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Welcome to deathbystep1’s page.
Contributor score: 14


Comments ...

 +1  (step2ck_form7#12)

IV contrast dye used for pulmonary angiography worsened the renal insufficiency(inc in serum CR). Adequate hydration before IV contrast in patient with renal insufficiency can prevent this.


 +11  (nbme24#6)
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lla het terho sveless, iether hvea callatrloe siuspelp or hyet lpuysp ot ganors thwi iumlltep uerssoc of oodbl upspyl

MIA and SAM bhot vhae alocelstral htwi ceha rohte lam(airng rrasteie dna nenieargdm rar,iet)es os aenics etehr is evinotenmlv fo oen fo hte srateeir het oldob pyslup ormf eohrt anc evrpnet ih.aecsmi

tbu if ohtb MAS dan MIA are denvivlo ti wduol ultrse in mihaiecs nad pmystoms debedisrc ni eth oqiust.en

paperbackwriter  Spot on! +

 +0  (nbme24#13)
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ntoopi B) eh(t retrcoc otopni sa epr mebn) the: tpaenti sah a imin telnma sttae fo 0323,/ so that uodhsl nmea ahtt she 'snit ealapcb fo iagnmk her nwo disniecos! so tsahw hte point ni gniaklt to rhe laiyptevr otiwhtu rhe dtguhre?a

pntooi A) is rgown caueesb uyo ntac tsuj eidh eht dgiossain orfm hte aittnpe adn rhsea ti twhi eht lyfami

tnipoo C a;m&p oDuy) oncnta direrdags het sett or ptaree the test sa bhot eth sett are ovi,itsep PRR is a geecnnsir stte wiht lsse estiicyifcp utb hguooacneimatltigimnr si a iyhglh ecpsiicf etts os seh lfeenityd sha plihly!ssi

inotpo )E edtnos aekm nssee ucsbaee yhw ulwdo ouy do abulmr upctnuer rof ?s!isyilphl

i tkhni heyt gfrtoo ot gvei an pntioo F) sjtu kafenir atter hre for isp!l!hi!yls

saturdaynightpalsy  "Patients with suspected neurosyphilis should undergo lumbar puncture and subsequent VDRL, FTA-ABS and/or PCR of cerebrospinal fluid" per my notes and the internet Lumbar puncture is used to diagnose neurosyphilis, so that's what I put. +1
saturdaynightpalsy  To add to that, I didnt choose the other answers you listed for the same reasons you listed. +1
ac3  which of the following is the NEXT BEST STEP meaning you wouldnt want to jump straight to a lumbar puncture especially when there are answer choices that suggest discussing the diagnosis with the patient first. If you went to the doctor and they diagnose you they will discuss this with you before ordering additional testing. +1
yerpderp  23/30 is also just mild cognitive impairment so I just thought she still had decision making capability as 24/30 is still normal +2
cbreland  Are we expected to interpret MCI scores +




Subcomments ...

submitted by buttercup(14),

Bone marrow examination is generally not required for the initial evaluation in most cases of unexplained isolated thrombocytopenia in children. This child has pancytopenia and therefore requires a bone marrow aspiration.

jesusisking  Why wouldn't it be platelet transfusion 1st? +  
jesusisking  Just found the answer. Patient was stable and not actively bleeding w/ 30K platelet count. For this type of patient, start transfusing at <10K: https://www.aafp.org/afp/2011/0315/hi-res/afp20110315p719-t2.gif +4  
deathbystep1  well the question said "his gums started bleeding when he brushed his teeth". So wouldn't that be considered active bleeding? I was aware about the aafp guidelines as there was a similar question in Uworld as well. The only reason i chose platelet transfusion was because he was "actively" bleeding from the gums. Otherwise it was clear that he had pancytopenia and you need to do a bone marrow biopsy. +  
zalzale96  Isn't bone marrow aspiration considered an invasive procedure and thus we should transfuse since his platelets level is below 50k? +  


submitted by medstruggle(12),
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Why is it ton ovanair ofcillel els?cl I uhtgoth hte mfeael gaonla fo itorelS and iyeLgd is clrotaenagsa/uh e.lslc

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +7  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +37  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +17  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


submitted by m-ice(326),
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eeimivtpotC istbironhi sicrenea teh Km of eht atsbs.erut heT mK enrestreps ohw elsaiy a srsebautt acn nibd eht cviate siet, htiw a wleor mK rispentgnere syea ,bginidn dna a igerhh Km nmeigna emor tid.lcifuf fI uyo add a ievtitcempo iobrhitin, liek oaelhnt in thsi asc,e it kmsae it remo ciidufltf rof hte mehnolta ot bind eht itceva iest, acesbue it tsmu ocmepte wthi teh elthnoa.

deathbystep1  but how is ethanol a "inhibitor" of alcohol dehydrogenase? isnt the concept that both ethanol and methanol compete for the same binding site of alcohol dehydrogenase and hence ethanol displaces methanol preventing its metabolism? if ethanol were to be a inhibitor it would have to shut off the enzyme, which is does not. +  
krewfoo99  @deathbystep1 Competitive inhibitor simply means increasing concentration of a particular substrate will allow more binding of the substrate to the enzyme. Thus the substrate with the higher concentration will competitive inhibit the other substrate by binding to the enzyme. It dosent necessarily shut off the enzyme +3