Welcome to doublethinker’s page.
Contributor score: 1
I agree with you - I was thinking HD when they alluded to anticipation, but was thrown off by the maternal part.
Does anyone know what they're alluding to when they said "unable to fix his gaze on one point or protrude his tongue for more than 30 seconds?" Is that describing EPS? Oculogyric crisis is involuntary prolonged upward gazing (not an inability to fix his gaze) & orofacial chorea is involuntary repetitive movements (not inability to protrude the tongue). Am I missing something? It's entirely possible at this point of dedicated. My brain is gobblygook
Isn’t it all part of the choreiform movements the eyes and tounge....
Trick is, I think, that HD is Autosomal Dominant. Though it may be rare to get anticipation through the mom (I forget the exact reason why but it's something with genetics) I think they just wanted to emphasize it is possible.
lolll apparently 15% of cases are inherited x-recessive. I just ignored the inheritance part and answered based on the functions of all those proteins
According to the rare diseases government website, it's OFTEN X-linked recessive: "Alport syndrome can be inherited in three different ways. About 80 percent of cases are caused by mutations in the COL4A5 gene and are inherited in an X-linked recessive pattern."
Question def threw me off tho, because I was continuously thinking it's X-linked dominant...
@chandlerbas is this pneumonic in order of most common to least common, as in is prostate cancer the most common cause of metastasis to the bone regardless of wether the patient presents with osteoclastic or osteoblastic lesions?
One addition: Breast cancer causes mixed metastases, whereas lung cancer causes either lytic or blastic depending on the cancer type. Small Cell Lung Cancer causes blastic lesions and Non-Small Cell Lung Cancer causes lytic lesions.
First Aid 2019: pg. 224
Uworld has a great Venn diagram on all the bone mets.
Okay I feel like an idiot cause I thought: Above the Standard = Doing a good job keeping old people from getting ulcers. Thumbs up. Below the Standard = I wouldn’t let my worst enemy into your ulcer ridden elder abuse shack.
@zelderon Ohh damn. I could totally see how one could view the answer choices that way. I think it is important to read how they are phrased - they are asking if the center is above THE standard or below THE standard. The “standard” is an arbitrary set point, and the results of the study are either above or below that cut off. Maybe if it was “above/below standards” that would work. Also, being above the standard could either be a good thing or bad thing. If say you were talking about qualifying for a competition and you have to do 50 push ups in a minute, then being above=good and below=bad. In this case, having more ulcers than the standard = bad.
@aladar Thank you!!! but how did you get the 15 new ulcers per 180 patient⋅years? I mean I understand the 15 part, but not the second part ... hence why I messed this up, lol :|
@saysomore Because the study is looking at 100 residents over a period of 2 years. Since 10 already had the disease at the start, when looking at incidence you only include the subjects that have /the potential/ of developing the disease, so 90 patients over 2 years. This would be 90 patient⋅years per year, or a total of 180 patient⋅years over the course of the study.
@zelderonmorningstar I thought the same exact thing. Had the right logic, but then just put the backwards answer.
I wonder if they chose this wording on purpose just to fuck with us or if this was accidental. My guess is there's some evil doctor twirling his thumbs somewhere thinking you guys are below the standard.
Got it wrong!messed up in understanding options,
Btw, 15/90 is somewhat 16 percent and their standerd is 50/1000 5 percent!.. this is how i knew that incidance is way up!
Patients with an ulcer are not immune to getting new ulcers --> You should include all patients at risk. But either way, the answer is the same as long as you can read NBME speak.
Damn, guess my reading comprehension is not "up to the standard" of the NBME writers. Smh.
If you forgot that its patient years (15/180) not (15/90) you still get the right answer because they are both above 5% :).
carbonic anhydrase inhibitors can cause Type 2 RTA
but it is not the cause here (cystinosis)
Yeah, I said CA too. Problem is that CA deficiency wouldn't lead to lack of reabsorption of all the ions listed.