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Welcome to youssefa’s page.
Contributor score: 126


Comments ...

 +6  (nbme24#15)
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So uebmrn of eassc tihw ovepiits soyoegrl nirgud ket""ina rnesrepets neavelpcer dna udoshl ton eb dteocunac ofr when ligcnaulcat lpnotiopau ta srki. napPouloti ta kirs = olTat lppootauni - lapcne.vere ogDni ta,ht msu up het anunla neicsencid eftl = 400 + 052 + 025 + 030 + 003 = 150.0

Aygiplnp dncneciei orlufma = 0000-5)0/040(01,01 = 520. veor a oaltt fo 5 raye.s

unnAla = 2/5.50 = .5%00


 -2  (nbme24#22)
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I amne hwy wloud a csltieet nurt oduran lstfei nwhe so'meenso esng.epil ihsT cltylpaiy osrucc frtea /rsopst cyeclib niidgr .te.c

brotherimodu  People can move in their sleep? +2
prolific_pygophilic  Actually in highschool this happened to a couple of my friends in their sleep, woke up with the sack all twisted +

 +6  (nbme24#30)
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aIllintiy ikml indnirgk swa aodeitsasc ithw loEi.c keoturba thiw .93O=R dan 100;t.&lP0 c(tga)iS.nif.n.i frAet totiifrasnatic into tae esokioc and idd ont eta kooiecs OR eacemb 1 ntedais fo 9.3 naigemn het oncoiassati esdpraad.pei o,hefereTr getnia oecoisk aws a ncuerfdnoo adn rhete si no rela ntcaosiiaos etbnwee innridgk kiml dan .acni,e.d..list.oE 'ikmsl eth( funo)rcndeo ibninrootcut wsa oeispnblser fro teh RO fo .39 ni eth itfsr pl.cae This saw derruethf orddamtetens wiht OR fo 6 in hte ieooksc eaonl go.pru


 +15  (nbme23#2)
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omtahP:a - ysechmtLopy era hte ostm sitseinve llsec to howel odby adoantiri - ecayonrsulGt a(iMnly uelhn)proist rea urlpatyrlica eyrv iseivstne ot echepiorahttcume tyklgianla aegsnt gqeuni(rri -CFGS yosrhlt fert)a

arcanumm  Always think of NEUTROPENIA when chemotherapy is treating rapidly dividing cells (a small fever is an ER visit for these patients). +6

 +2  (nbme23#30)
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So tiunctg orhguth eth tsneeniti wlil aagdme het ptrcsy fo rhneLkiüeb ichwh tanonic emst leslc atth aplerce sltrnegyteecte/boo slelc ().aFid Tsih calk of eergnertvaei iytblai will eavh ltaeletps nad intmmarolfay ellcs to be trudeierc in orred ot medaeit giehaln h(hwic ned lrtuse si fib)issor heT nilstiaetn llaw iklagnc ctpsry of ernLüeikbh astc tryetp chmu kile bltsea lslec e(.:g eacs)toiyrdmcoy cwhhi ctnnoa eb egraetednre and so isbsfroi suesen .g:e( aSrc is awalys ned tuocdpr retfa IM).

youssefa  Correction: I meant Permanent cells instead of Stable cells. The hepatocytes in this case will act as a stable cells which will exit G0 phase and proliferate in response to injury. +1

 +1  (nbme21#24)
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'nlotWdu caeut hlcoaol stunpionmco eevn ni deortmea nmuota uaesc blvriesere cthaiep allreucl ruynij rertdhzaecica yb lurcaell oanlng?oilb It udhlos be hte rtihg rnsaew usnlse hte niuqseto etms msena deks"W"ene

hello  No. The order of liver damage due to alcohol is: fatty changes --> cellular swelling (cellular balooning) --> necrosis. This Q stem states to the patient consumed large amount of alcohol on a weekend -- he has acutely drank a large amount of alcohol on one weekend --> this corresponds with fatty changes +3
et-tu-bromocriptine  It's not in pathoma, but I have it written in (so he or Dr. Ryan may have mentioned it) - Alcoholic hepatitis is generally seen in binge drinkers WITH A LONG HISTORY OF CONSUMPTION. +
krisgsxr600  Its kind of in pathoma Chapter 1, "free radical Injury", Section 2 "examples of free radical injury" goes over how free radicals (caused by drinking) lead to fat accumulation +
sallz  You can't get the steatohepatitis before getting the steatosis (fatty change). All the FAs caused by the alcohol consumption eventually lead to cytokine release, inflammation and finally the hepatitis seen in balloon swelling. +

 +1  (nbme20#30)
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Fmro Fdai 2901 enw ef:irug I-1FG iylmna onunistcf as na abnailoc normeoh on seusclm nad nsbeo e(tptry mchu ikel nsi;lugnit-& seaecedrs sumer gcou)ls.e HG scat leestpayar by igrmnotpo lunniis caitssener ics(aingnre usmer ueg)lsc.o T,erhorfee -IFG1 si nto het erans.w fI GH saw aogmn eth esraswn it uwdlo vhea gto aeyllr sf.ucingno

charcot_bouchard  Can anyone take a little time to curse on that daughter? +5
dbg  Sure, charcot. Just wished on her to get a couple of charcots (the triad, your aneuryms, marie tooth, etc). +1
noorahsaahir  Charcot_bouchard and dbg best comments .... 🤣🤣🤣🤣🤣 +




Subcomments ...

submitted by fahmed14(29),
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Hisaemint lyaps a oamjr eolr in teh iaancrdl isgns fo ltaianmiofn.m tI shelp imaetde ooastnivdali adn sarvlcau iyitalbremep (aiv liehentdola clel orncto)tci.na heesT tow utoisnfnc aer dyarlae rycatorn to A, ,B ,C dan D. yB irnsnicgea duilf ni the iitietrlatsn pceas, ouy anc arenos ahtt rethe lilw eb reciaensd hymlp wf.lo

youssefa  If more transudates are leaking into the interstitium wont this dilute the interstitial proteins and cause a decrease in oncotic pressure and increase in interstitial hydrostatic pressure? +12  
titanesxvi  @youssefa I think because it is an exudate from increased permeability of venules, the oncotic pressure in the interstitium is not going to decrease +6  
thotcandy  @youssefa transudate is like pulmonary edema due to CHF, no proteins, just fluid congestion and leaking out. That would decrease interstitial oncotic pressure because it has very little protein. Exudate due to inflammation/histamine has a high amount of protein (due to inc permeability) so the IOP doesn't change. +6  


submitted by medstruggle(12),
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naC emsenoo iplenax why oeds tihs paetnti evha kmhieapo?lya

colonelred_  Catecholamines activate the Na/K pump, which will drive K inside. +11  
trazabone  Read online that catachelamines are released following tonic clonic seizures. Besides that, BP of 180/100 could indicate that catecholamines are circulating. +1  
fulminant_life  This mechanism is why giving albuterol for hyperkalemia works +8  
nbmehelp  Why does this guy have increased catecholamines tho +  
johnson  His SNS activity is seriously increased --> increased catecholamines. +  
nbmehelp  Why is his SNS activity increased? Is the BP literally the only hint? +  
youssefa  Alcohol withdrawal creates a hyper- catecholaminergic state + Seizures do that as well. +5  
water  My best guess is that withdrawal puts the body in a state of stress (same for seizures) and with stress you have release of catecholamine which we'll see in the BP and the hypokalemia. +3  


submitted by medstruggle(12),
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yWh is it nto ravniao fclloile csle?l I gttuohh hte eemalf alogna of ltiSeor dan yeLdgi is /lgtsohenuraaac l.secl

colonelred_  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +7  
brethren_md  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +4  
sympathetikey  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
s1q3t3  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +11  
masonkingcobra  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +3  
mcl  Wait, but did anyone mention that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen??? +37  
mcl  But seriously though, pathology outlines says sertoli-leydig tumor "may be suspected clinically in a young patient presenting with a combination of virilization, elevated testosterone levels and ovarian / pelvic mass on imaging studies." As for follicle cell tumors, granulosa cell tumors usually occur in adults and would cause elevated levels of estrogens. Theca cell tumor would also primarily produce estrogens. Putting the links at the end since idk if they're gonna turn out right lol Link pathology outlines for sertoli leydig granulosa cell tumor theca cell tumor +12  
bigjimbo  LOL +  
fallenistand  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +5  
medpsychosis  So after doing some intense research, UPtoDate, PubMed, an intense literature review on the topic I have come to the final conclusion that...... ...... ...... ...... Wait for it.... ..... ..... Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +9  
charcot_bouchard  Hello, i just want to add that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
giggidy  Hold up, so I'm confused - I read all the posts above but I still am unsure - are sertoli-leydig cells notorious for producing androgen? +4  
subclaviansteele  Hold the phone.....Females can get sertoli leydig cell tumors which are notorious for producing androgen? TIL TL;DR - Females can get sertoli leydig cell tumors = high androgens +  
cinnapie  I just found a recent study on PubMed saying "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +2  
youssefa  Hahahahaha ya'll just bored +9  
water  Bored? you wouldn't think so if you knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +5  
nbmehelp  I dont get it +  
redvelvet  how don't you get it that females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen? +1  
drmomo  what if this means..... females can get Sertoli Leydig cell tumors, which are notorious for producing lots of androgen +  
sunshinesweetheart  hahahaha this made my day #futurephysicians #lowkeyidiots +  
sunshinesweetheart  @medstruggle look up placental aromatase deficiency (p. 625 FA 2019), it would have a different presentation +  
deathbystep1  i am sure i would ace STEP 1 if i only knew that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +2  
noplanb  Wait... I might actually never forget this now lol +3  
drmohandes  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen. +1  
lilmonkey  Don't forget that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! You're welcome! +  
drpatinoire  Now I get it that females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens. Thank you very much.. So why choose Sertoli-Leydig cell tumor again? +  
dr_ligma  The reason is because females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of androgens! This is easy to remember, as you can remember it through the simple mnemonic "FCGSLCTWANFPLOA" which stands for "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen!" +17  
minion7  after receiving a f*king score..... this post made me smile and thanks to the statement-- females can get sertoli-leydig cell tumours, which are notorious for producing lots of androgen! +1  
djtallahassee  My worthless self put adrenal zona fasciculate but now I will never forget that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen +1  
medguru2295  Wait..... so can females get Sertoli Leydig cells that produce androgens then?????? +  
peqmd  Going to snapshot this to my anki deck card: "females can get Sertoli-Leydig cell tumors, which are notorious for producing lots of {{c1::androgens}}" +1  
paperbackwriter  Watch me f*ck up the fact that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgens on the real deal. +2  
alexxxx30  just made sure to add to my notes "Females can get sertoli leydig cell tumors, which are notorious for producing lots of androgens" +2  
peridot  I also just wanna add that if you look on in FA on p.696969, you'll see that they'll mention "Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen" +  
mbate4  According to the literature [lol] females can get sertoli-leydig cell tumors, which are notorious for producing lots of antigens +  
drdoom  the tradition lives on +1  
jamaicabliz  Wait... so for clarification, is it that females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen? Or that Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen?? HELP +  
abkapoor  Females can get sertoli-leydig cell tumors, which are notorious for producing lots of androgen sorry for bad Englesh +  
faus305  Sertoli-leydig cells are notorious for producing lots of androgens, females can get these. +  
djeffs1  the fact that a bunch of medstudents can get so weird about how females can get sertoli-leydig cell tumors: notorious for producing lots of androgens- just made my week!! I love you guys +  


submitted by cinnapie(19),
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Wyh dseo veery NBEM eavh neo ro otw otireecn ldreate ns?qo?esuit

youssefa  Cause we all know what bout to happen to us in this exam :D +35  
niboonsh  lmfaooooooo +  
corgilobacter  erections are a very hard subject +9  


submitted by youssefa(126),
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So untitgc tohhgru eth iesteinnt iwll egdmaa eth tysrpc fo hrebiküenL ichwh ctionan tsme llces atht lcaerep eetelrtngsctobey/o clles )(.adFi sTih kcal fo vgereaeienrt tlibyia lilw eahv lpleaetts nda ymtrnlmaaifo lecsl to be drirectue ni drore ot etimade eilgnha (ihhcw nde rsuetl is ibsisorf) ehT nteilitsan lwla lkigacn tspyrc fo Leüikrhebn scta tprtey cmhu ekli lsbeat slcel e.:g( rcemaoiyc)otsdy whhic coatnn eb edtrgeeaern and so ifirosbs nesues g:.e( Scar is waasly edn trdcpou rtfea I).M

youssefa  Correction: I meant Permanent cells instead of Stable cells. The hepatocytes in this case will act as a stable cells which will exit G0 phase and proliferate in response to injury. +1  


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eoynAn nwko who ot reul otu lslam etneinits on tish ?eon I hotugth eth notmeum pyelad a erol ni anglhei ni eht b,eanomd utb ralycel 'mI sisingm osgmeinht ehre.

what  Small intestine has smooth muscle in the walls which will fibrose on injury +  
youssefa  So cutting through the intestine will damage the crypts of Lieberkühn which contain stem cells that replace enterocytes/goblet cells (Faid). This lack of regenerative ability will have platelets and inflammatory cells to be recruited in order to mediate healing (which end result is fibrosis) The intestinal wall lacking crypts of Lieberkühn acts pretty much like stable cells (e.g: cardiomyocytes) which cannot be regenerated and so fibrosis ensues (e.g: Scar is always end product after MI) +3  
thotcandy  The way i thought of it was: small intestine PERFORATION repair -> the basement membrane and stem cells were definitely disrupted thus limiting regeneration ability Liver = puncture wound, not necessarily all the way through = basement membranes and stem cells are probably still intact -> regenerate without fibrosis +2  


submitted by sajaqua1(524),
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Srmue nkseissc is a epyT 3 eihyentsspvitiry oaitne,cr in ihchw eth dyob ersdpnos ot ngtiaenci ilmaced stceubsnsa dna oescrdpu etna.bsidoi ehsTe eioaisbdnt in iolitnucrac enth ndbi to het anceigitn sudgr dan ets off the olpncemmte ad.escca ohiumetadR rhriitast si aols a pyTe 3 yyveisihiptrents ioe.rantc

)A pAsotosip fo rasmhapgc-oe oispospta si genlrlaye nto a pyte fo yvsniheitpeiyrst .taicreno )B satM lec daueoliat-ngnr thsi is prta fo a pyTe 1 senpteihyyrivits ,sanl/phyaoaiercxatin ni hwhic mtas lcesl dibn EIg on ihter r,escfau nad gEI dbignni to the reatgt gaentin scdnuei a niotolmoacfrna cghaen in eth gIE taht ests ffo mtas clle ultadnioe.argn )C Nautlra irKlle lelC -nglkili aslyp a vtreiya fo lse,ro iuidgncnl aecrcn esissoprupn and tdieunstcro fo lilyavr nieedcft lecs.l If htye play a relo ni ptteyrhiyv,seinis ti is rpat fo pTey 2 RHS in icwhh they udwol pesdonr to Ig no the ellc rs.feacu E) eeWhl adn lrfea icr-seonat shiT is aols a Type 1 R.HS

meningitis  I didn't pick this one because I thought Serum sickness was too systemic and RA was a more localized Type 3. Again, im overthinking things. +  
youssefa  Goljan: RA is a mixed type III and type IV immune reaction +6  
dinagohe23  I though NK cell killing was similar to T cell so and RA is also Type IV +4  
nephcard  ,blll sdouof +3  
usmile1  NK cell killing would be a type of innate immunity, not similar to memory T cells. because they did not give an example of a type 4 HSY, the answer must be serum sickness. +  


submitted by sne(46),
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uAtec mtsaah x ci.enbert1oaa Aolbtr2el u. tCscrotdeir .so3oi Itmpiourrpa

youssefa  I guess they described a COPD exacerbation here since she's a smoker and Xray showed a wide AP diameter. Either ways Ipratropium would make the best answer since its used in both cases. +3  


submitted by jrod77(27),
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I hinkt ehty tmgih be gicsedrinb a..non.antgi r.ues 2TXA is ebssoerinlp for aelelttp iaogaostngr,eg ti may be ticnriubogtn to bsomr,ioths huts smaehiic to het ciadrca .tussei

sympathetikey  Agreed. I'm pissed though because PGE2 mediates pain, which is why I picked it. +34  
he.sanchez14  If im not mistaken, the question describes unstable angina. Unstable angina is due to thrombosis with incomplete occlusion. So, yes TXA2 is responsible for the thrombus that is causing the symptoms in this patient. I'm also pissed because I also went straight for the PGE2 +5  
vik  hahah, seems like all in same boat like me +  
yb_26  thromboxane A2 is also vasoconstrictor, so my thoughts were about vasospastic angina +4  
youssefa  Went for PGE2 ... shit +  
need_answers  I went for leukotriene B4, what the hell was I doing....SHIT +13  
hopsalong  I picked Leukotrine B4 thinking that the neutrophil infiltration was the source of the pain, seems wrong lol. +  
bballhandler11  Sometimes it helps me to think of it in a general, non med school textbook kind of way. When answering, I narrowed it down to PGE2 and TXA2 as well. Then I asked myself, if someone is experiencing chest pain, would I recommend Aspirin or Advil? That's helped on a few over the counter pharm questions. +7  
ususmle  same here I M PISSED PGE2 +3  
krewfoo99  Maybe PGE2 isint the answer because it mediates pain and fever during episodes of acute inflammation? Thus making TXA2 more likely. +2  
djtallahassee  ditto on the looked at it for 2 seconds and went PGE2 +1  


submitted by mcl(586),
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Pntaite amy aehv iahetrrdey eadaneg,moi hchwi is tacaseoids hiwt "rnrtrcuee atsakct of ,nstneie sisem,va azcodiell osectnbuauus damee nvoivilgn het mis,treietxe ailt,inaeg c,eaf or r,kunt ro abcsluusmo mdaee fo puper rwaayi ro s.weblo" hTe tilrcae soeg no ot ysa t"ras-s1eeCe iobirtinh kwosr itledycr on the otecmelpnm nad cttcoan lpasam dsceacsa ot eeucrd nrkbyinaid esrelea" cwihh si olas alyorpbb gdoo to .wonk

iMg/rcsp6wlhith.l/6.3n/i.tv/wnbs.t:c8pew/m/P63c1omanC

notadoctor  Thought this was a trick question as C1 esterase deficiency also results in a decrease in C4. However, the second answer choice was not referring to C4 but to C4 binding protein, which I now know is different. I also didn't realize C1 esterase was technically a complement protein. +4  
youssefa  Based on many sources hereditary angioedema does NOT cause a rash (urticaria) which is a main differentiating point between angioedema and allergy. This mislead me in this question. Any clarification? +22  
ergogenic22  +1 on the above because uptodate states that c1 esterase inhibitor deficiency, both acquired and nonhereditary, are both non-urticarial, non-pruritic, and that is confirmed by the above linked article +2  
sahusema  Question writer probably didn't know the difference between cutaneous urticaria and subcutaneous edema. +3  
almondbreeze  same. got it wrong bc the pt didn't have sx of hereditary angioedema - swollen lips and eyelids +2  
teepot123  fa 19 pg 107 +  
beloved_bet  According to Amboss "Mast cell-mediated angioedema Often associated with urticaria and pruritus Other associated with clinical findings of allergic reactions (see type 1 hypersensitivity reaction) Presents within 30 minutes to 2 hours after exposure and resolves over hours to days" +1  


submitted by jejunumjedi(29),
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I thkin this si icidgenbsr a alnsig editepp dop(hbocihyr ta .nurstN-mei) uothtWi lgsina edtepip ;gt=& anct’ be tetrdosarpn iont oaecdlnpsim .cmrleituu

youssefa  Is this even in FA? Biochem chapter only mentions SRPs. +1  
lovebug  @youssefa FA19, pg 47.[cell trafficking] but not details... +1