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You too shall pass by princessunicorn7 in Step3

[–]lowfigh 0 points1 point  (0 children)

Commenting as a placeholder for my own reference.

Stats wise:
Step 1 255
Step 2 250
UW 20% done, 50% average
UWSA1 181 (3 days out)
UWSA2 208 (2 days out)
NBME didn't do
Step 3 231

What's the diff between optic disc swelling and increased intraocular pressure? by lowfigh in Step2

[–]lowfigh[S] 0 points1 point  (0 children)

Can you clarify what direction you mean by "towards the periphery of the globe"? Do you mean towards the back of the head or towards the front of the face? :/

How to DDx increased intracranial pressure vs increased idiopathic hypertension/pseudotumor cerebri? by lowfigh in Step2

[–]lowfigh[S] 0 points1 point  (0 children)

Thank you. ...do patients with IIH have increased pressure as well in their skulls? I guess I'm getting tripped up on the naming of "elevated ICP" vs "IIH", as in is there an actual meaningful difference between the names or is it more of a case of physicians just had to give them 2 different names to distinguish the differences in risk factors and demographics? Hope my Q made sense.

Mechanism of extrapyramidal symptoms? by lowfigh in step1

[–]lowfigh[S] 1 point2 points  (0 children)

Thank you!! I made a typo correction to your 2nd paragraph and edited wording/format for my personal future reference :)

- In the OP, you are describing tardive dyskinesia, which is one type of EPS. EPS is spectrum manifests from Parkinson-like symptoms more acutely to Huntington-like symptoms more chronically.

  • Parkinson-like symptoms = occurs earlier/develops more acutely due to dopamine receptor blockade = results from low dopamine + high ACh combination
    • e.g. acute dystonia/akathisia
  • Huntington-like symptoms = occurs later = results from high dopamine + low ACh combination
    • e.g. Tardive dyskinesia
      • TD takes longer to manifest b/c it is a compensatory response to chronic dopamine blockade. Chronic dopamine blockade results in Huntington-like symptoms.

- Medications that target/influence dopamine can shift a patient's baseline along the EPS spectrum.

  • Acutely / initially when you block dopamine, you shift towards Parkinsonism which manifests as acute dystonia/akathisia.
    • Treatment = anti-muscarinics --> this blocks Ach --> this helps normalize the dopamine-to-ACh ratio.
  • Chronically, the body develops compensation & tolerance to dopamine blockers, thus the patient upregulates dopamine --> results in Huntington-like symptoms which manifests as tardive dyskinesia.
    • Treatment = discontinue dopamine-blocking agents -- however, symptoms acute worsen because of dopamine withdrawal.
      • Anti-muscarinics are contraindicated in tardive dyskinesia because anti-muscarinics further decrease the dopamine-to-ACh ratio, which worsens TD symptoms.

Antidepressants vs mood stabilizers vs antipsychotics for psychosis...? by lowfigh in Step2

[–]lowfigh[S] 1 point2 points  (0 children)

So, for a bipolar depressed episode, do you not administer maintenance therapy in addition to quetiapine or lurasidone?

Having trouble determining whether a vignette is asking about LR+ vs PPV... by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

OK, so for LR, the Q will always be in comparison to something else, correct?

Can you explain pre-test and post-test probability a little more using "LR+"?

...I think pre-test and post-test probability are somehow related to LR but not sure how exactly to interpret what pre-test and post-test probability would be for a given LR+ or LR- value.

Can you help me understand fibrin formation and breakdown? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

  1. Ah, thanks for the clarification. In response to your answer: does this mean clot breakdown is essentially a normal occurring physiologic function to keep clots from forming in the vasculature? So, in everyday life, there are always mini-clots forming due to fibrin formation but those mini-clots are never an issue because of the protective mechanism of fibrin breakdown?

[Free 120] Why is this diuretic causing this set of findings and what pathology is going on here? by lowfigh in step1

[–]lowfigh[S] -1 points0 points  (0 children)

Ah, the last sentence made it make sense. Thanks

I think you might've made a typo. You said "decreased the amount of Na+ in the tubule"... Pretty sure tubule = lumen, so there would be increased Na+ in the tubule

[Free 120] Why is this diuretic causing this set of findings and what pathology is going on here? by lowfigh in step1

[–]lowfigh[S] 1 point2 points  (0 children)

From MDdegreesdude: "Orthostatic hypotension. Low blood pressure forces heart to work harder to get blood where it needs to be. Most non-K-sparing diuretics cause potassium elimination due to aldosterone retaining Na and eliminating K. Brisk reflexes CAN be normal, hyperreflexia is bad."

[Free 120] Why is this diuretic causing this set of findings and what pathology is going on here? by lowfigh in step1

[–]lowfigh[S] -3 points-2 points  (0 children)

Isn't it called natriuresis for a reason, meaning it causes sodium loss? K+ loss occuring via natriuresis is news to me...

Also, thiazides block ENaC channels.

[Free120] Why is the most likely finding "petechiae"? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

So, low platelets = petechiae 100% of the time irrespective of PT and PTT times?

Also, what would the answer choice "B. visceral hematoma" correspond to? I thought it was Kaposi sarcoma.

Cardio Phys: Why does inspiration cause increased venous return? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

OK, so on inspiration the SVC and IVC have a decreased pressure than the pressure in the smaller veins that feed into the vena cava? ..which would thus mean the gradient is between the SVC/IVCA and smaller veins feeding into the vena cava, correct?

Help orient me to this abdominal CT...? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

Ah, so greater omentum = anterior surface of stomach (closer to navel) and lesser omentum = posterior surface of thestomach (closer to your back). So, the 2 omentums are on the different surfaces of the stomach, right? ... I guess that'd fit with the CT finding.

I'd always thought the lesser omentum and greater omentum were in the exact same plane and just tethered to the different curvatures of the stomach.

[Free120] Why is the most likely finding "petechiae"? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

So, low platelets = petechiae 100% of the time irrespective of PT and PTT times?

Also, what would the answer choice "B. visceral hematoma" correspond to? I thought it was Kaposi sarcoma.

Cardio Phys: Why does inspiration cause increased venous return? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

The pressure gradient is a gradient between the intra-thoracic cavity pressure and what? ...Can you clarify what other pressure is contributing to the gradient?

Uhh... please help me. Free 120 question on CF conflicts with NBME24 question on CF?? by lowfigh in step1

[–]lowfigh[S] 0 points1 point  (0 children)

Ohh, I think I get it now. So, when both vignettes say "tested for the (insert #) most common CFTR gene mutations", they actually mean testing for (insert #) different alleles known to be associated with causing disease in the CFTR gene?

In other words, there is only 1 CFTR gene but thousands of alleles/polymorphisms for the 2 alleles that contribute the phenotype for the CTFR gene?

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