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Welcome to sattanki’s page.
Contributor score: 56


Comments ...

 +2  (nbme24#35)
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Dsoe neayon haev nya aide no htsi uiseqtn?o hoghTtu ti was AL.S

ankistruggles  I thought it was ALS too (and I think it still could be?) but my thought process was that a lower motor neuron lesion would be the more specific answer. +1
sattanki  Yeah makes sense, just threw me off cause ALS is both lower and upper motor neuron problems. Corticospinal tract would have been a better answer if they described more upper motor neuron symptoms, but as you said, they only describe lower motor neuron symptoms. Thanks! +3
mousie  Agree I thought ALS too but eliminated Peripheral nerves and LMN because I guess I thought they were the same thing ....??? Am I way off here or could someone maybe explain how they are different? Thanks! +1
baconpies  peripheral nerves would include motor & sensory, whereas LMN would be just motor +12
seagull  Also, a LMN damage wouldn't include both hand and LE unless it was somehow diffuse as in Guil-barre syndrome. It would likely be specific to part of a body. right??? +
charcot_bouchard  No. if it was a peri nerve it would be limited to a particular muscle or muscles. but since its lower motor neuron it is affecting more diffusely. Like u need to take down only few Lumbo sacral neuron to get lower extremity weakness. but if it was sciatic or CFN (peri nerve) it would be specific & symptom include Sensory. +
vulcania  I think it's ALS too. The correct answer choice here seems more based on specific wording: the answer choice "Corticospinal tract in the spinal cord" wouldn't explain the tongue symptoms, since tongue motor innervation doesn't involve the corticospinal tract or the spinal cord (it's corticobulbar tract). This is a situation of "BEST answer choice," not "only correct answer choice." +

 +1  (nbme24#40)
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ehT tp is hnviga a esevre aesc fo inaie/ssepmonspu (,R)A?SD sa thas’t wyh her OP2 is wlo at .46 oS in mueinapon theer si sadcneeri ylriplaac egleaka deliang to unyapmolr .eadme


 +1  (nbme24#30)
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This neo teerh weer foru sdod aoi,srt eon vepdriod nerdu hace aebl.t The yoln eon taht dha an ddos aotri geterar tnha 10. wsa eth aeblt in teh otp ghtri (sOdd iRtoa = 6, I eveb)i,el hwich ewhn uoy dolkeo at het ,llebsa del ot hte itrhg ena.srw


 +15  (nbme24#5)
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esluMc npia + rrtilopbiea dmeae is a aiclcss tipeonrstane ofr hiraloeclnt sirs.pail tsBe iaosgsnid fro iths is a mulcse ,opisby as hte yorwm lekis ot nhtuoga tinwhi hte ue.lmcss

sympathetikey  That's what you get for killing polar bears. +52
dr.xx  That's what you get for not cooking them well. +3
charcot_bouchard  Theres nothing called "well cooked polar bear meat" +2

 +21  (nbme24#49)
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npyAtarlep ether si a cloepmytel epeartsa sinlap droc felxer weehr rdceti lnpeei aolsitmunti sedla ot na .tireceon hisT xrflee nloy neesd na naitct acr ni 4S,2-S so sa olng as iths nioreg is otn ,eurijnd an tcneieor nca tlsli rcocu. wHe,eovr hwit nnctraeoist at ,C8 hent eht hpcesicoyng crnoeiet elerfx aonnct roccu, sa iths ereqursi cdsdgnniee rifesb omfr eht x.treoc

lsmarshall  Just saw a good summary of nerves/vessels involved saying, "pelvic parasympathetic fibers from S2-S4 can cause cavernous arteriole vasodilation via the cavernous nerve without of central stimulation." +6
seagull  S2-3-4 keeps the penis off the floor +30
drdoom  Modifying @seagull into iambic pentameter: “S2, S3, and Number 4 / keeps the big ole penis / off the floor” +
myoclonictonicbionic  I can assure you the validity of answer (speaking from experience) +2
raddad  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896089/ Under the "autonomic control" header +
llamastep1  I've always wondered how quadraplegics got it up. I guess their girls help em lol +

 +1  (nbme24#8)
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a’ntC phle cuhm on the axetc oigersann y,wh ubt teerh era a efw rWdUol sqintosue no sthi ewrhe fi a enneoat sha geym,lpicoyah isostke adn a,rmnehpoiameym a naiorcg icad sedrdiro osluhd eb eesspdctu oc(roppnii adic or itneymolalmhc cai)d. essL osisupisuc of an RAT esuca iplcmgoayyeh is tno tcistcihraraec of .htta

sweetmed  Im assuming because N-acetylglutatmate is an allosteric activator of CPS I needed in urea cycle. and N-AG is made of glutamate and acetyl coA. So in organic acidemias, all the acetyl CoA is being used to make ketones for energy since gluconeogenesis is messed up. So Urea cycle doesnt work as well and NH3 accumulates +3

 +5  (nbme24#39)
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Trhee rae tow sncmishaem fo aegurlting ernal dloob olf,w the gecyniom mhanescim dan gouleb-uarlormlut c.ebkfaed Tshi iqsuntoe kssa urpley bouat teh encimogy mhcinase,m ichwh si rehew eht fefntrea rtaoriele rltcnsoo boold lowf dsbae ulepyr off bodol rpeesrus nenrgeit the ,ndykie cwihh is yhw ecresadde eetnarff erraltriao rcasetnsie is het sebt neraws hte( liraeteor si tanlgiid in rseesnop to hte areecddse lobod wlfo ni tpatemt ot atmiinna nrmaol loobd ofwl ot hte y)niek.d

nwinkelmann  Man... I took this WAY TOO FAR, lol. I totally didn't recognize the clue of GFR and RPF as staying the same to tell me it was talking about normal, physiologic autoregulation. Silly mistake! +3




Subcomments ...

submitted by sattanki(56),
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Deso nnoyae hvea ayn iead no hsit otu?ieqns ouhTthg ti aws SL.A

ankistruggles  I thought it was ALS too (and I think it still could be?) but my thought process was that a lower motor neuron lesion would be the more specific answer. +1  
sattanki  Yeah makes sense, just threw me off cause ALS is both lower and upper motor neuron problems. Corticospinal tract would have been a better answer if they described more upper motor neuron symptoms, but as you said, they only describe lower motor neuron symptoms. Thanks! +3  
mousie  Agree I thought ALS too but eliminated Peripheral nerves and LMN because I guess I thought they were the same thing ....??? Am I way off here or could someone maybe explain how they are different? Thanks! +1  
baconpies  peripheral nerves would include motor & sensory, whereas LMN would be just motor +12  
seagull  Also, a LMN damage wouldn't include both hand and LE unless it was somehow diffuse as in Guil-barre syndrome. It would likely be specific to part of a body. right??? +  
charcot_bouchard  No. if it was a peri nerve it would be limited to a particular muscle or muscles. but since its lower motor neuron it is affecting more diffusely. Like u need to take down only few Lumbo sacral neuron to get lower extremity weakness. but if it was sciatic or CFN (peri nerve) it would be specific & symptom include Sensory. +  
vulcania  I think it's ALS too. The correct answer choice here seems more based on specific wording: the answer choice "Corticospinal tract in the spinal cord" wouldn't explain the tongue symptoms, since tongue motor innervation doesn't involve the corticospinal tract or the spinal cord (it's corticobulbar tract). This is a situation of "BEST answer choice," not "only correct answer choice." +  


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owH do you ownk he ash an ereaicntracd annlgiiu ehrina adn tno lacef npi?miatoc

sattanki  So as far as I understand, you don’t really get a bulging, defined abdominal mass with fecal impaction. Much more likely to see this with a hernia. +6  
xxabi  Fecal impaction can be palpated in the abdomen, since it'd be accumulating in the rectum and colon, not the groin. Hope that helps! +11  
pseudorosette  a little late but they also mention that the mass had bowel sounds hence it was an incarcerated bowel! :) +5  
waterloo  question said right groin, so idk, didn't think fecal impaction would be that low. + the bowel sounds made me think there is something at the groin that can make bowel sounds? --> Hernia. +  
thisshouldbefree  think in 3D. mass in right groin. in my head thats very low down below the belt line. i thought if its fecal impaction it would be on the left groin. next they hear bowel sounds over this mass in the right; if it was impaction right there i dont think youll be hearing anything, therefore the bowel loop is over there and is not impacted and thats what they hear. +  


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yWh rae eht MAI adn SMA tmos ylekil to be faecedft in rhe doio?tnnci

sattanki  Again, not too sure, but I think they were describing a patient with chronic intestinal angina, which is classically from atherosclerosis of the IMA/SMA. +1  
mcl  I was also thinking about which areas have crappy blood supply (watershed areas), which I assume would be worse off in the case of chronic mesenteric ischemia. If you look on page 357 of FA 2019, SMA & IMA at the splenic flexure is a watershed area; the other is rectosigmoid junction (sigmoid branch from IMA and superior rectal). +  


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Why is aslba rietocetanyk : aaubsaplrs tyatcnokiree hte lcle ntounijc ’htast tsom lileyk to be cdafe?eft Is it cueseab t’is eth nloy wnsear ahtt tsisl a injtcnuo enewteb two soycentik?reat

sattanki  Not too sure on this one, but I interpreted the basal keartinocyte:suprabasal keratinocyte as the stratum spinosum region, which is known to have the most desmosomes. +  


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owH do uyo wkon reh uynaromlp yspomtsm are eud ot lpouynmra clpayairl eakeagl and nto ai?onyltptnoehvi Is aprnlyumo rlliyacpa agelake usjt neaohrt wya fo ngiasy mauplroyn ?aeedm

sattanki  Hypoventilation in no way leads to pulmonary edema. +  
fenestrated  Hypoventilation would increased the PCO2 +