NBME Answers : rocmed's page

Comments ...

+0 (nbme24#35)

Desmoglein: Component of desmosomes, which connect keratinocytes in the stratum spinosum - FA 2018, p.467, Pemphigus Vulgaris

By this I can only assume that they mean that desmoglein connects keratinocytes to EACH OTHER, hence why the other options connecting keratinocytes to other structures are incorrect

charcot_bouchard The epidermis primarily consists of keratinocytes[4] (proliferating basal and differentiated suprabasal), which comprise 90% of its cells. You are right. both are keratinocyte

+3 (nbme21#12)

Can't renal cell carcinoma cause invasion of the renal artery, obstructing blood flow (resulting in a bruit), thereby upregulating RAAS and increasing blood pressure?

rocmed And isn't smoking also a risk factor for RCC?

lispectedwumbologist It is but RCC tends to present later in life (6th or 7th decade). In a 55 year old smoker, atherosclerosis of the renal artery is am much more common cause of bruits

seagull Hypertension is also a risk factor of an atherosclerosis leading to more inflammation. Eventually dilation (aneurysm) might occur... if im wrong then ignore this

illogical Renal Cell Carcinoma has a tendency to invade the Left Renal **Vein** (Pg 134, Pathoma 2018). Thus it has an association w/ obstructed drainage of the Left Spermatic Vein leading to a varicocele. Renal artery stenosis is more commonly due to atherosclerosis (almost 85-90%) or fibromuscular dysplasia.

ratadecalle With RCC and renal vein invasion you would see B/L lower edema and venous collaterals in the abd wall (Uworld). Also he has a severe headache and confusion which are signs of a hypertensive emergency.

-14 (nbme21#6)

A "serum Ca concentration of 16 mg/dL" as well as "bilateral hilar adenopathy" indicate squamous cell carcinoma which commonly produces PTHrP, NOT PTH!!! PTHrP will act just as PTH, stimulating the kidney to produce 1,25-(OH)2 Vit D.

+10 (nbme21#15)

Patient has positive urine bilirubin test indicating that he has water soluble bilirubin accumulating in his body that has already been metabolized by UDP-glucuronosyltransferase. In order for water soluble bilirubin to be accumulating in his body there must be defective excretion of such bilirubin. The only option available that matches such is "obstruction of the bile duct".

Subcomments ...

submitted by rocmed(-1),

Can't renal cell carcinoma cause invasion of the renal artery, obstructing blood flow (resulting in a bruit), thereby upregulating RAAS and increasing blood pressure?

rocmed And isn't smoking also a risk factor for RCC? +

lispectedwumbologist It is but RCC tends to present later in life (6th or 7th decade). In a 55 year old smoker, atherosclerosis of the renal artery is am much more common cause of bruits +

seagull Hypertension is also a risk factor of an atherosclerosis leading to more inflammation. Eventually dilation (aneurysm) might occur... if im wrong then ignore this +1

seagull Hypertension is also a risk factor of an atherosclerosis leading to more inflammation. Eventually dilation (aneurysm) might occur... if im wrong then ignore this +

submitted by mcl(228),

Page 250 FA - Ethambutol is associated with visual disturbances (changes in color vision).

rocmed Ethambutol is associated with optic neuritis which can cause loss of visual acuity and red-green color blindness +

dashou19 On FA page 250, it is said that Isoniazid can also cause optic neuritis and color vision change. Sometimes it hurts if you know too much lol +