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Welcome to step1soon’s page.
Contributor score: 45


Comments ...

 +5  (nbme22#33)
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ulTeitsrca psiebios fo utadl lemas hwit ltfieeKlnre dsmnyeor rea chdaeeacztirr yb seetxiven fboisirs adn tiianolhaznyi fo the feomersiisun tbesluu adn esppaihlayr of eht tinitrsum;tei ,erevohw eht lesuutb yam hswo laudrise cfoi of rpesieng.saoetsm ooiiHgslct ifnsgdin yam idcluen llsm,a fmir essett whit unormeseisfi ltbrauu anaihnozlyiit; rsicl;oess dna ohraytp hitw clofa paeilprhays of otymsl aeeetddrgen dyigLe eclls

idd/n.rmeKatnitico/yradpS./mante.epmoplelwh_ehwotiwh:ft-


 -8  (nbme21#7)
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ctyorchiOm:e eOn ro thbo ctetsisel is odrevem thgrhuo a lamls uct in oury utroscm. iusset avmolre mrfo doby → on tstneirnu → lelc haetd

  • ahll rakm of lcle ehdat = NAD anoiafentrgmt
dhkahat  no no no no no lol +

 +0  (nbme21#35)
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rteaH ae:fiurl iTsh si hte stom reossiu ipconltmacoi fo alegr ovsotrniaeeur fssat.ilu eciSn ryou odolb fslwo emor cuylqki hhugrto an rsotvnriaeeuo isaftul atnh it duolw fi yuro bldoo lfodew tuhhrgo a roamln osucre fo isererat, iareslapcil adn evi,sn yuro hrtea smupp radrhe ot paesecmotn rof eth podr in lodob eprussre clda(le gh-piutothu ertha u)ailefr. veOr ,tmie teh ideaenrsc tisyntnei of uyro t'arehs npimupg cna akenew oruy ehart ,lsmeuc neilagd to herat ueailrf.


 +0  (nbme21#39)
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Ti,em apce,l nmae → ssseases oeioiartnnt → ot ees fi pt si for lmpxeae iitaxecndot ro tno

Dsoiince inamkg aictycap is aedbs fof fo erhethw teh pneatit nurtndaesd reh sidgasino nad si gamikn an mednfori soctnne → seh knwso and udsesdtannr


 +4  (nbme21#18)
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Dginru het leatMn Mini ettSa Emxa MS)ME,( a lhehta safsleopnrio assk a entitap a sseeri fo instqueso diegdsen to tset a rnega fo reyevayd maentl s.iklsl Teh mixmuma MSME ersoc is 03 nop.sit

20- to 42 sutessgg ildm 13eed- mntia ot 02 usgssget mdoarete sde ieeslmtna- hatn 21 aseiitcdn ervees etm.einda


 +3  (nbme21#48)
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bwgw?ywwOcuaOc/:jMtou/LvtHeGw=osRhttph..m/C

Good nopaalxntei


 +16  (nbme21#16)
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/tvalhlregoaeead-a-oclmdiou/.:esrtss/tryyavikh/p

Lkoo ta werhe hte sspuc rea nogitnip → wdsaupr efrhtroee o.catri fi suspc rewe roaddwwn → enth ialmrt alvve doluw be the hgrti rsnwae

misterdoctor69  mitral valve would only have 2 cusps even if it were replaced though right?... +
bbr  After staring at this for awhile, I wanted to elaborate on this to make it even clearer. The 3 areas that meet at a point would be the 3 cusps. These 3 flaps are going to get blown open. Means flow is from down to up. +3

 +0  (nbme21#20)
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We acn erlu uto A B dan C sbeauce tis rencca dna tp wlli peesnrt w/ geihtw ossl. erHe het tp lyielk ash umonnaipe /w levdetea coulketey ntuoc icntdignai .iitnefcno nO SB,P slcel kolo klei srptnoluihe e(sen in tuace nmalryatfmoi a)sstte hwihc ear gyesrcluaotn roeerhtef it si tareevci usygi.nosloratc


 +0  (nbme20#18)
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nI stoecopitbvtusr desuriis hte enUri si ulylasu yocnpohti twhi gearl uatsnom fo odimus ,eclhdori mposi,aust ppstohhae nad mgaienusm n3e] i[rU tuptOu t&;g 125 - /2hrL0o0mu etfra lifree of ounrottbsci rfo at elats 3 viuccseteon is4reouh[ U]rn mitslOraoy ;&tg ksm0/g2m5o []5

seisiisets-ii/okpdwti/utr_vrcrohwbtP/k:/s.oemugt


 -1  (nbme20#13)
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The oerptder edniceicn fo naaCpl edryomns is 1 ni eyerv 0,00010 ppl.eeo shTi sah nbee a ldgnincie menrub eud to oelrw uexrpseo to clo,a sosa,steb nda s.cilai rcPeeelvna of nalpaC soendymr is rheihg ni sipentta wtih csilia eusreoxp epaomcdr ot the rhtoe asseuc. Teh irtfs oeomlidiegipc tsydu euantdkren yb eht ueoPonnismcios ahceersR tUin sdroeebv na dcinreesa rpleeavnec of RA nomstga mne tihw revsergpsoi siesvma fsisbior P)M(.F ilMla te a.l ufndo on irensceda lrnacepvee of mhtiouraed rstithrai ni emisrn henw eoadrmpc ot a yutimocmn ehrew PMF dna eoaturdimh iitartrsh erwe vntlrpaee dan eoeetfhrr loucddnce htat eth ygoloeit of AR asw tno saeociatds wiht epuoesxr to tdus ro ungl anshgce fo elctdmcpoai onucsimesno.pio Terhe wsa a hihg ecpevenlra tera of FMP dan ciuutrsbloes oamtsgn imnrse dna enmx-seir ihwt daorimehut 5as[]t4[i.rih]tr

Apyalhhn soigyotPo: mimaoutuen iitcnoond is a eeonopnmhn weehr n'eso doyb has mmlniratyoaf sclel hwhic tkcata sit onw tsiseu d,an ni the easc fo A,R the smvyon.ui tI is bleivede taht in etehs tnteapi,s there is an tnilotaear hwihc uassce teh dcsnearie mnimue soepsner to oginefr milatsrae ni teh ugnls. hreTe is nummei rhpytyavticie htta si kradpse by acsiil ni wichh encosmyot nda pgrcmohasea elrseae iesotcnky scuh sa uileet1nknir- dan ytisimluoalnth-l-etoygemrnguccr-nacogpaoa tfcroa adn morut oesrisnc rtaocf ha.alp heT hrspa egsde fo the ciials lsao cuesa slysi of loasoysml stepasoer in crmes.ghpaao Lpescyyohtm aer daietcatv by hte yktneicos daerelse by ga.cmseoaphr shTi lla sadle to na uummitneao pmnoeennoh gtourhh upreseox to isalci hcwih is irgdgrtee in tealgnciyel sdeiesdoppr dviauliidsn ohw eavh .AR

wtondl'u het leruyinndg aessedi eb RA ihhwc si ehnt gacusni boneorgccinh cara?mcnio m'I fons!deuc!

kpjk  i dont think its RA, because they said xray shows new bone formation, where as RA would have erosion +

 +6  (nbme20#8)
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negWniid fo the = EUYRNASM!

xEatr lmenu in mdiea fo ortaa = OETSIDINSC

SITH pt ahs na ciroat isedsntoci

1 RISK focrat si Hesi!ny o!prent

ssupi(lyhl uwold be ocrectr fo teh tp adh an enyrumas ubt HIS CTSHE -RYAX OD TON ohsw wdnienig of eht )otara

gabriela  @step1soon were you upset when you wrote this comment? lol +3

 -9  (nbme20#14)
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thiyAnng perup ipl + beoav → saabl clel mciocaran

nyniAthg orwel ilp → mouuSsaq elcl ncrmaoiac

FA 9102 -gp 374

adong  it's saying upper vs lower lip. this pt has it on the nose +1

 +1  (nbme20#36)
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sOn EBM aAr,g iasldote clooiens of tomlefcnrsee-tgina cabtaire aprpea ronwb ot le-cublbka ni l.rcoo eichEisrcah loci paeraps sa lra,eg lbaukc-bel ,enlocois onfte twhi a ngree alcmtlei esne.h aeEtecbnrort .pps eeptnrs as borwn ot blakble,-uc imucdo necoosli ihwt no sneeh. -sgroioncteN-neenamtfl sneo,iocl hsuc sa liSghlea ps.p nda mlaelSaoln ,p.sp prpaea nparsetrant nad coossrlel.

eW clyilabas dndeee to etlareroc ahtt → on smgoinras esne ubt yonl prsnuiothel ot ngieb a etcslao n-roneoretnfm rogamni.s reoefrThe eht enawrs is ghleliaS dan ton E loci


 +0  (nbme20#15)
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paaCicnsi dceuisn eht erleeas of ebsuansct ,P noe fo eth clippanir tde-rochmmaesoi fo pina usepmisl mrfo teh reihprpey to the nlctrea uvnesro tmysse SN)(C. rfeAt rtpedeae ,apiaoclintp iapiccasn dsteepel eth nrnuoe of saebnucts P nda vtrpnese sit eac.lcauomurtni


 -2  (nbme20#31)
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iicatacS si a atbitgindeli idcioonnt ni cihhw eth aitptne piexcsenree pian oan/dr esashstariep in teh rtniidisbout of hte aitccis nerve ro an oacisdeats oblslmacrau enevr orot. eOt,fn a mnmoco kaitsem si rieerrgnf ot yan low cakb pnia or alrdiacru lge napi as iia.tascc iSicacta si secpfici to het niap thta si a itcedr urltes fo citcsai renev ro acticsi nvree root hotg.opayl Teh cscitai rneev is dame pu fo het L4 ghutroh 2S rneev ostro hwihc colaeesc at teh esplvi to mrfo eht cisatci .evrne tA up ot 2 cm ni a,dermtie the sticica eevrn si ayesil the lgersta rveen in the dy.bo caaicSit npai otnfe is wseodrne hiwt neloxfi of hte baurml sinep, ii,ngttws de,inbng ro i.gocgnuh heT casiitc vener irodepvs rditce ootmr ontifunc ot hte ssaim,rhntg eorwl eettrxiym ,otdcusrad adn icdrnite otmor tfnounic ot eth alfc ,lumssce atrreoni orwel elg mc,sslue nad omse rtniiicsn tofo lcs.emsu sol,A lycietnrid rohtguh tsi eltrmian rsh,ancbe the caitsci never eiosrpvd iasntosen to eth ioseotprr and lrlaate rowle leg sa lwel as eth aatnprl fot.o

yAn iotdinocn taht yma srurtyacultl citapm ro spocmser teh tcicsai rnvee mya ucsae ictcaias p.stmomys heT smot cmonmo sauec of acisitca si a ieadhetnr ro ignglbu ralumb leatreinvrerbt .dcis nI eth eyredll oinoupaltp, amlbru nilaps tsesnois aym ausec sheet spomsymt as .elwl eoostsidhSpliynsl ro a livaeret ltsiinmmaneg fo neo eraretbv varlteie to hrnetoa amy oasl ueltrs ni tcisiac tmmo.syps ynaAddlliot,i rmabul or ivlcep lruamcus asmsp nadr/o nfmaaimloitn aym mniigpe a mulbra or alasrc evern otor csgaiun itiscca smtypso.m A islnpa ro anlprspaai assm nlidcgniu mnga,nclyia ipadleru o,ahmatme ro eudlarpi sscsbae mya laos csuae a esml-sika ecfeft and acatcsii smtmy.ops


 +4  (nbme20#19)
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ootyliEg → r tieteagC ognmiks si rmjoa isrk frctao 0-8(05% of car,nesc skri iseoatacds htwi tdiuanor adn no )inAltsyites reanaisyml n-2eiha(npay)hmtl nda anileni Iydsne oegineldpv necto,rsui chisosaSmto mbmtaoehuai aov rea dpsdeioet in abelddr wall nad cusea cnrhoic monim,ntilafa sosauuqm esatl,pmaia pislad;asy 70% of routsm rae aosmqsuu lcle VrPaoHca mcni amy ecusa nl,cmaodoy qassuoum ypsl,daasi amsuquso lelc icaacrmon ucneseqteaneec hiPn seu sual(uly nogl mtre sue ni rgnoyeu mw,eon mtuors ievolnv uppre cctoeillng t) sneoicCsmyrh unrayri rctta cinfnoiet nda aiceurlcylaRl ohoshedciapycmpl wtih nolg trme esu


 +2  (nbme20#26)
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heT 3 inma nisoerpt tath rycar het aojmrtyi (&59%g);t fo oyhrdTi ormeHson )T(H ear dionhr-bietnxngyi ogillunb G)T(B, trashnttinyre T,TR( ro ea)upilmn,br dan .ualnmib A orinm oiotrponpr of hte TsH si dnobu no esmur opeipi.rstnlo Vyer ,alryre and in het ttxonec fo tiTaH-n dnebiaotsi ni nmuueoimat otdriyh iedse,as oomigmisunnlblu aols mya dibn HT. TH gbidinn ot GTB is rratdcacehize by owl aitccpya ubt hihg ivyitda; the nreecovs is et,ru i,e ihhg tapcicay btu olw daiv,iyt orf TH ndgbnii ot RTT nda um.lanbi

A iccdenyefi ni HininT-bgd iorpesnt is ceupsetsd ehnw mybaalorln owl esmru attol HT otciaeoncntsrn aer uerendecnot ni llnciayilc ithroudey uscesbtj in teh ercpeesn fo nlramo ersmu hpyriroottn ei(, ituidhytitgalnms-ro nrmhooe S[]TH). oeMr leaciips,cfly owl BTG is eegtsgusd baecues shti enpiort eiarscr eth itamyjro fo het rsmue .HT

relvaSe staste fo neidecycif fo itsh ternpio hvae enbe ecdresidb ttha are eethri itirhnede ro cireu.aqd Tihdyor nfiocunt setts sT(F)T ni stptanie wiht TBG eenidciycf whos ramnol SHT dna efre T,4 tbu wol oatlt 4T d,an acycalonio,sl lwo atotl T3 rusme .otacicnntornes eTh smot ntptmairo allciinc acptse fo TBG fdceiiyenc esttsa si rntoncoeigi of sthee odiersrsd nda aeaconvdi fo rnenucseyas dan eaolttinypl umhfral TH rncmleeetap eh.ayrtp





Subcomments ...

submitted by seagull(1404),
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HTis uoqtisne is ujts rtcaiilc gh.nintki eTh adnresal ear tballleiray dna milcyrsayltem almls. lAl orhte srwnea ccisoeh ear tno lyekil ot eb evne rbtaielly.la Crcena nwt'o qlyaelu ardpes in rpfecet strmmyye nro toencsiuif cusase eihwl innmiaaitng het aanlrde ricehrtueac.t

slim23shady  Will TB be the answer if they'd mentioned the patient from developing world? +  
step1soon  Autoimmune adrenalitis aka addisons disease → adrenals atrophy common cause: 1. developing world: TB 2. Western world:autoimmunne FA 2019 page 334 +14  
drschmoctor  FA 2020 p 349. +  
drzed  I think the cancer reference (C) was with respect to an ACTH secreting tumor, which would symmetrically and bilaterally HYPERTROPHY the adrenals +2  
drzed  ^Just kidding, it says metastatic. My bad! +1  


submitted by bubbles(66),
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Fro hte pspee ohw got fuonsdec no shti entoiqus bc of orUWsl'd rwedi sqenitou no HVI lravi ao:dl

aucet I1VH- o:tnceiinf IGHH vrail lado, low b-IV A2H fcn:itinoe LWO vliar d,alo lwo bA (cb asdrdtan HIV asassy edtcte 4p,2 hhicw is nto serntpe no H-)2VI

idnaK ndnaeoy I dmssie an ayes omlmgynoiu eptncoc entisouq :/

eacv  I feel you my friend! same stupid mistake over here -.- +3  
step1soon  FA 2019 pg 176 +2  


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My uottghh rcosesp wsa tath opmpsttua-r eingblde si ayslulu lrdetae to eth u,srteu nad hmuc of eth iceplv irsevac si piulpdes yb reacnhbs of hte inelrnta cilai rytar.e

neonem  This sounds like a case of acute endometritis. In any case, uterus is supplied by uterine artery (branch of internal iliac artery) with collateral flow from ovarian artery (comes right off aorta). I don't think there are any branches of external iliac artery into the pelvis; it becomes femoral artery once it passes under inguinal ligament. +4  
tsl19  Here's a picture that I found helpful [Female Reproductive Tract arterial supply] (https://teachmeanatomy.info/wp-content/uploads/Blood-Supply-to-Female-Reproductive-Tract.jpg) +14  
sympathetikey  @tsl - Thank you! +  
step1soon  uworld Qid:11908 +  


submitted by egghead(1),
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This is eon fo etsho insesouqt I wsa eevrn ongig ot etg. It's tno ni F,A I 'tnod ntkih veI' nese it in s.lcsa

hungrybox  same :( +  
masonkingcobra  My issue was the stem said no skin damage (I would think pulling out your hair damages your scalp) [Turns out it does not](http://onlinelibrary.wiley.com/doi/full/10.1111/j.1529-8019.2008.00165.x) +  
gh889  FA 2019, pg 551 +8  
meningitis  Compulsively pulling out one’s own hair. Causes significant distress and persists despite attempts to stop. Presents with areas of thinning hair or baldness on any area of the body, most commonly the scalp. Incidence highest in childhood but spans all ages. Treatment: psychotherapy is first line; medications (eg, clomipramine) may be considered. +13  
step1soon  FA 2019 pg 551 +1  
teepot123  damn its in FA and Ive never ocne read it XO +  


submitted by egghead(1),
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atWh si wthi het urt?ipce I tjsu doulw rneve kcpi citiivrsultedi tthwuoi seenig a cdemvr.itliu.u.

quaper  I spent so long looking at that picture and thinking what the heck are they trying to show me here. I couldn't see any diverticuli, didn't see any cobblestoning, figured the dark patch in between the white patches was necrosis in the end. +8  


submitted by lianallado(2),
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izShcdio opnlyiastre rddsroei si ehcczireradta by aunlovytr aslcoi ilwthdaaw,r dileitm tolaeinmo xesnsioper adn scilao .ionaslito

step1soon  Answer is not avoidant personality because these people actually desire relationships whereas schizoid personalities do not (they are content with being loners-like this pt) +2  
mambaforstep  i think i saw this on a @DirtyMedicine youtube video but i always think schiZOOOOid wants to be/is happy to be a lOOOOOOner +  
jawnmeechell  Or perhaps schizoid wants to avoid :) +2  


submitted by hayayah(1056),
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Ptntaie ahs glacntinoe dmhyihtsoypiro ()mnsrt.ieci gi:nsidFn top leylb, ,elap aff-,yfudcpe clubaiilm aernhi, colog,aasimrs ,niphayoto orop biran oevelnmpedt CM( asecu fo aebatltre enltam ia)or,etdrnat ragle nrreaiot .nsltafnolee

whossayin  how can you differentiate the symptoms of cretinism from Down syndrome? +  
step1soon  @whossayin Down Syndrome: upslanting palpebral fissures, atlantoaxial instability, bent little finger, congenital heart disease, displacement of the tongue, excess skin on the back of the neck, flaccid muscles, hearing loss, immune deficiency, low-set ears, mouth breathing, obesity, obstructive sleep apnea, polycythemia, seborrheic dermatitis, single line on palm, thickening of the skin of the palms and soles, thyroid disease, or vision disorder +3  
ally123  I was confused about why the infant was jaundiced, and found this: "Hypothyroidism causes decreased rate of bilirubin conjugation, slows gut motility and impairs feeding, all contributing to jaundice." Source: http://www.pathophys.org/neonatal-hyperbilirubinemia/ +6  


submitted by hpsauce(-2),
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I ielevbe hits si aCnalp omrdSyne igro(ncnchobe raccomian + tmoaeudrih sti.iarhtr) Olny awlf to atht is atth eth mlraonuyp gsnidnif ton'd creelpyft nrteperse moneuci.eopnsso

dbg  it's just bronchogenic ca, type of adenoca, which is classically associated with 'hypertrophic osteoarthropathy' +  
woodenspooninmymouth  To get it for the test, remember that lung adenocarcinoma is associated with clubbing. Mechanistically, this woman probably had RA. Then she was exposed to asbestos. The asbestos in the context of RA lead to caplan syndrome. The asbestos also triggered her bronchogenic carcinoma. +  
step1soon  Then why isnt Rheumatoid Arthritis right? what comes first? bronchogenic carcinoma or rheumatoid arthritis? +  


submitted by cienfuegos(64),
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do'Ctunl you laso decserea eht OI2F? erP FA, PPC osal nsceaiesr to yaphiox losa sedecsrea CPP nhew 2OP t;&l 05 m.Hgm

cienfuegos  Obviously not the BEST option in this scenario, but seems like it could work unless I'm missing something. +1  
step1soon  Its primariy driven by PCO2! only when O2 levels drop <50 mmhg is when the body responds to low O2 pressures +1  


submitted by xw1984(4),
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I tog isht Q ro.ngw I asw goinwdenr hyw shti tptneia h“as on oelrpnas ro lmfayi oht”yirs. ierryeHtad soopiscyhesrt loudsh eb a AD ,eaissed s,o learnlyge ngsikape, hsit izd solduh be nese ni cahe geniet,raon ?irtgh

step1soon  I was thinking the same! +  
wuagbe  Several genetics questions on NBME20 appear to be trying to throw us off by changing the descriptions of inheritance, leaving us to assume incomplete penetrance, smh. +