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Welcome to weenathon’s page.
Contributor score: 40


Comments ...

 +14  (nbme20#12)

Diabetics get peripheral neuropathy from glucose damaging Schwann cells. For what I believe is an unconfirmed reason, T2DM patients tend to see parasympathetic autonomic neuropathy before sympathetic.

The hypogastric nerve carries sympathetic innervation to the posterior urethra and is responsible for ejaculation.

Inferior rectal nerve is a branch of the pudendal nerve that innervates the external anal sphincter and provides sensation below the pectinate line. A peripheral nerve problem with this nerve would cause the sphincter to remain relaxed and cause incontinence, not constipation.

Pelvic splanchnic nerves are parasympathetics (craniosacral outflow). If he is constipated, his rest and digest (parasympathetic) system is not working.

Perineal nerve is a branch of the pudendal nerve. It has both motor and sensory, is involved in the external anal sphincter, urethral sphincter, and is responsible for conscious sensation of the need to urinate.

Sacral sympathetic inhibits peristalsis, and contracts internal anal sphincter to maintain continence.

spaceboy98  Amazing man, thank you for this +

 +0  (nbme20#8)

Anybody know why fatty acid degradation doesn't play a role?

andro  The question specifically asks for a process in myocytes Fatty Acids ( Triglycerides ) are primarily stored in adipocytes . It is from adipocytes, that the fat can be mobilized for use by other cells . Loss of adipocytes can decrease the width of the calf , but then again we are talking about mechanisms of muscle atrophy and the most important mechanisms for this is ubiquitination - breakdown of the cytoskeleton proteins +1




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weenathon  I originally chose vein because I was thinking maybe the hormone release couldn't be carried to the body anymore, but looking back the working of "moderate hemorrhaging" and vessels requiring ligation is what implies it's an artery. Just throwing that out there in case you thought like I did. +4  
cheesetouch  if you were clueless like me (well I knew artery but..), picking one with 'thyro' in the name when discussing a thyroid surgery is a good guess :) +6  
cbreland  I'm really out here picking one of the answers with vein +  


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weenathon  This question confused me because wouldn't she have already formed antibodies in her previous pregnancy? +4  
nbmeanssux  Pregnant mothers don't form anti-RhD antibodies until around 28 weeks (that's why we administer it then) so she shouldn't have formed any from the 12wk aborted first pregnancy +5  


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weenathon  For anyone else who was wondering why a cancer was undergoing apoptosis (classically we think of cancer EVADING apoptosis), apparently it's due to the myc mutation classic in Burkitt Lymphoma. While myc causes the cell to proliferate, it also induces apoptosis - hence the tingible bodies containing apoptotic cells. (https://www.ncbi.nlm.nih.gov/pubmed/8247541) +1  
itsalwayslupus  Also just for people who watch boards and beyond or pathoma (I don't remember which exactly it is from), the "stars" in the "starry night" appearance of Burkitt's (what is being shown here) are lighter because the the cells are dying/gone via apoptosis (supposed to be the "holes" in the "night sky" lol). +4  


submitted by hayayah(1074),
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realfakedreams  @hayayah you were being lazy.. smh.. Homie started anti-retroviral therapy. HIV infects CD4 T-Cells through either CCR5 or more commonly CXCR4. Because of anti-retrovirals start working, HIV isnt able to infect anymore CD4 T cells. Thus CD4 t lymphocytes levels start to rise and are able to active B cells. +13  
myf1991  Why can't it be monocyte? macrophage eat MAC and interact with CD4 +1  
weenathon  @myf1991 I also incorrectly chose monocytes, but if you look at the question carefully, it is specifically asking what cell is required for the lymph nodes to enlarge, not which cell is handling the mycobacterium avium infection. Since CD4 cells stimulate B cells to proliferate in lymph node follicles, which would make them bigger, CD4+ T cells is the answer. +3  
j44n  macrophages dont enlarge nodes in fact they make them smaller, tingle body macs eat all the bad B cells in a node so improved mac fxn would decrease the node size +  
mpel14  To add to @namira, an infectious disease doc described this concept in an HIV lecture where he said that prior to the Tx with antiretroviral therapy, the pt has such low CD4 count that their immune system cannot form a response to the infection, and after their immune system is given a slight boost with the drugs, their immune system can finally "see" the infection -> mount response -> causes S/S +  


submitted by arkanaftus(12),

Is it appropriate to ask a question about the structure which is absent on the picture? It was super confusing! How can you say it was not a defect of the tissue cut?

drdoom  why did this get downvoted? +  
weenathon  The missing structure is the cerebral peduncle (also called the crus cerebri). You can tell it is a good slice and not a weird cut because of the symmetry of the rest of the midbrain structures. Everything is symmetrical except the cerebral peduncles, with the left one missing. I also think it's a safe bet to say it's not a random piece of tissue missing because tissue artifact is not one of the choices. +8  


submitted by jinzo(14),

A - nucleus ( with nucleolus inside ) B - mitochondria C - RER ( you can see attached ribosomes ) D - ?? may be lysosomes E - glycogen granules

weenathon  I don't think A is the nucleus, It seems more like a lysosome with digested material inside. If you watch the video below it shows the relative size of the nucleus to the mitochondria - a nucleus would be MUCH bigger than the mitochondria +5  
weenathon  https://www.ncbi.nlm.nih.gov/books/NBK26858/ There are very similar looking pictures in this article, it must be a peroxisome +1  


submitted by jinzo(14),

A - nucleus ( with nucleolus inside ) B - mitochondria C - RER ( you can see attached ribosomes ) D - ?? may be lysosomes E - glycogen granules

weenathon  I don't think A is the nucleus, It seems more like a lysosome with digested material inside. If you watch the video below it shows the relative size of the nucleus to the mitochondria - a nucleus would be MUCH bigger than the mitochondria +5  
weenathon  https://www.ncbi.nlm.nih.gov/books/NBK26858/ There are very similar looking pictures in this article, it must be a peroxisome +1  


submitted by breis(50),
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hpsbwz  Why is it regurg instead of stenosis? +3  
minhphuongpnt07  Vague question requires a lot clinical reasoning. mitral regurgitation: holosystolic murmur( this cv: midsystolic), enlarged LA, LV Mitral stenosis: diastolic murmur, enlarged LA, normal LV. only best explanation I can think of: early stage Mitral regur, that's why the murmur is not holosystolic but midsystolic and LV still adequately handle the situation +4  
dickass  @hpsbwz it's regurgitation because the murmur is SYSTOLIC, when the mitral valve is not supposed to make any sound. mitral valve leaks in systole, which causes blood to back up, which causes the left atrium to work harder and eventually hypertrophy. Mitral stenosis would be a DIASTOLIC sound, which is when the left atrium normally contracts. +8  
themangobandit  I'm still confused as to why mitral regurg has an enlarged left atrium. Are we supposed to think that it was mitral stenosis for a time, the high LA pressure led to hypertrophy, and then became mitral regurg? That's how it works in rheumatic fever, right? +  
shapeshifter51  I agree that mitral regurgitation is a holosystolic murmur heard best heard over the apex. However, with the murmur being found in the mitral valve area of auscultation it was the only answer choice that could result in LA enlargement and normal LV. Ruled out mitral valve stenosis since it is a diastolic murmur. +  
weenathon  @themangobandit I believe mitral regurg could cause an enlarged left atrium from the increased amount of blood flooding back into the left atrium with each systole causing increased pressure on the wall. +  
rockodude  why is LV size normal? doesnt cause MR cause increased preload and overload over time leading to enlarged LV? +