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Comments ...

 +1  (nbme20#23)

its due to vascular scleorsis and stiffening- changes with aging- leads to high sys BP





Subcomments ...

submitted by haozhier(17),

Can someone please explain to me: If the posterior 1/3 of the tongue is developed from 3rd and 4th pharyngeal arches, why is it wrong to choose pharyngeal arch?

therealslimshady  Welcome to NBME +2  
mutteringly  First time? (meme) +2  
drdoom  That would be like choosing “blastula” if it were an option: it's not wrong but there's a more precise answer. +  
pontiacfever  That is wrong. They're indicating towards thyroglossal duct/thyroid which originates from Pharyngeal pouch not arch. secondly, they're asking that the mass originated from which structure. So, as we know it is associated to foramen cecum which is related to tongue. +  
drdoom  @pontiacfever, i believe you’re responding to @haozhier’s original comment, yes? +  
pontiacfever  @drdoom, yes the original comment by @haozhier +1  


submitted by haozhier(17),

Can someone please explain to me: If the posterior 1/3 of the tongue is developed from 3rd and 4th pharyngeal arches, why is it wrong to choose pharyngeal arch?

therealslimshady  Welcome to NBME +2  
mutteringly  First time? (meme) +2  
drdoom  That would be like choosing “blastula” if it were an option: it's not wrong but there's a more precise answer. +  
pontiacfever  That is wrong. They're indicating towards thyroglossal duct/thyroid which originates from Pharyngeal pouch not arch. secondly, they're asking that the mass originated from which structure. So, as we know it is associated to foramen cecum which is related to tongue. +  
drdoom  @pontiacfever, i believe you’re responding to @haozhier’s original comment, yes? +  
pontiacfever  @drdoom, yes the original comment by @haozhier +1  


submitted by hungrybox(1026),

ACUTE alcohol inhibits CYP → Increased bioavailability of acetominophen

CHRONIC alcohol induces CYP → Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite


I got this wrong because I assumed chronic alcohol meant years and years. I guess a weekend will suffice?

Honestly, fuck this problem.

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +4  
pontiacfever  Drink a lot for a week makes you a chronic alcoholic? +  
pontiacfever  That means alcohol abuse = chronic alcoholism +1  
skilledboyb  Why would increased bioavailability of acetaminophen place the patient at increased risk of liver injury? What's dangerous about that? +  
i_hate_it_here  Metabolism of acetaminophen turns it into toxic metabolites (NAPQI) that inhibit glutathione in the liver forming toxic tissue products. FA2020 pg: 485 +1  


submitted by hungrybox(1026),

ACUTE alcohol inhibits CYP → Increased bioavailability of acetominophen

CHRONIC alcohol induces CYP → Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite


I got this wrong because I assumed chronic alcohol meant years and years. I guess a weekend will suffice?

Honestly, fuck this problem.

lfcdave182  Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +4  
pontiacfever  Drink a lot for a week makes you a chronic alcoholic? +  
pontiacfever  That means alcohol abuse = chronic alcoholism +1  
skilledboyb  Why would increased bioavailability of acetaminophen place the patient at increased risk of liver injury? What's dangerous about that? +  
i_hate_it_here  Metabolism of acetaminophen turns it into toxic metabolites (NAPQI) that inhibit glutathione in the liver forming toxic tissue products. FA2020 pg: 485 +1  


submitted by cassdawg(1101),

She has left homomynous hemianopia, which can be due to lesion of the contralateral optic tract or as in this case lesion to the contralateral occipital lobe. It is not mentioned explicitly but this causes macular sparing. (FA2020 p542 gives the visual field defects)

bbr  tricky tricky +1  
pontiacfever  Left homonymous hemianopia w/o macular sparing can also occur due to damage to parietal and temporal lobes. But occipital lobe damage is more common. +  
i_hate_it_here  <-- +  
pakimd  macular sparing will only occur if there is an infarct of the posterior coronary artery supplying the occipital lobe. this is because the macular region of the visual cortex has a double blood supply from the middle cerebral artery and the posterior cerebral artery. this woman has breast cancer hence the mets are probably directly to the occipital lobe causing left homonymous hemianopia WITHOUT macular sparing. FA pg 542 look at the illustration: it says number 3 (left homonymous hemianopia WITHOUT macular sparing) and 6 (if PCA infarct when there is left homonymous hemianopia WITH macular sparing) +1  


submitted by rio19111(10),
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I ktnih a olt of uoy ssdime het tino.p ehT wsnaer si tolrCiso cseebau it pshel taamniin lobdo eesrrpsu enev in eht etgnsti rewhe eh is ruhdelnmsoi.a

rio19111  FA 2019, Pg. 329 +2  
pakimd  according to pathoma, cortisol is the hormone neccessary for life. in a condition like the one presented in the Q-stem the most important hormone will be cortisol. +2  
pontiacfever  Also Cortisol is generally a stress hormone. Starved body is generally understress--Cortisol +  


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dulxy071  Wouldn't Granulation tissue be the (more correct) answer since the initial collagen laid down for wound healing is Type III collagen which is consistent of granulation tissue? Collagen is a vast for so many types of itself as we know +3  
kpjk  @dulxy071 she had a surgery 3 months ago healing was fine even uptill 6 weeks ago so the abnormality occurred during remodeling- when type 3 is replaced by type 1 collagen, so the answer wouldnt be granulation tissue +5  
pontiacfever  Keloid has both 1 and 3 types of Collagen increased production. Whereas, granulation tissue consists of type 3 collagen only. which is why collagen synthesis as answer would be more specific +