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Contributor score: 11
But why are there no bite cells? Question stem states that there is normal morphology? That's why I didn't pick accessory spleen
Bite cells are seen when splenic macrophages take "bites" out of hemoglobin precipitates in G6PD deficiency, which doesn't have to do with our question.
This patient had a splenectomy 3 months ago, 6 weeks later showed Howell-Jolly bodies (asplenia), and then today now has normal erythrocytes (spleen is working again somehow = accessory spleen)
@spow Bite cells are associated with G6PD deficiency, not ITP.
Poison Ivy/ oak /Sumak
Uworld Q ID 1133
GATC related to methylase --> https://en.wikipedia.org/wiki/Dam_methylase
When the answer is so obvious that you pick a stupid answer instead of it. DOH
Funny thing I noticed is "he is alert and cooperative. He appears to be in pain" So he was so high that he was alert and cooperative during the basal ganglia hemorrhage
@sympathetikey That fucking guy who drinks 2 six packs a day with liver failure got me like that.
probably the "drug" have to be a stimulant or a hallucinogen which causes HTN & Tachycardia.
Lol. I got the right answer but took long time
The patient's B.P. and pulse are raised + Bilateral dilated pupils = Most likely use of a stimulant
Thats how I reasoned it anyways
Bilateraly messed up pupils = Drugs (most of the time)
why is there basal ganglia hemorrhage?
Wait! doesn't it take like a week or two to get the results back!?!? i chose to measure catecholamine levels because that may be more timely. but clearly i'm wrong