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Welcome to pparalpha’s page.
Contributor score: 78


Comments ...

 +0  (nbme22#5)
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aCn esmoneo aepsel naipexl hyw ti ouldw ton be ogyclneg ?onlepidte I ugttohh het iteqouns swa tligkna tobua the Wgraurb .o.mpe.nnoehn so yhw otn knedwbaro of gcenyglo ot ?solgecu

I egsus it duwlo ton xapleni het ?eamde

hello  Glygocen stores are depleted within 24h. This person has signs and symptoms of longterm nutritional deficiences. +2
raffff  it would not explain the edema, yes +
drzed  Also the warburg phenomenon has to do with cancers preferentially taking up glucose; there is no indication that he has cancer. +
haydenelise  The first sentence says that he has lung cancer. +1

 +7  (nbme22#8)
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dnicoArgc to :nBB

lrCveica ibr si an omulnsaao aretx ibr mrfo eth h7t lrivccea rr.evabete lPeeop wthi htsi ear at skri ofr cctrhioa ttueol enyodsrm ka(a mecnorsposi of nveres and eelvsss ttha eleva eht r.htaxo sThi crscuo eoabv het itsfr rbi nda dhebni eht )v.cellcia

liCaclni erfuates nicu:lde

1) icbarlah luspex ujynir s(uhc sa mpuleKk s,pyal ichhw si a wlreo psxlue i)unyrj

2) useoVn nosmioprsec

3) lArtaire sesrocpiomn

An* arntoitpm oitaamacln rlcoeeart the eanelsc agiletnr rt(roaien c,eeasnl eddilm saeenl,c avebo eth rtfsi )irb

llamastep1  The cervical rib is underneath the brachial plexus, the pressure of the backpack compresses these nerves causing the pain https://lh3.googleusercontent.com/proxy/m6FASqomZvlebUu8MoUePvFzMXP7u8vgEnT0VamRq3Wij_sOH7gtJTfK1L9LCeOgsq-O6Rpxd_Z0mhjL +1
rockodude  link didn't open for me +

 +5  (nbme21#21)
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tnihoibnii fo ribecuutmlo ioalopyermnzit → ihsiibnit hpasotiogsyc fo treua ctlasys,r toyeucekl ititnovaac nad ,ritgonaim nda lcle itcshxe.amo

teepot123  fa 19 pg 476 +

 +3  (nbme21#47)
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heT gnailniu trpa of teh oiusqtne inotps ouy to a a femlroa ierhan

Froaelm :narhei cnmuomon tpye fo aiinlugn ,ihnera in hwcih aintlinoabmd-ra etostcnn (ni hsti csea eth llasm o)ebwl rniahete itno eht loafemr anlca uhgtohr hte eomafrl grin

ehT eg:iam agarlintutsn:o hccsmiie osciners fo oetsnntc witihn hte ahrein acs sa obldo owfl is coomedspmri edu to riacinotnrcea dcilire(reub alemfor erhain ude to tarpped hiraen ttsneonc in ehrian as)c

oS, in rtsho: ralmfoe rahien cna dale ot a coinatimlocp eacldl eotnricniraca wihch can lead to niatlnugtsaor

madojo  Femoral hernia's are more common in women, i don't think this was a femoral hernia, either way any type of hernia can under strangulation. +

 +1  (nbme21#12)
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omniCpiaoclts fo PC:SO

dasaurlCviraco stenve

epTy 2 sbetdiae litulesm

Eolrmtainde cancerisrapaye=hlp

cesadrnIe igmeisrcraa erat


 +7  (nbme21#9)
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xTeniaomf

ecmaMi:shn lvicestee rntgeseo ortecper rladtoomu RM)(ES htta scat as na otnantgais on eth rtesogne oerpcetrs of het aestrb nad scat sa na atiaprl tisango no egrnoets orepscert in beno dna rsuuet. hT,eroefre ↑ iksr fo traemienold nrcaec nda ↑ Rkis fo etiuenr srmaoac

:Uess ER ro PR eopvsiti uomsrt t(s)erba


 +20  (nbme21#35)
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daLe otyxTiic :

asCse:u dniiurtsop fo emeh etsynshis aiv biiitnnioh of AAL iitveo(nlulmnaae ed)seahytrad

dsgiiFnn:

A: mieanA

B: hBpiiolacs ptniisplg

C: coilC

D: ierrhaaD

E: yEnpalopahtche

F: ooFt rpdo

G: Gum disop/rttwsogeh entarratuotgi/do

H: HNT adn ehurepcraymie

tOrhe renasws:

iZcn ceidinefyc:

useas:C olw n,atike rn'sCho eedssia

ndnsi:iFg unmmei ndfuyonic,st piameidr odwnu ghlinea rf(o het ongermidle aeshp of nwduo ,ehialng znic is ednede by ielnaoseaesomttrpl to aekrb owdn etyp III agloel)nc, gydmpoi,shano ,arearihd e,itadrtmsi oelacpa,i bamalorn ettsa nda lmles

sesxcE is .rr..ea but anc lead ot /d/nv nda mlonbdaia ipan

uineMsmag eficencyid:

Ceu:ass a,gceintnol oirauylp, itnltmrin,uao xaliveta uebas

nngs:idiF atne,yt aurprteme lurinetcvra n,rtctioncao sairnedec QT nrveliat

12B cndiyfceei:

:seusaC envga ,tied iorencupsi m,eanai naeicpctar ssuise, csiargt yabsps ryergs,u robtpmlsiaaon r(,hoCn ps,)ure thpilhyuDoirlomb laoaru/mmwptcte nieintocf

nFgidnsi: itmrco,cayc lotbsmagleica eia,nma rnoue osmympts, sdreneica ocoeysehimnt adn AMM eesvll ni emrsu

edsarecIn mVantii D:

Cssua:e mantoulusroga esiedsa osc)osi(asird

iFnndsi:g oben e,orprisont oto chmu mual,cci ssol fo e,teatipp sptoru

lovebug  2019 FA, pg 411. +
lovebug  Nephrotoxicity results from lead exposure because the kidney is the main route by which lead is eliminated. Lead is absorbed by the proximal tubular cells of the renal tubules, where it binds to specific lead-binding proteins. +

 +4  (nbme21#32)
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VEB HV4()H- itfnecs B ecll orhhtug 1C2.D

lAptaiyc ethyyspmolc on lpierpaher bodlo rmase tn(o nefeitcd B ,elcsl but tircaeev ioxctctoy T l)lcs.e

u"oM"noisonls:ce + tmonspoo ttse ts(nbadeioi tecedtde by tginaigotluna fo hepes ro ehros sC)BR

sbryant6  Atypical lymphocytes are CD8+ T cells, not CD4+. Remember that. +10
mangotango  I remember this because Infectious Mononucleosis is caused by a virus (mostly EBV, sometimes CMV) and MHC Class I functions to present endogenous antigens (e.g. viral or cytosolic proteins) to CD8+ T cells. In comparison, MHC Class II is more involved with presenting exogenous antigens (e.g. bacterial proteins) to CD4+ T cells. // FA 2019, pg 100 +

 +5  (nbme21#44)
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ePnacrleev fo sesdiae ghghh=iih =iVhPhPg sereptt ibbaopirlty

VNP svaier siynveler ihtw elenacrepv ro eteprst otyiaplbibr

.p 572 fo AF





Subcomments ...

submitted by noselex(4),
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orDtxe sv eeoni:dC Bhot rae iuvstst,sneia but tdexro is orme of NAMD osinagt thta alos hsa opiiod tasgnio tv.iicyta xeortD si neoft esudab to teg a isliarm out fo bdyo ilefgen due ot tsi NMDA goistna fetc.ef idnoCee no teh toreh erhot is a -onfull iidoop i.osagnt ’sIt osla sued sa detrr-nl,ihaaai so osnntitocpai is yrev mnocmo adeserv f.feetc

trpuoimoTi is gworn ecusbae t’is ton an tt.ievsianus s,olA sti’ na rncihtiecgaloin ihwhc is ()1 odindnacietactr in edlelyr nuelss eyllra dtindacei, (2) a twdlmconeldeeu- irioeginanclhtc tefecf si otacpon.sitin

pparalpha  According to Sketchy and Amboss: dextromethorphan is a weak opioid receptor AGONIST and NMDA receptor ANTAGONIST (it's not an agonist). +2  


submitted by neonem(503),
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Sousnd eilk a seca fo irieunaFmL- rdomysne - cseni 3p5 si a omtur pssousprre rfo a chnub of clel eyspt, oansiutmt ni htsi neeg (sa in SF)L treusl ni a dimayr fo amlfilai troum .tseyp

pparalpha  Li-Fraunemi syndrome = SBLA (sarcoma, breast, leukemia, adrenal gland syndrome) and occurs because of an autosomal dominant inherited mutation of p53 APC: linked to FAP (colorectal cancer) RET: linked to papillary thyroid cancer, MEN 2A, MEN 2B RB1: retinoblastoma +9  
privatejoker  The thing that threw me off was that the only connection in her FH to the above SBLA reference was the mention of a paternal cousin with adrenocortical carcinoma. The other two mentioned had brain cancers, which seem completely outside the scope of the above mnemonic. Then again, as mentioned elsewhere, I suppose the best policy on these is just to rule out the absolute wrong answers. I swear, the NBME is lying when they tell us to choose the "best" answer on some of these. What they actually mean in practice is for us to choose the least shitty. +14  
dbg  ^ this guy cracked the code. nbme ur doomed. +4  
cienfuegos  @privatejoker: I feel the pain. Quick FYI: UW includes brain in the associated tumors. +3  
hyperfukus  we can just make her thing SBBLA and hopefully never get this wrong again +7  
jakeperalta  @privatejoker: according to UW, Li Fraumeni includes SABBB(sarcoma/adrenocortical/breast/brain/blood(leukemia)) +2  
ac3  side note: RB1 = retinoblastoma with an increased risk of osteosarcoma +  
lukin4answer  TP53 associated with SBLA + Brain tumor + Anaplastic Thyroid ca + Transitional cell ca. -UW +  


submitted by usmleuser007(326),
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.1 r"Tehe LHA sanf lliw try h"em
t    a. iehTnoern = herTe 
    .b iHnstidei; inin;rgAe enyLis = AL
H    .c nyinaahelnPle = fa
ns    .d e;alinV ocseuIne;li ieuecLn = lli
w    .e tynaTpohpr = yr
t    f. oennMhteii = ehm
t
pparalpha  Thanks! Good mnemonic +1  
b1ackcoffee  best mnemonic +  


submitted by nicnac20(17),
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Mdexi osvune gonxey ntonise is the uamnot of goxeyn dbuon to iongoehblm sa it nrruets ot het hgrit eisd of hte etrha treaf nitlvarge ot eth sis.setu

edraDcees egonxy rdiyeevl to hte ietsuss deu to dasdercee cicadra uptout alsed ot teh sieusst cgrtneitax rmoe gnyexo rfom het apssing CBRs naht hyte lormlyan ,wuldo hwhci esrecesad the olravel demix vnesuo xynego .ninesto

pparalpha  A helpful equation is CO=rate of O2 consumption/(arterial O2 content-venous O2 content): Fick principle If CO is decreased, then the difference between arterial O2 content and venous O2 content is increased +13  
misterdoctor69  To clarify a little bit, the tissues wouldn't necessarily extract MORE oxygen from the passing RBCs than they normally would. They would extract the same amount as they normally would to carry out their own functions. However, because the starting amount of O2 delivered to tissues is lower, you'd end up with less O2 bound to hemoglobin returning to the right heart. +2  


submitted by haldol(11),
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PB si low so yoobvsliu eht boyd lwil atnw ot ornpsed by enagnsiric mpsycsthteai nad secrnagedi eristpthmaapyc.sa ecnis eht BP is lwo, ehrte is elss psseuerr aagsint teh llaw fo hte atidorc isnsu -- gaimenn ssle litoniatmus nad feerw .iplseusm wfree oadritc ssepilmu msnea wefre sciyppaaetahrtsm

pparalpha  Hyotension will lead to decreased arterial pressure and DECREASED stretch. This leads to decreased afferent barcreceptor firing (carotid sinus and aortic arch). This leads to an increase in efferent sympathetic firing and decreased efferent PNS stimulation. This leads to vasoconstriction, increased HR and increased BP. +1  
sahusema  The way I remember this, carotid massage slows the heart. So baroreceptor stimulation (more impulses) increases parasympathetic output. +3  
cienfuegos  FA 2018 pg 291 has helpful image/description +