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If you were stuck between Chondrosarcoma(malignant) and Enchondroma(benign) remember
enchondromas may erode the cortex but can never invade/disrupt the cortex. I think this
was the distinction the question was testing. Also: Enchondromas are most common in young males (liek 20s)
whereas chondrosarcoma are most commin in middle aged men (esp. hips)
Histology showed coagulative necrosis (preserved architecture of myocardial fibers)
with neutrophil infiltration which hinted that the MI was within 24 hours.
Most likely cause of death within first 24 hours of MI is arrhythmia.
Myocardial rupture would also be visible on gross appearance of the heart,
Which they described in the stem
Candida is a part of the normal flora of skin, could cause contamination of a
central venous catheter. The question states that the organism is purple,
budding, did not respond to broad spectrum antibiotics (aka they didn't use fluconazole or amphotericin B).
Lastly, they showed it plated on blood agar and there was no hemolysis which eliminates staph
(the only other possible contender here.)
Cryptococcus usually involves meningitis in immunocompromised pts.
E. coli is gram negative sporothrix is usually transmitted by a thorn on a rose or someone with a history of gardening
I was thinking Chron’s because of the narrowing of the lumen and the
picture seemed like there was creeping fat. Now that I think about it though,
the LLQ and constipation should have led towards diverticulitis pretty quickly.
FA 2020 pg.383 Most common area for Diverticulosis to take place is the sigmoid
colon and diverticulitis can cause obstruction (inflammatory stenosis).
The key here is recognizing the risk factors (>60, chronic constipation)
and signs of acute inflammation (fever, chills and LLQ )) Granulomatous colitis is Chron’s,
which also doesn’t fit bc it presents commonly in the terminal ileum and does not usually
present with fever as it is an inflammatory pathology rather an infectious one.
B shows a parietal cell
whichreleasees HCl
infarcts would be a more peripheral wedge shape
abcess wouldnt be invasive to the surrounding area i think.
squamous cell is more centrally located
wasn't 100% sure but thats the best answer slthough stupid
to give 0 symptoms and just a picture, nothing like an actual clinical scenario
This is a picture of Giardia lamblia… caused by drinking contaminated water with cysts.
Multinucleated trophozoites
Rx -- Metronidazole -- forms toxic free radical metabolites in the bacterial cell that damage DNA = BACTERICIDAL
PCOS is associated with abnormal production of sex steroids,
including dysfunction of estrogen production and progesterone.
Chronically elevated levels of estrogen can cause endometrial hyperplasia.
this is a cervical spinal cord section. the cuneate fasciculus is intact (UE) vibration and proprioception,
but the white section is the gracile fasciculus (LE) and is damaged. I think the lateral portion that is uneven is just natural/artifact.
They way I thought about it was: Granulocytes:
multi lobed nucleus Lymphocytes: single lobe +9
 Side note: atrophy of the caudate nucleus
leads to a widened anterior horn of the
lateral ventricle. I've seen it worded both
ways in UWorld
 Visceral pain is typically poorly localized
(heart attacks are usually described as "crushing pressure" t
hat radiates to the shoulder or neck), so this patients "sharp"
right-sided pain in the setting in multiple right-sided rib fractures
is likely related to the ribs. The intercostals run with the ribs and
provide sensation to the chest wall.
HELLP syndrome: Hemolysis Elevated Liver enzymes Low Platelets.
Note: The abducens n. is actually the
nerve most likely to be damaged by an
expanding internal carotid aneurysm
in the cavernous sinus but they give
you specific CN3 function in this question.
Some quick rules I've found that apply to ethics questions:
1. ALWAYS acknowledge the pt's problem, distress, situation, etc.
2. NEVER ask the pt to lie 3. NEVER be a dick. The answer may sound robotic, but should never be mean
. 4. NEVER refer the patient to another resource (in this case, the nurse, but could also be risk management,
therapist, etc.) 5. COMMUNICATE. Talk to other clinicians/experts, etc. to resolve issues.
Often, this is the best option because "speaking" isn't really taking any action so no room for error
They should figure out what the patient would have wanted
The patient suffered from Immune Thrombocytopenia.
autoantibodies against the glycoproteins GP2B/3A.
On labs, you’ll see: increase in megakaryocytes;
on the question stem they’re described as “rare but large.”
Megakaryocytes are not suppressed.
Bruh let me tell you a lil secret
PEEP prevents Atelectasis AKA dat LUNG COLLAPSE
Dont be worryin about random words they puts in front of the HIGH YIELD ones
First Point : Lymph forms at the Capillary level of blood vessels ( as this is where fluid moves in and out of
vessels along with metabolites and nutrients ) .
The function of lymph is to return excess proteins and interstitial fluid back to the bloodstream
( Recall Lymph eventually drains into the large veins)
Second Point : We may increase lymph either by increasing 1. the rate at which we form it .
2. Decreasing the rate of drainage ( i.e - obstructing lymph vessels )
To increase lymph formation we have to increase the rate at which fluid filters out of the capillaries .
This can be done by altering Starlings forces in the capillary
Increasing hydrostatic pressure

Decreasing Oncotic pressure

Secondary hyperparathyroidism
(usually d/t chronic renal failure).
Lab findings include ↑ PTH
(response to low calcium),
↓ serum calcium (renal failure),
↑ serum phosphate (renal failure), and
↑ alkaline phosphatase (PTH activating osteoBlasts).,
also remember that in renal failure, 1-alpha-hydroxylase activity is down, so
there will be less activation of 25-hydroxycholecalciferol to 1,
25-hydroxycholecalciferol, which is a key mechanism causing hypocalcemia
Vibrio cholerae is a gram-negative, comma shaped
bacteria that can cause watery diarrhea. Cholera toxin functions
by activating the Gs proteins --> increasing activity of adenylyl
cyclase --> increased cAMP --> increased Na+ and Cl- efflux --> diarrhea.
Think of it this way: Kid has Vit.D deficiency/ Rickets.
He needs Vit D to mineralize bone, which means make osteoid into mature bone.

No Vitamin D means excess unmineralized bone aka osteoid.

this was a dumb question. the mneumonic "DIDanosine causes pancreaDIDis" is useful here
Glutamate receptors include NMDA vs AMPA, coexist at same receptor,
both are permeable to Na+ and K+
weak stimulation of presynaptic terminal leads to glutamate to release and
bind to both types of receptors, weak stimluation only activates Ampa receptors resulting
a slight depolarization. It doesnt go through the nmda receptor because it is blocked by Mg2+ ions
then when there large stimulus and enough depolarization from AMPA depolarization which

the magnesion and allows for Na+ and more importantly Ca2+ to come through, leading to singaling cascades, suchs as CaMKII an
aka ampulla of Vater or the hepatopancreatic duct
 Cardiac Tumors in adults -- usually myxoma Cardiac tumors in kids
\ -- usually Rhabdomyoma ( ass. w/ Tuberous Sclerosis. )
--> its in the first aid rapid Review +17
The Stem is describing hemochromatosis, characterized by
abnormal iron sensing and increased intestinal absorption.
This increases Iron, increasing ferritin. In response, TIBC is decreased,
which increases transferrin saturation as there is less circulating carrier molecules.
With excess iron in the blood, it will accumulate in tissues including the liver, skin,
pancreas. Sequelae include dilated cardiomyopathy, hypogonadism,
diabetes, arthropathy 2/2 calcium pyrophosphate deposition, and Hepatocellular Carcinoma
Glutamate receptors include NMDA vs AMPA, coexist at same receptor,
both are permeable to Na+ and K+
weak stimulation of presynaptic terminal leads to glutamate to release and
bind to both types of receptors, weak stimluation only activates Ampa receptors resulting
a slight depolarization. It doesnt go through the nmda receptor because it is blocked by Mg2+ ions
then when there large stimulus and enough depolarization from AMPA depolarization which

the magnesion and allows for Na+ and more importantly Ca2+ to come through, leading to singaling cascades,
suchs as CaMKII and increases ampa receptors. Enhanced response, long term potentiation.
Recurrent kidney stones should include hyperparathyroidism on your differential,
couple that with gastrinoma and you’re looking at MEN 1. Lipomas are also associated with MEN 1.
Arthropod for sure, but for the record I'm pretty sure this was Chikungunya Virus.
Only got this from a UWorld question as I hadn't seen it until then, but apparently
the arthralgia is really bad, which is what drew me to the answer.Dengue is also known as "bone break fever"
which makes me think its more likely to be dengue due to the "excruciating pains in joints and muscles".
FA pg.372. Squamous cell carcinoma occurs in the upper 2/3 of esophagus
whereas adenocarcinoma occurs in the distal 1/3. Since this was in the mid esophagus,
its squamous cell carcinoma. Key feature of squamous cell carcinoma is keratin pearls.
ACTH is being over-produced to stimulate the adrenals to produce cortisol,
but they can't respond, either due to atrophy or destruction (TB, autoimmune: DR4, etc.)
The first 13 amino acids of ACTH can be cleaved to form α-MSH,
which stimulates melanocytes, causing hyperpigmentation
 Macrophages secrete Il-1,6,8,12 and TNF - alpha. In this scenario,
the patient is Il-12 receptor deficient. When macrophages engulf an object,
it releases Il-12 to stimulate T-lymphocytes, that in return, release Ifn-gamma,
which would convert the macrophage into an epithiliod histiocyt
currently her TSH is good --> well-controlled hypothryoidism HYPOTHETICAL high TSH
--> her hypothyroidism must NOT be well-controlled (due to disruption of the T3/T4/TRH/TSH
endocrine axis)
So, now that we understand that the question is asking
"what would happen if her hypothyroidism was uncontrolled?"
Hyperparathyroidism causing bone lesions is via Osteoblasts
increasing RANK -L expression to bind to RANK on Osteoclasts
and stimulating them ---> inc Bone Resorption
ructural compactness” to the collagen, i.e. put a kink in the alpha helix).
If glycine is misplaced by something else, I don’t think pro-collagen can form its correct secondary structure.
When working on acid/base disorders, it helps to look systematically at the following:
(1) pH (which sadly was not given in this problem), (2) figure out which problem is primary
by looking at PaCO2 and bicarb, and (3) look for any compensation (which the question
doesn't ask but still).
Here, we see that the CO2 is high on the ABG.
This means that patient is hypoventilating since levels of CO2 are
ventilation dependent, and also that patient has respiratory acidosis.
Also, bicarb is low, which implies that it's being "soaked up" by metabolic acidosis.
thiazolidinediones (pioglitazone) increase insulin sensitivity (in muscles and liver)
through activation of peroxisome proliferator-activated receptor-gamma (PPAR)
I think they are asking about primarily mechanism of action, that's why it is E
This occurred within 6 hours and caused some pulmonary edema and respiratory
distress after a transfusion caused by the donor's anti-leukocyte antibodies just
destroying the recipients neutrophils and respiratory endothelial cells.
while allergic/anaphylaxis can cause respiratory arrest and shock it has a somewhat different picture,
no wheezing, itchiness or whatever and according to first Aid it happens within minutes to 2-3 hours
which is at least double what we're seeing here. also beware of IgA deficient people in this choice.
Mixed venous oxygen tension is the amount of oxygen bound to hemoglobin
as it returns to the right side of the heart after traveling to the tissues.
Decreased oxygen delivery to the tissues due to decreased cardiac output
leads to the tissues extracting more oxygen from the passing RBCs than they normally would,
which decreases the overall mixed venous oxygen tension. A helpful equation is CO=rate of O2
consumption/(arterial O2 content-venous O2 content): Fick principle If CO is decreased, then the
difference between arterial O2 content and venous O2 content is increased
Key Fact Being Tested: Pyruvate Kinase (PK) is the only enzyme in glycolysis that occurs
AFTER the formation of 1,3-BPG
Normally, Glucose -->--> G3P --> 1,3-BPG --> 3-PG -->--> Pyruvate
In this case, 1,3-BPG cannot be converted to 3-PG.
Thus, 1,3-BPG is shunted to 2,3-BPG. This step bypasses ATP production
. Since rbc's rely on glycolysis for ATP, this leads to hemolysis"
Among the most prevalent hematologic abnormalities in patients with rheumatologic disorders
are the anemia of chronic disease (ACD), a mild anemia that is generally asymptomatic, and iron
deficiency anemia.
In iron-deficiency anemia, the TIBC would higher than 400–450 mcg/dL because stores would be low.
Patients with RA occasionally have concurrent iron deficiency anemia and ACD. When this occurs, t
he hemoglobin level usually drops to below 9.5 g/dL, and the MCV is less than 80.
 FA 2017: Fibrate ADRs include myopathy increased risk with statins, cholesterol gallstones

statin + fibrate = myopathy. possibly most HY pharm principle tested

Syphilis pathogenesis is the inflammation and obliteration of the vasa vasorum (small blood vessels)
that feeds bigger blood vessels like aorta, arteries, arterioles. It does not matter what the stage is,
T. pallidum infects the vasa vasorum and, in the process, obliterates the nerves and blood vessels.
This kills blood supply to those areas = ischemia but no pain (painless chancre).
More localized in earlier stages, and in later stage, the spirochetes disseminate, so you have the aorta and
spinal cord involvement but same pathogenesis. (Edit: Goljan explained this somewhere.)
Niacin (vitamin B3) antagonizes VLDL cholesterol secretion

Fibrates stimulate PPAR-alpha --> LPL upregulation --> decreased triglycerides.

However, this question asked about a vitamin. Vitamin B3=niacin
Type 1 Familial Dyslipidemia (pg. 94 FA 19 )
increased TG ---> pancreatitis Eruptice / pruritis Xanthomas and HSM
Can be caused by Lipoprotien lipase or Apoprotien CII deficiency
they said that LPL is fine so its APO CII
Heparin seperates LPL from Herparin Sulfate Moeity on Vasc Endothelium allowing us to test its function in the lab.
cyclosporine inhibits transcription of IL2
Neuropathic Pain after stroke is central Post stroke pain Syndrome
caused by contralateral thalamic lesions
Pg. 504 FA19
Major risk factor for aortic dissection is hypertension, and in this case might be due to cocaine use,
which causes marked hypertension. Dissections cause a tear in the tunica intima --
blood can flow backwards into the pericardium and cause tamponade.
This manifests as crackles in the lung due to poor left ventricular function (filling/diastolic problem due to compression).

There is another clue, the man has diminished pulses in just one arm,
which means that the left subclavian artery must be involved somehow,
and an aortic dissection would be the best answer explaining this. +11
 Li-Fraunemi syndrome = SBLA (sarcoma, breast, leukemia, adrenal gland syndrome) \
and occurs because of an autosomal dominant inherited mutation of p53 APC: linked to FAP (colorectal cancer)
RET: linked to papillary thyroid cancer, MEN 2A, MEN 2B RB1: retinoblastoma
AV Fistulas re-rout blood from the arterial system to the venous system, by-passing the
Arterioles = Increase PL ---> INCREASE VR. All in all = Increase CO.
Pleural space: Midcavicular line: 6-8th ribs Midaxillary line: 8-10th ribs Paravertebral line: 10-12nd ribs
So physician must insert a needle in 8-10th ribs in midaxillary line; but insertion below the 9th rib still has a
risk to damage abdominal organs such as liver. Upper border of 9th rib is fine.
there are two essential fatty acids: linoleic = omega 6, and alpha-linoleic = omega 3.
I like to work backwards. 1) patient has normal testicles on histology,
normal appearing penis this must mean a Y chromosome is present, as testis determining factor
is on the y chromosome (see above post point #2). I.e. you can eliminate choice A and B.
Theoretically, 47XY and 47XYY could also present with female genitalia due to lack of MIF,
but normal 46XY is more common +13
There are 3 pathways involved in peeing:
Pelvic n. (aka pelvic splanchnic n.) sends parasympathetic fibers to deltrusor to contract --> squeeze bladder and pee.
Hypogastric n. sends sympathetic fibers to the deltrusor to relax, as well as the internal sphincter to contract --> hold back pee
Pudendal n. sends somatic fibers (under conscious control) to the external sphincter to contract --> hold back pee
In this question, the patient's bladder is filling up so much that it's forced to overflow. That means there is a problem
with scenario 1 - damage to pelvic n. so that he can't squeeze his bladder even when it's super full.
Ptx appears to have Muscle spasticity as a result of MS.
Spasticity is treated with a muscle relaxant like Baclofen which is a GABA agonist.
Bethanacol is a Cholinomimentic which can be used to treat Urinary dysfunction in Multiple sclerosis.
but the Question asks what would help treat the spasticity.
Option A is the only option where both muscles are part of the orbital floor.
Also, the last sentence in the question stem is a total modifyer of what one
would expect the question to be asking. It is not asking for you to assume that
these muscles have been severed, paralyzed, or rendered flacid. It is asking you to
assume that they have become "entrapped" if the muscle is entrapped, then it cannot
allow the eye to move into whatever position it would be in when the muscle is at its lengthened position.
So in this case, It is the inferior rectus being entrapped in a functionally shortened position that is preventing upward gaze.
increase in cAMP (Gs) - beta2 - vasodilation
decrease in cAMP (Gi) - alpha2 - vasoconstriction
increase in IP3 DAG (Gq) - alpha1 - vasoconstriction
increase in cGMP - M3 - NO induced vasodilation
Ubiquitin-mediated proteolysis is not reversibly affected by insulin.
The question asks for reversible ways that insulin affects it, and ubiquitination
would lead to degradation via proteases, which is not reversible.
Nuclear/cytoplasmic shunting makes sense because FOXO is a transcription factor, so it can’t do its job if it is in the cytoplasm!
This b has Sarcoidosis so her granulomas be activatin dat VitD
if postpartum bleeding does not stop you can ligate the internal iliac
but you should remember that reproduction is not compromised because the ovarial artery provides a collateral. FA 2020 P 641
It’s an osteosarcoma. Sarcoma = hematogenous mets. It’s in the legs so think how a DVT goes to lung. Same idea.
Neutropenic Fever, give GCSF to bring all his cells back up
Orchiectomy = ↓ testosterone production = ↓ DHT =>
prostate cells undergo apoptosis. (This mechanism is similar to using 5α-reductase blockers to treat BPH.)
Apoptosis is characterized by DNA fragmentation (pyknosis, karyorrhexis, karyolysis).
Page 506 FA 2019 describes headaches.
Cluster
Unilateral
15 mins to 3 hours
Periorbital pain with lacrimation and rhinorrhea
Tx: Sumatriptan
Migraine
Unilateral
4 to 72 hours
Pulsating pain with nausea, photophobia, phonophobia, may have "aura"
CN V, meninges or blood vessel irritation
Tx: NSAIDS, triptans, dihydroergotamine
Tension
Bilateral
4 to 6 hours
Band-like pain
Tx: analgesics, NSAIDS, acetaminophen
Hypoxic pulmonary vasoconstriction (HPV), also known as the Euler-Liljestrand mechanism
, is a physiological phenomenon in which small pulmonary arteries constrict in the presence
of alveolar hypoxia (low oxygen levels).
While the maintenance of ventilation/perfusion ratio during regional obstruction of airflow is beneficial,
HPV can be detrimental during global alveolar hypoxia which occurs with exposure to high altitude,
where HPV causes a significant increase in total pulmonary vascular resistance, and pulmonary arterial
pressure, potentially leading to pulmonary hypertension and pulmonary edema.
CNS Hemorrhage/ damage 1) 12-48 Hrs = red neurons 2) 1-3 days = neutrophils (liquefactive necrosis) 3)
3-5 = macrophages (microglia) 4) 1-2 weeks = Reacitve gliosis (+ vascular proliferation) 5) more than 2 weeks = Glial scar
(note: the pathogenesis is similar to MI and its scar formation; however, the time course for CNS is just faster)
to add up, the urologist himself doesn't add or remove accuracy (since this is a blood test),
what decreases the accuracy is the fact that in order to be sent to a urologist you probably
are sick in the first place (selection bias), so your urea nitrogen is likely to be altered.
the majority of carbon dioxide molecules are carried as part of the bicarbonate buffer system.
In this system, carbon dioxide diffuses into the RBCs. Carbonic anhydrase (CA) within RBCs
quickly converts the carbon dioxide into carbonic acid (H2CO3). Carbonic acid is an unstable
intermediate molecule that immediately dissociates into bicarbonate ions (HCO3-) and hydrogen (H+) ions.
The newly synthesized bicarbonate ion is transported out of the RBC into the plasma in exchange for a chloride i
on (Cl－); this is called the chloride shift. When the blood reaches the lungs, the bicarbonate ion is transported
back into the RBC in exchange for the chloride ion. The H+ ion dissociates from the hemoglobin and binds to the bicarbonate ion.
This produces the carbonic acid intermediate, which is converted back into carbon dioxide through the enzymatic action of CA. T
he carbon dioxide produced is expelled through the lungs during exhalation.
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
 both MHC 1 and 2 are present antigens that are PROTEINS (FA 2019 pg 100).
so in order to elicit a T cell response, you need a protein (CANT BE A POLYSACC).
that is why vaccines for polysaccaride antigens are often conjugated to PROTEINs--> so that we can elicit a T-cell response (FA 2019 pg 127).
 mononucleosis does not equal monocytes. Mono-nucleosis refers to the increase of mono-nuclear cells (lymphocytes)
in the blood, as opposed to polymorpho-nuclear or “segmented” white blood cells like neutrophils, basophils,
or eosinophils—which all have their nuclei divided into 2 or more “lobes” (multilobar cells). “Mono-nucleosis”
just refers to an increase in the blood of those cells with a “single, unlobulated/unsegmented” nucleus = lymphocyte
per UWorld, "cortisol exerts a permissive effect on many hormones to help improve the response to a variety of stressors
. For example, cortisol increases vascular and bronchial smooth muscle reactivity to catecholamines".
FA also uses the effect of cortisol on catecholamine responsiveness as the lone example for a permissive drug
interaction (FA2018 pg 229). The difference here is that we're talking about exogenous glucocorticoid and adrenergic agonist.
I guess it was expected for us to assume that the mechanism is analogous for the analogous drugs
C dip exotoxin inhibits protein synthesis(translation) via ADP ribosylation of EF 2.
Nephrotoxicity results from lead exposure because the kidney is the main route
by which lead is eliminated. Lead is absorbed by the proximal tubular cells of the renal tubules,
where it binds to specific lead-binding proteins.
 So this guy basically has hypertensive emergency.
I'm already thinking it's renal artery stenosis. Next sentence? A bruit over the left abdomen.
Bingo. Renal artery stenosis, most often caused by atherosclerosis in older men (as compared to
fibromuscular dysplasia in younger women).
with PCT you are supposed to avoid excessive sunlight and UV exposure. Methoxsalen makes your skin more susceptible to UV light.
Pemphigus vulgaris is vulgar in that the blisters rupture and it's gross. + Nikolsky sign.
(Its also more vulgar to use your mouth which is why only vulgaris has oral blisters.) Desmosomes are shot.
bullous pemphigus is therefore not vulgar and doesn't pop = - Nikolsky sign. Hemidesmosomes are shot.

Bullous pemphigoid antigen must be hemidesmosome. FA: bulla are "bullow" the dermis (subepidermal blister). BP also yield "tense" bulla.
xactly...i just thought the problem has to be where they meet or somewhere similar to both.
.hence the common pathway 12(PTT Heparin) 7 (PT, Warfarin) 11 9 10 5 2 1 In my head, both sides are looking for the perfect 10
Deltoid is innervated by axillary nerve, which comes from roots C5/C6. Actions of the deltoid include abduction of the upper extremity.
COPI protein is needed to coat vescles from the RER to send to golgi.
Thus, with a mutation in that protein, the packaged proteins that should
bleb off and be sent to the golgi, instead accumulate in the RER and dilate it. Thus the answer.
Hydrochlorothiazide is a thiazide diuretic => thiazide diuretics are associated with hypokalemia.
What other diuretics are associated with hypokalemia? Loop diuretics.
Why?
Inhibition of Na+ reabsorption occurs in both loop diuretics (inhibit NKCC cotransporter) and
thiazide diuretics (inhibit NaCl cortransporter). All of this increased Na+ increases Aldosterone activity.
Relevant to this problem, Aldosterone upregulates expression of the Na+/K+ ATP antiporter
(reabsorb Na+ into body, expel K+ into lumen). This results in hypokalemia in the body.
Hang on, there's more high yield info!
Aldosterone does one other important thing - activation of a H+ channel that expels H+ into the lumen.
So, given that this patient has hypokalemia, you know there is upregulation of Aldosterone.
Do you think her pH would be high, or low? Exactly, it would be high because inc.
Aldosterone => inc. H+ expelled into the lumen => metabolic akalosis.
Now you understand why both loop diuretics and thiazide diuretics can cause what's called
"hypokalemic metabolic alkalosis."
This is a case-control study because it selects first by disease outcome (intellectual disability)
and then retroactively looks at exposure/risks (TV usage). Odds ratios are used to evaluate case-control studies; i
heres how I remember this: Temporal lesions are on Top,
so parietal lesions are below. and always remember the visual field and the side of lesion are the opposite sides.

lower quadrantanopia: parietal lesion

vs upper quadrantanopia = temporal lesion
 Small cell lung cancer causes SIADH. Location + exclusionary clues.

To expand, SIADH may also result in euvolemic hyponatremia.

This is because, as we know, ADH increases absorption of water
and therefore initially results in an increased circulating volume.
However, this results in increased stretch of the atria and subsequent secretion of ANP
. ANP (atrial natriuretic peptide) then results in loss of sodium and water.
when diff single strand repair mechanisms are used:
repair newly synthesized strand: mismatch repair (Lynch syndrome)
repair pyrimidine dimers caused by dat UV exposure: nucleotide excision repair (Xeroderma pigmentosum)
repair spontaneous/toxic alteration: base excision repa
Multiple myeloma = neoplasm of plasma cells.
Plasma cells produce secretory Ab's (aka produce Ab's) -- plasma cells do not have membrane-bound Ig (aka do not have BCR').
To recap: membrane-bound Ig = BCR while secretory Ig = Ab.
Now, anti-idiotypic antibody = antibody against antibody.
Plasma cells do not contain surface Ig -- because plasma cells only be secrete Ab's.
Therefore, anti-idiotypic antibody would not work to target myeloma cells because myeloma cells = plasma
cells aka plasma cells lack surface molecules that anti-idiotypic Ab's would need to bind to/target.
euthyroid sick syndrome is sometimes called "low T3 syndrome."
Also you know that the patient is euthyroid because her T4 and TSH are within the reference range. She is sick.
lol embarassing she just has proteinuria which is nephrotic
of the choices membranous glomerulonephritis is the only one
with granular basement membrane IgG and C3 complex
Irrerugularly Irregular rhythm = Afib Afib --> stasis of blood in the Heart --->
Thrombus formation Thrombus will embolize to the (likely) the popliteal artery leading to acute limb ischemia

it's bc clopidogrel won't bust a clot, just prevents them from forming.
retroperitoneal structures: SAD PUCKER: Suprarenal (adrenal) glands [not shown]
Aorta and IVC Duodenum (2nd through 4th parts)
Pancreas (except tail) Ureters Colon (descending and ascending)
Kidneys Esophagus (thoracic portion) Rectum (partially)
Rabies attacks the nicotinic Acetylcholine receptor, and travels
retrograde via dynein motors after binding AChR, according to FA.
Schizoid (clusterA)= voluntary self withdrawal and is content with social isolation.
(vs Avoidant, they wan to have relationships).
Its at the very top
this is actually a UW question (14992) Peripartum cardiomyopathy manifests as a dilated cardiomyopathy,
can occur during last month of pregnancy or within 5 months after delivery, pathogenesis poorly understood,
but may be related to impaired function of angiogenic growth factors (e.g VEGF) or predisposed by mutations
in cardiac structural proteins.
Misoprostol is indicated for prevention of NSAID-induced peptic ulcers
(FA 2019 pg 393). Omeprazole is better for treatment +2
Tennis elbow results in strain of the common extensor tendon and inflammation of the periosteum of lateral epicondyle.
Lateral elbow pain, often felt when opening a door or lifting a glass.
origins of the muscles that may be affected (all have extensor in the name so if you
remember that you could get this question by elimination):
extensor carpi radialis longus
extensor carpi radialis brevis
extensor digitorum
extensor digiti minimi
extensor carpi ulnari
Usual interstitial pneumonitis is the histological definition of Idiopathic pulmonary fibrosis.
We know that this patient has pulmonary fibrosis because the question states that there is
fibrous thickening of the alveolar septa. This question was just testing that we knew the other
names for Pulmonary Fibrosis.
Basically, with fewer measurements, the CI gets wider because you need
a larger sample size for more valuable results.
This question is describing terminal insomnia, which is common either in MDD or normal aging
. Out of those two MDD is the only thing in option choice. Plus, old age is a risk factor for MDD.
While antihistamines with action at H1 receptors are used for allergies,
H2 antihistamines are typically used for ulcers.
Therefore the best answer is stabilization of mast cell membranes.
These drugs (cromolyn) prevent vesicles of histamine from fusing with the membrane.
 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)

Yo dawg we all about PVT TIM HaLL

Phenylalanine, Valine, TryptoDANK, Threonine, Isoleucine, Methionine, Histidine, Leucine Lysine
bleomycin Induces free radical formation -> breaks in DNA strands.(Anti-tumor effect)
FA19, pg431. and other tissues have Bleomycin Hydrolase. but Lung doesn't. So lead to Pulmonary fibrosis.
Key phrase is hexagonal crystals in urinary sediment which means means its Cystine
(i remember it as SIX-tine for hexagon) crystals which is made up of 2 cysteine molecules.

Positive Nitroprusside test

Due to a hereditary inability to reabsorb : Cysteine, Ornithine, Lysine, And Arginine ( COLA ) ---->
Only Cysteine percipitates to make renal stones although all can be found in the Urine.
Mechanism: selective estrogen receptor modulator (SERM)
that acts as an antagonist on the estrogen receptors of the
breast and acts as an partial agonist on estrogen receptors in bone and uterus.
Therefore, ↑ risk of endometrial cancer and ↑ Risk of uterine sarcoma
There is splenic vein thrombosis. The short gastric veins normally drain into the splenic vein.
Due to the thrombosis, there may be fluid backup and increased pressure, resulting in varices.
how i remember it for all granulomas formed by...IFN gamma Maintained by TNF alpha
Gonadotrophs are the FSH/LH producing pituitary cells. No ovaries, no hormones, no feedback inhibition.
Per First Aid: antibodies against ABO blood types tend to be IgM or IgG,
which is why the answer is IgG + complement and not IgA + complement

IgA also has no role in any hypersensitivity reaction

Diarrhea causes loss of water, Na and Bicarb.
Remember that diarrhea is a cause of non anion gap metabolic acidosis because the loss of bicarbonate
is compensated by increasing Chloride reabsorption. So she can have hyperchloremia or hyponatremia
due to intake of only free water for 24 hours. But she has SEIZURES so hyponatremia is most likely
The question is asking you how much water must the woman take in to maintain the same osmolality.
This woman takes in 450 mOsm of solute per day. This is a unit of measurement -- think of it like grams.
For her to keep the same osmolality she must excrete 450 mOsm per day. The only way for her to excrete the s
olute is via the kidneys. The only way for her kidneys to excrete 450 mOsm is if they excrete 1 liter of water also.
This is the max concentration that her kidneys can produce. (Her kidneys are not “powerful enough” to make her
urine any more concentrated than that.)
This woman is also losing another liter of water to feces, sweating and respiration. This is the “insensible water loss”.
That means if she losing 1 liter of water to sweat, respiration and feces per day plus 1 liter of water to urine
(because she needs to dissolve her solute in something!), for her blood to stay the same osmolality, she must
replace the water she lost thus must, at minimum, drink 2 liters of water per day.
Type 2 pneumocytes produce stem cells and surfactant.
BP is low so obviously the body will want to respond by increasing sympathetics and decreasing parasympathetics
. since the BP is low, there is less pressure against the wall of the carotid sinus -- meaning less stimulation and
fewer impulses. fewer carotid impulses means fewer parasympathetics
ethambutol = EYEthambutol
Great mnemonic for remembering that EYEthambutol is the component that causes visual problems
in RIPE therapy for TB.
This is lateral medullary/PICA/Wallenberg syndrome. The woman has damage in the sympathetic chain
(sensory syndromes are lateral according to the rule of 4s) resulting in Horner syndrome, spinothalamic tract
(pain/temp which are also sensory), and CN IX and CN X dysfunction resulting in the dysphagia/dysarthria
(helps us localize to the medulla).
It’s acute alcohol consumption so fatty change more likely.
Cellular swelling indicates alcoholic hepatitis which requires chronic
alcohol consumption (See FA 2019 pg 385). At least that’s the logic I used to pick fatty change.
Stretch or dilation of the cervix and vagina are strong stimuli for oxytocin secretion
, mediated by neural pathways called the Ferguson reflex.
CholecystokinIn is secreted from the I cells of the duodenum and jejunum.
Gastrin is released from the G cells of the antrum of the stomach.
IF is secreted by the stomach and absorbed in the terminal ileum with B12.
Pepsin is secreted from the chief cells of the stomach and plays a role in protein digestion.
Secretion of VIP increases intestinal water and electrolyte secretion by acting on the parasympathetic ganglia

Gastrin, intrinsic factor, and pepsin are secreted by the stomach. VIP is synthesized in neurons,
so CCK (from I cells of duodenum) would be most directly affected by a duodenectomy.
The thyroid is supplied with arterial blood from the superior thyroid artery,
a branch of the external carotid artery, and the inferior thyroid artery, a branch of the thyrocervical trunk.
Fructose makes up 99% of the reducing sugar present in semen
. This sugar is produced in the seminal vesicles. Diminished levels
of fructose have been shown to parallel androgen deficiency and the testosterone level
. Following testosterone therapy, the level of fructose increases.
why hemolysis is wrong:
There should almost never be straight up bilirubin in the urine. In hemolysis,
the excess bilirubin is excreted in the bile. After bacterial conversion and reuptake,
some will be excreted in the urine as urobilin. However, in obstructive disorders, the
conjugated bilirubin will never have the opportunity to undergo bacterial conversion to sterco/urobilin.
In this way, the conjugated bilirubin has no other way to be excreted other than directly in the urine.
Cysteine-cysteine chemokine receptor 5 (CCR5) is a protein found on the surface of CD4 cells.
Valine and isoleucine are ketogenic amino acids
Renal artery stenosis is going to decrease blood flow to the kidney. JG cells sense
the decrease in perfusion pressure and secrete renin.
Renin is produced by the JG cells, JG cells are in the cortex
(they are modified smooth muscle of the afferent arteriole).
expiratory flow is = FEV1. In restrictive conditions, FEV1 is normal or increased due to decreased
FVC. Interstitial fibrosis = increased airway parenchyma scaffold around the airways, which is what
provides radial traction. The greater the radial traction, the lower the collapsing force, and so expiratory
flow is increased.
Didanosine, Lamivudine, and Tenofovir are NRTIs that inhibit nucleotide biding
to reverse transcriptase and terminate the DNA chain so those don't affect viral entry.
Nevirapine is an NNRTIs that binds to reverse transcriptase and thus also doesn't affect viral entry.
Enfuvirtide binds gp41 to inhibit the fusion of HIV and the target cell, thus inhibiting viral entry.
Assume schizophrenia d/t presentation is young male late teens/early 20s. Atypical antipsychotics (Risperidone) are first line.
inhibition of microtubule polymerization → inhibitis phagocytosis of urate crystals, leukocyte activation
and migration, and cell chemotaxis.
we learnt that at lower GFR, loop diuretics still work.
That's why you should use them in renal failure. Thiazides would not work with a GFR of <30.
Nonserious fungal infections: treat with _conazole
Serious fungal infections (eg, immunocompromised patients with disseminated infection): treat with amphotericin B
APocrine = your armpits smell like an APE
ceRUMen = there’s no ROOM in your ears since they’re full of wax
EC-CRYne = when you ECercise, your pores are CRYing
SEBaceous = SEBum is SEEPing out of your pores
Hemostasis (blood clotting): Within the first few minutes of injury,
platelets in the blood begin to stick to the injured site.
This activates the platelets, causing a few things to happen.
They change into an amorphous shape, more suitable for clotting, and they release chemical signals to promote clotting.
This results in the activation of fibrin, which forms a mesh and acts as "glue" to bind platelets to each other.
This makes a clot that serves to plug the break in the blood vessel, slowing/preventing further bleeding.[5][6]
The cervix is the only structure that would result in bilateral blockade.
NSAIDs --> block prostaglandin syn

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