NBME Answers : goodkarmaonly's page

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-2 visit this page (nbme23#41)

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The ECG shows a Mobitz Type 1 block (prolonging PR followed by a dropped wave. These blocks usually arise as a byproduct of a dysfunctional AV node, so ablation at the AV node is the most appropriate answer in this case

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kcyanide101 This looks more like a mobitz type 1. You can compare the ecg readings to that on FA.... First Degree HB & Mobitz type 1 are usually AV problems.... While Mobitz type 2 and 3rd degree are HIS purkinje fibre issues +

+3 visit this page (nbme23#6)

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Disorders common in east Asia according to Goljan: Hepatitis B EBV infection - mostly leading to nasopharyngeal CA Alpha Thalassemia Nitrosamine linked Intestinal type gastric CA

In this question, since the patient is asymptomatic and EBV isnt exactly "screened for", went with HepB as the answer

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ls3076 i think asymptomatic is really the key here -- good catch +3

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submitted by bigbootycorgi(5), visit this page

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So I got this one wrong because I thought that since he didn't have hepatosplenomegaly and ascites his liver was still fine, but I guess if he already has gynecomastia, hypogonadism and the ever obvious spider angiomata he's definitely still ok

Now that I think of it, you don't need hepatosplenomegaly to have alcoholic liver failure I believe.

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bigbootycorgi sorry my bad this was the wrong question i responded to but i still got this one (ED one) and the gynecomastia one wrong i think it's liver for this one because they say it has regenerative potential and because even though the small intestine has regenerative potential, it can apparently fibrose? i have no idea, i put small bowel +

kateinwonderland @bigbootycorgi : I put small intestine too. From what I've searched after, it says that liver fibrosis reversible -> no evidence of fibrous scarring +

goodkarmaonly Just to add to that, a cirrhotic liver is a small shrunken liver so you wont be able to find hepatomegaly anyways. The other signs are the stigmata of Liver disease +

submitted by seagull(1933), visit this page

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This patient is tripping balls. Better do a drug screen which seems obvious.

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sympathetikey When the answer is so obvious that you pick a stupid answer instead of it. DOH +49

jooceman739 Funny thing I noticed is "he is alert and cooperative. He appears to be in pain" So he was so high that he was alert and cooperative during the basal ganglia hemorrhage +5

yotsubato @sympathetikey That fucking guy who drinks 2 six packs a day with liver failure got me like that. +2

yogi probably the "drug" have to be a stimulant or a hallucinogen which causes HTN & Tachycardia. +3

charcot_bouchard Lol. I got the right answer but took long time +

goodkarmaonly The patient's B.P. and pulse are raised + Bilateral dilated pupils = Most likely use of a stimulant Thats how I reasoned it anyways +1

llamastep1 Bilateraly messed up pupils = Drugs (most of the time) +1

targetmle why is there basal ganglia hemorrhage? +

dul071 Wait! doesn't it take like a week or two to get the results back!?!? i chose to measure catecholamine levels because that may be more timely. but clearly i'm wrong +1

usmile1 basal ganglia hemorrhage is an intraparenchymal hemorrhage secondary to hypertension. according to FA, this occurs most commonly at the Basal Ganglia (FA19 pg 501) +3

fatboyslim I think this is cocaine intoxication which raised his blood pressure too high and it popped an arteriole in the basal ganglia. +