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Welcome to johnson’s page.
Contributor score: 26


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Hwo od you ghtuisisind shti morf csieatrtlu tosro?ni sI it tjus cuasebe ti adetsrt in eth telf ?afkln

neels11  and there's no mass in the scrotum, whereas testicular torsion will have that "bag of worms" feel (along with a lack of cremaster reflex) testicular torsion usually happens in a younger age group +9  
medpsychosis  @neels11 I would like to clarify a piece of information. I believe you are confusing Varicocele with Testicular Torsion. Varicocele will present with "bag of worms" feeling. While the absence of cremasteric reflex is a sign of testicular torsion. +15  
johnson  This is the classic "loin to groin pain" of nephrolithiasis. +5  
suckitnbme  Testicular torsion would also tend to have a unilateral high-riding testicle. +  


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U...hg ogt dpetirp up htiw Refre" obht tiapetn dna erh enrsatp ot a edctiii"na

verO Ik.nig.ih.nt huhtgot hte suocer fo htire rtugmnsae weer ta aelm tsemi o..elscyie.sapl bmaye yhet anc nifd a gdoo usionlot twih a endiait.ic

MACsCO RZORA SHIT .SIHT eepk ti pselim updsti. ehT narwse istf hte bset rfeat er igarend .ti

nwinkelmann  SAME.... ugh! +  
johnson  Also - you're almost NEVER referring/passing on a patient with the USMLE. +8  
bmd12  They are at meal times, which is why she's having difficulty following the prescribed diet bc her parents are arguing during that time so its difficult for her to correctly execute it when theyre constantly bickering, and bc she's only 13 so she cant effectively manage her diet without the help of her parents. And since the diet has been working with the patient prior to all the bickering, you can assume the diet is not the root cause. +1  
jamaicabliz  the universal constants: Death, Taxes, and never consulting the ethics committee +  


submitted by medstruggle(12),
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naC ooemsne npalxei hwy seod htis ipetnat haev pihlmkye?oaa

colonelred_  Catecholamines activate the Na/K pump, which will drive K inside. +11  
trazabone  Read online that catachelamines are released following tonic clonic seizures. Besides that, BP of 180/100 could indicate that catecholamines are circulating. +1  
fulminant_life  This mechanism is why giving albuterol for hyperkalemia works +8  
nbmehelp  Why does this guy have increased catecholamines tho +  
johnson  His SNS activity is seriously increased --> increased catecholamines. +  
nbmehelp  Why is his SNS activity increased? Is the BP literally the only hint? +  
youssefa  Alcohol withdrawal creates a hyper- catecholaminergic state + Seizures do that as well. +5  
water  My best guess is that withdrawal puts the body in a state of stress (same for seizures) and with stress you have release of catecholamine which we'll see in the BP and the hypokalemia. +3  


submitted by m-ice(321),
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eTh smot trpatmion cliateh pelirnicp that uesesdpser lal eohstr is tyouoman. roFm na eicatlh tn,otasndpi tihs tipaten hsa eth rhtgi ot feurse eurrtfh eanmerttt sa eh si ltymlena pcmteno,te ni hist esac in eth rfmo of ignhva teh reairorytsp eedmvro. mrFo a lgale ,tsdtionnpa the hcpsyniai si ledolaw ot sneictnudoi nmtteater rof a ietapnt if hatt si awth the atetnip ws.tna hTis si fdierntfe rofm tasstnioui fo hinaspyic isaessdt s,diiuec hicwh si more ocdceimtapl dna hsa ableiarv cihets adn ly.igatle

rhsteps  isnt this considered physician assisted suicide? +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +3  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
proteinbound123  In Physician-Assisted Suicide, the patient should be deemed “terminally ill” and “mentally competent” (by 2 different doctors) with less than 6 months to live (with or without treatment), he requests (written request, done twice, 15 -day interval) assistance to die and the doctor prescribes a lethal dose of a medication for the patient. If, in the meantime, the patient develops a life-threatening acute problem and requests the doctor to withhold or withdraw treatment, by the Principle of Autonomy the doctor should proceed as the patient wants. In fact, by the Principle of Autonomy, any competent patient has a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law. Competent adults can refuse care even if the care would likely save or prolong the patient's life. +1  


submitted by m-ice(321),
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eTh omst mttoirpna iethcal inicperlp ttha dereessspu lla rothse si uootn.yma romF an eitaclh intopdnat,s itsh npateti hsa eht rgtih to ersuef htrefur etratmnte sa he is nelmatly p,noctemte ni stih eacs in the fmor fo hiagnv eht ireroytrspa od.emrve oFrm a glale snptotaidn, het ipsyhinac is dlowlea ot iusoeticnnd tmnatreet ofr a atiepnt if htat si twha the anteipt wsant. isTh si etffidern form inusttoais fo pcihnisya iessstad ,icsduie hchiw si oerm paitcdcelom nda ash lbivarae ishcte dna lli.yetga

rhsteps  isnt this considered physician assisted suicide? +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +3  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
proteinbound123  In Physician-Assisted Suicide, the patient should be deemed “terminally ill” and “mentally competent” (by 2 different doctors) with less than 6 months to live (with or without treatment), he requests (written request, done twice, 15 -day interval) assistance to die and the doctor prescribes a lethal dose of a medication for the patient. If, in the meantime, the patient develops a life-threatening acute problem and requests the doctor to withhold or withdraw treatment, by the Principle of Autonomy the doctor should proceed as the patient wants. In fact, by the Principle of Autonomy, any competent patient has a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law. Competent adults can refuse care even if the care would likely save or prolong the patient's life. +1  


submitted by m-ice(321),
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hTe omst tmtnioarp ailcteh icelrnppi that edsspeeurs lal rtsohe is .noauomyt moFr an haetlic tdiotp,nsna tihs epitant hsa eth gtirh ot efeusr fhruter reatentmt sa eh is eltmanly metcet,opn in tsih easc ni hte fomr of hgnaiv hte sarrtyeoirp veo.mder mFro a eallg dsapotnt,ni the iiscyhpan si wloadel to tcdunosenii narttetme ofr a tnepita fi ahtt is twah eth nitaept wstan. ihsT si rntidfeef omrf iossaitunt fo npchisaiy sastsied iedsiu,c chihw is omer ticmlcoeadp adn ahs bilaevra cehtis dan leigta.yl

rhsteps  isnt this considered physician assisted suicide? +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +3  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
johnson  No - treatment is being withdrawn per the mentally competent patient's wishes. m-ice explained it well. +1  
proteinbound123  In Physician-Assisted Suicide, the patient should be deemed “terminally ill” and “mentally competent” (by 2 different doctors) with less than 6 months to live (with or without treatment), he requests (written request, done twice, 15 -day interval) assistance to die and the doctor prescribes a lethal dose of a medication for the patient. If, in the meantime, the patient develops a life-threatening acute problem and requests the doctor to withhold or withdraw treatment, by the Principle of Autonomy the doctor should proceed as the patient wants. In fact, by the Principle of Autonomy, any competent patient has a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law. Competent adults can refuse care even if the care would likely save or prolong the patient's life. +1  


submitted by mcl(579),
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looll os dtsenia of iugns zloiefompe eyth juts goann get him lear rdkun

johnson  yep - supposedly, ethanol is used when a hospital/facility doesn't have fomepizole. +5  
usmlecrasherss  Drink vodka man , either way you're dying +  
drschmoctor  Or if you really wanna get drunk and have a warm place to sleep, drink a bunch of methanol in the waiting room of the ED, then let them pump you full of ethanol and keep you safe. +2  


submitted by vshummy(153),
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oS het bets i uodcl dfin saw ni tsiFr Aid 0912 pg 634 neurd biDiatec iedatosoc.Kis eTh eiyrgphycmale dan parelykmahie ucsae na tosmcio resisuid os hte rnieet doyb estg eedptedl of i.fdslu ecenH ywh arpt fo the rateemtnt orf DKA si VI siuf.ld uYo ghmit veen ryel on that eipce fo tiinomnaofr olaen to anrews this quoi,tesn taht KAD is erettad tihw IV u.lfsdi

fulminant_life  I just dont understand how that is the cause of his altered state of consciousness. Why wouldnt altered affinity of oxygen from HbA1c be correct? A1C has a higher affinity for oxygen so wouldnt that be a better reason for him being unconscious? +6  
toupvote  HbA1c is more of a chronic process. It is a snapshot of three months. Also, people can have elevated A1c without much impact on their mental status. Other organs are affected sooner and to a greater degree than the brain. DKA is an acute issue. +5  
snafull  Can somebody please explain why 'Inability of neurons to perform glycolysis' is wrong? +3  
johnson  Probably because they're sustained on ketones. +3  
doodimoodi  @snafull glucose is very high in the blood, why would neurons not be able to use it? +1  
soph  @snafull maybe u are confusing bc DK tissues are unable to use the high glucose as it is unable to enter cells but I dont think thats the case in the neurons? +1  
drmomo  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909073/ states its primarily due to acidosis along wth hyperosmolarity. so most relevant answer here would be dehydration +1  
drmohandes  I thought the high amount of glucose in the blood (osmotic pressure), sucks out the water from the cells. But you also pee out all that glucose and water goes with it. That's why you have to drink and pee a lot.. +7  
titanesxvi  Neurons are not dependent on insulin, so they are not affected by utilization of glucose (only GLUT4 receptors in the muscle and adipose tissue are insulin dependent) +24  
drpatinoire  @titanesxvi You really enlightened me! +  
mutteringly  I don't make the connection of what titanesxvi said to the question - can someone explain? +  
motherhen  @mutteringly it explains why the answer choice "inability of neurons to perform glycolysis" is wrong +1