antidepressant
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2.Choice (C) is the correct answer. Familial hypocalciuric hypercalcemia is an autosomal dominant disease that is caused by defective calcium-sensing receptors in the parathyroid glands. As a result, the calcium set point for parathyroid hormone is increased. The result is hypercalcemia, hypophosphatemia, and inappropriately low to normal levels of parathyroid hormone for the degree of hypercalcemia. Essentially, the calcium "thermostat" has been set higher in familial hypocalciuric hypercalcemia. A defective Gsa (Choice A) results in pseudohypoparathyroidism when the mutated gene is inherited from the mother. Pseudo-pseudohypoparathyroidism results when the mutated Gs a gene is inherited from the father. Symptoms of vitamin D toxicity (Choice C) include nausea, vomiting, weakness, and mental status changes. Lab values consistent with vitamin D toxicity include both elevated serum calcium and phosphate levels. In addition, elevated calcium levels result in decreased secretion of parathyroid hormone by the parathyroid glands. Primary hyperparathyroidism (Choice D) is usually caused by a parathyroid adenoma that results in excessive parathyroid hormone (PTH) production. PTH is elevated resulting in hypercalcemia and hypophosphatemia. Hypoalbuminemia (Choice E) results in hypocalcemia, because calcium is bound to albumin. However, the ionized calcium level is usually normal. Hypoalbuminemia is seen in many disease states, some of which include liver disease, malnutrition, and nephrotic syndromes
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| antidepressant
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There are some extra interesting information about protamine, oh they said due to release of histamine.
Protamine is a highly cationic molecule that binds heparin and reverses anticoagulation. It is derived from fish sperm, and patients who have a history of vasectomy or infertility have a higher risk of developing antibodies to protamine that can result in anaphylaxis. Protamine causes histamine release and is associated with systemic hypotension, bradycardia, flushing, bronchoconstriction, and anaphylaxis. It is also associated with nausea and vomiting. When administered in the absence of heparin, protamine has a weak anticoagulation effect. The other choices are incorrect.
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| GoodGirl
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 Oh my I got the 2nd right ?
You know, I hope that kind a questions we will not see on exam, they are not even tricky, these are the kind you need to know it, or not, and I hate when they ask about something minute ....
Glad you shared, till now I never heard about smashstep1. Now I have an idea. Thanks.
And keep moving .... 
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Prioritize & simplify
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| GoodGirl
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 Fish sperm !
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Prioritize & simplify
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| antidepressant
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lol. yes, i heard about it in usmleforum a lot, last time, because they have some unusual questions, if i see too many of those, i will be very mad, i just wanted questions in different layout, but same questions tested on the exam, because i am used to uw, and i think even kaplan qbank, i might get used to them, and how many time, am i going to buy them . besides, downloaded one doesnt help me, and they are not in mixed, timed.
Different lay out totally freak me out! and this is a very bad quality in me! i made many known mistake in the first block of this question bank. But, if I get done soon enough, and i get many unknown, i am going back to old ones.
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| Melu
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Thanks Ad.Good girl, congratualtions on getting second one right.It was the toughest.
I too was not sure about the answer too.As I went out for a walk I was thinking if I mentioned it while posting the answers.Every source says Vitamin D toxicity goes with hypercalcemia and hyperphosphatemia.
Ad very good job , you are going for more than the regular.I always belive in going a mile extra to while aim to ace any thing.Ad at this rate 99 is yours!
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"The best preparation for good work tomorrow is good work today."- Elbert Hubbard
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| antidepressant
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no meluyou dont know my situation! didnt i say, i got wrong in all of those, not only those, something more, which i should have got right, Melu, i really dont know how, will i get there to reach a place that i get 70%, i am far away, but i need to take the test by december first week. Please pray for me, i am no 99er, i want to get 70%, which could be anything ranging from 85 to above. i dont know. i was frustrated, then i watched "secret" that motivational dvd for an hour. Then, i felt better, and before my husband came did 20 more questions(got 60%),which was better, only saw 3 weird questions, i know those will never come in exam, need to do 30 more.
then 10 nbme solving from nbme4, section 4, (every day 10)
But today, you can give me credit for not sleeping or over sleeping, not wasting time on tv. just cooked.lol, that way, i did good. i think, since its only 900 questions, i have to do other question banks. happy studying, may be c u later.
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| mjbapana
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Hey!!did just hear u say u r not a 99er!!!!WHO R U KIDDING?!!!!!u r doing such an awesome job girl dont even think that forget saying it!!!
Ad very good job , you are going for more than the regular.I always belive in going a mile extra to while aim to ace any thing.Ad at this rate 99 is yours!
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Philippians, chapter 4verse 13 : "I can do all things through Him who strengthens me."
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| antidepressant
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Thank you Mj, good to see you back. the motivational dvd i saw, it said, if you resist something, it will happen more. if you fight against proverty, or terrorism, or war, that will happen more, so you have to be pro peace, pro abundance of food for everyone! and mother theresa said, dont invite me if its a rally against war, if there is a rally for peace, i will join. So, from that point of view, i should resist being 99 er,lol.
But, seriously, if you give me credit for working hard, i will take it, yesterday, i did work hard, and today i plan to do also. But if anyone has to be applauded for a future 99er, i would say GG, anyway, thanks for having so much faith in me, MJ and melu. You too are doing great, have you seen Melu's journal lately, MJ? its loaded! wow! So, i see so many stars in here, and i am enlightened, wow! i made a good statement, of my own! ok, all kidding asides, lets work hard!
Since, yesterday, i was bothered by smashstep, i found an old cd i had, came free with other usmle stuff i bought, and it has some qbank's mixed questions. I did a block, got 70%, but i know many of those i did when i had the qbank, and i couldnt complete in one hour. i was distracted in between, So, my biggest challenge is time, except for the other challenge, memory. So, i have to make sure, 1. Solidify the memory, so that i dont waste time in easy ones. 2. Try to stay focused.
I wanted to complete this new qbank, which doesnt seem that great to me, but, i think, i should focus on other question sources too. One of my best reliable friend advised, to do more questions, that helps most. I am little dissapointed, if I can take the test by first week of december or not, i have to make sure, in repeated questions, i get 75% or higher atleast, so, i need to work a LOT!
Questions+Soving+Reveiw for next 20 days. Hope, i will be able to take nbme in 20 days.(12th november?)
Happy studying, everyone!
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| usmlekiller
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AD u've got the right mindset.......QUESTIONS QUESTIONS N QUESTIONS.....did i mention to do questions? keep at it looking forward to takin nbme around the same time as ur planning......lets do this goodluck
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| Melu
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Yesterday when you wrote that you were only expecting to get a decent score , I went thinking."Gosh, Ad is good and improving by leaps each day and she belives she might not be able to a get 99 , then what about me?Will I even pass?"
Ad , you are being modest, I am sure you will get a smashin' score over 90(mostly 99).If you think you are still not up to it then you will be very soon,NO DOUBT ABOUT THAT !!
You are working for it and you have everything to go with it.
As USMLEKILLER says too Question quetions ........more questions!!
Good luck for today dear!
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| antidepressant
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yes, Killer, and melu, questions, questions and questions. . i am still not there, but hopefully we all will get somewhere better than before, when i would be getting 70% stat, i can hope to pass. I thought i will aim for 210-220, so even i get less, it wont be too less, and i was suprised to read hottie's experience, nbme 5 and 6 her score was 430/201 and 440/204, her real score was 83/203. so, I cant aim for 430 on nbme, because if you aim that, you may get even lower. anyway, hope i can get there. forget about numbers. and you know what, even hottie said to someone, listen Goljan over, and over and over again, until you hear his word in head, i only hear his jokes in my head . ok, done with crying, lets get back to studies again.
I finished, the block i did before lunch,3-5, then i did one block of smashstep1,5.30 to 6.30, 64%, it was easier this time. made 3 silly mistakes. and got few weirdos right. My eyes are hurting, now, i am back after dinner and half an hour tv, and spending time with hubby, its 11, , i have to reveiw those questions, since those arent that tough, it will be fast. I was supposed to listen to Papi, if i can, i will. I still get low in hematology and nervous system.
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| antidepressant
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here is some points from smashstep1, happy studying to you everyone.
Epoprostenol is synthetic prostacyclin.
Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia, is an autosomal dominant condition characterized by recurrent epistaxis, telangiectasias, and arterio-venous malformations. The condition is caused by mutations of endoglin, which is a cell surface glycoprotein that is part of the transforming growth factor beta-receptor complex (TGF-beta). The TGF-beta receptor complex is involved in cardiovascular development and is highly expressed on endothelial cells. Osler-Weber-Rendu is also caused by mutations of activin receptorlike kinase 1 (ALK1).
ApoB-48 is found exclusively on chylomicrons. ApoB-100 is the principle apoprotein found on LDL ApoE is found on chylomicrons, VLDL, IDL, and HDL. ApoE also binds to the LDL receptor. ApoC-II is found on chylomicrons, VLDL, IDL, and HDL, and activates lipoprotein lipase. ApoA-I (Choice E) is the primary protein found on HDL.
The a wave is the pressure increase caused by atrial contraction. The c wave is a small pressure spike caused by the bulging of the tricuspid valve into the atrium during systole. The x-descent is a result of atrial relaxation. The v wave occurs as blood fills the right atrium while the tricuspid valve is closed, and the y-descent is the result of the opening of the tricuspid valve. Changes in the waveforms can be observed with various pathologies. Atrial fibrillation results in the absence of a-waves. A prominent y-descent is seen in constrictive pericarditis secondary to a decrease in right ventricular compliance. Augmented v- waves are seen in tricuspid regurgitation.
Edited by antidepressant on 10/23/08 - 08:28 PM
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| DRFP
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antidepressant wrote:yes, Killer, and melu, questions, questions and questions. . i am still not there, but hopefully we all will get somewhere better than before, when i would be getting 70% stat, i can hope to pass. I thought i will aim for 210-220, so even i get less, it wont be too less, and i was suprised to read hottie's experience, nbme 5 and 6 her score was 430/201 and 440/204, her real score was 83/203. so, I cant aim for 430 on nbme , because if you aim that, you may get even lower. anyway, hope i can get there. forget about numbers. and you know what, even hottie said to someone, listen Goljan over, and over and over again, until you hear his word in head , i only hear his jokes in my head . ok, done with crying, lets get back to studies again. I finished, the block i did before lunch,3-5, then i did one block of smashstep1,5.30 to 6.30, 64%, it was easier this time. made 3 silly mistakes. and got few weirdos right. My eyes are hurting, now, i am back after dinner and half an hour tv, and spending time with hubby, its 11, , i have to reveiw those questions, since those arent that tough, it will be fast. I was supposed to listen to Papi, if i can, i will. I still get low in hematology and nervous system.
I agree with you
I want a 450 on NBME this weekend and man I'm scared
I have no idea what 70 to 76% on these downloaded really mean so I've got to pony up and take one online.
I will. By Sun ( Mon) is my goal and I usually do what I set out to do.
Hang in there and keep the faith!
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| dowjunk
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Gr8 going AD..................can smell success badly from this place!
cheerz all!
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Grad of 2007. Work in progress.......
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| Karime
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AD.......you're doing GREATTTTT!!!
keep going., don't give up !!! 
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| 5fluorouracil
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hey AD!!!! you're doing great!!!! awesome! keep it up!!!
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Yes we can.... and yes we will!!!!!
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| antidepressant
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A newborn boy is born with a large tongue, hyperglycemia, and a large midline abdominal defect with protruding abdominal contents. He is an extremely large baby. What is the most likely diagnosis?
a. Beckwith-Wiedemann syndrome
b.Treacher-Collins syndrome
c. Gardner syndrome
d. Down syndrome
e. Turcot syndrome
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| antidepressant
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Thanks Dj, Karime and fluro. Tomorrow will be no studies, or may be 2 hours if possible, sunday, will try to do more, even in an hour i will be gone out for dinner. I am pasting 3 questions, if you find it interesting. I will post the reply, within an hour,
Ok, that was what I typed before previous post, somehow it was lost . so, here is your 2nd question.
2. An 83-year-old woman presents to the emergency room with a severe headache and mental status changes. A head CT scan shows subarachnoid blood. A subsequent cerebral angiogram shows the presence of a right middle cerebral artery aneurysm. The patient is brought to the operating room where a neurosurgeon clips the aneurysm. During the operation, the surgeon places sponges soaked with papaverine around aneurysm site. Papaverine will have which of the following effects?
a. Vasospasm prevention
b. Activation of clotting cascade
c. Postoperative analgesia
d. Reduction of inflammation
e. Anticoagulation
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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| antidepressant
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this is the last one,
3. A 63-year-old woman complains of vaginal itching and pain during sexual intercourse. A pelvic exam reveals shiny, white vulvar patches with a smooth surface. The labial skin is thin and atrophic with areas of fissuring. What is the most likely diagnosis?
a. Squamous cell carcinoma
b. Lichen planus
c. Lichen simplex chronicus
d. Lichen sclerosus
e. Condyloma acuminata
f. Atrophic vaginitis
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CSF value of Glucose 50-75 mg/dl,pressure: 70-180 mm H2O,protein: < 40 mg/dl.alpha1 agonist: phynelephrine, methoxamine.Non selective alpha blocker: Phentolamine, phenoxybenzamine. alpha 2 blocker: yohimbine, mirtazapine
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