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Comments ...

 +0  (nbme22#4)

spironolactone acts as an aldosterone antagonist which means decreasing Na+ permeability


 +0  (nbme24#50)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909073/

says that hyperosmolarity and acidosis alter mental status.

which correlates with the right answer

p.s i got it wrong too :)


 +0  (nbme24#6)

the only thing made me choose IMA and SMA is the fact they supply the intestine which is the common site for ischemic mesenteric disease.


 +1  (nbme24#38)

my way was

SV =EDV-ESV

EDV increases in pregnancy due to an increase in plasma volume


 +0  (nbme24#24)

guys VG would worsen with galactose infusion, remebmber they dont have G6Pase which means they cant convert anything to glucose


 +0  (nbme23#35)

ok the way i looked at this was:

youre not 100% sure she was attacked nor do you want to be the person telling the husband hes an attacker so you remove: B C

allowing him in with the patient, god knows what that guy has hidden with him also you will make a huge scene : A

the only thing to do is be diplomatic as people know they arent allowed in the treatment area and by that you assure her saftey.

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  (nbme23#6)

the child is asymptomatic because hepatitis B is mostly silent in infants due to poor lymphocyte system. other diseases would probably show more symptoms


 +2  (nbme23#12)

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)

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)
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  (nbme23#13)

The medical requirements to obtain a permit vary by state, but are usually confined to specific types of disabilities or conditions. These as a general rule include the use of any assistive device such as a wheelchair, crutches, or cane, as well as a missing leg or foot. Some states also include certain cardiovascular, pain, or respiratory conditions. About half of US states (26) include blindness as a qualifying disability enabling the person to obtain a disability parking permit for use as a passenger, and 14 states include a disabled hand as a qualifying disability. Four states include deafness, and two states (Virginia and New York) include mental illness or developmental disabilities as qualifying disabilities

our guy uses a cane so...

btw i got it wrong :) cause i thought it is up to the DMV

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV

 +0  (nbme20#8)

legionella : very common in advanced age, COPD, immunosuppressed patients and " going back from a residence hall" which probably had a contaminated AX system (basically fits every one in the Q)

adeno X : would present with conjunctivitis, throat pain ... flu virus: not everyone got the disease RSV: no children strep pneumo: would target a larger population of healthy people as well.


 +0  (nbme20#19)

https://www.youtube.com/watch?v=k0YqEpA-62A

guys this video explains alot


 +3  (nbme20#31)

ok here is how i broke it down: a) wrong because most cases would have some risk factor "old female ..." b) "deltoid" c) under pressure it can burst and frankly it is mentioned in FA as a very common cause. D) i think it would need something like a posterior dislocation of hip. e) would probsbly not cause neruo S $S


 +0  (nbme21#9)

i did the

(Hco3-)x1.5 +8 +-2

it should CO2 that is wat higher than compensation indicating mixed

another way is the ↑ ↓ way


 +0  (nbme21#15)

ok i think i have a theory in regards for this:

the whole procedure is done to decrease the portal HTN. which means the shunt should be portal to systemic avoiding the liver.

a) hepatic (systemic) to inf phrenic ( systemic ) ; no B) ileocolic (portal ) to inf mesentric (portal) ; no c) splenic (portal) left renal (systemic); yes d) superior epigastric (systemic) to inferior epigastric (systemic) ; No e) superior rectal (portal) to superior mesentric ( portal) ; NO

whossayin  You’re a legend. Good theory man, makes memorization a whole lotta easier!

 +0  (nbme21#21)

guys!!

the question doesnt say that the 500 got cured, so it will be 2000 who are at risk.


 +0  (nbme21#23)

IFN y will inhibit differentiation of Th2 cells and therefore (a,e wrong) b) regulatory T cells d) if the case was talking about virus


 +0  (nbme21#45)

i did this through elimination:

a,c and D intrinsic; ↑PTT only

B) which is actually the PIP2; involved in Gq signaling


 +1  (nbme21#28)

ok guys and i quote from https://www.orthobullets.com/pediatrics/4102/osteogenesis-imperfecta

"90% have an identifiable genetic mutation COL 1A1 and COL 1A2
causes abnormal collagen cross-linking via a glycine substitution in the procollagen molecule "

which means that OI has a glycine substitution and therfore its unable to form a secondary sturucture.





Subcomments ...

submitted by usmle11a(12),

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)

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) +1  
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) +  


submitted by usmle11a(12),

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)

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) +1  
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) +  


submitted by usmle11a(12),

The medical requirements to obtain a permit vary by state, but are usually confined to specific types of disabilities or conditions. These as a general rule include the use of any assistive device such as a wheelchair, crutches, or cane, as well as a missing leg or foot. Some states also include certain cardiovascular, pain, or respiratory conditions. About half of US states (26) include blindness as a qualifying disability enabling the person to obtain a disability parking permit for use as a passenger, and 14 states include a disabled hand as a qualifying disability. Four states include deafness, and two states (Virginia and New York) include mental illness or developmental disabilities as qualifying disabilities

our guy uses a cane so...

btw i got it wrong :) cause i thought it is up to the DMV

usmle11a  also it is the dr who decides the eligibility then sends it to the DMV disability --> Dr --> DMV +1  


submitted by imgdoc(30),

This question is asking about the insulin receptor tyrosine kinase pathway. So take it from there,

  1. The phosphorylation of the IRS activates a signal transduction cascade that leads to the activation of other kinases as well as transcription factors that mediate the intracellular effects of insulin. Nuclear/Cytoplasmic shuttling - yes (reversible)

  2. Serine/Threonine kinases are also known to reduce the activity of insulin. - yes (reversible)

  3. Ubiquitin - mediated proteolysis - no (not reversible), and also insulin metabolically increases protein synthesis so it doesn't match what insulin does anyways.

correct me if I'm wrong.

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


submitted by cr(1),

why not increased 25-hydroxycholecalciferol?, with the same logic haliburton explain +

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. +