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 +0  (nbme20#16)

The mnemonic I like for remembering the locations of the cranial nerves is the "2,2,4,4 rule"

Above brainstem= CN I + II Midbrain= CN III, IV Pons= CN V, VI, VII, VIII Medulla= CN IX, X, XI, XII


 +0  (nbme20#39)

the question was very poorly worded in my opinion, anybody else agree?

niboonsh  yea it was a dumbass question, whoever is writing these questions is undoubtedly a crazy genius but homeboy (or homegirl...homeperson?) needs a few grammar lessons.
yex  I agree. We know that it is a teratogen, but how does that question directs you to think about teratogenic effects instead of something physiologic?

 +0  (nbme20#26)

why can't "organification defect in T3 and T4" be the answer?

sugaplum  I think if it was organification defect you wouldn't have a normal T4 level in the serum.




Subcomments ...

submitted by dragon3(2),

What's the difference between reactive granulocytosis vs lymphocytosis?

whossayin  Yes I’m at a loss for this one too. Still can’t figure out how we’re expected to differentiate those based on this slide shown. The only logical explanation that I can think of is that reactive lymphocytes may be seen in LYMPHOMAS as opposed to granulocytes which are seen in LEUKEMIAS Such a shitty way to trick us, hah! +  
henoch280  reactive lymphocytes are seen in EBV infection. you would see lymphocytes in the slide not neutrophils FA2018 pg 165 +1  
whossayin  That makes sense.. but was the question talking about EBV infections or hematological malignancies? Just a vague question I wasn’t really sure what exactly was it trying to teach us, I guess the reactive lymphocytosis just threw me off! Anyways, thanks for the clarification buddy! +  


submitted by mcl(133),

Gait problems raises suspicion for alcohol abuse or inhaled glue. However, onset of gait problems is relatively rapid (couple of months) and gait disturbance with regards to alcohol is either due to intoxication or chronic abuse. Alternative explanation available on SDN. Also see toluene toxicity on medscape.

sbryant6  I got this correct solely based on the patients demographic. Glue is cheap and easily accessible to underage populations. +  
whossayin  Kinda racist of us but that’s how I reasoned my answer too lol @sbryant6 +  


submitted by usmle11a(1),

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! +  


submitted by dragon3(2),

What's the difference between reactive granulocytosis vs lymphocytosis?

whossayin  Yes I’m at a loss for this one too. Still can’t figure out how we’re expected to differentiate those based on this slide shown. The only logical explanation that I can think of is that reactive lymphocytes may be seen in LYMPHOMAS as opposed to granulocytes which are seen in LEUKEMIAS Such a shitty way to trick us, hah! +  
henoch280  reactive lymphocytes are seen in EBV infection. you would see lymphocytes in the slide not neutrophils FA2018 pg 165 +1  
whossayin  That makes sense.. but was the question talking about EBV infections or hematological malignancies? Just a vague question I wasn’t really sure what exactly was it trying to teach us, I guess the reactive lymphocytosis just threw me off! Anyways, thanks for the clarification buddy! +  


If you couldn't remember which were essential; then alternative would have been to realize that growing children need cells to divide. This requires DNA replication and translation. Of which the nucleic acid thyime is important. It requires a methyl transfer.

This is where methionine comes in. Methionine combines with ATP to form SAM (a methyl donor)

whossayin  That’s a legendary explanation. Thanks dude! +  


If anybody has a good way of distinguishing/remembering all the different presentations for genital sores, I'd appreciate the help.

hungrybox  Pls post as a separate post and not a comment to this tho. The formatting for these comments sux +  
whossayin  Assuming u have UWorld, just type sexually transmitted infections.. that table is the best IMO +  


I also had difficulties with this, especially w/FA being so abbreviated. There is one word in FA that helps, and then I have a link for more info: "grows rapidly and regresses spontaneously by 5-8 years old." Which means it's done with its involution phase by then. This NCBI article helps: The Lessons I Learned from a Hemangioma Clinic TLDR: rapid growth occurs for the first few month, followed by a few months of rest, and then years of involution. Since the question is asking what happens over 5 years, the majority of that time is spent in involution phase. Hope this helps.

whossayin  totally not NBME related, but I think you username is brilliant lol +1  


submitted by hayayah(284),

Patient has congenital hypothyroidism (cretinism). Findings: pot belly, pale, puffy-faced, umbilical hernia, macroglossia, hypotonia, poor brain development (MC cause of treatable mental retardation), large anterior fontanelles.

whossayin  how can you differentiate the symptoms of cretinism from Down syndrome? +  


submitted by hayayah(284),

By age 75, the thymus is little more than fatty tissue. Fortunately, the thymus produces all of your T cells by the time you reach puberty. They are long-lived and that's why you can lose your thymus without impairment of your immune system.

sweetmed  Memory T cells live for six months or less in healthy humans (Westera et al., 2013), whereas naive T cells can live for up to nine years +1  
whossayin  so the bone marrow does not take the role of the thymus? +  


submitted by hayayah(284),

Benign tumors are usually well-differentiated and well-demarcated, with low mitotic activity, no metastases, and no necrosis.

Malignant tumors (cancers) may show poor differentiation, erratic growth, local invasion, metastasis, and apoptosis. High mitotic activity.

Fat tumors:

  • Lipoma: benign, low mitotic activity
  • Liposarcoma: malignant, increased mitotic activity
whossayin  why can't it be a rhabdomyosarcoma? +  
charcot_bouchard  Because of histology and gross appearance... very graphic description of fat cell tumor there +  


submitted by hayayah(284),

Most restriction enzymes bind palindromes.

So both 5'CCGG or 3'GGCC would have been acceptable in this scenario.

meningitis  Yes, correct. The 5'GGCC option could cause some confusion. +  
guillo12  I really don't understand the question nor the answer. Can someone explain it for dummies like me? +  
whossayin  yes please.. I'm with guillo12 on this +  
sugaplum  @guillo12 @whossayin questions says you've created a new cut site, 1. look at the region on the sick vs healthy. The C to G is the change 2. Write out the sick "CCGG" from 5'3'- you could write out the whole thing, but the answer only has 4 letters, so being lazy here 3. write under it, its complement, the dna base pair. So "GGCC" 4. remember both strands are going in opposite directions when you write them out on top of each other. 5. So the bottom strand actually reads 5' CCGG 3' so that is the answer I hope that clears it up +3