NBME Answers : sheska's page

Subcomments ...

submitted by step_prep5(246), visit this page

get full access to all content ⋅ become a member

Older patient who has been drinking 12-15 glasses of water daily and has a history of schizoaffective disorder found to have hyponatremia with low urine sodium and low urine osmolality, most consistent with psychogenic polydipsia
Key idea: Despite UWorld claims, urine osmolality does NOT need to be below 100 to diagnose psychogenic polydipsia
Key idea: Antipsychotics can commonly lead to dry mouth (as is seen in this patient), making a patient feel thirsty

get full access to all content ⋅ become a member

lindasmith462 so is psychogenic polydipsia always the term we use? I was taught that it was a specific subtype of "primary polydipsia" and isn't necessarily used for patients who drank alot of water for a "reason" (like this guy who just thinks he needs to drink this much to prevent an infection and didn't have this behavior before his infxn regardless of his schizoaffective disorder) +

sheska clearly this people dont know the definition of euvolemia (clear mucuous membrane) psychogenif polydipsia presents with euvolemia. tssss nbme +3

charcot_bouchard I think i ruled out this just seeing dry mucosa. +

submitted by seagull(1933), visit this page

get full access to all content ⋅ become a member

"No bruits are heard over the neck"

I swear I cannot bang my face hard enough against a wall.

get full access to all content ⋅ become a member

letsdothis Me too. Un-friggin-believable +1

cinnapie Yo @seagull I am a huge fan. I am a huge fan. I think we gave step 1 around the same time and now Step 2 CK. Anyway, keep up the good work, we need someone like you to add some humor to this fucking shit. Not all heroes wear capes!!!! +6

sheska if no bruits then why should we do a carotid duplex goddd +

tinylilron bruits probably are not sensitive or specific enough... duplex is probably a better test +4

lindasmith462 "everything is in the question for a reason" I tell myself "not everything is a trap. how many questions have you gotten wrong because you thought something was a trap? go based whats on the question for once self!" NBME going Admiral Ackbar on my butt over here. +2

submitted by usmleuser007(464), visit this page

get full access to all content ⋅ become a member

My understanding is that the pulmonary circulation changes very little in terms of an acute MI.

It is b/c pulmonary circulation has a lot more room to fill with blood much like the spleen in terms of blood accumulation.

With higher volume of blood in pulmonary circulation, more blood vessels are able to be recruited specially the apex.

With more recruited blood vessels = reduced pressure d/t circulation in parallel

get full access to all content ⋅ become a member

sheska yes, in boards and beyond he explain this. extralveolar vessels= arteries and veins, intraalveolar vessels=capillaries. capillaries will increase resistance because will have more blood from backup of the left atrium and will get smudged => increase PCWP arteries and veins with more blood will open more and thus decrease pulmonary vascular resistance. +