Anyone else figure out how a surgeon gets his hand inside the patient deep enough to avulse the hepatic veins from the IVC during a LAPAROTOMY? Baffles me.

If anyone wouldn’t mind: How am I supposed to know that T1DM has a similar pedigree to schizophrenia? Teach me how to think, ples.

When you have a traveler who has intermittent abdominal symptoms and diarrhea, and who has traveled to the likes of northern Africa and such, Schistosomiasis needs to be on your radar. At least, that’s how I’ve incorporated this nugget into my mental space.

This has to do with intron splicing. Remember GTAG. This mutation induced an AG closer where it was supposed to be, so some of that intron just became an exon.

This is the only choice that comes close to nicking the thoracic duct, specifically at its inlet, the left subclavian.

Encapsulated organisms run rampant in patients who have no spleen, whether physically or functionally. (Recall the wide-array of sequalae sickle cell patients experience thanks to their functional autosplenectomy.)

Annular pancreas is the only answer that accounts for the bile in the vomit; of the choices, it is the only obstruction distal to where bile enters the GI tract.

This is indirectly asking about peak bone density. That whole thing about weight-bearing exercises, eating right, yada yada, before and during that down-slope phase of life for bone density. All about reducing that 1% per year age-related bone density loss as best as we can. Level of activity is precisely like weight-bearing exercise. (Consider: no activity, bed-ridden -- say goodbye to your bones; highly active, runs every other day -- good amount of weight-bearing / stress to induce remodeling and maintain integrity of the bones.)

Decreased total, normal free (unbound) = Thyroid hormone-binding globulin deficiency

This is a conditional called craniocleidodysplasia. The kid on Stranger Things with the lisp has the disorder. No collar bones, too many teeth, frontal bossing => craniocleidodysplasia. CBFA1 is a gene highly implicated in osteoblast function.

This is a hypoplasia of the pleuroperitoneal membrane. The guts herniate into the thorax, usually on the left side, and result in hypoplasia of the lungs (because they're horribly compressed).

Is this the one with the poor kidney that was cut in half against its will and has a dilated distal ureter? If so, probably showing us transitional carcinoma with mild invasion into that distal ureter. Pathoma does a pretty awesome job of talking about GU cancers (and most cancers) ((and most medicine)) IMO.

I have regarded crepitus as the rubbing of bone-on-bone. My study partner and I think this is a purely definitional question. Yes, crepitus could also be trapped air. Context, I guess.

I think Shigella is the most appropriate, as it is actually regarded as highly inflammatory. Yes, E. coli can be of the EHEC/STEC variety, but E. coli could also be of the ETEC variety or whatever other strains it has. Ergo, E. coli may be plausible, but it is not the 'most likely.' Bleh to these kinds of questions.

If you want to clear a drug, it is probably best that it not be bound to proteins (so that it gets filtered) and it has a low volume of distribution (so it isn't in the deep, hard to reach tissues).

This patient is experiencing hypersensitivity pneumonitis from the parakeets. I was thinking M. Avium when I selected parakeets -- I think my logic was flawed given the specifics of the patient's story.

As a rule of thumb, if you give someone an ACE inhibitor and they get a problem, they had renal artery stenosis (usually bilaterally, or so we were taught at our med school). Probably has to do with decreased GFR thanks to decreased Angiotensin II–selective vasoconstriction of the efferent arteriole => decreased sodium delivery to macula densa => increased renin release.

Anytime you have a person who bumps their head, gets back up, and then has severe issues or dies like 6 hours later -- you have yourself an epidural hematoma from laceration to the middle MENINGEAL artery. (Goljan really emphasizes that you don't screw up and select middle cerebral.) You know it has to be an arterial laceration since the dura is tightly adhered to the skull's inner surface. Goljan referred to his experience with it as needing pliers to remove the dura from the skull; graphic, but it drives the point home. Tenting seen on CT is because the epidural hematoma gets stuck between the suture lines. When it manages to break past one of the suture lines, it is my understanding that then is when you get severe sequelae, like death or whatever.

Pregnancy + Hx of thrombosis --> think antiphospholipid syndrome

The PT and PTT are prolonged d/t interference from the antibodies to phospholipids. Thrombin time normal.

Had to find research articles about it so take it from here and don't waste your time...