Welcome to fkstpashlsโs page.
Contributor score: 23
Comments ...
djinn
I dont think the autor was a savant. Also I think is right proccess to think "cancer" can be bilateral and malignant but the "drug" that causes this isnt HCT. This question is bad written.
+1
hungrybox
According to Pathoma, galactorrhea is NOT associated with cancer ever (see 16.1 - breast pathology).
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djeffs1
according to strugglebus's numbers its more likely to be b/l cancer than thiazides...
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Subcomments ...
krewfoo99
I think its because his hypothyroidism is being overtreated with levothyroxine.
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wasifp
So I respectfully disagree that he is being over treated because the TSH would drop below 0.5 if that was the case. His hyperreflexia and resting tremor along with mutism and staring are consistent with catatonia which is seen in severely schizophrenic patients. Catotonia can be both "excited" and "retarded". The excited aspect of his catatonia is the hella purposeless movement (eg, tremor) and his spasticity maybe actually be a manifestation of posturing seen in these patients.
+3
fkstpashls
they're parkinsonian symptoms more than catatonia symptoms, though.
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cinnapie
Contraction of right SCM moves your chin to the left. I know its weird to think that the SCM kinda pushes the chin away but its how the origin and insertion of the muscle is.
+3
fkstpashls
If you're slouching in bed with your mouth open wondering why you get rammed by another question, tense up your SCM on one side and you'll feel your jaw move to the opposite.
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etherbunny
...in which case ultrasound would demonstrate vascular compression, so it's still a good option. However DVT is far more common with lower limb surgery and immobilisation (or was, before LMWH became a standard of care).
+2
fkstpashls
Just adding to the above, because it initially got me on UW: just because they're getting LMWH doesn't mean they can't get a DVT, it's just much less likely.
+1
jigermisker
I just read the question again. fixation was right leg, pain now is left leg.
+5
fkstpashls
Yup, just adding a little bit to this:
You can have a normal range pH but expect both primary resp alk and primary met acidosis afterwards to be present, making sure you have an elevated anion gap - if you have questions with the arrow shit to choose from.
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seagull
Seems like fatty change would require more than 1 weekend. I choose swelling since it's reversible and seems like something with a quick onset.
+51
nc1992
I think it's just a bad question. It should be "on weekends"
+17
uslme123
https://webpath.med.utah.edu/LIVEHTML/LIVER145.html
+27
uslme123
So his hepatocytes aren't dying ( ballon degeneration ) vs just damaged/increased FA synthesis due to increased NADH/citrate
+1
et-tu-bromocriptine
It's not in pathoma, but I have it written in (so he or Dr. Ryan may have mentioned it) - Alcoholic hepatitis is generally seen in binge drinkers WITH A LONG HISTORY OF CONSUMPTION.
+1
linwanrun1357
Do NOT think the answer of this question is right.
Cell swelling make more sense!
+1
fkstpashls
some asshole in suspenders and a bowtie definitely wrote this q, as I've seen both acute swelling and fatty change be used to describe one episode of drinking.
+15
msw
short term ingestion of as much as 80gm of alcohol (six beers) over one to several days generally produces mild , reversible hepatic steatosis . from big robin 8th edition page 858. Basically to develop alcoholic hepatitis with cellular swelling etc you have to have sustained long term ingestion of alcohol while steatosis can develop with a single six cap . hope that helps . ps i got it wrong too .
+3
mariame
After even moderate intake of alcohol, lipid droplets accumulate in hepatocytes increasing with amount and chronicity of alcohol intake. (...) Fatty change is completely reversible if there is abstention from further intake of alcohol.
The swelling is caused by accumulation of fat, water and proteins. Therefore this will occur later. From big Robins 9th pg842.
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l0ud_minority
Just thinking about this Alcohol is a Mitochondrial poison which would lead to stress uncoupling of oxidative phosphorylation and cellular swelling. I got it wrong with that logic though which is frustrating.
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mmm21
Okay i might be retarded, but why i canโt understand that they r asking about the thing that is damaged ? ๐๐
+8
sahusema
Seriously! The question says "the goal of treatment is the protection of which of the following structures?" If too much O2 damages the retina, how is this treatment supposed to be protective to the retina?
+2
ratadecalle
I think too much oxygen would be with the ventilator having a high FiO2 setting, which they don't mention here but I'm guessing thats the thing they're controlling to avoid oxygen toxicity?
+2
burak
they didn't give the patient fio2 100%, question asks the reason for it. but in a very stupid way
+31
naught
Supplemental O2 may also cause bronchopulmonary dysplasia or intraventricular hemorrhage (germinal matrix, located in subventricular zone NOT choroid plexus)
+1
fkstpashls
92-95% isn't high, but it's enough to get everything else oxygenated. Because it's not 100% high flow the retinas don't over-vascularize and lead to damage/hemorrhage, and shit like that.
+1
soccerfan23
In other words....the question is basically asking why they gave the patient a fio2 of 92-95% instead of 100%. The reason is because 100% oxygen would lead to retinopathy of prematurity. The lower 92-95% oxygen levels protect the retina from damage. The wording of the question sucks tho imo.
+3
randi
FA 2019 p210 under Free radical injury examples
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sympathetikey
Got the right answer too, but man, that whole "1 month after starting therapy" almost threw me off.
+1
fkstpashls
all I do is put the wrong answer when I'm between two. Fuck
+1
Process of elimination is the only way to get this answer without Savant levels of autism, as some bowtie wearing doucher who wrote the question probably has.
Cancer is unilateral almost all the time, DM doesn't make sense for any reason, HTN itself wouldn't cause milky boobs, and mast cells degranulating doesn't make milky boobs either. So, and because many drugs can have milky boobs, you're left with drug effects by process of elimination.