Official: "Wow, that's a great Board Q" (Awesome Medical knowledge) thread

Discussion in 'Step I' started by virilep, Jun 21, 2008.

  1. virilep

    virilep What can Brown do for u?

    Joined:
    Feb 12, 2004
    Messages:
    1,563
    Likes Received:
    4
    I figured it's about time we just start one thread that we can talk about questions or topics that seem pretty good or have seen sometime throughout our preparation. Even people that have taken the test, if you'd like to chime in with something you saw on the wards or anytime (after the big day)

    If you have an answer, keep it to yourself (or you can PM it). We can post our answer by just replying to the thread to keep it active. If we're late, send a PM.

    I'll start.


    female patient presents with Christmas disease. What other abnormalities can be seen? (thought this was kind of cool)

    :luck: everyone.

    ps. laryngeal lesions are not cool. :laugh:
     
    #1 virilep, Jun 21, 2008
    Last edited: Jun 24, 2008
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    Excessive shopaholic?
     
  4. DwyaneWade

    DwyaneWade Reiging *** Cynic

    Joined:
    May 7, 2006
    Messages:
    669
    Likes Received:
    0
    Status:
    Resident [Any Field]
    Saw a patient with empty sella syndrome (i.e. no pituitary).

    Sodium was 185.

    She was fine...
     
  5. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Administrator Physician PhD Faculty Lifetime Donor Classifieds Approved

    Joined:
    Oct 12, 2004
    Messages:
    18,895
    Likes Received:
    4,110
    Status:
    Fellow [Any Field], Attending Physician
    How do alpha and beta cells in the pancreas communicate with one another to coordinate hormone production?

    (I thought it was just a somatostatin thing shutting down all of them, but that's not the whole story....)
     
  6. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    I'm sure there's a lot more to the story that I don't know, but insulin has regulatory effects on alpha cells, and glucagon on beta cells.
     
  7. alpha06

    alpha06 Senior Member
    Bronze Donor Classifieds Approved

    Joined:
    Dec 21, 2007
    Messages:
    240
    Likes Received:
    0
    Status:
    Resident [Any Field]
    This thread should be retitled:

    Official: "Wow, that's a great Board Q&A" (Awesome Medical knowledge) thread


    I'm curious to know about the pancreas question as well...
     
  8. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Administrator Physician PhD Faculty Lifetime Donor Classifieds Approved

    Joined:
    Oct 12, 2004
    Messages:
    18,895
    Likes Received:
    4,110
    Status:
    Fellow [Any Field], Attending Physician
    Posting the answer to the pancreas question in white to avoid spoiling for those who don't want to know yet. Highlight below if you want to see it.

    It turns out that the endocrine pancreatic cells are connected by gap junctions. I was going, gap junctions in the endocrine pancreas??? Yes, if we are to believe Linda Costanzo; it's on page 255 of her BRS Physio: "Gap junctions link beta cells to each other, alpha cells to each other, and beta cells to alpha cells for rapid communication." Even Wikipedia knew this, though they didn't get it totally right: "Islets can influence each other through paracrine and autocrine communication, and beta-cells are coupled electrically to beta cells (but not to other cell types)." I can't imagine this info ever being the slightest bit useful, but it's kind of cool anyway. :)
     
  9. laxman310

    laxman310 TheManWithAPlan

    Joined:
    Nov 12, 2007
    Messages:
    166
    Likes Received:
    1
    Status:
    Attending Physician
    I hear that both signaling mechanisms and CD4 count/related HIV disease are both high yield for those pesky practice questions.
     
  10. lord_jeebus

    lord_jeebus 和魂洋才
    Moderator Physician

    Joined:
    Jul 12, 2003
    Messages:
    5,825
    Likes Received:
    162
    Status:
    Attending Physician
    My favorite piece of "could be on the boards but you will never see it in your medical career" medical trivia --

    What enzyme contains Selenium, and what is the consequence of Selenium deficiency?

    Glutathione Peroxidase / Congestive Cardiomyopathy ("Keshan Disease")

    (If this were to ever appear on the boards, the patient would likely be from Inner Mongolia or thereabouts)
     
  11. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    That was on our path practical and a written section exam.
     
  12. lord_jeebus

    lord_jeebus 和魂洋才
    Moderator Physician

    Joined:
    Jul 12, 2003
    Messages:
    5,825
    Likes Received:
    162
    Status:
    Attending Physician
    your professors are evil
     
  13. Ingersoll

    Joined:
    Jun 2, 2008
    Messages:
    14
    Likes Received:
    0
    yeah, I love that selenium association. can't believe Goljan left it out of his book.
     
  14. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    Yes... yes he is. Path at my school is quite an "experience."
     
  15. virilep

    virilep What can Brown do for u?

    Joined:
    Feb 12, 2004
    Messages:
    1,563
    Likes Received:
    4
    Since Christmas Disease - AKA Hemophilia B - is an X-linked recessive diease, and the patient is a girl, we can suspect that she only has one X chromosome. So she's has Turner's Syndrome. From that, I'm sure you can figure out what else she could have. Just never thought about it this way. There are case reports about this happening and I'm assuming it can happen to any of the X-linked Recessive diseases. Hope is helps someone. Back to the grind. Test in 4 days.
     
  16. Thread continues after this sponsor message. SDN Members do not see this ad.

  17. Its_MurDAH

    Its_MurDAH The DaVinci Savant

    Joined:
    Jun 28, 2005
    Messages:
    526
    Likes Received:
    4
    Status:
    Resident [Any Field]
    Are males with this disease sterile or do they die at an early age? I'm just confused...why can't BOTH of her X chromosomes be defective - as in, one from ma and one from pa?

    Or am I completely off?

    POST#500
     
  18. R_C_Hutchinson

    R_C_Hutchinson Senior Member

    Joined:
    Aug 16, 2003
    Messages:
    299
    Likes Received:
    0
    I think the prevalence for turner's is much higher than that of Hemophilia B so if a patient is female with a very rare X-linked recessive disease she's more likely to have Turner's/1 allele than 2 alleles.

    It does beg the question though about the effect of each deficiency on one another with respect to fetal viability i.e. a turner's/HemoB child would have to not be lost during pregnancy and would have a much higher rate of spontaneous abortion than a homozygous recessive HemoB female, possibly compensating for some of the allele frequency advantage the turner's/HemoB combo.

    Probably overthinking this one though.
     
  19. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Administrator Physician PhD Faculty Lifetime Donor Classifieds Approved

    Joined:
    Oct 12, 2004
    Messages:
    18,895
    Likes Received:
    4,110
    Status:
    Fellow [Any Field], Attending Physician
    The other thing you should consider for a girl w/ symptomatic hemophilia is that she's a mosaic. In other words, she could have had uneven lyonization of her Xs during embryogenesis and come out unlucky with more of the normal copies inactivated. My understanding is that even a lot of Turner's patients are mixed 46 XX/45 XO; I get the impression that mosaics are probably more common than total 45 XO karyotype. Mosaicism could help explain RC's question too.
     
  20. virilep

    virilep What can Brown do for u?

    Joined:
    Feb 12, 2004
    Messages:
    1,563
    Likes Received:
    4
    If a person has this condition, they would be immune to rabies? (not a vaccine...)
     
  21. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    :confused:

    Kartagener's is the only thing that comes to mind that might be remotely plausible.
     
  22. highyield

    Joined:
    May 21, 2008
    Messages:
    26
    Likes Received:
    0
    Status:
    Medical Student
    A really severe case of guillain-barre?
     
  23. virilep

    virilep What can Brown do for u?

    Joined:
    Feb 12, 2004
    Messages:
    1,563
    Likes Received:
    4
    ding ding ding
     
  24. osli

    osli Senior Member

    Joined:
    Oct 13, 2005
    Messages:
    1,279
    Likes Received:
    4
    Status:
    Medical Student
    heh, that almost makes me feel smart. almost.
     
  25. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
    Administrator Physician PhD Faculty Lifetime Donor Classifieds Approved

    Joined:
    Oct 12, 2004
    Messages:
    18,895
    Likes Received:
    4,110
    Status:
    Fellow [Any Field], Attending Physician
    Hahaha, I was just starting to ask for an explanation about the mechanism, and then I thought--dynein, retrograde transport, nerves, virus can't get to CNS. Um, yeah. Little bit of a delayed synaptic connection there. :laugh:

    Ok, here's another one that should be pretty easy to figure out if you think about it: you know how you can use anti-cardiolipin antibodies to test nonspecifically for treponemes? Why would cardiolipin be cross-reactive with a treponeme antigen? A hint that should make the answer pretty obvious is provided in white below if anyone wants it. (On a side note, I read that cardiolipin is the only antigenic human glycerol-containing phospholipid.)

    Look up where it's located in the cell.
     

Share This Page