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Welcome to specialist_jelloโ€™s page.
Contributor score: 31


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 -1  visit this page (nbme13#41)
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I get HOT T Bone STEAK IL 1 for fever

but 90% neutrophils, why cant it be LTB4 neutrophil chemotaxis?

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dentist  i picked LTB4 i guess the question itself is "which causes the patient's fever and leukocytosis" LTB4 wouldn't be a direct cause of fever. dumb question +1

 +0  visit this page (nbme13#40)
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https://basicmedicalkey.com/esophagectomy/. just refer to diagram

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 +0  visit this page (nbme15#29)
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H/o nasal polypectomy

  • Must've had to put nasal packing

  • Must've left it in too long

Staphylococcal TSS after Tampons and Nasal packing.

  • MOA : Superantigen activation
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 +9  visit this page (nbme15#33)
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NFKB is in its inactive state bound to IKB. As a part of the classical pathway, bacterial antigens bind to TLR and activate IKB kinase, (kinase phosphorylates)

  • IKB is ubiquinated and degraded

  • NFKB enters nucleus and synthesises the inflammatory stuff

Uw QID: 11955

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submitted by cassdawg(1781), visit this page
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These individuals have a poluymorphism in the breakdown pathway of 6-MP. Like most polymorphisms in drug breakdown pathways, this will lead to buildup of toxic metabolites unless the drug dose is decreased (i.e. the 6-MP will be shunted into the pathway that makes the toxic 6-thioguanine).

6-MP and its prodrug azothioprine inhibit purine synthesis (FA2020 p36 and p440).

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ali_hassan  my pea-sized brain doesn't understand why not give injections of XO. help +2
harbourlights  that's what I put. Because if you decreased their dosage wouldn't also cause a decrease in the final 6-TGN concentration making it less effective? +2
amira89  what is thiopurine methyltransferase (TPMT) and where does it act? +1
specialist_jello  qid 1890 +1


submitted by deberawr(12), visit this page
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i got ring worm from a friend's cat and so my awful middle school experience helped me answer this question

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fatboyslim  Tinea is not a ringworm though, it's a fungus +
fatboyslim  Ok just Googled it, it's called ringworm but it's a misnomer. They called it that because it looks like rings +1
specialist_jello  i answer most of my questions slumdog millionaire style, based on life experiences xD +3


submitted by alexb(53), visit this page
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First Aid 2019 page 622 stimulatory growth effects of testosterone include red blood cells. I think they expect us to know this.

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medstudent  FA 2020 p. 636 +
specialist_jello  Growth spurt: RBCs (fa2020 p 636) +


submitted by armymed88(49), visit this page
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Glucose is co-transported into enterocytes of SI via sodium

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toxoplasmabartonella  That makes that glucose needs to be given with sodium. But, what about bicarb? Isn't the patient losing lots of bicarb from diarrhea? +4
pg32  Had the same debate. I knew glucose/sodium was the textbook answer for rehydration but also was wondering if we just ignore the bicarb loss in diarrhea...? +4
makinallkindzofgainz  @pg32 - Sure, they are losing bicarb in the diarrhea, and yes this can effect pH, but it doesn't matter that much. You're not going to replace the bicarb for simple diarrhea in a stable, but hydrated previously healthy 12 year old. You're gonna give him some oral rehydration with a glucose/sodium-containing beverage. Don't overthink the question :) +2
makinallkindzofgainz  *dehydrated +
teepot123  salt and sugar, that's all the kid needs when ill simple +1
mtkilimanjaro  Hm I put bicarb/K+ since thats lost in diarrhea, but I think the key thing in this Q is that its only 6 hours of acute diarrhea and nothing else. You would prob give bicarb and K+ in more "chronic" diarrhea over a few days or longer not just a few hours +1
specialist_jello  ugh i overthought the question and changed my answer to bicarb/k +
an1  SGLT1 in the gut is a symporter. Glucose is needed to allow Na to enter, water will follow Na into the cell and reduce dehydration. Be sure to give a HYPOtonic ORS solution (more water than salt and sugar), otherwise solutes (move from low to high OSm will leave the tissues and enter the vasculature. +


submitted by cassdawg(1781), visit this page
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Fragile X syndrome is X-linked dominant inheritance associated with a trinucleotide repeat in FMR1 (FA2020 p62).

Even if you did not know this fact, fragile X syndrome (a disease affecting the X chromosome) should be X-liked of some sort.

Knowing the disease is X-linked, you can get to the answer because in the couple, the father is the only one with a family history of the disease. Whether the disease was X-linked recessive or X-linked dominant, if the father had the diseased X-chromosome he would have the disease (as males only have one X chromosome). Since the father does not have the disease, he does not have the chromosome and thus cannot pass it on. Thus, the chance of their child having the disease is 0%

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the_enigma28  Any reason why II-2 & II-3 females are not shown to be affected?? +3
yhm17  Possibly due to X-inactivation leading to mosaicism so they wouldn't demonstrate the phenotype. +14
specialist_jello  My thought process was trinucleotide repeat diseases show anticipation Stem says "SIMILAR EXPANSION" so the number of repeats cant be same generations later. +2
hivwizard  Yeah i figured that the chances of the next generation having the same repeat expansion as generation 0 would be really low +1


submitted by hungrybox(1277), visit this page
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Image from problem

Fluent speech, impaired comprehension โ†’ Fluent aphasia โ†’ Wernicke's area

Here are the others (as near as I could tell):

A: Broca's area โ†’ "Broken Boca" โ†’ would present with non-fluent speech with intact comprehension

B: ?

C, D: Motor cortex

E, F: Sensory cortex

G: ?

H: Wernicke's area


No idea what B or G are.

Here's a relevant image from Amboss

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kahin  B-Frontal eye field? G-Parietal lobe +
specialist_jello  G : Gerstmann syndome? angular gyrus? not sure +
pakimd  G does look like angular gyrus since it is right above the wernicke area +
srmtn  B: frontal eyelid field? G: angular gyrus? +
lovebug  FA2019 p489 +


submitted by ergogenic22(401), visit this page
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NAPQI is a toxic intermediate is formed by in small amounts by metabolism of acetaminophen. Depletion of hepatic glutathione stores by NAPQI leads to acute APAP toxicity and acute liver injury.

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cassdawg  Also relevant to the question: the CYP450 pathway is what turns acetaminophen into NAPQI, and chronic alcohol abuse is one of the inducers for the CYP pathway so it increases NAPQI production. Chronic alcohol abuse itself also depletes glutathione, increasing propensity for toxicity when acetaminophen is introduced. +3
specialist_jello  my probably stupid thought process was : treatment of acetaminophen toxicity is N acetyl cystine which regenerates gluathione. so toxicity will be coz of dec glutathione. +17
cheesetouch  FA18 470 & 243 +3
agraham416  Why would increased NADH be wrong? +
fatboyslim  @speciliast_jello your thought process is absolutely right. You are not stupid +
fahad_gondal  @agraham416 because the toxicity is being caused by the acetaminophen and not the alcohol, the stem doesn't mention anything about an acute alcohol overdose but does say he took a lot like 18 tablets in 3 days thats like 9g of acetaminophen but if the stem had instead said it was an acute alcoholic episode that caused all these symptoms we could say NADH increase was the answer but then again decreased NAD+ would also be an answer because the metabolism of ethanol consumes NAD+ to yield NADH so if 1 of them goes up the other must go down and vice versa so the question wouldve been done and styled differenttly with alternative options +


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