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 +0  (nbme20#36)

In the pancreas' beta cells, proinsulin splits apart to form one molecule of C-peptide and one molecule of insulin.

C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken exogenously and so does not generate C-peptide.


 +2  (nbme20#8)

Atrophy in myocytes. Atrophy is due to cytoskeleton degradation via ubiquitin-proteasome pathway.

Polyubiquitination: The binding of many ubiquitin molecules to the same target protein. Polyubiquitination of proteins is the triggering signal that leads to degradation of the protein in the proteasome. It is polyubiquitination that constitutes the "kiss of death" for the protein.


 -1  (nbme20#40)

It's called patient consent, you've probably heard of it


 +0  (nbme20#4)

Patient has infectious mono. Atypical lymphocytes (reactive CD8+ T-cells) are seen on blood smear for infectious mono.





Subcomments ...

submitted by neonem(262),

Alcohol withdrawal leads to a sympathetic-hyperactivity-like syndrome with tremors, HTN, insomnia, GI upset, diaphoresis, and mild agitation 3-36 hours after the last drink. There is a similar, but usually slightly later, overlap of withdrawal seizures 6-48 hours after the last drink.

katsu  Alcohol withdrawal sx (p. 554 FA 2018) Time from last drink: 3–36 hr: tremors, insomnia, GI upset, diaphoresis, mild agitation 6–48 hr: withdrawal seizures 12–48 hr: alcoholic hallucinosis (usually visual) 48–96 hr: delirium tremens (DTs) Treatment: benzodiazepine +  


submitted by hayayah(413),

Most common cause of gastric outlet obstruction in infants. Palpable olive-shaped mass in epigastric region, visible peristaltic waves, and nonbilious projectile vomiting at ∼2–6 weeks old.

Ultrasound shows thickened and lengthened pylorus. Treatment is surgical incision (pyloromyotomy).

katsu  FA 2019 p. 353: Most common cause of gastric outlet obstruction in infants (1:600). Palpable olive-shaped mass in epigastric region, visible peristaltic waves, and nonbilious projectile vomiting at ∼ 2–6 weeks old. More common in firstborn males; associated with exposure to macrolides. Results in hypokalemic hypochloremic metabolic alkalosis (2° to vomiting of gastric acid and subsequent volume contraction). Ultrasound shows thickened and lengthened pylorus. Treatment is surgical incision (pyloromyotomy). +  


submitted by ms2991(2),

FA 2018 page 165--> EBV is "associated with lymphoproliferative disease in transplant patients"

katsu  EBV also targets B lymphocytes +  


submitted by lianallado(2),

This patient presents with a mitochondrial myopathy since the disorder is inherited from the mother. Mitochondrial myopathies show “ragged red fibers” on muscle biopsy due to the accumulation of diseased mitochondria in the subsarcolemma of the muscle fiber.

katsu  Mitochondrial myopathies—rare disorders; often present with myopathy, lactic acidosis, and CNS disease, eg, MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes). 2° to failure in oxidative phosphorylation. Muscle biopsy often shows “ragged red fibers” (due to accumulation of diseased mitochondria). +