USMLE images
Started by Zuhal
It is most likely a child. Here's a hint: N/V+abdominal pain
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this was obtained at autopsy. The patient was suffering from edema and recurrent infections, and died from a pulmonary embolism.
Diagnosis prease?
sle?
This was obtained at autopsy. The patient was suffering from edema and recurrent infections, and died from a pulmonary embolism.
Diagnosis prease?
Progressive Multifocal Encephalopathy
It's a very short segment, but he emphasizes lack of MPO in AML-M5 monoblasts
Yes, that, thanks. Didn't want to put it up there until the question was answered, but wanted to say something lest I forget. Could see it as maybe being used as a buzz phrase distracter for Raynaud's
Here's another hint: if this problem is not corrected promptly, it can lead to metabolic acidosis
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Right but I see subendo deposits which are seen w/ diffuse proliferative glomerulonephritis which is seen in pt's with SLE.
SLE is a hypercoaguable state so I wouldn't be very surprised if this does turn out to be an SLE pt.
______poisoning+ H2O2--> OH--> peroxidation of membrane lipids
hydronephorsis due to a posterior urethral valve or vesicoureteral reflux?
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Good job!
HY for MCCEEs, not sure about the USMLE but thought i'd throw it out there just in case.
Is that the answer? It fits the equation but I'm confused why a kid would be more likely to have iron poisoning
it was iron poisoning - look up
it's pretty wild... never would have thought they look like that... another xray below
that's ****ing awesome. Those are just pills right? no reaction needed to see them?
Lol, here I am trying to think of the different mechanisms in kids vs adults or tying it back to lead poisoning and inhibition of hemoglobin leading to an increase of iron...all along the answer is "because they like sugar and bright colors". Sometimes I want to punch med school in the face
Ya I was trying to describe some of the weirder nephrotic symptoms (to eliminate SLE) just to reinforce them + subendothelial deposits = MPGN type 1 with tram tracking and all that. But I guess infections, embolism, and edema might be part of SLE too
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Yep! Radioopaque as a metal salt
Yeah, I knew this one because the wife and I are big pet people. Don't want them drinking radiator fluid, fairly common way pets commit seppuku
M = myeloid cell line (everything besides lymphocytes). Think of MPO as being neutrophil specific like P-ANCA (anti neutrophil Ab against MPO). Since this AML is specifically monoblasts (which diff. into monocytes), you won't have MPO.
at this stage of the condition...mcc of death would be due to what?
Progressive multifocal encephalopathy.
you're getting really good at this, strong work brother.
I will accept any and all explanations as to WTH I'm looking at
Never wouldve gotten that. Ruling pathology out of my future now
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Do I see CMV owl's eyes? Is PML ever the major cause of death in AIDS? If so, what's the CD4 cutoff that that's true for?
Edit: I may completely off base. lol
relax, dude is way off
Unfortunately, no CMV. CD4 count is normal.
It's all good, it's a learning experience. You should see some of the potato answers I've given for some of these things, lol.
A similar picture showed up in UWorld and I think there was a pretty high percentage of people getting it right. One liner question...and nothing else...felt like a potato.
Give us the multiple choice answers that UW had and we'd probably do alright as well.
My random BS guess is Rabies. Of course this is assuming this is anything but "classical"
Heh, swear to god that was my initial reaction to that picture but once everyone started mentioning brain stuff I thought I was WAY off base. I think USMLErx has a similar pic, why I originally had that reaction
oh man I knew the long cells with dark nuclei kind of looked like antiskow (spelling?) cells but the MCC death threw me off. I started thinking micro.
Good question!
ok, this is obviously lung tissue.
hx: 2 weeks ago had an MI. presents now with S3, dyspnea of exertion, and sleeps on top of 3 pillows at night
hx: 2 weeks ago had an MI. presents now with S3, dyspnea of exertion, and sleeps on top of 3 pillows at night
Totally hear ya on that one..I guess they really mean it when they say "don't change your answer"!
Yes that's right. I'm not taking it anytime soon though.
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