need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (“predict me!”)

Welcome to shakakaka’s page.
Contributor score: 18


Comments ...

 +0  visit this page (nbme23#50)
get full access to all contentbecome a member

Increased fetal vascular resistance=> reflex bradycardia (decreased HR)

get full access to all contentbecome a member

 +0  visit this page (nbme20#49)
get full access to all contentbecome a member

DHTR(delayed hemolytic transfusion reaction)- mild, hemolytic reaction that occur >24 hours after blood transfusion. Occurs in patients previously exposed to a minor RBC antigens(non-ABO). "+" Combs test.

get full access to all contentbecome a member

 +0  visit this page (nbme20#2)
get full access to all contentbecome a member

Anyone can explain why IgG is not correct answer ?

get full access to all contentbecome a member
drdoom  Newborn immune system will not produce a robust IgG response before about 6 months of age! +2

 +1  visit this page (nbme20#19)
get full access to all contentbecome a member

I understood that it was transitional cell carcinoma, and a smoking is a risk factor ( as it contains aromatic amines ) , but how about arylamine exposure? Its exposure also associated with blader cancer.

get full access to all contentbecome a member

 +3  visit this page (nbme16#21)
get full access to all contentbecome a member

Why not N.meningitidis ? Penicillin and ceftriaxone are treatment chooses for N.meningitidis and it's encapsulated.. If I'm not mistaken macrolides and ceftriaxone are treatment for S.pneumo , not penicillin

get full access to all contentbecome a member
shieldmaiden  This is prophylactic treatment, and penicillin is the one recommended by the AAP and CDC +

 +2  visit this page (nbme16#11)
get full access to all contentbecome a member

Risk factors for osteoporosis are gender( women) and ethnicity ( whites) according to BnB. In this case gender is answer, because she is African American.

get full access to all contentbecome a member




Subcomments ...

submitted by sympathetikey(1600), visit this page
get full access to all contentbecome a member

Good picture showing the anatomy of the thigh from a T2 MRI perspective.

https://radiologykey.com/wp-content/uploads/2016/01/B9781437707595000073_u007-009-9781437707595.jpg

get full access to all contentbecome a member
jcmed  Was so close to picking vastus intermedius +1
shakakaka  Why sartorius is so lateral.. +


submitted by strugglebus(189), visit this page
get full access to all contentbecome a member

Hydrocodone/Methadone can lead to dependence--you avoid in long term use. NSAIDs you also avoid due to partial ineffectiveness in neuropathic pain as well as ulcer risk. TCA's are known to treat neuropathic pain very well (i.e. diabetes, ART therapy)

get full access to all contentbecome a member
champagnesupernova3  Drugs for neuropathic pain: TCAs, gabapentin and pregabalin +1
mangotango  SNRIs +
mangotango  also SNRIs* +1
zevvyt  methadone isn't a pain med(even though it's an opiate), it's used for opiate addiction. And hydrocodone is used for "moderate" pain and this person is in "severe" pain. +
shakakaka  Drugs for neuropathic pain: TCA, SNRI, Anticonvulsant, Opioids, Lidocaine, Capsaicin +1


submitted by neonem(630), visit this page
get full access to all contentbecome a member

Methotrexate would be a drug of choice for psoriasis refractory to topical creams and light therapy; inhibits dihydrofolate reductase in order to decrease skin cell proliferation and reduce inflammatory response.

get full access to all contentbecome a member
69_nbme_420  Cyclosporine can also be used to treat Psoriasis (NOT cyclophosphamide - ans B) +11
len49  Drugs that can be used for psoriasis include cyclosporine, MTX, TNF-alpha inhibitors including Etanercept, lnfliximab, adalimumab, certolizumab, golimumab according to FA +2
medstudent  Kinda summed up in the index - p 791 2nd row halfway down +2
lovebug  as We all know, 1st line therapy of psoriasis is topical corticosteroid, Vit.D analog (Vit.D inhibits keratinocyte proliferation and stimulates keratinocyte differentiation. +1
shakakaka  What page if Fa says that these drugs can be used in psoriasis?) +
srmtn  FA 2019 p 476 +


submitted by hayayah(1212), visit this page
get full access to all contentbecome a member

GnRH agonists like Leuprolide are effective for patients with breast CA because if given in a continuous fashion, they downregulate the GnRH receptor in the pituitary and ultimately decrease FSH and LH.

get full access to all contentbecome a member
md_caffeiner  Quick question: FA19 691 says Leuprolide ClINICAl USE is Uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility... I guess all except infetility(pulsatile?) are used as continuous? +1
usmlecrasher  GnRH is synthesized and released in pulsatile fashion , so if you give in pulsatile way you induce GnRH effect , and if given in continuous way it will suppress synthesis, depended the desired effect you want to achieve - infertility induce GnRH with pulsatile , stop synthesis for prostate cancer , testicular cancer , hormone dependent Breast cancer give continuous +1
djeffs1  I thought Gonadotropin was released by the Hypothalamus, not the pituitary gland. am I crazy? +
kevintkim4  ^ Gonadotropins are referring to LH/FSH; Gonadotropin-releasing hormone (GRH) is released by the hypothalamus +2
shakakaka  *GnRH +1
dlakaswnd  ffffff.. the way they worded question was so confusing. +


submitted by breis(56), visit this page
get full access to all contentbecome a member

Psittacosis (sometimes called ornithosis or parrot disease or parrot fever) is an infection of the lung (pneumonia) caused by the bacterium Chlamydophila (Chlamydia) psittaci.

Signs and symptoms: fever. cough, usually without much phlegm. headache. rash. muscle aches. chest pain. shortness of breath. sore throat.

get full access to all contentbecome a member
charcot_bouchard  Update on my prev comment : Yes this is psittacosis. not hypersensitivity pneumonitis. How do u know? Lymphocyte and Presence of Granuloma - response to intracellular chlamydia. Now HS can also cause loose granuloma too and the clinical picture still more look like HS You know what ......... fuck this ques +2
shemle  Here Pt. doesn't have fever! +9
shakakaka  Noncaseating granuloma, patchy lymphocytic infiltration, and fibrosis are seen in Hypersensitivity pneumonitis , according to Uworld . +


submitted by guillo12(58), visit this page
get full access to all contentbecome a member

Negative nitrogen balance is associated with burns, serious tissue injuries, fevers, hyperthyroidism, wasting diseases, and during periods of fasting. This means that the amount of nitrogen excreted from the body is greater than the amount of nitrogen ingested.

Positive nitrogen balance is associated with periods of growth, hypothyroidism, tissue repair, and pregnancy. This means that the intake of nitrogen into the body is greater than the loss of nitrogen from the body, so there is an increase in the total body pool of protein.

get full access to all contentbecome a member
guillo12  by Wiki +
shakakaka  What is nitrogen retention, anyone can explain +
drdoom  @shakakaka Nitrogen retention is really just the opposite of having to break down nitrogen-rich molecules (amino acids, protein). This is the default state of your body, i.e., when you're well fed and not starving! +1
drdoom  So, nitrogen retention = “positive nitrogen balance” = an anabolic state. Your body only resorts to breaking down nitrogen-rich compounds (animo acids, protein) when preferred fuel sources like carbohydrates and fats are very low. +1
drdoom  ^ This is because conversion of amino acids to energy (ATP) does not yield as many equivalents of ATP as the other fuel sources, because the breakdown of proteins = breakdown of the very structure of the body (“structural integrity”), and because catabolism of proteins and amino acids often results in nitrogen-heavy byproducts like urea and ammonium that cannot be eliminated as easily as CO2 (which exits freely from the lungs). +
drdoom  “animo acids”? lol🤦🏻‍♀️ +1


submitted by ajguard26(55), visit this page
get full access to all contentbecome a member

Chorionic villi sampling is the taking of genetic material within in the chorionic villi of the placenta. Chorionic sampling is done when a patient is at high risk for chromosomal abnormalities (previous pos. tests, 35yo or older, family hx.) during the 10-13 weeks of pregnancy.

Confined placental mosaicism results when the C.V.S. testing comes back back showing a trisomy, but all subsequent testing (and the fetus itself) have normal chromosomal counts. This may be due to either a trophoblastic mutation, or by "trisomic rescue," in which trisomic cells that were supposed to be in the fetus are confined to the placenta to prevent an abnormal fetus.

get full access to all contentbecome a member
cbay0509  thank you +
shakakaka  Why It's unreadable.. +4
randi  unfortunately you have to have an account to unscramble most responses +
chaosawaits  Wow, a +16 response (rarely see those) that we can't read... FML +2


submitted by itsalwayslupus(48), visit this page
get full access to all contentbecome a member

Natural transformation is when bacteria take up naked bacterial chromosomal DNA in their environment (usually from cell lysis). A cell "lysate" is what remains of bacterial genes when the bacteria is dead (can be extracted from bacteria, as shown here). The SHiN bugs all can undergo transformation. You know it is transformation even without knowing which bugs can do so because it doesn't take up the DNA when DNase is added (it kills any free environmental DNA in the lysate)

get full access to all contentbecome a member
topgunber  just wondering why is plasmid transfer not a good option??? +2
m0niagui  Transduction requires the presence of a bacteriophage virus. Plasmid transfer requires two different live bacteria, point mutations will not occur across colonies so uniformly and neither will strand mispairing. +1
shakakaka  @topgunber I think DNase wouldn't stop the process in case of plasmids +4
topgunber  you're right in that DNAse wouldn't be able plasmids in living cells because they are inside the bacteria (same with their nuclear dna). Since living cells use sex pilli to transfer plasmids yes, DNAse wouldn't stop plasmid transfer. Key there is they had to be living. I do think a dnase can break down a plasmid in extracellular solution though (its just another piece of dna). +1
l0ud_minority  Key is heat-killed here and if you remember Griffith's Experiment it relates to transformation +


submitted by aoa05(34), visit this page
get full access to all contentbecome a member

A high stepping gate implies distal more than proximal weakness. Hammer toes are a finding in Charcot-Marie-Tooth (hereditary motor and sensory) neuropathies, most of which also feature demyelination of peripheral myelin sheaths. Slowing of nerve conduction velocities could have demonstrated the same thing less invasively.?

get full access to all contentbecome a member
notyasupreme  Ask me why I thought this was Friedreich Ataxia and not CMT fml lol +
shakakaka  Why did you think that it's FA? +1
fatboyslim  @notyasupreme because Friedreich's has hammer toes? +


search for anything NEW!