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 +0  (nbme20#29)

The way i look at this is the temperature.

A hypothermic patient will almost always present with septic shock because septic shock can present as both hyperthermia or hypothermia

Subcomments ...

submitted by hungrybox(1026),

Here's my approach (downvote if wrong):

falling on outstretched arm → usually scaphoid


scaphoid problem → pain in anatomical snuffbox

so then it goes to the next most commonly injured bone when you fall on an outstretched arm, your lunate

(which is right next to the scaphoid)

spaceboy98  Also, dislocation is most common in lunate, Fracture most common in Scaphoid +4  

submitted by apop(7),
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spaceboy98  Isnt alkaline tide related to an increase in pH after meals? Your logic is on point but I'm not sure whether we can apply that concept here. +1  
kevin  concept can be applied here because we need to replete the Cl- in order to create HCl; the stomach doesn't care if Cl- is low in serum, only that Cl- is low in the parietal cells and so will pump out HCO3- in its expense +  

submitted by weenathon(40),

Diabetics get peripheral neuropathy from glucose damaging Schwann cells. For what I believe is an unconfirmed reason, T2DM patients tend to see parasympathetic autonomic neuropathy before sympathetic.

The hypogastric nerve carries sympathetic innervation to the posterior urethra and is responsible for ejaculation.

Inferior rectal nerve is a branch of the pudendal nerve that innervates the external anal sphincter and provides sensation below the pectinate line. A peripheral nerve problem with this nerve would cause the sphincter to remain relaxed and cause incontinence, not constipation.

Pelvic splanchnic nerves are parasympathetics (craniosacral outflow). If he is constipated, his rest and digest (parasympathetic) system is not working.

Perineal nerve is a branch of the pudendal nerve. It has both motor and sensory, is involved in the external anal sphincter, urethral sphincter, and is responsible for conscious sensation of the need to urinate.

Sacral sympathetic inhibits peristalsis, and contracts internal anal sphincter to maintain continence.

spaceboy98  Amazing man, thank you for this +  

submitted by hayayah(1074),
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Mtos tirnecosirt nszeyme dbin r.snlieapmod

oS hotb 'GGCC5 ro 3GC'GC ouldw eavh eneb baclaeetcp in ihts eiansrc.o

meningitis  Yes, correct. The 5'GGCC option could cause some confusion. +  
guillo12  I really don't understand the question nor the answer. Can someone explain it for dummies like me? +10  
whossayin  yes please.. I'm with guillo12 on this +  
sugaplum  @guillo12 @whossayin questions says you've created a new cut site, 1. look at the region on the sick vs healthy. The C to G is the change 2. Write out the sick "CCGG" from 5'3'- you could write out the whole thing, but the answer only has 4 letters, so being lazy here 3. write under it, its complement, the dna base pair. So "GGCC" 4. remember both strands are going in opposite directions when you write them out on top of each other. 5. So the bottom strand actually reads 5' CCGG 3' so that is the answer I hope that clears it up +51  
shirafune  To add to the palindrome part, many restriction endonucleases actually function as dimers. Each individual subunit usually has a nickase, so to create a double-stranded break in DNA, they must bind a palindrome so that each enzymatic domain creates a single-stranded break (thus a double-stranded break). +1  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +2  
alimd  Why do we start from CCGG? Why not CGGG or TACC? +1  
ssbhatti  I think its due to the palindrome requirement? +  
bbr  Maybe I'm missing a part here, but the substrate that the enzyme will bind to will be the DNA. I went with the line that was from the questions stem, as it is the mtuated DNA will be recognized by the restriction enzyme. I didnt see the need to convert it into base pairing. Let me know what you guys think. +1  
uloveboobs  @bbr I agree. I'm definitely not an expert in these lab tests, but the question asks "substrate specificity." I was thinking that it would recognize the abnormal DNA; nothing to do with RNA. I didn't know about the palindromic preference of restriction enzymes, but I don't think there's any need to figure out base-pairing and whatnot here. (At least for this question it didn't work out that way!) +  
spaceboy98  sugaplum, I'd give you an award if this was Reddit +5  

submitted by fatboyslim(40),

I chose Aspirin. So aspirin is a non-reversible inhibitor of COX-1 and 2 which should decrease TXA2 levels, and according to FA 2020 page 485, TXA2 causes platelet aggregation and increases vascular tone...I'm guessing the overall combined effect of COX 1 & 2 inhibition will cause a net effect of either vasoconstriction or no change to vascular tone?

spaceboy98  Me too. i thought aspirin blocking off the TXA2 production would allow for vasodialation. +1  
kevin  This was a UWorld question. I originally thought the same, it's just cilostazol does the vasodilation and inhibition of platelet activation most directly +  

submitted by drdoom(874),
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spaceboy98  This is the kinda shit we need more of. Awesome explanation man, I wish they wrote FA like this +2  

submitted by madojo(176),
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As onednimet eraya,dl eht ecll si ustck in ehetmpasa nda aonctn edrougn hte asoeripetn aspe.hnaa M ceylc taerrs is satsadoeci itwh insvrcetini nad hwchi teh oicmitt pdsneli wchhi si wtha sarepseat het esoohcosmmr is ont org.finm

suckitnbme  The funny thing is that the image seems to show that the spindle did in fact form. +11  
spaceboy98  EXACTLY They showed the mitotic spindle is formed, so paclitaxel would be ok, but for vincristine, the damn thing would not even form +4