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Welcome to medpsychosis’s page.
Contributor score: 115


Comments ...

 +27  (nbme24#8)
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The awy I ouhttgh butoa ti was a letlti ermo tcmiilp.ssi We esu nno iseleecvt ateb koebcrsl ..(ge lrlorpno)Pao rof the tnramttee fo etnsilesa orte.rm feheorTer a beta tsoaing duwol vahe eht tioeposp ,tfefce aak auces or neencah rtrom.e

hungrybox  Genius +3
sunny  Also it(blockers) hides signs of hypoglycemia which are tremors. +3

 +10  (nbme21#6)
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ihsT aittenp dneeyiltfi has so rlCiea.osSusdic in enuiotqs -mfcaA sni:rte nemracAi mElhFmtaeaee -yr Nuoard-il emotBsla iHalr aehteap-aeAyoHmnpiclc ydr e(du ot –ya1lesyoimαrddehaxdte- vmiinta D aoicanvtti ni seprm.ac)hgao

FA 1208 (.P )856

icedcoffeeislyfe  FA2020 pg 676 +
lovebug  and FA2019 pg 662: Vit.D usually activated in Kidney. but They can be also activated by Macrphage like this case. +




Subcomments ...

submitted by m-ice(340),
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ehT inpetat eedns mieadlc nneotiatt mtadiye,lime chihw ietsnmleia boagtniin a tocru ,rrdeo ro nfragsrnitre .her A suenr sdeo tno vahe eth esma itngiarn dan ifasctqalioniu as a ,chysipian so ti lwuod eb pipeirortnapa to aks hmte ot enmeiax the tntai.pe ngsAki hte liophtas ichnpaal nagai cludo be aroeipi,anrtpp and owdlu teak rmeo mtei. hrree,fToe eht bets ootpni mgano ohtse neivg is ot ksa the apttien if seh lwil lwola tihw her aubndsh repn.tes

sympathetikey  Garbage question. +60  
masonkingcobra  So two men is better than one apparently +29  
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? +12  
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 +9  
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. +16  
sahusema  I showed this question to my parents and they said "this is the kind of stuff you study all day?" smh +26  
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 +5  
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. +12  
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. +11  
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 +  
alimd  well we should wait for the question "if a man shouts I CANT BREATHE with a police knee on his neck, what is your next step? Ans- wait 8 minutes." +1  


submitted by medskool123(29),
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anc meensoo xeinlap yhw htsi is tno sca?nuonrditt tsaL enbm I dais aojcnotignu nad got it rowgn rfo ocd.tt.uasnnri tihs eon I ays ratnonsuitcd adn sti onuajcoing.t

pseudorosette  I would say because this happened between two bacteria, but in transduction what causes the acquisition of bacterial resistance is coming from a bacteriophage, which is a virus that infects bacteria, but that is never hinted at the question! +4  
medpsychosis  Quick Overview of the involved topics and answer choices that are relevant in this question: Transduction: Involves phage, cleaves DNA and takes a part with it as it is packaged. Generalized is when is happens by accident. Specialized is an excision event. Transformation: bacteria takes up naked DNA around it and incorporates it therefore becoming "transformed" e.g. (SHiN) S. Pneuma, H. Influenza type B, and Neisseria. Transposition: Jumping from one location to another within same bacterial organism (e.g. from chromosome to plasmid) Conjugation: Above mentioned plasmid gets transferred from conjugal bridge from one bacteria to another. +17  
wowo  FA2019 p130 +1  
zbird  Easy here...first both are G-ves which likely have a sex pilus and if cultured together as in this case transfer their plasmid. Transduction need phage. Transposition is exchange of genetic material inside the bacteria b/n the dna and the plasmid or vv (FA2019) +  


submitted by neonem(572),
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Tish is tauce lyhitmoec fstroisanun ar,teinco a yept II hnsyirtpiyveeist rwehe r-peordmfe MgI nestbdaioi ndbi ot ecmitnioblap AOB iangnset no rodon BsCR, ichwh scuaes saaictrunvalr s.heoimlsy Rh acipibiytniom,lt keli lcelndoore_ i,dsa ecsmo mreo tnio ylpa with co-mlhbatipRtiyi fo cnnygeapr and ti si eud ot IgG no,itidbsea hicwh oerm noeft usaec lxrvcrausetaa lehyssoim insec epsilnc sceapogarhm vhea etsho -amFcRgm-a rtopscree ot nbid rahvteew GIg ahs ta.ghuc larctsuravaxE onts'ed asecu ttah nopo,styinhe re,fev lafkn anip eisdaatocs twih oglihiemnubora csine het sapgormceah hdol on ot eht dedaredg BRsC and tencvor it ot ner,livbiid hhwic acn ealfys be edcerext yb eth .rlvei

mousie  Could you help me with understanding why this isn't a Type I HSR? I understand that ABO incompatibility is Type II HSR but I don't know how to tell the difference between a patient who is IgA deficient and having a Type I Reaction to an infusion vs ABO incompatibility .... +8  
sympathetikey  @mousie - https://imgur.com/QH5rCEX Basically, think of Type 1 HS like a normal allergic reaction (itchy, wheezing, etc.). Whereas, with ABO incompatibility you get the question's presentation. +7  
medpsychosis  When it comes to Acute hemolytic transfusion reactions, they are Type II hypersensitivity and divided into Intravascular (ABO) and Extravascular (host Ab against foreign antigen on donor RBC). The differentiating factor between them is simple. Intravascular (ABO) will present with hemoglobinuria alongside all the other common symptoms (fever,hypotension, tachypnea etc.) Extravascular hemolysis will stand out with Jaundice as one of the presenting symptoms. Hope this helps! +6  
cassdawg  Also just to add: Rh incompatibility causes a delayed hemolytic transfusion reaction, this reaction was immediate so it is indicative more of the ABO blood group incompatibility (FA2020 p114 has all the blood transfusion reactions) +1  


submitted by neonem(572),
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iTsh niaeptt asec ussodn lkie he sha noir nfeeciycid iaeman a,eian(m wol h,iormctaet yiiccortm)c fmro a GI dble.e oT tge tsih tunqsoie girt,h uyo dah ot rbeeremm ttha het wot rjoam idethiren GI caecnr mesnrodys rea PFA e(ud to itnotuam ni ACP gnee, ihwhc si a rumto sopesrrups enge) and nchyL rmdesnoy KAA eaeirhrytd -liynsospoonp cltlceraoo nriacmcoa P(HC)N,C dasuec yb a mautoitn ni a rmnbue DAN shicammt rrpeai e,nseg of ihwt M2SH is a emor nomcmo .neo

Teh ceimsnamhs of tirhe ccomrnaia tnvmledoepe ear nitfre;dfe ni PAF, ustmor rasie rmof a mrloan -&-t;g aoadmen g-&-;t rcoamacin ceseequn whlie in ,CNPHC somtur aeirs rfmo 'aswth wnonk as a ttoimrscelieal tnbalyitisi hatwayp, inaegdl to oenatpnosus omotfainr fo a rcaiaonmc tn(o ededcpre by a ibnegn elnosi ikel an o.)aadn.e.m ouY tn'ddi eedn ot nokw itsh to tge tshi nsqteiou rgt,hi ubt iednlyftei good to n.kwo

medpsychosis  To make it even simpler, if you narrowed it down to FAP vs HNPCC and looked at the image provided in the question, you'd see it's less likely to be FAP due to absence of numerous polyps which would be expected. So HNPCC would be your best choice! +5  
yb_26  I always get Li-Fraumeni and Lynch syndromes confused :/ +1  


submitted by medstruggle(12),
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Wyh si it tno naarovi lllicoef selcl? I thgtouh teh leamfe gonlaa fo eolStri adn dyiLeg si gear/aostaulcnh selcl.

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +11  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +38  
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 +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
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. +9  
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? +4  
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" +2  
youssefa  Hahahahaha ya'll just bored +9  
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 +5  
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 +2  
noplanb  Wait... I might actually never forget this now lol +3  
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!" +18  
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. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
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 +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


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oHw do oyu shituidnsig sthi mfro sittlurace s?troino Is it stuj aesuceb it rtestad ni het left falnk?

neels11  and there's no mass in the scrotum, whereas testicular torsion will have that "bag of worms" feel (along with a lack of cremaster reflex) testicular torsion usually happens in a younger age group +11  
medpsychosis  @neels11 I would like to clarify a piece of information. I believe you are confusing Varicocele with Testicular Torsion. Varicocele will present with "bag of worms" feeling. While the absence of cremasteric reflex is a sign of testicular torsion. +16  
johnson  This is the classic "loin to groin pain" of nephrolithiasis. +8  
suckitnbme  Testicular torsion would also tend to have a unilateral high-riding testicle. +  


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PTH is reaeindsc ceauesb usrem iclcmau si w.lo uceBaes TPH is i,nrecdesa orohohsuspp is aescerde.d Teh amnow ni lanube ot bbsora ivtainm D (a tfa bllueso amii)nt,v so loicrlciat si erdcaedes o(n mnvaiit D ofr hte ekdnyi ot icaeavtt tnio olrtali.i)cc

gabeb71  What does this have to do with the Celiac Sprue? +1  
medpsychosis  I believe they were explaining the reason for the mentioned "mild osteopenia" in the pt presentation. +  
meningitis  No, I think this person got confused with another question about celiac sprue, PTH, Calcitriol, and Vit D (it was an arrow type question). +  
diabetes  explanation for decreased bone density . +  


submitted by mcl(601),
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dgcrcoAni ot sthi pa,per nislinu thbiiisn pahla elcls form srinleage lcogguan. Tsih is teh antrvlee irguef ofrm the rpae.p

medpsychosis  There are three ways that Glucagon secretion is stimulated: +(1) a stimulatory effect of low glucose directly on the alpha cell, +(2) withdrawal of an inhibitory effect of adjacent beta cells, and +(3) a stimulatory effect of autonomic activation. The response of Glucagon to hypoglycemia is diminished in T1Diabetes. Hence in this pt, the impaired release of Glucagon allows for prolonged Hypoglycemia. Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005043/ +9