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 -1  (nbme23#44)

microwaves are low energy EM waves they heat the food but does not cause radioactivity which is caused by HIGH EM waves as gamma nd x rays they removes the electron nd produces ions that can cause cancer





Subcomments ...

Did anyone else go down the: she's hypotensive so maybe she'll get waterhouse friderichsen syndrome because nothing else is making sense to me at this point??? route -

Turns out, severe malaria can cause cardiovascular collapse and hypotension.

shriya goyal  yes I answered it like that +1  
redvelvet  me too :( +  
abigail  me three :( +  
yex  Me four :-/ +  
link981  Slowly raising my hand as well +  
tinydoc  Sammmme +  
bullshitusmle  same here!!!:@ +  


submitted by jrod77(12),

I think they might be describing angina...not sure. TXA2 is responsible for platelet aggregation,so it may be contributing to thrombosis, thus ischemia to the cardiac tissue.

sympathetikey  Agreed. I'm pissed though because PGE2 mediates pain, which is why I picked it. +8  
he.sanchez14  If im not mistaken, the question describes unstable angina. Unstable angina is due to thrombosis with incomplete occlusion. So, yes TXA2 is responsible for the thrombus that is causing the symptoms in this patient. I'm also pissed because I also went straight for the PGE2 +  
vik  hahah, seems like all in same boat like me +  
yb_26  thromboxane A2 is also vasoconstrictor, so my thoughts were about vasospastic angina +  
shriya goyal  same I went for pgE2 ... I M PISSED +  
shriya goyal  same I went for pgE2 ... I M PISSED +  
youssefa  Went for PGE2 ... shit +  
need_answers  I went for leukotriene B4, what the hell was I doing....SHIT +1  
hopsalong  I picked Leukotrine B4 thinking that the neutrophil infiltration was the source of the pain, seems wrong lol. +  
bballhandler11  Sometimes it helps me to think of it in a general, non med school textbook kind of way. When answering, I narrowed it down to PGE2 and TXA2 as well. Then I asked myself, if someone is experiencing chest pain, would I recommend Aspirin or Advil? That's helped on a few over the counter pharm questions. +1  
ususmle  same here I M PISSED PGE2 +  
krewfoo99  Maybe PGE2 isint the answer because it mediates pain and fever during episodes of acute inflammation? Thus making TXA2 more likely. +  


submitted by jrod77(12),

I think they might be describing angina...not sure. TXA2 is responsible for platelet aggregation,so it may be contributing to thrombosis, thus ischemia to the cardiac tissue.

sympathetikey  Agreed. I'm pissed though because PGE2 mediates pain, which is why I picked it. +8  
he.sanchez14  If im not mistaken, the question describes unstable angina. Unstable angina is due to thrombosis with incomplete occlusion. So, yes TXA2 is responsible for the thrombus that is causing the symptoms in this patient. I'm also pissed because I also went straight for the PGE2 +  
vik  hahah, seems like all in same boat like me +  
yb_26  thromboxane A2 is also vasoconstrictor, so my thoughts were about vasospastic angina +  
shriya goyal  same I went for pgE2 ... I M PISSED +  
shriya goyal  same I went for pgE2 ... I M PISSED +  
youssefa  Went for PGE2 ... shit +  
need_answers  I went for leukotriene B4, what the hell was I doing....SHIT +1  
hopsalong  I picked Leukotrine B4 thinking that the neutrophil infiltration was the source of the pain, seems wrong lol. +  
bballhandler11  Sometimes it helps me to think of it in a general, non med school textbook kind of way. When answering, I narrowed it down to PGE2 and TXA2 as well. Then I asked myself, if someone is experiencing chest pain, would I recommend Aspirin or Advil? That's helped on a few over the counter pharm questions. +1  
ususmle  same here I M PISSED PGE2 +  
krewfoo99  Maybe PGE2 isint the answer because it mediates pain and fever during episodes of acute inflammation? Thus making TXA2 more likely. +  


The way I excluded vasodilation was this: the sympathetic receptor that dilates is β2, which is not stimulated by norepinephrine. So to stimulate the receptor, the stellate ganglion would have had to first stimulate the adrenal medulla to release epinephrine (stellate too high to stimulate the medulla).

shriya goyal  nice explanation +1  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
krewfoo99  But isint beta 1 (heart rate) also stimulated by Epinephrine? +  


The way I excluded vasodilation was this: the sympathetic receptor that dilates is β2, which is not stimulated by norepinephrine. So to stimulate the receptor, the stellate ganglion would have had to first stimulate the adrenal medulla to release epinephrine (stellate too high to stimulate the medulla).

shriya goyal  nice explanation +1  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
krewfoo99  But isint beta 1 (heart rate) also stimulated by Epinephrine? +  


The way I excluded vasodilation was this: the sympathetic receptor that dilates is β2, which is not stimulated by norepinephrine. So to stimulate the receptor, the stellate ganglion would have had to first stimulate the adrenal medulla to release epinephrine (stellate too high to stimulate the medulla).

shriya goyal  nice explanation +1  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
krewfoo99  But isint beta 1 (heart rate) also stimulated by Epinephrine? +  


The way I excluded vasodilation was this: the sympathetic receptor that dilates is β2, which is not stimulated by norepinephrine. So to stimulate the receptor, the stellate ganglion would have had to first stimulate the adrenal medulla to release epinephrine (stellate too high to stimulate the medulla).

shriya goyal  nice explanation +1  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
shriya goyal  nice explanation +  
krewfoo99  But isint beta 1 (heart rate) also stimulated by Epinephrine? +  


submitted by nwinkelmann(100),

Per pathologyonlines.com

Leukoplakia = risk factors include male gender, 40-70 years old, smoking, White patch or plaque, 5 mm or more, on oral mucous membranes that cannot be removed by scraping, not due to another disease entity such as lichen planus or candidiasis and not reversed by removal of irritants and lesion must be considered precancerous until proven otherwise. Premalignant lesion transformation would lead to invasion of the submucosa.

Micro = Varies histologically from acanthosis, hyperkeratosis, dysplasia or carcinoma in situ (associated with lymphocytes and macrophages). This article explains it much better and has pictures: https://emedicine.medscape.com/article/1840467-overview#a6. Based on this article and the pictures, I'd say the histo slide in the question is at least moderate squamous dysplasia.

Hairy Leukoplakia = White, confluent patches of fluffy (hairy) mucosa, bilateral, along lateral tongue, and associated with HIV+ patients (AIDS may appear within 2 - 3 years) but actually due to EBV infection

Histo = Hyperkeratotic oral mucosa due to piling of keratotic squamous epithelium, Cowdry type A intranuclear inclusions, Balloon cells with margination of chromatin (nuclear beading); EBV present in clear cells of spinous layer, variable koilocytosis, superimposed Candida infection, without inflammatory response.

From pictures (and this video: https://youtu.be/Shx61qKuIv8 timestamp 1:22), hairy leukoplakia has a lightly stained band of cells "ballon cells" in the stratum spinosum which is where the EBV lives. It looks much different than the histo slide shown in the question.

yb_26  great explanation, thanks for sharing! +  
shriya goyal  great explanation thanks +  
cathartic_medstu  on point +