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Welcome to usmle11a’s page.
Contributor score: 74


Comments ...

 +0  (nbme22#4)
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nipoonclraotes scat sa na tlodsaeeorn nsigtaotna whihc amnes gaciersden a+N mtiyaleierpb

j000  i think they're referring to triamterene and amiloride, not spironolactone spironolactone doesn't actually decrease Na+ permeability +
jackie_chan  @j000 It doesnt matter, spiro and triamterene/amiloride have a common effect of messing with ENaC. Aldosterone upregulates ENaC, spiro would inhibit that so in effect would decrease luminal permeability to Na in duct due to fewer ENaC channels; triamterene would block the channel directly, same effect. http://tmedweb.tulane.edu/pharmwiki/doku.php/potassium_sparing_diuretics +

 +0  (nbme24#50)
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a/Po/ie7cM3ti/b.sp.09nl:p/rwsnt./nmlccgC/9v2h0wwhmt.i

sasy htta erporitaomyhysl adn iasioscd raetl taenml t.sutas

whihc rrtsoeeacl hwit eht tgihr wrasne

.sp i tog ti norwg oot ):


 +3  (nbme24#6)
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hte lnyo ihtng eamd me scoeho IMA nad MAS si eth fcta they pulpsy het tnsitinee ihwhc si eht mnomoc stie ofr chcmisie cneimseter .daesesi


 +2  (nbme24#38)
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ym yaw was

VS =VEEVD-S

EVD neiecasrs ni pgcarneny edu to an ecraensi in smpaal mleuvo


 +4  (nbme24#24)
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uysg VG wludo nwseor tiwh osagtecal nfun,iosi rerembmeb eyth dnto hvea eaGP6s cihwh samen hyet actn nvreotc ntnygaih to cegulso

tyrionwill  Yes, VG makes the liver into muscle, where all sugars (except glucose) can only be burned to lactate+glycerol(from glycolysis), ATP (from TCA metabolism, to give uric acid), and fat deposit (from glycerol+pyruvate going to FA+TG) to worsen the situation. Sugar cannot be made into glucose in liver for other tissues. +

 +0  (nbme23#35)
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ko hte ywa i eodkol ta hsti w:as

uyreo tno 1%00 eurs she was adtcatke orn od uyo wtan to eb the osnrep gilntel het nabushd she an atkrtcae os uoy :vroeme B C

wolganil mhi in ihwt het ,atnetip gdo wonks thaw thta ugy has dnedih iwht imh alos ouy iwll aekm a ughe ncese : A

het lyon gnith ot do is eb atdmipolic as lpopee kwon tyhe nrtea alowdle ni the anerttetm aaer adn by htat uoy usrsea erh seyf.ta

drdoom  The prevailing rule of American medicine (and law) is individual autonomy. No other person, professional or otherwise, is granted “default access” or privilege to another person’s body—that includes the physician! The physician must receive consent from a (conscious) “person” before they become “a patient”. In the same way, the person (now, the patient) must give consent before anyone else is permitted to be involved in her care—spouses included! +1
llamastep1  Alright we got it! lol +1
123ojm  B and C are actually wrong because they put the patient in danger for when she is discharged and has to return home. she probably has things she needs in their home (eg passport, money, etc) and if the husband knows she has told you about the abuse she is at risk of being killed. +

 +1  (nbme23#6)
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the hlicd is aicoptmstamy cebseua psetiathi B si ytomsl iltsne in anistfn ued to ropo ephtoyclmy .mtesys othre saessedi luwod ybrlbpoa hswo more omsstymp


 +7  (nbme23#12)
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sguy thcwa isth : u.tsYavw?u//obousw.h=yK/ctuseho:twowtnTcGpm

wynaay (ps. i otg ti wo)rng

A) rd-sneessepoo = iolcbolagi liliyp.sbaitu s.p sohmwoe aeuq.l ) B )C E) sveyn;ititis Do)n wgr my nwas;re neoycnsisct fo rheto udsesit ( it nwast idepalp to ertoh uitosmi)ecnm

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +
stemcellpsc  wouldn't D be also true based on this video? +

 +6  (nbme23#13)
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ehT ilemcad rmreetseuinq ot atibon a mpreit vyra yb ,aetts tub era usluayl diefonnc ot speifcci sptey fo ltaieidsisib or .ncnitsdioo eehTs sa a agenelr elur unceild het esu of yan eivssasit cdeive csuh as a herciwea,hl uechtcr,s or nace, as wlle sa a mnissig lge ro otf.o meoS asstet lsao licenud irecant v,roialccsadrau pni,a or rrsitypearo isntdncio.o ubAot lfha fo US atsest (2)6 lcuiedn endlbsnis as a lgqiufnayi iiibtlaysd baelginn eth opesrn ot atinob a bdliyasiti rginpak tpmrei rof sue sa a ens,pgrase dna 14 sttsea liecudn a lebaidsd hand as a qgiilafynu idtabisli.y rFou tatess incuedl sneades,f nda otw tsaste Vgriin(ai nda New kYr)o dncuile telanm ileslns ro ovtpaelemlden biiaiesdslti sa qainyilguf ssliaetiidbi

rou ygu uses a cnea o...s

btw i otg ti rwong ): eusac i htghout ti si up to teh DMV

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV +4
peridot  I'm not sure if I'm being here or if the test question changed, but I don't see anywhere in the stem that says that the patient uses a cane? I even ctrl+F the word "cane" lol. I picked referring to PM&R specialist for full assessment cause I figured that another pattern is to always gather more info, but I guess that's not the case here T_T +4
azibird  It does NOT say he uses a cane. +2
sonofarathorn  I can also confirm that there was no cane involved. I repeat, NO CANE. +5

 +4  (nbme20#8)
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nlioelaleg : ryve nomocm ni acvneadd ega, DPOC, opsduermsnmpeuis saptinet dna " nggoi ckba rmfo a reneedsic h"lla chwhi lrbopayb ahd a ninaetocatdm XA esmtys lalybscia( stif vyeer oen ni eht Q)

andoe X : dulow snetpre hitw inctivsu,cjonti htator naip l.f .u. sui:rv not eoeevyrn got the esisdae SV R: no rihlecnd tep rs ne:poum ldwuo atgtre a rrglae iunpptoola of yhlaeth plepoe sa wl.le

bharatpillai  why would they say that the only people who didnt get affected by the disease were people on steroids (lupus nephritis and severe asthma) couldnt have been rsv since it causes croup in children. strep pneumo would cause fever and other systemic signs. i went for adenovirus because uworld says most common causes of copd excacerbation are viral infections... +2
brbwhat  I went for adeno forr the same reason. I guess the MAIN HINT is that this is not a copd exacerbation. Since people without prexesting copd also had pneumonia, also people with copd exacerbation will have different presenting symptoms, here it was told, that we are told that dx was penumonia. People with copd exacerbation wouldn’t be diagnosed with pneumonia if it was an adenovirus infections. +1
j44n  adenovirus doesnt cause pneumonia its just makes the current COPD sx worse +
j44n  the SLE and asthmatic patient were both considered slightly immunosupressed or theyre just more likely to get something (SLE pt= your B cells are too busy making Ig's to kill your kidney, and the asthmatic is on corticosteroids that aopotose your t cells) but they're not COPD patients so the pneumonmia wont be as severe, all in all legionella causes really really bad pneumonia in COPD patients and less severe (pontiac fever) in those with mild immunosupression +2

 +13  (nbme20#19)
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yooh6A=Ew/.-h?/cwwb/2YAktt0eqtavcsmt:puwpu.

usgy htis ieovd panilesx otal


 +6  (nbme20#31)
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ko eehr is owh i okrbe ti dwon: )a nwogr eebusac tosm acess lwoud aveh eosm iskr craotf do"l mealef ." .)b. tdedo "c)il" nedur eprsesur ti cna tburs dna yarlnkf it si tmienodne in AF as a ryve nocmmo s .ua)ecD i nikht ti lowdu nede gihtmenos liek a seoroptri dilnicaosot fo e)p .hi uwldo lpbysbor not esacu orenu S S$


 +2  (nbme21#9)
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i ddi eht

o5(cH.x13-) +8 -2+

it shdlou O2C thta si wta ihghre htna ipmesnnatcoo gtcdinaiin idexm

onethar yaw si hte ↑ ↓ wya


 +13  (nbme21#15)
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ko i nktih i vhae a htorye ni egdsarr rfo h:its

teh elohw pderocreu is eond to ecedsear the raptlo .HTN hichw mnsae teh ustnh shluod eb ltrapo to ytssmeci dionivga hte v.eirl

a) aepciht (sestmcyi) to ifn eicpnhr ( symetics ) ; no)B iicceooll op(tarl ) ot fin icmrneets top)a(lr ; c )no slpceni )r(ploat telf nrlea me;(cit)ssy d)sey usroipre rgeicptisa )ymt(csesi ot frreioni iresagicpt (stsmc)eyi ; )eNo souieprr aeclrt o)tral(p ot surpreio tinecemsr ( l)tproa ; NO

whossayin  You’re a legend. Good theory man, makes memorization a whole lotta easier! +
lovebug  2019FA, 359pg. +

 +0  (nbme21#21)
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!suyg!

hte teosinuq sednto say atht eht 005 otg dreuc, so it lwil eb 0200 how aer ta i.rks


 +1  (nbme21#23)
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INF y lwil hibntii ndnrttiioffeeia fo 2hT celsl dan oeetfrehr (,ea nrgo)b) w eugloyratr T lc)esdl if teh aesc swa lankigt uoabt srvui

teepot123  fa 19 pg 108 +

 +0  (nbme21#45)
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i idd itsh htghuor ioni:iltmnea

ca, dan D nscii;trni ↑TPT noyl

B) cihhw si yaaulctl the PI2;P vdvnlioe ni qG naiginlsg


 +4  (nbme21#28)
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ok gusy nad i tqoeu ormf tcrsl2ecgnsi./dhehcao4bipsewtstosimwt/ae0tf1strpu:./o/pree-/lemiootw

9"0% evah na litdefniabei ectinge ttauonim OLC 11A adn OCL 12A
ca euss omanabrl aglcoeln ogisckinr-sln via a lcneiyg tuotbstunsii in the lpglerncooa eolecuml "

chihw enasm tath OI ahs a cegiyln sbutitsontiu nad hretefor tsi aelunb ot mfro a sayecornd tr.sruueutc





Subcomments ...

submitted by usmle11a(74),
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yusg wchat siht : nuvy/s/tubmepuhtYo.csot/wTt?owhc=:oKaGsuw.w

naayyw .s(p i otg it row)ng

)A eoseednrpsso- = coilgaiobl ulpiibislya.t .ps esomwho aqu.el )B C) E) ssiiivetyn;t rowD)ng ym ;newasr cieysnncsot of treho etuisds ( ti awsnt pilpade to hteor umiosemc)itn

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2  
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +  
stemcellpsc  wouldn't D be also true based on this video? +  


submitted by usmle11a(74),
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gsuy chatw hits : GstTsoct.o?chY/wuw:wvmuK.soa/b=typwotuen/uh

wynyaa .p(s i tgo ti orgn)w

A) nsdrsesoeop-e = baooigilcl lisauypbl.iti sp. showmeo uqlea. B) )C E) etis;ytnisvi g)nroD w ym new;asr scetnniosyc fo hotre eustids ( ti twans eilpapd ot htroe mincism)oteu

usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +2  
usmle11a  guys watch this : https://www.youtube.com/watch?v=TnuosYuKGos anyway (p.s i got it wrong) A) dose-response = biological plausibility. p.s somehow equal. B) C) E) sensitivity; wrong D) my answer; consistency of other studies ( it wasnt applied to other communities) +  
stemcellpsc  wouldn't D be also true based on this video? +  


submitted by usmle11a(74),
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eTh dalimce rrnqueemtsei to ibaotn a pmiret ravy by t,etsa utb aer asulylu ocfninde ot cpciesif ysept fo liasietdisib or noidnoct.is ehTse as a gelaner luer cundeil the ues fo ayn itsvisase eevidc cush sa a cahlreei,hw te,crcuhs ro ne,ca as wlle sa a snigmis gel or .foto omeS stsaet saol nleiduc nceiatr iaavsaocdcur,rl ,ipna ro ryarpiretso .nictodnois tuobA half of US etstsa (6)2 dlcinue insnbsedl as a ynfaiiglqu dlytsiiabi ngnablei the spreon to onabit a aiyidtslbi raipgnk mrietp orf ues sa a g,srsnepae dna 41 sseatt iclnude a dalesibd nhad sa a auyqlgnfii ayb.silidit roFu asetst duinlce fesne,ads adn otw tetsas niiia(Vgr dan wNe r)Yok idnuelc taelnm lselnsi or eetdlpnovalme sibtdileaiis sa guiiafynql ilesdaiiitsb

rou uyg esus a cnea o...s

tbw i got it rwong ): sucae i thohgut ti is pu ot teh MDV

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV +4  
peridot  I'm not sure if I'm being here or if the test question changed, but I don't see anywhere in the stem that says that the patient uses a cane? I even ctrl+F the word "cane" lol. I picked referring to PM&R specialist for full assessment cause I figured that another pattern is to always gather more info, but I guess that's not the case here T_T +4  
azibird  It does NOT say he uses a cane. +2  
sonofarathorn  I can also confirm that there was no cane involved. I repeat, NO CANE. +5  


submitted by imgdoc(135),
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sihT etnqsoiu si giakns btauo eht isnlniu opreertc ontreisy inkaes .aytwahp oS keta it omfr eh,ret

  1. Teh harnopopstlhyoi of hte RIS stiaetavc a snaigl rditoncusant secadac ahtt dlesa ot teh aaiictontv of ohrte ssnaeik as well sa tiorpsncnrait asoctrf htat mdetiea eht alrltlrcaueni cefseft fo ilni.nsu Crs/yeuaoaltpNclmci tshiltgnu - sye levr(e)rsbei

  2. eerhneeo/innrTiS ssiaekn ear soal nnkow to dercue eth tivaciyt fo .nsiliun - esy ee(vrislbe)r

  3. iiiutUbnq - emdtedai osoiyeptsrl - on no(t e,lsibe)rrve and alos unislni baaolimellcyt srncaesie trinpeo eshysstin os ti snteo'd tcahm tawh unsniil seod snway.ay

corterc me fi 'mI ogr.nw

usmle11a  i think youre correct cause ubiquitin mediated proteolyis is an irreversible step. +1  


submitted by cr(4),
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ywh ton cedreanis ecoaeloi-rf,?dhro5hcyly2lxc htiw eth seam lgioc riabnotulh ipalenx +

usmle11a  i believe increase 25OHcholecalciferol indicates the storage capacity of vit D, which wont be affected in case of CKD. it goes like this, kidneys wont respond to regular PTH, loses Ca and cant execrete PO4, PTH gets made and tries to burn bone to produce Ca, resulting in elevated levels of Ca and PO4, Ca will bind the calcium and go to kidneys, yet same story all over. add to that the fact that 1 oh hydroxylase wont be able to function in a dead kidney. +1