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submitted by sahusema(143),
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aWht a EAGGARB oqs.utnei He aws iagten erksbfaat 2 hsruo oga sjut einf dna onw we ear dsesoupp ot evha het imaylf moec to a onsencssu tbauo a eigefdn utbe like 'hse no hsi tadhe d?eb USTIHLLB

daddyusmle  Did you get the question wrong? +  
notyasupreme  ^ ummm.. chile anyways.. +  


submitted by haliburton(213),
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uuolBls hpgdopimie enigatn tmsu be esedmmsemo.ioh FA: lbual ear wb"u"oll eth eirdms eslaub(mpredi .bertsli) PB oasl iedyl e"ent"s a.blul

seagull  I love how this cant be straight forward. All the other proteins are either subunits of desmosomes or cytoskeletal components. Because I know molecular biology that well on top of the majority of medicine....FML +10  
cienfuegos  @seagull: excellent comment, literally loling right now +  
cienfuegos  or sobbing and threatening to hold my breath if they don't make it stop +1  
daddyusmle  WHY DIDN'T THEY JUST PUT HEMIDESMOSOMES THE FUCK +13  


submitted by drdoom(873),
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250,0 nsuettds ... but you ifdn out uridgn uryo ltiniai rnesec atth 500 ylaaerd veah the eis.ades ,oS ktesitrou shtoe polpee. thTa evesal 0,200 dnessutt hwo ndo’t eahv the idsasee.

veOr eht escuro of 1 rae,y ouy dcvioers 002 tetnussd ldpoevdee teh ii.efntnco u:Tsh

200 enw sasec / 2,000 ppolee hwo d’nidt veah het sdiesae nweh you eadsrtt your ustdy = 10 pterenc

,kyrciT rytkic EBNM ...

sympathetikey  Ah, I see. Thank you! +  
niboonsh  Im mad at how simple this question actually is +7  
sahusema  Incidence is measured from those AT RISK. People with the disease are not considered to be at risk. So 2500 - 500 = 2000 people at-risk. Of those 2000, within one year 200 develop the disease. So 200/2000 of the at-risk population develop the disease. 20/2000 = 10% = incidence +3  
daddyusmle  fuck im retarded +2  


submitted by frijoles(14),

I chose E) because I was thinking androgen insensitivity syndrome. However, I realize the wording of the question is which HORMONE would be reduced and in AIS, testosterone levels would not actually be reduce.

To be clear though, AIS could have the EXACT same described presentation, yes? (46.XY with male genital ducts & female external genitalia) Just want to make sure there is nothing else that could have tipped me off. Thanks.

daddyusmle  Yup you got it. AIS is a defect with the androgen receptor in target tissues, not with the hormones. AIS has the same presentation: Genotypically XY but has female external genitalia and male internal genitalia. This is most likely 5-alpha reductase deficiency. +  


submitted by benzjonez(45),
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AF 0812 p. 690. tSseupc raheultr riyunj fi ldobo is sene at hte aruhlrte es.amtu minsacehM fo oorpstrei hrauetrl riunyj = levcpi racr,teuf ichhw we see in sith ant.itep aehtUlrr eheoinztirttaac si lreeyavtil ntind.eaoairdcct

hyperfukus  thank you! +  
baja_blast  Understood, but is there anything in the question that rules out BPH specifically? I honed in on the words "most likely" and saw he was 60. I guess I overthought it but I'd appreciate any insight as to what if anything in the Q makes that definitively wrong. +  
daddyusmle  I think the question stem, with the trauma and fractures, points you in the direction of membranous urethral trauma. Pelvic fractures are more associated with urethra damage than prostate damage, although they're right next to each other, and I can see why someone would choose prostate hypertrophy. Also, I'm not sure if bleeding is associated with BPH. +  
mumenrider4ever  FA 2020 pg. 627 +2  
nio5021  could someone explain why urethral stricture is incorrect? +  
nio5021  According to mayo clinic, strictures can be caused by trauma to pelvis as well. Would strictures be more likely if this patient had some sort of procedure done? https://www.mayoclinic.org/diseases-conditions/urethral-stricture/symptoms-causes/syc-20362330 +  
eghafoor  @nio5021: "Trauma to the anterior urethra is often from straddle injuries. This can occur with a sharp blow to the perineum. This type of trauma can lead to scars in the urethra ("urethral stricture"). These scars can slow or block the flow of urine from the penis. Trauma to the posterior urethra almost always results from a severe injury. In males, posterior urethral trauma may tear the urethra completely away below the prostate" Source: https://www.urologyhealth.org/urologic-conditions/urethral-trauma#:~:text=Trauma%20to%20the%20anterior%20urethra,of%20urine%20from%20the%20penis. +  
eghafoor  The key for this question was recognizing that the pelvis was fractured = unique only to posterior urethral injuries (FA 2020 p. 627), and after was to realize that you'd have an urethral disruption/tear +