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Welcome to macrohphage95’s page.
Contributor score: 7

Comments ...

 +2  (nbme23#48)
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MMAD si eth noyl hnclealguino tath has asepiyhtmtc tviaicyt as it is veredid frmo eaaienpmstmhhehtm ( lkoo at its )emna ... taht snxeilap riyehtnev.g

tyrionwill  Yes, good point to remember. In the category of FA stimulants, 2 agents has sympathetic activity: 1)MDMA; 2)PCP +
jackie_chan  Basically how I solved it, all the other drugs are downers +
jackie_chan  Even tho ketamine has sympathomemetic effects, they would be widly tripping, they dont call it falling into a K-hole for nothing. +

 +1  (nbme23#3)
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ym giatesurndndn of eht suoientq si htta he is gnisak taubo eht ueacs of ntaaenol ocymaheyplg.i

sa yuo wkno unsilni wlil be hhig tnyprllaea due to iaehlcegrympy dna ghih elslve lwil istp.ssre

so fi yuo iknth aubot me.iyhhgt.aopcl.ey almron sosneper fro het cloyeggn canierntnotco si ot sceeeadr (as ellw sa ggncoyle )steynsha dna het segeoonscleigun ot eseaicosn.r a pnreso twih iadpmeir cgesosueolignen (hiwch is orbam)nla is orme leylki to edopevl aiphyyeomlcg

 +0  (nbme23#4)
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icoepmagylHy is a qeeftrnyul entncrueedo aoiloncpitcm ni aicfrapulm maailra atth is aulylsu ebiarsdc to iarsndece ucleogs esu nad erdimpia golecus oundiocrtp acseud by hte onbtihniii of noengeol.eicsgsu

mrfo endrts ni arostlyig:p aosc/a4e-cift/t0pgh/rew1np/S4s/pt-w160.oyl)p0o:df21da.7(wlo5r/9.9s7td2lm

Subcomments ...

submitted by keycompany(296),
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rentNoig anlecba si a taerusenemm fo orintpe laoimmstbe ni hte y.bdo A vieaentg etnognri ebancla ensdtciai cmelus lso,s sa saeeidcrn somuant of aomni ciasd era bgeni izemdtlboae to rpoecdu eerg.yn shiT aercsiens eht otnuma fo gtirnnoe csetdeer frmo hte ob.dy aecBues the mtoaun fo nntoiegr uyo are iktgan ni si sesl anth eth ouatmn fo ogterinn ouy era ngersiect, ouy ehva a tginavee gtrinnoe alcbaen.

siTh nma si rshiademlu,on umeo,dtaes ,hccceiat dna has aniypulebiohmam. sThee ilcanlci ngsfdnii tinpo to tpienro tuarlnomniti swKhrkia(ao )sDaesei, hcihw uascse deeam due ot reaesdced esrmu nctoico .srpueers wLo ontcico ruepsesr ni tihs scea is ued ot tnopeir ls,so dan nehec a vatneieg tenornig cnlaaeb.

drdoom  Nice! +15  
dubywow  I knew your last sentence and suspected Kwashiorkor. It's just everything else I did not know. I have not heard or thought of muscle/protein changes in terms of "nitrogen balance" before... and that's why I got this wrong. Nice explanation! +3  
macrohphage95  I agree with you in first part but i dont think it has any relation to kwashirkor. It is simply due to cachexia which causes muscle destruction through the proteasome pathway .. +3  
zevvyt  also, it says that his albumin is low. +  

submitted by hayayah(1056),
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lamobCoo is an eye trmbyainlao ahtt ocsucr eerofb bhrit. rTh'eey gsimnsi eesipc of ssteui ni ruutrecsts ahtt omfr the .yee

  • oCosaolmb fefntciag hte iris, hhwci lesrut in a k"yolh"ee rppeaenaca fo eth plp,ui alleyreng od otn adle ot iinvso ossl.

  • malosoCbo vivglnion eth terain eurtsl ni nsioiv osls ni sicpfcie artsp fo hte ivlsua .dfile

  • Lraeg eltarin cboloamos or hoset agcfitefn the oitcp vnere cna uaces owl siv,oin which enasm inisvo sosl that ctnnao eb emopclytel odreccter ithw eglasss ro cntoatc els.sne

mousie  thanks for this explanation! +  
macrohphage95  can any one explain to me why not lens ? +  
krewfoo99  @macrophage95 Lens are an interal part of the refractive power of the eye. Without the lens the image would not be formed on the retina, thus leading to visual loss +4  
qfever  Do anyone know why not choroid? +1  
adong  @qfever, no choroid would also be more detrimental to vision since it supplies blood to the retina +2  
irgunner  That random zanki card with colobomas associated with a failure of the choroid fissure to close messed me up +11  
mnemonicsfordayz  Seems like the key to this question is in what is omitted from the question stem: there is no mention of vision loss. If we assume there is no vision loss, then we can eliminate things associated with visual acuity (weird to think of in 2 week old but whatever): C, D, E, F. Also, by @hayayah 's reasoning, we eliminate E & F. If you reconsider the "asymmetric left pupil" then the only likely answer between A & B is B, Iris because the iris' central opening forms the pupil. I mistakenly put A because I was thinking of the choroid fissure and I read the question incorrectly - but it's a poorly worded question IMO. +  
mamed  Key here is that it doesn't affect vision- the only thing would be the iris. All others are used in vision. Don't have to know what a coloboma actually is. +2  
azibird  The extra section of that Zanki card specifically says that a coloboma "can be seen in the iris, retina, choroid, or optic disc." Don't you dare talk trash about Zanki! +1  

submitted by sympathetikey(1253),
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Ciehoc A. uowld evha bnee ctercro fi hist aiettpn asw noiu.eidmcspmmmoor Per tFrsi di,A If" 4DC 01;&t,0l n.gFnrlBtno.lsei.:idaa Nrceoutliphi a.otilmannmIf

voHeer,w sa ihst tptnaei ash a ntecmotep eumimn etms,ys ubzz wsdor rae llaettes criontgzeni augonamrsl.

yotsubato  Everyones choice A is different. +  
sugaplum  they mean- Diffuse neutrophil infiltration +1  
macrohphage95  what does stellate necrotizng granuloma means ? +1  
krisgsxr600  always with the details! losing dumb points :( +1  
futuredoc12345  @sympathetikey Doesn't the biopsy finding vary with the biopsy location: Lymph nodes have stellate granulomas and Bacillary Angiomatosis (skin lesion) has neutrophilic inflammation. What do you think? +  
chextra  @sympathetikey Pathoma chapter 2 says cat scratch disease forms non-caseating granulomas +1  
almondbreeze  @ chextra Same with FA 2019 pg. 218 +2  
almondbreeze  Sketchy micro: Immunocompetent: regional LN in axilla in one arm (like our pt here) Immunocompromised: bacillary angiomatsis is transmitted by cat scratches +