need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything โ‹… score predictor (โ€œpredict me!โ€)

Welcome to kevintkim4โ€™s page.
Contributor score: 4


Comments ...

 +1  visit this page (nbme21#38)
get full access to all content โ‹… become a member

When I read "ginkgo biloba" as my answer choice (E) I thought I was getting delirious lmao

get full access to all content โ‹… become a member

 +0  visit this page (nbme24#38)
get full access to all content โ‹… become a member

A bit confused here because I thought T4 is converted to T3 INSIDE peripheral tissue. Why would serum T3 levels rise then?

According to this article, patients with hypothyroidism taking too much levothyroxine ended up having NORMAL serum T3 levels: https://pubmed.ncbi.nlm.nih.gov/26738396/#:~:text=In%20levothyroxine%20(T4)%2Dinduced,in%20over%2Dtreated%20hypothyroid%20patients.

get full access to all content โ‹… become a member

 +0  visit this page (nbme24#31)
get full access to all content โ‹… become a member

Anterior lead MI leading to cardiogenic shock with decreased LV contractility.

SVR rises in cardiogenic shock as compensatory response to low CO. PCWP rises because in anterior MI there's decreased contractility and blood backs up into LA.

That leaves one answer option of high SVR and high PCWP and you don't even have to think about PVR ;)

get full access to all content โ‹… become a member




Subcomments ...

submitted by hayayah(1212), visit this page
get full access to all content โ‹… become a member

GnRH agonists like Leuprolide are effective for patients with breast CA because if given in a continuous fashion, they downregulate the GnRH receptor in the pituitary and ultimately decrease FSH and LH.

get full access to all content โ‹… become a member
md_caffeiner  Quick question: FA19 691 says Leuprolide ClINICAl USE is Uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility... I guess all except infetility(pulsatile?) are used as continuous? +1
usmlecrasher  GnRH is synthesized and released in pulsatile fashion , so if you give in pulsatile way you induce GnRH effect , and if given in continuous way it will suppress synthesis, depended the desired effect you want to achieve - infertility induce GnRH with pulsatile , stop synthesis for prostate cancer , testicular cancer , hormone dependent Breast cancer give continuous +1
djeffs1  I thought Gonadotropin was released by the Hypothalamus, not the pituitary gland. am I crazy? +
kevintkim4  ^ Gonadotropins are referring to LH/FSH; Gonadotropin-releasing hormone (GRH) is released by the hypothalamus +2
shakakaka  *GnRH +1
dlakaswnd  ffffff.. the way they worded question was so confusing. +


submitted by bingcentipede(359), visit this page
get full access to all content โ‹… become a member

The key for this being dissecting aneurysm is that it's a widened aortic arch. Also, there's uneven pulses ("diminished pulses in the left upper extremity") meaning that blood is not passing from the aortic arch to the left subclavian artery (it's not passing the aortic arch).

get full access to all content โ‹… become a member
kevintkim4  only thing I would add is the acute nature (30 minutes) and hx of cocaine use helps point towards dissecting aneurysm +1
epiglotitties  Also, seeing as this is a Stanford type A (involves aortic arch), known complications are acute aortic regurgitation (manifesting in this px as 2/6 diastolic murmur heard best at left sternal border) and cardiac tamponade . :) +


search for anything NEW!