But i was thinking back and chest are protected by clothese and Scalp protected by hat or hair and Palm not much exposed. So I chose forehead.
No one talks about AR? That's much more unlikely in this case than XR
Hypersensitivity pneumonitis (inflammatory interstitial pneumonitis) is a hypersensitivity reaction following exposure to environmental allergens. It is associated with inflammatory interstitial lung disease. Chronic inflammatory pneumonitis leads to destruction of Type I pneumocytes, an increase in Type II pneumocytes to serve as progenitor cells to replace alveolar cells, and an increase in fibroblast proliferation.
This 36-year-old patient with protruding abdomen has fluid collection in the omental bursa (lesser sac) on CT imaging. The omental bursa (lesser sac) is the cavity in the abdomen that is formed by the lesser and greater omentum. It is connected with the greater sac via the omental foramen.
The omental bursa is a complex and important anatomical region. It serves as a barrier to block pathological processes, but it is also a channel for disease spread in the abdominal cavity. It is a large recess of the peritoneal cavity formed by a double-layered fold of serous peritoneum situated inferiorly to the liver, posteriorly to the lesser omentum and the stomach and anteriorly to the pancreas.
Under physiological conditions the omental bursa is poorly visualized, both because it is situated deeply in the abdomen and because the cavity is merely a potential one containing only a small amount of liquid, which acts as a lubricant. However, the omental bursa may become clearly visible in the presence of disease.
The pathological conditions of the omentum are varied, and findings may range from fluid collection to widespread infiltration. Ascites (regardless of the cause), pancreatic necrosis during and after acute pancreatitis, chronic pancreatitis, surgery involving the pancreas or trauma may cause peripancreatic fluid collections. The omental bursa may therefore present noninflammatory or inflammatory fluid collections in different phases, pancreatic pseudocysts and hematoma.
a link to anatomy https://eidimages.s3.us-west-1.amazonaws.com/images/coronal%20diagram%20of%20abdomen.png-1592945646758.png
The patient is presenting with headache, myalgia, fatigue, sudden onset of high fever and chills, unilateral swollen and tender lymph nodes, and buboes containing malodorous pus discharge has the bubonic plague and must be treated with aminoglycosides which interfere with ribosomal assembly. The bubonic plague is caused by Yersinia pestis โ a small facultative intracellular gram-negative bacilli. It is transmitted from rodents to fleas to humans. Reservoirs include rats, squirrels, and prairie dogs of the southwest US. The bubonic plague presents with hot, red swollen lymph nodes (especially in the inguinal regions), and skin hemorrhages with black discoloration.
Alternatively, this patient may be infected by Francisella tularensis โ another small gram-negative coccobacillus that is facultative intracellular within macrophages. The organism enters at site of infection, then travels in macrophages to reticuloendothelial organs where it produces caseating granulomas. It is transmitted from wild animals to Dermacentor tick/deer flies to humans. Ulceroglandular Tularemia is one of the presentations and presents with black skin ulcer at the site on infection, swollen, red lymph nodes; all of which closely resembles the bubonic plague.
Both Francisella tularensis and Yersinia pestis infections can be treated with an aminoglycoside
But i was thinking TUMOR NECROSIS (factor, TNF).And fact that rapid growing tumor alwasy get necrosis due to deficient blood supply(eg. GBM). And Burkitt is definitely rapid growing(High ki-67) Please correct me thx
The key is when her legs up, Bp normal and symptoms free. In contast, When standing up(running), low Bp and syncope. And Low volume is surly the MMC. It's just so weird. "retrospective posture change"??
For those choosing puppies: Puppies, New pet-----Toxocara canis Pet feces(eg puppies)---Yersinia
FA2021 p276 "Thank the patient for being patient and apologize for any inconvenience. Stay away from efforts to explain the delay." So it's another ugly FA-copying Qs
Most petroleum jelly today is used as an ingredient in skin lotions and cosmetics, providing various types of skin care and protection by minimizing friction or reducing moisture loss (from wiki)
Firstly, I chose ADH. When I thought twice in review, I picked crossed ADH and picked ANP. My logic to cross ADH: 1. The main inducer of ADH are Osm and BP/vlomue. THis pt, Osm obviously not high, Bp obviously not low. So, nonsense in increased ADH. 2.You may see AngII also induces ADH. But it seems to be a minor inducer. Meanwhile, if it is exactly high AngIIโ high ADH. Then, Aldo must be high as well, and High Aldo โSalt preservingโ HOW CAN serum Sodium be LOW? "Low Cardiac outputโ High RASS (AngII Aldo ADH)" pathway is WATER-SODIUM retention. NOT pure WATER retention Please correct me
Can anyone explain what "diplopia" implies? I got sutck by"these clinical findings" (thinking upward gaze+ diplopia....) Or is "Diplopia" just a unspecific word in exam??
No such thing as hypoallergenic dogs!!
The major dog allergen, Can f 1, is responsible for allergies in most people who are allergic to dogs. Hypoallergenic breeds of dogs were promoted because it was thought they would produce lower concentrations of Can f 1, and therefore cause less (or even no) allergic symptoms in people with a dog allergy. Examples of dog breeds that have previously been labeled as hypoallergenic include Poodles, Labradoodles, and Yorkshire terriers. There is no scientific proof these breeds truly produce lower amounts of Can f 1; these dogs were simply labeled as hypoallergenic because of the false assumption that dog breeds that do not shed hair must release less allergen.
(Nicholas CE, Wegienka GR, Havstad SL, Zoratti EM, Ownby DR, Johnson CC. Dog allergen levels in homes with hypoallergenic compared with nonhypoallergenic dogs. Am J Rhinol Allergy. 2011;25(4):252โ256. doi:10.2500/ajra.2011.25.3606)
X linked recessive there can never be any Male to Male transfer since the male offspring gets Y from father. the pedigree shows Male to Male transmission so this cannot be X linked recessive
Can anyone clarify why "BOTH PARENTS had learning difficulties??""
its best to think about pituitary adenomas as one of three big options, prolactin secreting, ACTH secreting, or GH secreting. The only pituitary tumor that causes osteoporosis and therefore the compression fractures seen in the questions could be a ACTH secreting pituitary adenoma (note: macroadenoma just means that the tumor is >10mm in size). increased ACTH leads to increased cortisol and therefore decreased osteoblastic activity (bone formation) = osteoporosis
Here's how I understand this; please correct me if I'm wrong: Fibrin exudation is part of the acute inflammatory response if the inflammatory stimulus is a lacerating wound, (such as, in this patient, perforated diverticulitis), along with platelets and other clotting factors, in order to clot the wounded area. Hence in this patient who died 2 days following acute perforated diverticulitis, the inflammatory exudate surrounding the liver would most likely contain fibrin (not collagen, since the inflammation is acute and not chronic). Fibronectin and proteoglycans, the other two options, are extracellular matrix proteins.
Petrolatum is a compound found in sunscreen.
He started working outdoors AKA getting sunburns (if left unprotected, lower lips are one of the prime locations where people can develop squamous cell cancer later on). He should really use sunscreen, which is a barrier (absorbs the UV rays so the skin does not-- rather than deflecting the sun rays.)
If it ain't broke don't fix it. The patient is showing improvement and there are no signs of developing drug resistance or unwanted side effects, so maintain the patient on her current therapy.
Typical antiretroviral HIV therapy regime is:
3 NRTIs OR 2 NRTIs AND 1 NNRTI OR 1 Protease inhibitor OR 1 Integrase inhibitor
In this case the patient is on 2 NRTIs (emtricitabine, tenofovir) and an NNRTI (efavirenz)
Histone acetylation allows for relaxation of the DNA so that transcription can proceed. All trans retinoic acid causes the granulocytes in APML to further mature, which requires DNA transcription / translation.
A laminectomy removes the lamina and spinous process. The lamina is the posterior bridging segment (D). The lateral bridging segment is the pedicle (B).
However, I don't understand how you could access the herniated disc from this angle, the spinal cord would be in the way! Can someone explain?
https://www.mayoclinic.org/tests-procedures/laminectomy/about/pac-20394533
Hemochromatosis, aka "bronze diabetes". Cannot be Addison due to the hyperglycemia and normal BP
Although acetaminophen (Tylenol) is not considered an NSAID, it too may provoke an aspirin-like sensitivity.
corticosteroids - steroid bind to receptor located in nucleus or cytoplasm --> transformation of receptor to expose DNA-binding protein etc pg 332 FA 2019
Pronator teres and quadratus are both supplied by median nerve (C5/C6/C7/C8/T1, so that's not super helpful.) Extension of the forearm is radial nerve (also C5-T1, also not helpful). This does tell us is it can't be isolated median or radial. Triceps tendon reflex is C7/C8, which narrows it down to these two.
Can anyone explain why it's C7 over C8?
I think alot of people might have over emphasized how important ANP and BNP really are, yes it is important to know these peptides get secreted by the atrial/ventricular myocardium during heart failure. However their overall effectiveness in treating heart failure is zilch, a preceptor told me that if ANP and BNP were so useful in natriuresis then why do we give diuretics? It's because RAAS overpowers this system hence causing negative effects and the endless loop of heart failure. AKA why we give ACE inhibitors.
Knowing that ANP gets neutralized by the RAAS system, we can shift our focus back to heart failure in this patient, where cardiac output is decreased, leading to ADH secretion and finally dilutional hyponatremia.
Segmented neutrophils should be the largest population of leukocytes. This girl has had a very low neutrophil population since birth, indicative of congenital neutropenia. All other cell counts are normal (RBC count and hematocrit at birth are actually high but normalize by 1 month).
None of the other disorders would cause severe neutropenia. SCID and DiGeorge are more likely to have lymphopenia. Congenital CMV causes hearing loss, seizures, rash, chorioretinitis, and periventricular calcifications. Alloimmune hemolytic disease of the newborn would present with anemia.
Inferior oblique = helps you look up & in.
Also, they said floor of the orbit, so it makes sense that the inferior muscles would damaged.
No such thing as hypoallergenic dogs!!
The major dog allergen, Can f 1, is responsible for allergies in most people who are allergic to dogs. Hypoallergenic breeds of dogs were promoted because it was thought they would produce lower concentrations of Can f 1, and therefore cause less (or even no) allergic symptoms in people with a dog allergy. Examples of dog breeds that have previously been labeled as hypoallergenic include Poodles, Labradoodles, and Yorkshire terriers. There is no scientific proof these breeds truly produce lower amounts of Can f 1; these dogs were simply labeled as hypoallergenic because of the false assumption that dog breeds that do not shed hair must release less allergen.
(Nicholas CE, Wegienka GR, Havstad SL, Zoratti EM, Ownby DR, Johnson CC. Dog allergen levels in homes with hypoallergenic compared with nonhypoallergenic dogs. Am J Rhinol Allergy. 2011;25(4):252โ256. doi:10.2500/ajra.2011.25.3606)