need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything โ‹… score predictor (โ€œpredict me!โ€)

Welcome to usmleaspirant2020โ€™s page.
Contributor score: 9


Comments ...

 +0  visit this page (nbme24#25)
get full access to all content โ‹… become a member

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become

get full access to all content โ‹… become a member

 +3  visit this page (nbme24#25)
get full access to all content โ‹… become a member

quarantined at home during the coronavirus pandemic and selecting the right answer as CoRona without thinking twice as i use the sanitizer to kill those little bastards knowing they are enveloped..wow what has life become

get full access to all content โ‹… become a member
procrastinator  Lol, I couldn't really figure this question out so I was like F it. Coronavirus it is. +

 +0  visit this page (nbme23#45)
get full access to all content โ‹… become a member

https://d1yboe6750e2cu.cloudfront.net/i/0b2159dfcfd96ee300a97e2e07d7d0c0229a2d3f

get full access to all content โ‹… become a member




Subcomments ...

submitted by ferrero(48), visit this page
get full access to all content โ‹… become a member

A very similar question I have seen in Qbanks will ask why a patient with right heart failure does not develop edema and the answer is increased lymphatic drainage. I got this question wrong originally because I answered along this line of reasoning but I think in this case it all has to do with WHERE the extra pressure is coming from. In this question the pt has diastolic hypertension so you can think about the pressure as coming "forward" so constricting precapillary sphincters can prevent an increase in pressure in the capillary bed. However for right heart failure this extra fluid is coming from the OPPOSITE direction (backwards from the right heart) and constricting precapillary sphincters can do nothing (on opposite side of capillary bed) - the only way to prevent edema is to increase lymphatic drainage.

get full access to all content โ‹… become a member
seagull  The question clearly lead us to think about Osmotic pressure by talking about protein and urine. I wonder how many people used that line of reasoning (like myself)? +20
mousie  Great explanation, I chose lymphatic drainage for the same reasoning (similar Q on different bank) +9
sympathetikey  My reasoning was much more simplistic (maybe too simple) but in my mind, systolic BP is determined by Cardiac Output and diastolic BP is determined by arterioles. Therefore, what comes before the capillary and regulates resistance? Arterioles. That's why I said that pre-capillary resistance. +41
cr  the main difference between the 2 cases is that in this case the patient has high BP +1
link981  So in kindergarten language the question is essentially asking how high pressure in the arterial system is NOT transmitted to the venous system (which is where EDEMA develops). But you know they have to add all this info to try confuse a basic principle and make you second guess yourself. (Got it wrong by the way) because of what @ferrero said of Qbank questions. +9
hello  @ferrero what are you talking about? lymphatic drainage is the wrong answer... +1
hello  ok never mind. i got it. hard to understand b/c it was a big block of text. +2
asteroides  I think they may be talking about the myogenic compensatory mechanism: https://www.ncbi.nlm.nih.gov/books/NBK53445/figure/fig4.1/?report=objectonly "Increased arterial or venous pressure also induces myogenic constriction of arterioles and precapillary sphincters, which raises arteriolar resistance (thereby minimizing the increase in capillary pressure) and reduces the microvascular surface area available for fluid exchange. For example, because vascular smooth muscle in arterial and arteriolar walls contracts when exposed to elevated intravascular pressures, this myogenic response increases precapillary resistance and protects capillaries from a concomitant rise in their intravascular pressure." +7
stsfyt  makes sense. sometimes we use vasodilation(CCB) + venodilation (ACEI) combo to balance the pressure, and prevent leakage and edema. +


submitted by sugaplum(487), visit this page
get full access to all content โ‹… become a member

always remember them in order with formula, SITS=AEEI
and the two on the END are AD-DUCTION

get full access to all content โ‹… become a member
makinallkindzofgainz  The supraspinatus AB-ducts. The Subscapularis ADDucts +
makinallkindzofgainz  disregard my comment, I misread what you meant +
drzed  How are you supposed to remember which S is which? +2
drschmoctor  @drzed "Supra" = on top, so the 1st S is for supraspinatus. +1
usmleaspirant2020  according to Physeo : INFraspinatus--EXternal rotaTION------INF-ECTION +
destinyschild  wow, sugapulm, that mnemonic is gold. you are gold. +2


submitted by stinkysulfaeggs(125), visit this page
get full access to all content โ‹… become a member

Did anyone else go down the: she's hypotensive so maybe she'll get waterhouse friderichsen syndrome because nothing else is making sense to me at this point??? route -

Turns out, severe malaria can cause cardiovascular collapse and hypotension.

get full access to all content โ‹… become a member
redvelvet  me too :( +2
abigail  me three :( +2
yex  Me four :-/ +2
link981  Slowly raising my hand as well +2
tinydoc  Sammmme +2
bullshitusmle  same here!!!:@ +2
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +19
aisel1787  me five( +1
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +5
alexxxx30  sammmeeeee +
snripper  Dumbasses unite lmao +
usmleaspirant2020  lol saaaaame! +
usmleaspirant2020  lol saaaaame! +
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +2
veryhungrycaterpillar  I have no idea how I got this right. +
feanor  And here I was thinking that maybe I'm the Lionel Messi of interpreting stems by diagnosing it as Babesiosis lols. +1


submitted by stinkysulfaeggs(125), visit this page
get full access to all content โ‹… become a member

Did anyone else go down the: she's hypotensive so maybe she'll get waterhouse friderichsen syndrome because nothing else is making sense to me at this point??? route -

Turns out, severe malaria can cause cardiovascular collapse and hypotension.

get full access to all content โ‹… become a member
redvelvet  me too :( +2
abigail  me three :( +2
yex  Me four :-/ +2
link981  Slowly raising my hand as well +2
tinydoc  Sammmme +2
bullshitusmle  same here!!!:@ +2
usmlecharserssss  patient has malaria with obvious picture and clinic, i answered because only thing associated with liver was hypoglycemia +19
aisel1787  me five( +1
myoclonictonicbionic  I was thinking that she is hypotensive which can cause an infarct of the pituitary (since pituitary is growing during pregnancy) and therefore she'd have secondary adrenal insufficiency. +5
alexxxx30  sammmeeeee +
snripper  Dumbasses unite lmao +
usmleaspirant2020  lol saaaaame! +
usmleaspirant2020  lol saaaaame! +
anechakfspb  me also :/ sitting there trying to figure it out during the test I thought I was so smart too - like "wow nbme, way to tie in micro and endocrine, not getting me though!" ... i was wrong. +2
veryhungrycaterpillar  I have no idea how I got this right. +
feanor  And here I was thinking that maybe I'm the Lionel Messi of interpreting stems by diagnosing it as Babesiosis lols. +1


search for anything NEW!