Tanner stages start at TEN years old

Stage I:

• I is flat, as in flat chest;
• I is alone, as in no sexual hairs.

Stage II (2): stage II starts at 11 y/o (II look like 11)

• 2 balls (testicular enlargement)
• 2 hairs (pubic hairs now appearing)
• 2 breast buds form

Stage III (3): starts at 13 y/o

• If you rotate 3, it looks like small breasts (Breast mounds form);
• If you squiggle the III they look like curly+coarse pubic hair
• Increased penis length and size can be represented by: II --> III
  (your penis was thin II but now its thicker III)

Stage IV (4): starts at 14 y/o

• First imagine: The I in IV represents the thigh, and the V in IV looks like the mons pubis between your legs:
  MEANING: you have hair in mons pubis (V) but you have a border detaining the hair from growing into thighs.
• The V is pointy, as in now the breasts are pointy (raised areola or mound on mound)

Stage V (5): 15 y/o

• V has no borders detaining hair from growing into thighs (pubic hair + thigh hair)
• 5 fingers(as in hands) flattening the areolas when grabbing them (areola flatten at this stage and no more "mound on mound")

According to Goljan, men have boobs three times in their lives: when they're babies, when they're going through puberty, and when they're old. It's physiological/normal.

Tanner stages start at TEN years old

Stage I:

• I is flat, as in flat chest;
• I is alone, as in no sexual hairs.

Stage II (2): stage II starts at 11 y/o (II look like 11)

• 2 balls (testicular enlargement)
• 2 hairs (pubic hairs now appearing)
• 2 breast buds form

Stage III (3): starts at 13 y/o

• If you rotate 3, it looks like small breasts (Breast mounds form);
• If you squiggle the III they look like curly+coarse pubic hair
• Increased penis length and size can be represented by: II --> III
  (your penis was thin II but now its thicker III)

Stage IV (4): starts at 14 y/o

• First imagine: The I in IV represents the thigh, and the V in IV looks like the mons pubis between your legs:
  MEANING: you have hair in mons pubis (V) but you have a border detaining the hair from growing into thighs.
• The V is pointy, as in now the breasts are pointy (raised areola or mound on mound)

Stage V (5): 15 y/o

• V has no borders detaining hair from growing into thighs (pubic hair + thigh hair)
• 5 fingers(as in hands) flattening the areolas when grabbing them (areola flatten at this stage and no more "mound on mound")

The question here stated that the patient was stabbed beneath the 12th rib grazing the inferior pole of the left kidney.

From this you have to know the anatomical associations with the left kidney. The left kidney is in contact with the spleen, stomach & splenic flexure.

Out of these 3 options you have the stomach and Splenic flexure anterior to the kidney but what makes the splenic flexure the best answer is the description of where the he was stabbed. Stomach will be higher up than the splenic flexure.

Apply the same concept to the left kidney!

Hope this helps

For those that didn't quite get what the stem was saying, basically Osler's sign is when you're squeezing the blood pressure cuff and keep going higher and higher because the arteries won't collapse as easily (due to natural stiffening of the arteries with age). The lack of collapse upon squeezing is why you can still feel the radial artery in the stem. So even though the pressure inside the arteries might be normal, you're gonna measure it as high (pseudohypertension). Apparently it's a common finding in the elderly.

This one was a little tricky. For this one the key is the low radioiodine uptake. This patient has high T4 and low TSH which makes sense in a hyperthyroid patient, perhaps your first thought is that this patient has Grave’s disease. However, in Grave’s your thyroid is being stimulated to make more thyroid hormone from scratch and as such would have an increased radioiodine uptake because the thyroid is bringing in the required (now radiolabeled) iodine. This is why it is not Graves (“release of thyroid hormone from a thyroid stimulated by antibodies”).

So if its not Grave’s what could it be? For this you’d have to know that Hashimoto’s Thyroiditis (also known as Chronic Lymphocytic Thyroiditis and is often referred to as such on board exams to throw you off) has three phases - first they are hyperthyroid, then euthyroid, then the classic hypothyroid that you would expect with low T4 and high TSH. This was the key to this question. The reason for this is that antithyroid peroxidase antibodies in Hashimoto’s cause the thyroid to release all of its stored thyroid hormone making the patient hyperthyroid for a short period of time. After this massive release of thyroid hormone, the antibodies make them unable to make new TH and therefore they become euthyroid for a short period and then hypothyroid which you would expect! Since they can’t make new TH, the thyroid will not take up the radioiodine and therefore there will be low radioiodine uptake. Hence, “release of stored thyroid hormone from a thyroid gland infiltrated by lymphocytes.” aka “Lymphocytic (hashimotos) thyroiditis”.

I think “release of thyroid hormone from a lymphomatous thyroid gland” is referring to some kind of thyroid cancer in which case you would expect them to be describing a nodule on radioiodine uptake.

​Summary video here and also a great site in general: https://onlinemeded.org/spa/endocrine/thyroid/acquire

Ketorolac is a reversible NSAID given IV, all NSAIDs have a risk of interstitial nephritis, renal ischemia, gastric ulcers, and aplastic anemia.

the best answer is renal failure b/c it is given IV and has less of a chance of causing gastric ulcers

Does anyone know where I can find this information on FIRST Aid 2020? I can not find it . Thanks for posting the answer!

The wording of this question confused me. This is asking "which of these vessels is the high pressure system" right? So the high pressure superior rectal is causing increased pressure into the inferior rectal?

easy question, know that its a case of multiple myeloma, and they have impairment in competent immunoglobulin production. i wish i had used this concept .

it was literally a give away and i screwed it