Welcome to hopsalong's page.
Contributor score: 20
I would say: "I understand why you are missing injections, but you're going to have a BAD TIME IF YOU KEEP MISSING INJECTIONS"
@dentist, I was searching for that answer as well, but it wasn't there so I picked C ahahaha
Great explanation. Always found it hard to differentiate between ATN and AIN due to NSAID use. This made it clear. Thanks!
"occasionally writhes in pain" -- as a guy who has had a kidney stone, writhing in pain definitely hits the mark. Picture yourself knees on the ground, face on the couch, screaming incoherently while the paramedics are there because you can't control your own body movement and don't know if you're dying or whatnot from the canonball sized hole that (may or may not be) in your flank. Then imagine one of the paramedics is your premed study buddy. Never forget writhing and nephrolithiasis and premed study buddies. You will forever get this question correct in the future.
i swear to god ive done a similar question on the usmlerx qb and they answer was renal papillary necrosis. which is why i got it wrong :(
i also remember that uw ques which got me this ques wrong. i think in that ques,patient sibling or he himself had sickle cell
Something that could help. Gabapentin is a narrow spectrum anti-epileptic drug used to treat seizures. It blocks voltage gated Calcium channels. It also treats neuropathic pain (which this vignette hints at both).
My thinking for this question: the patient is having seizures so must be sodium abnormality. But then they mention the pins and needles and involuntary contractions, and this being the first seizure, it sounded less like a sodium issue and more so Calcium.
I think what hopsalong said makes a lot of sense. I think there is a pharm angle this question could have taken as well.
Agreed. I'm pissed though because PGE2 mediates pain, which is why I picked it.
If im not mistaken, the question describes unstable angina. Unstable angina is due to thrombosis with incomplete occlusion. So, yes TXA2 is responsible for the thrombus that is causing the symptoms in this patient. I'm also pissed because I also went straight for the PGE2
hahah, seems like all in same boat like me
thromboxane A2 is also vasoconstrictor, so my thoughts were about vasospastic angina
same I went for pgE2 ... I M PISSED
same I went for pgE2 ... I M PISSED
Went for PGE2 ... shit
I went for leukotriene B4, what the hell was I doing....SHIT
I picked Leukotrine B4 thinking that the neutrophil infiltration was the source of the pain, seems wrong lol.
Sometimes it helps me to think of it in a general, non med school textbook kind of way. When answering, I narrowed it down to PGE2 and TXA2 as well. Then I asked myself, if someone is experiencing chest pain, would I recommend Aspirin or Advil? That's helped on a few over the counter pharm questions.
same here I M PISSED PGE2
Maybe PGE2 isint the answer because it mediates pain and fever during episodes of acute inflammation? Thus making TXA2 more likely.
ditto on the looked at it for 2 seconds and went PGE2
I use barrett's esophagus to remember these questions. Remember barrett's esophagus is squamous to columnar metaplasia -> this happens because of increased acid in the esophagus. What this means is that columnar cells are better for dealing with acid/internal fluids, and are a better cell type. Squamous is a better cell type for dealing with outside irritants. This means the vagina will be lined with squamous cells normally, and the cervical canal will be lined with columnar epithelium.