This patient has osteoporosis from hyperparathyroidism.
Hyperparathyroidism osteoporosis leads to hypercalcemia from CORTICAL SUBPERIOSTEAL EROSIONS
whereas osteoporosis from age/menopause affects trabecular bone. The latter has normal bone mineralization and normal lab values (normal Ca and PO43-)
Why would it not be answer C) Lutenizing hormone?
My thought process was this:
Leydig cells make testosterone (internal genitalia) that also gets converted to DHT (external genitalia)
Without the leydig cells working you don't have internal genitalia (patient in stem) and you dont have male external (patient in stem)
You could give pralidoxime but you have to give it second (after atropine) because it temporarily worsens the cholinergic toxidrome (wet picture)
Pra li dox ime an tag M+N
The vaccine is against Hemagglutinin that is important for binding and entry
ATP is hydrolyzed before the power stroke (contraction). It allows the power stroke to happen
Defective cross linking of elastic fibers is Ehlers Danlos syndrome
They have described what you assume is a classic case of pneumonia. But, PNA isnโt an answer choice. What the next best thing? The cause! Old frail people (and alcoholics) love to get aspiration pneumonia. RLL is the most common site, which they have provided (thank you, big vertical bronchus). They even gave you the hint that the patient has โdifficulty swallowing,โ which is code for โaspirates when swallowing.โ
FA pg614
tight junctions between adjacent sertoli cells form blood-testis barrier--> isolate gametes from autoimmune attacks
I think alot of people might have over emphasized how important ANP and BNP really are, yes it is important to know these peptides get secreted by the atrial/ventricular myocardium during heart failure. However their overall effectiveness in treating heart failure is zilch, a preceptor told me that if ANP and BNP were so useful in natriuresis then why do we give diuretics? It's because RAAS overpowers this system hence causing negative effects and the endless loop of heart failure. AKA why we give ACE inhibitors.
Knowing that ANP gets neutralized by the RAAS system, we can shift our focus back to heart failure in this patient, where cardiac output is decreased, leading to ADH secretion and finally dilutional hyponatremia.
Weight loss - think cancer Hyponatremia - SIADH from small cell lung cancer Edema + JVD - SVC syndrome
Weight loss - think cancer Hyponatremia - SIADH from small cell lung cancer Edema + JVD - SVC syndrome
While I understand why it's hyperplastic arteriosclerosis and how it classically occurs with HTN, I was wondering why it couldn't be berry aneurysm? Is it because the question is asking which is "most likely", making C the better answer? Thank you.
Why is medullary thyroid cancer on the lateral side of the neck???