terms of blood supply distribution. Left sided hemiparesis and weakness of lower 2/3 of face are both indicative of a MCA rupture/stroke (First Aid 2018 pg. 498). Furthermore, since the injury has affected motor function we would be considering the descending tract i.e. lateral corticospinal which courses through the ipsilateral posterior limb of the internal capsule then decussates in the caudal medulla. +1  
mrsmac  You're considering the wrong CN here. CN5 motor function involves muscles of mastication and lower 2/3 of tongue. The nerve in question in this case is CN7/VII Facial n. CNVII UMN injury affects the contralateral side, whereas LMN injury affects ipsilateral (First Aid 2018 pg. 516). i.e. before and after the nucleus in pons respectively. I hope this helps. +2  
nala_ula  Spastic means UMN lesion, since they also don't specify if there is arm or leg weakness, I didn't assume it was MCA stroke. I went with the reasoning that for there to be spastic hemiparesis, there must be damaged to the UMNs and therefore the internal capsule is where these tracts are. +  
champagnesupernova3  Omg this whole discussion is confusing. Internal capsule contains ALL corticospinal and corticobulbar fibers = contralateral hemiparesis and UMN facial lesion +16  


submitted by hungrybox(968),
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Teh 2 emsanmndtmoc of cehsti uti:enqoss

  1. 'tonD erev icpk an ewarns ewerh uyo usdon ekil a ikcd
  2. 'Dnot ever ustonlc the thesic imocetmte

vSdere em ewll no hsit qn.ieuots

linwanrun1357  If there is a choice about asking what the patient is worried about. Is this right? It does not sound like a dick :) +1  
champagnesupernova3  If this were about a treatment asking why hes worried would be right but hes kind of doing the hospital a favor so I dont think you're supposed to try to convince or pressure him +1  
brasel  also, any patient participating in any research study can withdraw whenever they want. Answer E is wrong because he shouldn't have to go through hoops to quit, he can just drop out at any time. +1  


submitted by nwinkelmann(284),
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nI esac ayoenn si a sneed as I ma dna tsju ndidt' bsreedder/rnmeautmn atwh ctxyale tryrpixaeo lfow is = VE1.F nI etiviercrst iocsti,nndo FEV1 is oamnrl or iadrsence edu ot deecsarde F.VC tarnieItslti ssroiifb = ieerscdan ariawy mearnacphy fasfocld narduo eht sa,rwiay wchih is hawt iopvsedr dlaria tacort.ni hTe agreret teh riadla troa,cnit the eworl eth onislpaglc ec,fro nda so rptixeaoyr wfol si ne.aircdse

champagnesupernova3  FEV1 is increased due to greater recoil of the lung tissue. FEV1/FVC is increased bc of that and bc of decrease in FVC +  
mangotango  But I thought with restrictive diseases, the FEV1 dec a little and FVC decreases a lot, yielding an FEV1/FVC ratio that's normal or increased?? +1  


submitted by nbmeans(-3),
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I naswt eusr of htsi ,oen ti disa rnoithbm meit was manolr

champagnesupernova3  A normal thrombin time indicates fibrongoen is functioning normally +  


submitted by yotsubato(968),
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lWle tsaht a allrey ecdur awy to ersenc orf n..d.oeepisrs

champagnesupernova3  There's really no other way to say it without using euphemisms +2  
drdoom  You can’t rule out suicidal thoughts via inference. +  
drdoom  LAWYER: Did you ask the patient if she was suicidal? DOCTOR: Well, um, no, not exactly — but, I mean, she seemed okay .. +  
drdoom  LAWYER: So, a patient walks into your office, you suspect post partum depression — a diagnosis with known suicide risk — and you didn't ask if she was suicidal? +  
drdoom  DOCTOR: gulp +  


submitted by kimcharito(14),
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.ei.llw.n 01F8A2 sadi ilomorsptso ienraces crdoinupot of GRATICS mocuas dna hte eiutnsoq sdia SGAHOPUES y.msaa.aa.mua.oc be si atth saeron

champagnesupernova3  Reducing acid production helps mucosa heal alot more than increasing prostaglandins. We learn about misoprostol because it can be used if you dont have anything else but you're never gonna choose it over a PPI +3  


submitted by hayayah(1056),
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A igb gthin erhe too is ginontic htat het LAP is edcerd.ase bolststOae yitavcti si earemdus by neob AP.L I thnki htat aws teh amin scfou here nad nto that uoy ncaieyssler ened ot nowk eth AC1FB egne mo.anttui

sympathetikey  Exactly. That's the only way I got to the answer. +3  
pakimd  isnt increased alk phos consistent with increased osteoblastic activity? +  
champagnesupernova3  A defect with chondrocytes would cause an short limbs like in achondroplasia so those are ruled out +  
pg32  Exactly. Can also be helpful if you remember that the clavicles are formed by intramembranous ossification rather than endochondral; that allows you to rule out the chondroblast/cyte answer choices. +4  


submitted by usmleuser007(370),
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w/nodvm0b.g.e.6:l5wt/bhmp/1p/n3iunict8whs.

lfiRee fo natbrtaelic iapn aws odeucprd in sxi nahmu sttieapn yb ttonlamiisu of lscetreode altnyepenrm epaldimnt in het vtcerueprilnrai nad qdlueapcuriate rayg .atterm heT evlle fo olmntsuiati fnsifutiec to neicdu pnai elifre essem ont ot rteal teh ceuat pina ldrtes.ohh imnncaritIised epvitreite uiatomnslti edcrdupo neraletco to hbot -mitponclautroisedud inap fielre dna eht cnslagaie tinaco fo ancotcir meoaticni;d siht opecssr odlcu eb eredsrev by ebcsniaent orfm alnuitoimt.s mnodSeduil-ptitcoaru leifre of ianp wsa dreveser by oaxolnen in evfi tuo of six tpteasn.i seTeh tslrsue guestsg htat sisfraotatyc lelvtoinaai of stptneiser apin ni nhmuas may eb ientodab by neloitrecc stuto.inlaim

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by usmleuser007(370),
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vc.0n.:mlniwh1gs6u./dpiwb5p/tmt/ho3n8e/wb.

fleRei fo retbtlanaic npai aws coudprde in xis hnmua tstapnei by tiotmaliuns fo dotseelcre yemntapernl eldtmniap ni the perivanrrteclui dna ruceitquaedpla yarg .aemttr hTe evell of lutmiasitno fisntfueic to dicune inpa eelrif seesm not to etral the aectu pina thhe.srodl atiicnrnIemids eveepttiir tutinmlosai rpdudeco tcroneela ot tohb omnirsdd-epaultociut napi rieefl nad eht aceialngs itcnoa of coiarcnt ineiacomtd; hsti cpessor lcoud eb vresered yb nsnceeatib mfor nota.miliust dpcolttm-Sunideioaru eeilfr fo nipa asw srvderee yb oaeonnlx in fvei tou fo ixs spet.aint eTehs erssutl ggsutes atth rfscoaitysat aiiavnltleo fo nstertsipe npia in nuahms yma be otdibena yb coneelictr toitmlu.iasn

usmleuser007  These questions seem unfair to test because they are based on experimental data. Guess they are there to limit a perfect score. +2  
xxabi  I just read it as patients take opioids to blunt or control pain. So if the electrode does the same thing (decrease pain), then an antagonist of opioids (naloxone) would bring the pain back? Idk if that reasoning is sound but that's the logic I used, I didn't even think of it as experimental. +22  
xxabi  Also its the only one that's an opioid antagonist from the list! +2  
redvelvet  they are writing these questions in an evidence-based manner because the questions in medicine cannot be produced by a self imagination or logic. But that doesn't mean that we have to know their exact evidence like this question. we can use our own basic knowledge and adjust it with logic. so opioids have an analgesic effect in the body and naloxone can revert it. +4  
champagnesupernova3  Anything that reduces pain by brain stimulation is increasing endogenous opiods like endorphins and encephalitis. +2  
champagnesupernova3  Enkephalins* not encephalitis +  


submitted by strugglebus(163),
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dohateroHoddynMneeoc/ acn ldae to ny-eddoe-cneepu ivdoa in logn etrm .ues ISADsN ouy asol adiov ude to trlipaa vneseefiefsicnt ni pircohuntae nipa sa llwe sa ucrle ir.ks sCTA' are wnkno to teart rnoaihcpteu npai vrye wlel .i(e. et,isabed ART ye)aptrh

champagnesupernova3  Drugs for neuropathic pain: TCAs, gabapentin and pregabalin +1  
mangotango  SNRIs +  
mangotango  also SNRIs* +1  
zevvyt  methadone isn't a pain med(even though it's an opiate), it's used for opiate addiction. And hydrocodone is used for "moderate" pain and this person is in "severe" pain. +  


submitted by ergogenic22(301),
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tP sah ssing dan xS of yhisre.otrclpo wlomaoLnr/ CATH ravfso vdtaeeel stcroilo edpentdenin of TAHC, eordfnmic by calk of noepessr ot aoxahsedmetne resi.pnsospu aZno lfcuacstiaa is ngiroi fo soorclti oncrpdo.uit

champagnesupernova3  They tried to confuse us saying both low dose and high dose dexamethasone didnt suppress it. But when ACTH is low you dont even need to do high dose dexamethasone test. The high dose is only to differentiate between Pituitary adenoma and ectopic ACTH production +5  
hungrybox  @champagnesupernova3 fuck they got me +11  
azharhu786  They got me on that question as well. I thought it was ectopic ACTH production due to some paraneoplastic syndrome and this is why Low/ high dose dexa is unable to suppress it. +1  


submitted by hayayah(1056),
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A aufrtcder ricbrmorfi talep oiarten(r llsuk rmaat)u anc lsutre in akilgne fo pensrleaoricb dlifu itno eht snoe dan olss fo eessn of lelm.s meSll lyasp a glear orel ni eht enotpepirc of t.tsae S,o ni iapre,ctc a apeintt aym pmnciola fo olss fo setat erhrta hant of l.smel

brownielove79  can it be a facial nerve??? with lateral head trauma (injury during passage through middle ear, or external auditory canal??) doubt!!! +1  
doodimoodi  Olfaction is actually more important that tongue sensation in terms of food taste (think of how food tastes bland when you have a cold) +1  
doodimoodi  than* +  
champagnesupernova3  If taste is completely lost then it's an olfactory issue. If its lost only on a part of the tongue then the nerve that provides taste to that area is suspected. +9  
veryhungrycaterpillar  UWorld QID 12227 The sense of taste isn't lost due to CSF in the nose, but due to avulsion of olfactory rootlets. +7  


submitted by hayayah(1056),
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llCician use of rgipKsna- uisdicret:

  • lsmayrooesediHtnpr
  • K+ lonedipte
  • HF
  • tecahip tsiaces oenr)cipnsoot(la
  • hncgpreneio ID i()mlieoard
  • grinadotnaen
redvelvet  Patients with hepatic ascites have hyperaldosteronism; because the intravascular volume is escaped to third space(ascites). So adding spironolactone is a good choice. +3  
champagnesupernova3  Always combine a K+ losing diuretic with a K+ sparing diuretic +10  
bryno20  My rational was a bit different. The patient likely has hepatorenal syndrome leading to a the ascites and decreased GFR. All diuretics, except for the steroids (eg, spironolactone), require secretion into the PCT in a GFR-dependent manner; for this reason, patient's with renal impairment show best success the steroid diuretics since their action is independent of renal function and GFR. +  


submitted by dickass(84),
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icnNlaoemfe:cne “Do on .ham”r

evnE fi teh tepntai nastw to e,di I .gesus

champagnesupernova3  FA says you cant assist suicide but you can prescribe pain medication which they can conveniently overdose on +1  
dickass  "Physicians may, however, prescribe medically appropriate analgesics even if they shorten the patient's life." (wink, wink) It's vague, but I guess the main point is to let the patient have relief, side effects no longer important. I still don't think you can just give the patient a bottle of benzos though. +1  
raga7  FA 2018 PG 260 +  
misterdoctor69  FA 2020 p. 268 +  


submitted by strugglebus(163),
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,kO os ouy can esrnoa isht by wnrdaig uto RITE r(yosr I ncta' rwda it )eh.er nAw,yoh ouy kwno its a cttvesireir oidersrd nda iwll vhea a ddceaeser V,R so aalotalmicytu yuo nwko ttah VR si a mnconpteo fo FCR R(C=F ER.R+V)V uTh,s RFC uholsd soal eb erdseecad. uoY loas kown ttha etevrrtisci sdiasees era tarcchreadzei by a daetsy eeadecrs ni E/FFVV1C sicne obht tnpsmoecon era nrgeeas.icd hTsi veaesl oyu wtih VC sgaiednerc inesc C=FV erfcod altiv taa.cpiyc

champagnesupernova3  FEV1 and FVC both decrease but FEV1/FVC actually increases because FVC decreases more than FEV1 so the ratio increases +  
fluentinwhale  Excuse my stupidity but what is REIT? +1  


submitted by celeste(78),
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elhWi the flmiiete risk in eht lganeer iltppauoon is ujts wloeb ,%1 it is 65%. in rfeesge-trdi eaitesrvl fo ttniasep dan it iesrs ot more hnta 0%4 in otnogioczmy siwnt of cedtefaf oepepl. laiznAygn clacssi dssiuet of eth snteeigc fo ihpzhseoirnac eond sa ylrae as ni s193,0 hcFeirs locusnecd ttah a cdarncoenco tare rfo isphcsyso of uobat %50 in ncomtiyogzo iswtn esesm to eb a elirticas eatm,iets hhwci si ngiylsifacint hrighe than htat in ctyoiidgz sntiw fo aobtu 910–%1 (//r2.3..ci5o4smrt/iCc6P#nnepiln9Mmvfegchb63la/)

imnotarobotbut  How is one supposed to know this before having read this article? +32  
imgdoc  This question falls under the either you know it or you dont category. It isnt in FA or Uworld +  
jaxx  So why would these A-holes put it on there as if prepping for this exam isn't stressful enough :-| +7  
doodimoodi  Lol just why seriously +2  
champagnesupernova3  This was mentioned in the Kaplan behavioral videos +  
usmlecrasher  and there's so much unnecessarily BS instead of real questions +1  
j44n  I'm just glad we're seeing this garbage now instead of having an aneurysm in the prometric center +1