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Welcome to masonkingcobra’s page.
Contributor score: 232


Comments ...

 +0  (familymed1#33)
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oN noe eerv odes stih ayass it :emess

Uep:DtaTo eHo,wvre recgolsoi tetss ureqrei iaiatvondl ta het lolac vel,el ciwhh si lcairamtcip in iorteun tei.parcc nI tao,indid ncoecrsn orev tis ucyacrac aveh mlediti sit sue.

Teh reua betrah tets is itsrf eiln



 +5  (nbme24#19)
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lAl oautb ihng:stti

i/.tten.etceoioneeu.oajaspoctsbeffhn/h:ccu/sstitahge/ddlwrod/n/smns

charcot_bouchard  When i faced this ques i did some Kegel. Felt something in my pee pee but not in my b*e. I exclude all option because they are bigger muscle of pelvic floor except EUS & IAS. And also remeber Kegel can be used as a treatment of prem. ejaculation not premature defication. +10
paperbackwriter  @charcot_bouchard Actually Kegels are used in the treatment of fecal incontinence as well because of effect on EXTERNAL anal sphincter and surrounding muscles which are under voluntary control (you can most definitely feel it if you do a kegel lol). The answer is internal anal sphincter because internal is not under voluntary control (tonically contracted via symp. --> parasymp. relaxes it --> gotta go feeling --> no incontinence because of external sphincter's voluntary contraction). +2

 +5  (nbme23#33)
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hrhnd_ihraeeeib.d/.ttktuhsv/lpht:a/tiraclah.cw.lmen

ysEa pescrtui ot udsntadrne


 +7  (nbme23#39)
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In tdidinao to eth revoisup aoateiplnx:n

heS is nori deienitfc and accile ctefsaf eht ilrxpoma noeuu.mdd "I ecFdku ra"tBtiny = o,Inr e,tlFao B12 ofr d,unDoume ujneJum nad mlIeu

krewfoo99  Great analogy lol. But just a correction, First Aid states that Celiac Disease affects distal duodenum and proximal jejunum. But you are right, it would still cause iron deficiency anemia as it affects the duodenum. +2
fexx  OR you could just remember 'Iron Fist Bro' (F includes folate and fat, B includes B12 and bile salts) +3

 +0  (nbme23#28)
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osyeaPlnlr my sieus thiw shti uioetsqn si atth I hogtuh B21 ueacss anydntlmieeio ni tbho teh STLC dna eht MLDC (CDS) ubt yteh ear tteigsn eht mahminces eher lraeyl iwht eth olewh mhylmncoieta ciad ibt nad het iediarpm mieyln siysnhtse

If yuore' ucsruoi

//2s/d.tr16e/ustcm0cwhsr:6sactotail.cwepnwan


 +0  (nbme21#5)
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Link

necrotizingfasciitis  Going off of the comments people have posted above & kinda bringing things together: PDA flows from aorta to pulmonary arteries, which reverses after birth. This means de-oxygenated blood flow from the pulmonary arteries to the aorta & less volume being sent to the LF side of the heart. This results in a decreased afterload because there is less blood flowing from the lungs to re-fill the LF ventricle, & the heart is still pumping with the same force as before, so the same volume of blood is leaving, but less in entering the LF side of the heart. From here, you use CO = SV x HR SV = preload - afterload (which is decreased due to the PDA) This results in SV being larger than normal, so when you plug that into CO = SV x HR you get a higher number for cardiac output. +
didelphus  The ductus arteriosus flows from PA --> aorta in utero to bypass the lungs, which have extremely high resistance to flow. This reverses after birth due to a drop in PGE2 (which was supplied by the placenta) and increase in left-sided systemic resistance. So a PDA typically flows aorta --> PA (assuming there are no other defects). +

 -1  (nbme20#8)
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'isnobb:R Teh otw ostm trtponmia ucsesa of aitcro ysnresmua era staoreislsercoh and troisepynn.eh rlhrscsstAeeoio si het rmoe nnitoamd toarfc ni lndbimaoa aictor seruymns,a eilwh pionthsereyn si scsdaeatoi wtih innasdceg cotiar enamyru.ss



 +25  (nbme20#21)
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ePga 2 ahs a garet upcietr

c2-.-oe1S98jw.rt1(pwcel:3la/67n1/g/rntw60sta6f)pdii/4o09/ih0

kamilia20  chlamydophila psittaci?? +


 +3  (nbme20#38)
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nI ygocpcehsni ipayislpdo, mresu usmoid is l,ow nda aertf awrte dtairnvoiep te,st eurni yoilaslomt is d.inUe rsrcaenie ololtmiasy eosd nto iacenser with rssnvpesiao oniintcje

nI npnhoircege tsieebad iiids,psun uesmr omusid is hghi and etehr is on amg/nlchide aeesirnc in reuni maoolytils freat tware ranpedtviio

yotsubato  This patient does not undergo a water deprivation test +9
niboonsh  Compulsive water drinking or psychogenic polydipsia is now increasingly seen in psychiatric populations. Effects of increased water intake can lead to hyponatremia causing symptoms of nausea, vomiting, seizures, delirium and can even be life threatening if not recognized and managed early. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579464/ +7
missi19998  Just wondering why it in not resistance to ADH action of vasopressin +
amarousis  because he would be hypernatremic with no ADH. can't resorb any water +1
minhphuongpnt07  low osm/urine, low os/plasma => psychogenic polydipsia +
benitezmena  In this question the pt had a normal urine osm (80) a low urine osm would be <50mosmol/kg. +
euchromatin69  u world 212 +

 +3  (nbme20#37)
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In moeactlib a,kssilaol usitsompa vseom ntio eth clesl

hTe olss in mouvel otruhhg sesime etrsrgig ASAR lutrnsegi in nsredceia oedletrosnA esleaer and trufehr iapumssot oitreencx

it/:e.n/1asw6h.p/alwpdwbettte/1t





Subcomments ...

submitted by m-ice(272),
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heT inattep sndee ilmcade ntteniota m,aeieitmldy hhiwc tsimaeienl niangotib a rtcuo ro,dre ro rnirngetrsaf he.r A rsenu edos ont ahev eth msea rtanniig nda icoiqitsfulaan sa a a,cnihpisy so it dluwo eb ipaaopntirrep ot ksa mhte to amineex hte pitaten. kinsgA eht oslaipth inhplcaa ainga oducl be rpipnir,etpaoa nad owdlu aetk oerm et.im ,rTeerhofe hte tebs oinpto noagm hsteo inveg si ot kas het neattpi if hse lliw llowa wthi ehr bhnsdau spt.erne

sympathetikey  Garbage question. +44  
masonkingcobra  So two men is better than one apparently +23  
zoggybiscuits  GarBAGE! ? +1  
bigjimbo  gárbágé +4  
fulminant_life  this question is garbage. She doesnt want to be examined by a male how would the presence of her husband make any difference in that respect? +10  
dr.xx  I guess this is a garbage question because what hospital, even small and rural, does not have a female physician on staff. NBME take notice -- this is the 2010s not 1970s. https://images.app.goo.gl/xBL4cK31ta7nG4L39 +8  
medpsychosis  The question here focuses on a specific issue which is the patient's religious conservative beliefs vs. urgency of the situation. A physician is required to respect the patient's autonomy while also balancing between beneficence and non-maleficence. The answer choice where the physician asks the patient if it would be ok to perform the exam with the husband present is an attempt to respect the conservative religious belief of the patient (not being exposed or alone with another man in the absence of her husband) while also allowing the physician to provide necessary medical treatment that could be life saving for her and or the child. Again, this allows for the patient to practice autonomy as she has the right to say no. +12  
sahusema  I showed this question to my parents and they said "this is the kind of stuff you study all day?" smh +20  
sherry  I totally agree this is a garbage question. I personally think there is more garbage question on new NBME forms than the previous ones...they can argue in any way. I feel like they were just trying to make people struggle on bad options when everybody knows what they were trying to ask. +  
niboonsh  This question is a3othobillah +4  
sunshinesweetheart  this question is really not that garbage....actually easy points I was grateful for... yall are just clearly ignorant about Islam. educate yourselves, brethren, just as this exam is trying to get you to do. but yeah I agree there should be an option for female physician lol +5  
drmohandes  I think this NBME24 is a waste of $60. On one hand we have these types of questions, that have 0 connection to our week-month-year-long studying. On the other hand we have "Synaptobrevin" instead of SNARE, because f*ck coming up with good questions. +10  
myoclonictonicbionic  @sunshinesweetheart I actually have studied the religion tremendously and there a clear consensus among all Muslims that in the case of an emergency, it is completely allowed to have someone from the opposite gender examine you. I think this actually represents how ignorant the exam writers are of Islam. +6  
korahelqadam  All it takes is one NBME question concerning muslims for the Islamophobia to jump out I guess +  
sars  This is a very fair question. I agree with sunshinesweetheart above. That is all. +  
wrongcareer69  Garbage question +  


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ntboFiircen si an aurletlxleacr itxram ci,plgyeornot lewhi mlina is na neamirttedie tanfmeil htta laipicylscef vesdpior usoprtp ot the ecll ule.nusc ontD’ sfuneoc nlmai hiwt aiinmnl ceicns(e ahset us yalc;)rle nianlim is elik ,ioenbnricft na ECM ltogcyneroip dan a ojmra tcnmepono fo hte lasab nmaail fo mneebsat emsamnrb.e

masonkingcobra  Lamin looks like a "cross" and held up Jesus and the basal lamina is super important just like jesus (you bet there are people who believe this) https://answersingenesis.org/biology/microbiology/laminin-and-the-cross/ +17  
dr.xx  blasphemy @masonkingcobra +1  
luciana  I clearly confused lamin with laminin, now I know +2  
almondbreeze  FA 2019 pg 48 lamin +1  
almondbreeze  picked tubulin but i guess tubulin makes up microtubules and therefore is spherical +  
gandon  I used to kill and rob people before I found Lamin. He died for my sins on the Cross and changed my life. +  


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Wyh si it nto onviara olilcefl sell?c I ogtuhth het alemef glaano of torliSe dna idegLy is c/saalorunghtae secll.

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +4  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +7  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +28  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +10  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +4  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +6  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +3  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +1  
youssefa  Hahahahaha ya'll just bored +4  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
noplanb  Wait... I might actually never forget this now lol +1  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +14  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +1  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +1  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +  


submitted by joker4eva76(21),
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The usietqno smte si erdgsibinc a iohiarcmodltn saids,ee iwhhc omomycnl ntsepre htwi tcailc caiosi.ds eThre is na iearcesn ni biaeonrac fmros of eegnyr optnudiocr li.yglss(o)cy hTe tdmhiarnocio rea atyu,fl so hyet cnt’a eus the dne uocdrpt fo iyylosslgc y)aervp(tu ni TA.C deItnas tavpreyu si uendhst vroe adn is dsue by HLD (ltaecat aedgedohne)yrs to getnerea ur.etvyap

:sdAie lcRlae atht HLD seus NDHA adn taeeensgr AD.N+ iyeniDfcce of DLH cna edal ot ssol of rnoreigenaet fo DN+A nda hniibsit cisyosyl.lg

drdoom  ... pyruvate is shunted over and is used by LDH (lactate dehydrogenase) to generate lactate*. +2  
chris07  It's hinted in the answer, but I would like to clarify: max O2 consumption is decreased because O2 is consumed in the Electron Transport Chain, which occurs in the mitochondria. With the mitochondria not working, the ETC cannot work, and thus there is less demand for Oxygen. +14  
masonkingcobra  Mitochondria are the powerhouse of the cell +42  
uslme123  Apparently ragged red fibers are the result of coarse subsarcolemmal or intermyofibrillar mitochondrial accumulations.. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/mitochondrial-myopathy +2  
mnemonicsfordayz  As @chris07 said, less O2 is being consumed in the ETC... but I also was thinking that the diaphragm is a muscle and if the mitochondria in her diaphragm are also not functioning, then she's not breathing properly and less O2 is being inhaled and therefore decreasing her oxygen consumption. Is that totally off base or am I just grasping at straws here? +  


submitted by tinydoc(190),
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Tepy 1 Flmliaia yDseliipiamd pg(. 94 FA 91 )

srdanceei GT ;-tg--& trtaeaipisnc rtepcu iE / upsrirti mahn sdXantoa SMH

nCa eb uacsde yb poeitLrnopi elasip ro pnpotoeiAr CII dcyieeincf

htye iads atth LLP is enif os ist POA ICI

rnpaeHi pertssaee PLL fmro anrHiepr leauftS iMotye on sVac hienEldmuot gawinoll su ot ttse sit ucinofnt in eht .lba

I otg it rgonw oto - uitSdp teoR miairtmeozno lrecla teiou.nsQ

masonkingcobra  I think you need to know that ApoCII activates LPL not necessarily know the disease +9  
yotsubato  Knowing the disease makes it easier to remember the details though +2  
pg32  Mnemonic for these 4 types of dyslipidemias and their causes: 1 = LP meaning LPL is deficient (or anything associated with activating LPL, like C-II) 2 = LD meaning LDLR is deficient (or anything involved in interacting with LDLR, like B-100) 3 = E meaning ApoE is defective and 4 for more (VLDL) ("more" just meaning more letters in the cause (VLDL oversecretion)) +1  
castlblack  One too many chylomicrONs, two much cholesterol, threE apo E gone, 4 put the fork down fatty +1  


submitted by egghead(1),
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hisT si neo of tehso qsotiusne I aws vneer nggoi to .etg sI't tno in F,A I ot'dn inkth I've esen it ni lcass.

hungrybox  same :( +  
masonkingcobra  My issue was the stem said no skin damage (I would think pulling out your hair damages your scalp) [Turns out it does not](http://onlinelibrary.wiley.com/doi/full/10.1111/j.1529-8019.2008.00165.x) +  
gh889  FA 2019, pg 551 +7  
meningitis  Compulsively pulling out one’s own hair. Causes significant distress and persists despite attempts to stop. Presents with areas of thinning hair or baldness on any area of the body, most commonly the scalp. Incidence highest in childhood but spans all ages. Treatment: psychotherapy is first line; medications (eg, clomipramine) may be considered. +5  
step1soon  FA 2019 pg 551 +1  
teepot123  damn its in FA and Ive never ocne read it XO +  


submitted by mcl(517),
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Thsi aigem si evyr e.lhplfu

seagull  http://www.siumed.edu/~dking2/erg/GI178b.htm Another histology slide with labels +1  
masonkingcobra  I like to think that the parietal cells look like "fried eggs" classically +  


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nCa esmodoyb spalee pixanel hyw the aKp hsa to be 6 inesadt fo ?01

masonkingcobra  Since an ionized form is charged (by definition), it will not easily cross a nonpolar lipid membrane. Thus, it is important to recognize the potential of the drug to ionize in order to predict its solubility and the degree to which it can be reabsorbed. The degree of ionization is determined by the drug’s pKa and the pH of its environment. Weak acids and bases are 50% ionized and 50% unionized when the surrounding pH equals the drug’s pKa. At 2 pH units above or below the pKa of the drug, nearly 100% of the drug is ionized or unionized. +3  
masonkingcobra  Basically weak acids are best excreted in alkaline urine, but weak bases are excreted more readily in acid urine. +  
masonkingcobra  In summary, because this is a weak acid at pKa 6, making the urine alkaline will result it its ionization and excretion. Ionized cant move through lipid membranes so can't get reabsorbed and is pissed out. +6  
yex  Following on masonkingcobra explanation: A pKa 4-9 can be either weak acid or base. Weak acid pKa 4-7; strong acid pKa 1-3 Weak base pKa 7-9; strong base pKa above 9 Differents pHs: stomach: 1-2 duodenum: 3-5 early jejunum: 5-7 late jejunum: 7-9 ileum: >9 urine: 4.5-8 Weak acids (pKa) gets absorbed in acidic (pH) environments and cleared in basic. Weak bases gets absorbed in basic environments and cleared in acidic. THIS DOES NOT APPLY TO STRONG BASES OR ACIDS!!!! The best explanation for this is a Biochem lecture from Pass Program and it is available on YouTube, its long but it is for sure worth it!! Look for 19 Biochemistry 1 from Pass Program on YouTube. +1  


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Can ydmseboo peasel epanxil wyh eht pKa ash to eb 6 daitsne fo 10?

masonkingcobra  Since an ionized form is charged (by definition), it will not easily cross a nonpolar lipid membrane. Thus, it is important to recognize the potential of the drug to ionize in order to predict its solubility and the degree to which it can be reabsorbed. The degree of ionization is determined by the drug’s pKa and the pH of its environment. Weak acids and bases are 50% ionized and 50% unionized when the surrounding pH equals the drug’s pKa. At 2 pH units above or below the pKa of the drug, nearly 100% of the drug is ionized or unionized. +3  
masonkingcobra  Basically weak acids are best excreted in alkaline urine, but weak bases are excreted more readily in acid urine. +  
masonkingcobra  In summary, because this is a weak acid at pKa 6, making the urine alkaline will result it its ionization and excretion. Ionized cant move through lipid membranes so can't get reabsorbed and is pissed out. +6  
yex  Following on masonkingcobra explanation: A pKa 4-9 can be either weak acid or base. Weak acid pKa 4-7; strong acid pKa 1-3 Weak base pKa 7-9; strong base pKa above 9 Differents pHs: stomach: 1-2 duodenum: 3-5 early jejunum: 5-7 late jejunum: 7-9 ileum: >9 urine: 4.5-8 Weak acids (pKa) gets absorbed in acidic (pH) environments and cleared in basic. Weak bases gets absorbed in basic environments and cleared in acidic. THIS DOES NOT APPLY TO STRONG BASES OR ACIDS!!!! The best explanation for this is a Biochem lecture from Pass Program and it is available on YouTube, its long but it is for sure worth it!! Look for 19 Biochemistry 1 from Pass Program on YouTube. +1  


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Can oybmdeos saeple alixpen hyw eth Kap sah ot eb 6 atnisde fo 01?

masonkingcobra  Since an ionized form is charged (by definition), it will not easily cross a nonpolar lipid membrane. Thus, it is important to recognize the potential of the drug to ionize in order to predict its solubility and the degree to which it can be reabsorbed. The degree of ionization is determined by the drug’s pKa and the pH of its environment. Weak acids and bases are 50% ionized and 50% unionized when the surrounding pH equals the drug’s pKa. At 2 pH units above or below the pKa of the drug, nearly 100% of the drug is ionized or unionized. +3  
masonkingcobra  Basically weak acids are best excreted in alkaline urine, but weak bases are excreted more readily in acid urine. +  
masonkingcobra  In summary, because this is a weak acid at pKa 6, making the urine alkaline will result it its ionization and excretion. Ionized cant move through lipid membranes so can't get reabsorbed and is pissed out. +6  
yex  Following on masonkingcobra explanation: A pKa 4-9 can be either weak acid or base. Weak acid pKa 4-7; strong acid pKa 1-3 Weak base pKa 7-9; strong base pKa above 9 Differents pHs: stomach: 1-2 duodenum: 3-5 early jejunum: 5-7 late jejunum: 7-9 ileum: >9 urine: 4.5-8 Weak acids (pKa) gets absorbed in acidic (pH) environments and cleared in basic. Weak bases gets absorbed in basic environments and cleared in acidic. THIS DOES NOT APPLY TO STRONG BASES OR ACIDS!!!! The best explanation for this is a Biochem lecture from Pass Program and it is available on YouTube, its long but it is for sure worth it!! Look for 19 Biochemistry 1 from Pass Program on YouTube. +1  


masonkingcobra  The pathogenesis of post-transplant lymphoproliferative disorders (PTLD) in most patients relates to the outgrowth of Epstein-Barr virus (EBV)-positive B cell proliferations in the setting of chronic T cell immunosuppression. +2  


submitted by onyx(36),
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A idyaaoihlgcrpral vliisbe ildu-afir elevl ssgetgsu a tetryp elgra lnsoie hc(,een i)ya“var”ct. t'hsaT not iongg ot embcoe ronalm tisuse anai.g iSx mnstoh wlglifono surnoletoi of mspsomty you acn txpcee aenlihg in teh omfr of a ac;sr ahtt i,s isfboisr tbu yonl ni a signle tpos.

masonkingcobra  Robbin's: The basic mechanisms of fibrosis are the same as those of scar formation during tissue repair. However, tissue repair typically occurs after a short-lived injurious stimulus and follows an orderly sequence of steps, whereas fibrosis is induced by persistent injurious stimuli such as infections, immunologic reactions, and other types of tissue injury. The fibrosis seen in chronic diseases such as pulmonary fibrosis is often responsible for organ dysfunction and even organ failure. +4  
stevenorange  What Differentiates Normal Lung Repair and Fibrosis? Basement membrane ! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645241/ +  
step1234  I'm a little confused here since FA20 209 states Klebsiella causes liquefactive necrosis in the lungs. Does the pulmonary fibrosis occur after the necrosis? +  
fatboyslim  @step1234 Yes pulmonary fibrosis occurs after liquefactive necrosis as a means of repair. Think of it as liquefactive necrosis = damage done in response to Klebsiella -> 6 months later you will see focal fibrosis in that area (scar formation) where the damage happened. +1  


submitted by hayayah(990),
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veiPcl pahnnislcc erenvs rae atrp of teh tphymaaretipsac eys.tms

masonkingcobra  The inferior hypogastric plexus innervates internal pelvic viscera; has both sympathetic and parasympathetic components; parasympathetic contribution helps stimulate detrusor of bladder (along with pelvic splanchnic nerves), sympathetic contribution helps stimulate internal urethral sphincter +  


submitted by hayayah(990),
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ouY eahv a %52 acnceh of ntihriiegn het msae LAH rarksme as uory lnisb.gsi

masonkingcobra  Two siblings have a 25% chance of being genotypically HLA identical, a 50% chance of being HLA haploidentical (sharing one haplotype), and a 25% chance that they share no HLA haplotypes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628004/ +20  
alimd  It looks exactly like an Autosomal recessive mode of inheritance. +1  


submitted by hayayah(990),
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Teh dgaame si ni het L biirdanm ni hte eara fagitefnc eht psaoicicltnro t.trca cBuseea it is ni eth indi,ambr aouitncdses in teh imysadpr admelu(l) so it lliw ohsw llptirasiea oducnnasyltfi ootrm gsi.ns

Ptooh of naibrmdi nad arotmtpin saa:re rhuaslroLtmtR/y.H

masonkingcobra  Just for clarification, on the left side, you see where he had the infarction 7 years ago and the tissue is gone. +1  
chefcurry  so is the dysfunction on the contralateral side? +  
praderwilli  If the decussation is in the pyramids of the medulla, shouldn't it be contralateral hemiparesis if the damage is on the right? It confuses me because of the labeling right and left at the top of the pictures. +  
endochondral1  that link isnt working @ hayayah....is there any good picture to look at to know where the tracts are on this section? +  


submitted by strugglebus(154),
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The posn sah evensr ,-58 os hte tinmergila lwduo eb cdeteaff reeh

masonkingcobra  Thalamic pain syndrome would involve dysesthesias on the entire contralateral body so more than just the face. Also it occurs often after post-stroke. Additoinally, these dysesthesias appear weeks/months later +3  


submitted by thomas(-1),
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rewAns si tyt.oserAc ientPta sah gslimaobloat elruiom.mft uAolhthg mmansieoign yam orccu at sineovit,exc oiinaengmms rea bgnein nad oefnt cy.apotmmiats yThe mya cusea h/a essz,eiur but lduow be yielnulk to eucsa dheta iwn/ m6 fo tosen fo /.ha The seiz fo motru adn erocsu of lslnise is sniosectnt with eht ecorus fo MBG

masonkingcobra  Above is obviously incorrect because the answer is Meningeal lol. Here is a link to a good picture: http://neuropathology-web.org/chapter7/chapter7fMiscellaneous.html +16  
kernicterusthefrog  Obviously thomas is disagreeing with the presentation of the question, and I agreed with him! This absolutely sounds like GBM, with rapid onset leading to death, and the symptoms. The question stem leads you to GBM, and the gross image to meningioma (I guess). +2  
kernicterusthefrog  Furthermore, where are the meninges on the gross image form which this (meningioma) grew?! It should at least show the tissue from whence it came! +1  
nala_ula  Had the same problem, got confused since it appeared that the growth was malignant :( +  
sugaplum  FA 2019 pg 514, also agree with everyone. weird presentation. Glios are malignant death within 1 year, meningioma are often asymptomatic or have focal signs. just a gross pathology question at this point +  
garima  ı think she died bc of pressure or something guys, its obviously round shaped benign lesion, its also extra axial not like GBM. she had this maybe years before death +2  


submitted by hayayah(990),
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VL soptedp iogk,nrw pueesrrs bacekd pu itno lmpu ccui.itr mlPu riitucc uhlroyg is edma fo 3 t"sar"p - the rlaileca,psi aliisnttteri psa,ce dna hte leial.vo

In igraeocicdn ohskc, eth axert dolbo scenreias alpryilac ysihdotrtac ererpuss, divigrn luifd itno the itnsialetrit c.sape mdeCropa ot the vaoilel, het riatelisntti cespa now has orem idufl t(hsu oerm iisilartnett htcsydorati srrpseeu dna ssel ocoticn essurerp ued to aiotr of udilf ot p)niro,et adn as a tlruse fo htis lnugnnabcai of ocf,sre idufl msoev tion hte oavilel g--&;t rmlnoupya eed.am



submitted by step420(33),
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rOteh kdenyi eiporyHphsetr deu ot nridceesa esstsr &-gt-; tno pyraipshale cb otn ocsurneca

masonkingcobra  Above answer is incorrect because hyperplasia can be either physiological or pathological. Prolonged hyperplasia can set the seed for cancerous growth however. Robbins: Stated another way, in pure hypertrophy there are no new cells, just bigger cells containing increased amounts of structural proteins and organelles. Hyperplasia is an adaptive response in cells capable of replication, whereas hypertrophy occurs when cells have a limited capacity to divide. Hypertrophy and hyperplasia also can occur together, and obviously both result in an enlarged (hypertrophic) organ. +24  
johnthurtjr  FTR Pathoma Ch 1 Dr. Sattar mentions hyperplasia is generally the pathway to cancer, with some exceptions like the prostate and BPH. +4  
sympathetikey  Tubular hypertrophy is the natural compensation post renal transplant. Just one of those things you have to know, unfortunately. +2  
charcot_bouchard  Isnt Kidney a labile a tissue & thus should undergo both. This ques is dipshit +  
brbwhat  Dr Sattar says, kidney is a stable tissue, at least pct is as seen in ATN. But I read, basically kidneys are mostly formed whatever number of nephrons have to be formed by birth, after that they can only undergo hyperplasia aka increase in size/or regenerate if need be in case of atn. We cant have more number of nephrons. +1  
mambaforstep  @brbwhat , do you mean kidneys can only undergo hyperTROPHY? +1  


submitted by hayayah(990),
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sCea fo teasslrsrreo.iloico

lptycraieHps ocsrsosiioaerrtlel envvlsoi niitenhkcg of lvsees wlla yb eyiasppalhr of toshmo lesmcu i(n-onoin'ks ae'near)pcap

  • Ceensqncueo of talnminga tinhrsoeepyn 0(2/10;8t&g1 w/ uceat deno-narg g)aedam
  • Rsustel in dedercu sevsel crbiale htiw rnoae-ndg iaeishcm
  • yaM dale to nibdirofi iocnssre of the evssel lwla wthi ee;hhgrarmo aaylccslsli sscuea caetu nlare ureailf AF)R( hitw a tesiatrrccihac 'bla-etti'enf rnpaaacpee
masonkingcobra  From Robbin's: Fibromuscular dysplasia is a focal irregular thickening of the walls of medium-sized and large muscular arteries due to a combination of medial and intimal hyperplasia and fibrosis. It can manifest at any age but occurs most frequently in young women. The focal wall thickening results in luminal stenosis or can be associated with abnormal vessel spasm that reduces vascular flow; in the renal arteries, it can lead to renovascular hypertension. Between the focal segments of thickened wall, the artery often also exhibits medial attenuation; vascular outpouchings can develop in these portions of the vessel and sometimes rupture. +  
asapdoc  I thought this was a weirdly worded answer. I immediately ( stupidly) crossed of fibromuscular dysplasia since it wasnt a younger women =/ +15  
uslme123  I was thinking malignant nephrosclerosis ... but I guess you'd get hyperplastic arteries first -_- +  
hello  The answer choice is fibromuscular HYPERplasia - I think this is different from fibromuscular DYSplasia (seen in young women); +21  
yotsubato  hello is right. Fibromuscular hyperplasia is thickening of the muscular layer of the arteriole in response to chronic hypertension (as the question stem implies) +6  
smc213  Fibromuscular Hyperplasia vs Dysplasia...... are supposedly the SAME thing with multiple names. Fibromuscular dysplasia, also known as fibromuscular hyperplasia, medial hyperplasia, or arterial dysplasia, is a relatively uncommon multifocal arterial disease of unknown cause, characterized by nonatherosclerotic abnormalities involving the smooth muscle, fibrous and elastic tissue, of small- to medium-sized arterial walls. http://www.medlink.com/article/fibromuscular_dysplasia +1  
smc213  *sorry I had to post this because it was confusing!!!*Fibromuscular dysplasia is most common in women between the ages of 40 of and 60, but the condition can also occur in children and the elderly. The majority (more than 90%) of patients with FMD are women. However, men can also have FMD, and those who do have a higher risk of complications such as aneurysms (bulging) or dissections (tears) in the arteries. https://my.clevelandclinic.org/health/diseases/17001-fibromuscular-dysplasia-fmd +1  
momina_amjad  These questions are driving me crazy- fibromuscular dysplasia/hyperplasia is the same thing, and it is NOT this presentation and it doesn't refer to arteriolosclerosis seen in malignant HTN! Is the HTN a cause, or a consequence? I read it as being the cause (uncontrolled HTN for many years) If it was the consequence, the presentation is still not classical! -_- +1  
charcot_bouchard  Poor controlled HTN is the cause here +  
charcot_bouchard  Also guys if u take it as Fibromuscular dysplasia resulting in RAS none of the answer choice matches +  


submitted by hayayah(990),
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oN ,trsmianalbieo noyl osme ng,mivito oskol lewl w/ on euilraf to terh.iv stMo llekiy ermiautm .ELS

masonkingcobra  http://www.sedico.net/English/SedicoInformationCenter/Physicians/gerd_e.htm +8