Chat transript - golijan path (cell injury, inflammation, ,

[Anonymous]

21:00:44 [Step_1] ok, lets start with stuff about cell injury and inflammation, etc. and take it from there. if you have questions from other parts, feel free to mix those in too.

21:00:57 [Hmmmmmm] what kind of calcification in parathyroid tumor?

21:01:16 ash enters this room

21:01:26 [Hmmmmmm] hey ash

21:01:26 [drkittu] Metastatic

21:01:30 [ash] hi all

21:01:34 [drkittu] Hi Ash

21:01:39 [Step_1] hi ash

21:01:45 [Lorena] hi ash

21:02:03 [Lorena] agree metastatic

21:02:07 mimo enters this room

21:02:12 [Hmmmmmm] good

21:02:19 [Step_1] dystrophic

21:02:21 [mimo] hi again

21:02:24 [ash] hey guys can i make a suggestion ?since patho is so imp. for this exam can we do it till next weekend?

21:03:06 [drkittu] ok with me

21:03:19 [Hmmmmmm] um we have to finish pharam too ash how bout we come in tomorow as well ill be there if u wana discuss more?

21:03:22 [Step_1] i was thinking that we can do it during the one week break between pharm and the next schedule

21:03:59 [ash] good idea hmmmmm and step_1

21:04:23 [Lorena] i loike step 1 suggestion

21:04:27 [Hmmmmmm] so whoever wants to discuss more and come 2morrow 2 not compulsory

21:04:43 [ash] ok i will be there

21:04:44 [Hmmmmmm] we'll post the transcript

21:04:57 [drkittu] i will be there too

21:05:11 [Step_1] name some examples of where you will find psammoma bodies?

21:05:15 [Lorena] i'll try

21:05:26 [mimo] easy...

21:05:40 [Lorena] meningiomas and thyroid, ovary carcinomas too

21:05:48 [ash] great ,we will do what step_1 suggests too.as path is 70 %of usmle we need to focus here

21:05:48 [Hmmmmmm] a diabetic patient comes in with a black looking leg. its shiny and the doc says it need to be amputated.....what kind of necrosis?

21:05:51 [Lorena] hi mimo

21:06:05 [Hmmmmmm] yeah ash for sure

21:06:06 [ash] liquefactive

21:06:16 [mimo] mehi lorena

21:06:31 [drkittu] liquefactive

21:06:32 [Lorena] gangrenous

21:06:32 [mimo] you forgot mesothelioma

21:06:34 [ash] hi mimo

21:06:45 [Hmmmmmm] yes its wet gangrene

21:06:49 [mimo] hi ash

21:07:08 [ash] wet gangrene has liquefactive necrosis

21:07:18 [Step_1] psammoma bodies found in serous cystadenocarcinoma of ovary, papillary adenocarcinoma of thyroid, memingioma, and mesothelioma

21:07:21 [Hmmmmmm] step1 ans please

21:07:30 [ash] what are mallory bodies made of?

21:07:54 [Hmmmmmm] thanks step1

21:07:58 [Lorena] aggregates of intermediate filaments of prekeratin

21:08:00 [mimo] eosinophilic cytoplasmic inclusion bodies

21:08:08 [hutals] intermediate filaments??

21:08:31 [Hmmmmmm] agree with lorena

21:08:36 [ash] hutals which intermediate filaments?

21:08:37 [Lorena] in hepatocytes

21:08:48 [ash] lorena right

21:08:53 [mimo] ok

21:09:40 [hutals] i was luck to get intermediate filaments....you mean theres different kinds??

21:09:40 [Lorena] i'll post a list of all the "bodies" i have read about....

21:09:53 [ash] phytohemaglutinins for t cells are staph. a for b-cells.what are they?

21:10:02 upman enters this room

21:10:21 [Step_1] hi upman

21:10:26 [ash] yes hutals keratin,vimentin,desmin,neurofilaments etc

21:10:27 [Lorena] hi upman

21:10:36 [ash] hi upman

21:10:40 [Hmmmmmm] hi upman

21:10:53 [upman] hello everybody.....i will mostly be here as if i wasnt here ; )

21:11:03 [Hmmmmmm] ash i didnt get ur question?

21:11:23 [mimo] hi upman

21:11:37 [hutals] is it keratin filaments?

21:12:24 [ash] what are phytohemaglutinins and staphylococcus a used for in assay with t and b lymphocytes?

21:12:35 [hutals] no prob upman, join in whenever you feel comfortable

21:13:29 [Hmmmmmm] no idea

21:13:35 [Lorena] i dont know ash......ans?

21:14:40 [Step_1] name some factors that left shift the O2 dissosiation curve. Name the ones that right shift.

21:15:02 [ash] they are used as mitogens.lymphocytes are stimulated to divide(will have increased uptake of tritiated thymidine )if they are functional

21:15:14 [Hmmmmmm] a child has fever thrombocytopenia and irritabity.... he had diahrrhea 2 weeks ago? name the cause?

21:15:29 [Hmmmmmm] ty ash

21:15:49 [Lorena] thanks ash

21:16:00 [Hmmmmmm] right shift is increase height, 2,3DPG

21:16:26 [ash] left_low 23 bpg,c.o.,meth hb,hbf,low temperature,high ph

21:16:46 [Lorena] agree with ash and hmmmm

21:17:24 [ash] wiscott aldrich?

21:18:05 [Lorena] igM is low

21:18:12 [Step_1] left shift is decreased 2,3 BPG, CO metHb, HbF, hypothermia, alkalosis. Right shift is acidosis, fever, inc BPG, high altitiude. Just think of excercising muscle for right shift which readily releases O2 into blood, so low pH (lactic acidosis) and high CO2, high BPG from high glycolysis,high temp

21:18:25 [Lorena] sorry i thought it was a q's

21:18:34 [ash] hmmmmmm is the ans wiscott aldrich?

21:18:41 [Hmmmmmm] no HUS and the organism was Ecoli ( can remmeber the number)

21:19:16 [ash] h157 7

21:19:33 [ash] imean o 7

21:19:36 [Hmmmmmm] there we go

21:19:44 [Hmmmmmm] thanks step1

21:20:26 [ash] what is the difference bet. atrophy and aplasia?

21:20:34 [Hmmmmmm] what glycoprotein need for platelet aggregation?

21:20:54 [ash] 2b3a

21:20:59 [Hmmmmmm] atropy decrease size aplasia decrease no

21:21:04 [Hmmmmmm] good

21:21:09 [drkittu] Hmmmmmmm ans 2b 3a

21:21:24 [Hmmmmmm] good drkittu

21:21:31 [ash] and diff bet agenesis and aplasia?

21:21:47 [ash] good hmmmmmmmm

21:21:59 [Hmmmmmm] agnesis doesnt form, aplasia decrease no.

21:22:05 kmonica26 enters this room

21:22:13 [drkittu] Ash agree

21:22:21 [ash] hi kmonica26

21:22:22 [Hmmmmmm] hi monica

21:22:30 [drkittu] hi monica

21:22:56 [ash] hmmmmmm decrease in number is hypoplasia

21:23:48 [Hmmmmmm] a pregant woman goes into labor and suddenly starts going into shock she gets dyspnic and starts getting dizziness and finally dies dx?

21:23:57 [Hmmmmmm] whoops sorry ash ur rite

21:23:59 [ash] in agenesis no primordial(embryonal)tissue present .in aplasia embryonal tissue is present

21:24:16 [ash] d.i.c?

21:24:17 [hutals] aplasia is lack of development of an organ or tissue.

21:24:38 [drkittu] Thanks ash

21:24:40 [hutals] atrophy is a decrease in size

21:24:54 [ash] yes but primordium of the tissue is present

21:24:55 [Step_1] pt comes to ER for overdose of acetominophen. What drug given to prevent what? Hint, this drug is also used for CF.

21:24:56 [kmonica26] sheehan syn

21:25:08 [ash] in aplasia

21:25:29 [kmonica26] acetylcysteine

21:25:46 [Hmmmmmm] agree with monica

21:25:50 [hutals] amniotic embolism

21:26:06 [Hmmmmmm] very good hutals

21:26:13 [Hmmmmmm] that was a tricky one

21:26:31 [ash] what is the function of ubiquitin?

21:26:41 [Step_1] kmonica, you might want to pick a brighter color from rainbow on the right

21:26:54 [kmonica26] ok

21:27:04 [kmonica26] Thats better

21:27:09 [Hmmmmmm] ubiquitin marks cells for apop.

21:27:10 [Step_1] thanks

21:27:39 [Step_1] acetylcysteine is correct....aka mucomyst

21:27:52 [kmonica26] yep

21:27:53 [Hmmmmmm] ty step2

21:27:59 [Hmmmmmm] whoops step1 ;(

21:28:22 [ash] yes hmmmmm it binds to old or damaged protein and delivers it to proteases

21:28:48 [Step_1] havent changed my name yet, thanks for reminding me

21:29:03 [ash] what do tau protein and mallory bodies have in common?

21:29:05 [Hmmmmmm]

21:30:11 [Step_1] a pt with small cell carcinoma presents with dark pigmentation on skin. What caused this?

21:30:30 [ash] acth

21:30:40 [kmonica26] Increase in ACTH

21:30:42 [ash] melatonin like

21:31:54 [ash] blood was allowed to clot and centrifuged.what factors are in the supernatant and what factors are in the clot?

21:32:04 [Step_1] that was a real question. ectopic synthesis in SCC of the lung can result in increased ACTH....good job

21:32:09 [Hmmmmmm] a child 6months old get recurrent viral infections? also has a very characteric grimace and is tense dx?

21:32:29 acestep1 enters this room

21:32:40 [Step_1] hi ace

21:32:42 [ash] di george

21:33:03 [ash] hi ace

21:33:04 [hutals] di georges

21:33:14 [Hmmmmmm] hi ace

21:33:20 [hutals] hey ace

21:33:33 [Hmmmmmm] perfect ash, hutals

21:33:45 [Hmmmmmm] hey where did lorena go?

21:34:25 [ash] gray hepatisation of lung has what necrosis?

21:34:52 [Hmmmmmm] coagulation?

21:35:00 [drkittu] Coagulative

21:35:01 [acestep1] oops hey step1

21:35:10 [acestep1] how r u

21:35:15 [acestep1] :0

21:35:19 [acestep1]

21:35:25 perch30 enters this room

21:35:29 [acestep1] im so sorry my comp is slow

21:35:37 [kmonica26] whats the answere to the 6 mnth old hmmm?

21:35:39 [Step_1] this was another real one, so I dont have answer. pt has exposure to sun. this results in an increase in what? number, size of melanocytes, melanosomes, etc?

21:35:40 [ash] no it is liquefactive

21:35:41 [perch30] hi

21:35:54 [ash] hi perch long time no see!!!!

21:36:11 [Hmmmmmm] a 6month old child gets recurrent emetic episode whenever he is fed milk? his IgG titer is diminishing (the ones he got from his mother) dx?

21:36:15 [perch30] hi)))))

21:36:16 [Step_1] hi perch

21:36:22 [Hmmmmmm] melanosome!

21:36:23 [hutals] hey perch

21:36:33 [Hmmmmmm] hiya perch

21:36:45 [acestep1] lactose intolerance

21:36:53 [kmonica26] Milk protein allergy?

21:36:56 [ash] i think melanocytes no. remains same only the action of tyrosinase increases.i may be wrong

21:37:04 [acestep1] i think no

21:37:23 [Hmmmmmm] very good ace

21:37:27 [ash] brutons

21:37:33 [Hmmmmmm] what if the child was newborn?

21:37:46 [kmonica26] TE fistula

21:37:50 [acestep1] thnx

21:37:55 [Hmmmmmm] perfect monica

21:37:58 [acestep1]

21:38:03 [kmonica26] thnx

21:38:17 [Step_1] i think that the melanocytes remain the same (even between races), but the melanosomes are larger and more numerous. but not sure??

21:38:19 [Hmmmmmm] ash IgG titers from mom lowers naturally by 6months

21:38:29 [ash] but how does igg decrease in t.e. fistula?

21:38:39 [Hmmmmmm] i think ur rite step1

21:38:51 [ash] ok i got it thanks

21:38:51 [Hmmmmmm] ash thats just to throw u off

21:39:01 [Hmmmmmm] u have to think the most common one

21:39:37 [ash] where do you find kulchitsky cells?

21:39:46 [ash] thanks hmmmmmm

21:40:00 omwaseem enters this room

21:40:02 [Hmmmmmm] np

21:40:09 [ash] what will happen to e.s.r. in polycythemia?why?

21:40:20 [ash] hi waseem

21:40:22 [Hmmmmmm] whoa this is hte first time i have ever heard of those cells!!

21:40:29 [Hmmmmmm] hi waseem

21:40:31 [omwaseem] Hi

21:40:52 [hutals] respiratory system

21:40:59 [Hmmmmmm] polycythemia esr goes down

21:41:18 [drkittu] Ash is it GIT

21:41:18 [ash] great hutals!they cause carcinoid in bronchus

21:41:20 [Hmmmmmm] soemthing to do with no space to sediment

21:41:36 [ash] right hmmmmmm.

21:42:10 [ash] drkittu in git you see similar cells called argentaffin cells

21:42:19 freaha enters this room

21:42:26 [drkittu] oh ok thanks

21:42:49 [freaha] hi everyone

21:43:03 [ash] what is vaginal adenosiis a precursor of?

21:43:10 [ash] hi freaha

21:43:38 [Hmmmmmm] a person works in the insulation industry? what kinds of cancer can he develop?

21:43:47 [hutals] hey freaha

21:43:48 [Hmmmmmm] adenocarcinoma ash?

21:43:52 [ash] mesothelioma

21:44:00 [Hmmmmmm] howdy freaha

21:44:02 [ash] and if he is a amoker ca lung

21:44:10 [kmonica26] DES exposure?

21:44:17 [ash] i mean smoker

21:44:22 [kmonica26] arsenic exposure

21:44:25 [ash] due to asbestosis

21:44:41 [freaha] clear cell

21:44:44 [kmonica26] in insulation industry

21:44:51 [acestep1] agree with ash

21:44:51 [Hmmmmmm] very good kmoica but what kind of tumors?

21:45:12 [ash] des exposure giving rise to clear cell ca. good monica and hmmmmmm

21:45:25 [ash] and freaha

21:45:53 [ash] hmmmmm dont you use asbestos in insulators?

21:45:55 [Hmmmmmm] broncogenic ca and malignant mesothilioma

21:46:11 [kmonica26] ok

21:46:15 [Step_1] pt has recurrent staph aureus infections and NBT dye test comes back negative. What does this indicate and what is the likely dx?

21:46:39 [Hmmmmmm] um ash i thought it woudl be arsenic? lemme make sure

21:47:04 [ash] cgd

21:47:19 [kmonica26] But NBT should be positive in That

21:47:22 [acestep1] agree with ask

21:47:24 [kmonica26] iN CGD

21:47:36 [ash] two substances giving garlic odour to breath?

21:47:53 [Hmmmmmm] step1 can u explain the NBT test?

21:48:04 [ash] no kmonica nbt test is positive in a normal person

21:48:14 [Step_1] a "negative" test is usually a good thing in medicine. but not in the case of NBT dye. a neg test means no resp burst present, most likely because of absence of NADPH oxidase. Dz is known as Chronic Granulomatous Disease (CGD)

21:48:30 [kmonica26] Oh yes I got mixed up!!!

21:48:43 [ash] in a normal person nbt is converted to a blue colored dye

21:48:47 [Hmmmmmm] ty step1

21:48:50 [acestep1] yes agree with step1

21:48:57 [Hmmmmmm] ash answer please?

21:49:01 [acestep1]

21:49:21 [ash] arsenic and phosphorus

21:49:43 [ash] what is minamatas disease?

21:49:48 [Hmmmmmm] what bout grape scented breath?

21:50:39 [ash] wine

21:50:48 [Hmmmmmm] hahah

21:51:00 [ash] just kidding .dont know

21:51:11 [kmonica26] caused by ingestion of fish that had been contaminated by mercury

21:51:26 [Hmmmmmm] a child has recurrent infections and grape scented breath dx?

21:51:42 [ash] good kmonica.it has cns symptoms

21:51:51 [Step_1] as far as Cluster designations (CD), what is the CD marker for Reed Sternberg cells in Hodkins? What about EBV on B Cells? What about Tcells and Helper vs cytotoxic B cells?

21:51:58 [Hmmmmmm] pseudomonas infection and dx cystic fibrosis

21:52:32 [kmonica26] EBV CD19, CD3, CD4, and CD8

21:52:47 [kmonica26] Cant remember hodgkins

21:52:49 [Hmmmmmm] EBV had CD19 rite? CD5 in reedstienber?

21:53:08 [ash] r.s. cells cd15,30

21:53:16 [ash] b cells cd21

21:53:33 [ash] e.b cd21

21:53:37 [acestep1] hmm i dont remb i thought ebv= cd 21

21:53:48 [Step_1] RS cells is CD 15 and 30, EBV is CD 21, T cells is CD 3, Helper T are CD4 while cytotoxic are CD 8

21:53:52 [kmonica26] I thought CD19

21:54:07 [Hmmmmmm] doh

21:54:14 [ash] t cells all have cd3 heper cd4 and cytotoxic cd8

21:54:48 [ash] what about n.k cells and a.l.l?

21:54:56 [Hmmmmmm] ty ash

21:55:07 [Hmmmmmm] ty step1

21:55:38 [Step_1] nk is 56

21:56:36 [ash] oh i thought n.k. cells is cd 16

21:56:48 [ash] a.l.l. is cd10

21:57:36 [ash] most common radiation induced cancer?

21:57:45 [acestep1] i thought both 16 n 56

21:57:58 [ash] oh thanx

21:58:04 [Hmmmmmm] leukemia

21:58:04 [acestep1] sking ca?

21:58:19 [acestep1] skin ca but i dunno

21:58:23 [ash] which leukemia?

21:58:33 [Step_1] yes, i agree, NK cells are both 16 and 56

21:58:56 [acestep1] k. thnx step1

21:58:57 [Hmmmmmm] aml

21:59:03 [acestep1]

21:59:17 [ash] one more.cd marker for histiocytosis x?

21:59:27 [Hmmmmmm] yeah ty step1 and ash

21:59:50 [ash] cml is the most common cancer in radiation

22:00:19 [Hmmmmmm] thx

22:00:30 [ash]

22:01:20 [kmonica26] CD1a???

22:01:37 [Step_1] CD 1

22:01:39 [ash] most common connective tissue disorder associated with cancer?

22:01:54 [ash] kmonica you are good!!!!

22:02:06 [ash] right step_1

22:02:09 [kmonica26] Thanks

22:02:30 [ash] most common cause of death in cancre?

22:02:45 [ash] i mean cancer

22:03:59 [Hmmmmmm] an african american lady shows markedly progressing dyphagia and has problmes passing tool, and has yellow scelra? she has autoantibodies against an enzyme! what enyzme and dx?

22:04:08 [ash] is someone answering>???

22:04:24 [Hmmmmmm] brain mets ash?

22:04:36 [ash] antitopoisomerase

22:04:47 [Hmmmmmm] sorry ash we're all slo here and have slo nets

22:05:07 [Step_1] sounds like sleroderma

22:05:15 [ash] most common cause of death in cancer is gram negative infections

22:05:20 [acestep1] :0

22:05:28 [acestep1]

22:05:34 [ash] i am sorry i was rude

22:05:40 [Hmmmmmm] very good step1 and enzyme?

22:06:05 [acestep1] np ash

22:06:10 [ash] antitopoisomerase

22:06:16 [Hmmmmmm] oh no its ok ash

22:06:58 [Hmmmmmm] very good ash

22:07:02 [Step_1] topoisomerase 1

22:07:25 [Step_1] i was trying to figure out how to spell it

22:07:29 [Hmmmmmm] sorry i didnt see u answer in the begginning ash yes step1

22:07:46 [Hmmmmmm] hahahahah step1

22:07:46 [ash] pt. has fever ,wt loss and cough.serum analysis shows dilutional hyponatremia.diagnosis?

22:07:48 [acestep1]

22:08:01 [hutals] H pylori

22:08:04 [ash] thats alright

22:08:18 [acestep1] it si chronic

22:08:25 [acestep1] imean tb

22:08:40 [acestep1] ash is it a chronic d/s

22:08:47 [ash] yes it is chronic

22:08:58 [acestep1] oops sorry

22:09:04 [acestep1] ok

22:09:24 [acestep1] i dunno i thoughttb but dec na

22:09:51 [acestep1] is it legionellea peumonia ? but penumoias r acute

22:09:52 [hutals] small cell carcinoma

22:10:06 [ash] it is small cell ca. lung with ectopic adh production

22:10:06 [Hmmmmmm] im thinking diabetes insipidi

22:10:18 [ash] great hutals

22:10:42 [acestep1] gd one

22:10:50 [hutals] SCC can cause SIADH....but that was a tough one

22:10:53 [acestep1]

22:10:59 [hutals] good question

22:11:02 [Hmmmmmm] gj hutals

22:11:22 [ash] a toddler with abdominal mass,increased r.b.c mass,normal pao2 and normal plasma volume.likely diagnosis?

22:11:33 [ash] thanx

22:11:48 [ash] but very good thinking hutals

22:12:00 [hutals] thanks

22:12:17 [kmonica26] neuroblastoma?

22:12:40 [acestep1] renal ca

22:13:17 [Hmmmmmm] agree with ace

22:13:27 [ash] close ace .what cancer in a toddler can you think of?

22:13:36 [acestep1] wilms

22:13:43 [ash] great!!!

22:13:46 [freaha] wilms

22:13:47 [acestep1]

22:13:56 [acestep1] thnx

22:14:15 [Hmmmmmm] polycythemia vera

22:14:19 [acestep1] yes i remb wilms n lung both can cuz polycythemia n inc pth sec

22:14:34 [acestep1]

22:14:34 [ash] ok heres another one.pt. with fever wt loss and chronic cough. his pth levels are low. diagnosis?

22:14:34 [hutals] by the way, i just noticed in my notes that the question about hyponatremia from small cell carcinoma was a real question

22:14:45 [acestep1] oh

22:14:58 [acestep1] thnx hutals

22:15:16 [ash] oh i made it up from g o l j a n s .it has a statement about this

22:15:19 [drkittu] Squamaous cell carcinooma

22:15:20 [hutals] actually, it was step 1 that gave us that info in a previous chat i think

22:15:51 [ash] right drkittu.why the low pth levels?

22:15:58 [acestep1] oh ok . thnx step1

22:16:26 [Step_1] you're right, that sounds very familiar

22:16:35 [drkittu] pth like substance produced by Sq cancer can't be measured by normal methods

22:16:46 [drkittu] so low PTH levels

22:16:52 [ash] very good

22:16:59 [acestep1] lol

22:17:22 [ash] another name for albumin of fetus?

22:17:30 [Hmmmmmm] what is the cause of high rbc mass?

22:17:32 [Step_1] most common cancer in southeast china (real question)

22:17:51 [drkittu] Gastric

22:17:54 [ash] polycythemiadue to erythropoietin

22:18:05 [ash] nasopharyngeal

22:18:31 [drkittu] sorry nasopharyneal

22:18:41 [Hmmmmmm] ash> huh? what question is scc the answer to?

22:19:00 [Step_1] thats right, nasopharygeal carcinoma secondary to EBV....very good

22:19:24 [ash] pt with chr cough and low pth levels hmmmmm

22:19:34 [acestep1] ic

22:19:46 [ash] gastric cancer is common in the japanese

22:20:21 [ash] patient with pure red cell aplasia.tumor is in>?

22:20:35 [Step_1] yes, gastric carcinoma is MC cancer in Japan due to smoked products

22:20:40 [Hmmmmmm] ash> and the answer to the polycythemia questin was (im sorry i didnt see this question in my chat box)

22:20:45 [drkittu] bone marrow

22:21:15 [ash] polycythemia is seen in renal cell ca.

22:21:23 [Hmmmmmm] oh ok

22:21:41 [Hmmmmmm] thanks man

22:21:53 [Step_1] bone marrow

22:22:01 [ash] the question was -a toddler with increased red cell mass and an abdominal mass. normal pao2 and plasma vol

22:22:26 [Hmmmmmm] gotcha

22:22:33 [kmonica26] Diamond Blackfan Syndrome

22:22:39 [ash] patient with red cell aplasia.the tumor is in thymus.thymoma

22:23:01 [ash] kmonica you are something

22:23:22 [Step_1] as far as incidence, what is the 3 most common cancers in the US in men?

22:23:46 [Hmmmmmm] walking dictionary of pathology!!!

22:23:48 [acestep1] prostrate

22:23:52 [ash] prostate,lung and colorectal

22:23:56 [acestep1] lung

22:23:56 [kmonica26] prostate, lung

22:24:04 [kmonica26] and colon

22:24:09 erum enters this room

22:24:11 [Step_1] cancer incidence in men is prostate, lung, colorectal....very good. what about incidence for women?

22:24:13 [acestep1] i dunno the rd one

22:24:13 [Hmmmmmm] agree with ace and ash

22:24:16 [Step_1] hi erum

22:24:22 [acestep1] k

22:24:39 [acestep1] ba ,lung

22:24:41 [ash] breast,lung and colorectal

22:24:46 [erum] hi all

22:24:46 [acestep1] n colon ?

22:24:54 [acestep1] hi

22:25:01 [Hmmmmmm] breast ,.ung and clolon

22:25:04 amen enters this room

22:25:08 [kmonica26] hi

22:25:08 [erum] sorry im late

22:25:13 [ash] how about causes of death in men and women.cancers?

22:25:15 [Step_1] breast, lung, colorectal for incidence in women. what about mortality in men?

22:25:21 [Hmmmmmm] hi erum and amen

22:25:21 [Step_1] hi amen

22:25:24 [ash] hi amen and erum

22:25:43 [kmonica26] lung,prostrate and colon

22:25:45 [Step_1] both men and women, or separately?

22:26:04 [ash] mortality is lung,prostate and colon in men

22:26:22 [ash] separately and both ,both

22:26:23 [kmonica26] well there cant be prostrate in women!!!!

22:26:26 [Hmmmmmm] ill be back ppl my internet and computer are really slo, ill restart

22:26:31 [drkittu] Lung ,breast, colorectal for women

22:26:35 [amen] COMMONEST CAUSE OF MORTALITY IN FEMALE CANCER IS OVARRIAN CA

22:26:39 [Step_1] mortality in men is lung, prostate and colon.....good. what about mortality in women?

22:27:08 [amen] COMMONEST FEMALE CANCER IS BREAST

22:27:12 [ash] amen are you sure?

22:27:29 [Step_1] amen, that would be for gyn cancers only as far as ovarian

22:27:33 [acestep1] i think ba

22:27:40 [amen] SURE I WILL NOT GIVE WRONG INFOR

22:27:44 [Step_1] amen, you might want to pick brighter color

22:27:46 [erum] lung ca

22:28:05 [ash] thakx amen

22:28:14 [amen] WHAT'S WITH LUNG CANCER?

22:28:46 [Step_1] mortality in women is lung, breast, colon. here is the real trick....what is the 2nd most common cause of death by cancer in BOTH men and women?

22:29:14 [ash] boy with hyperthyroidism,precautious puberty and mass in testis.diagnosis?

22:29:24 [ash] colorectal

22:29:27 [drkittu] colorectal

22:30:17 [erum] colorectal

22:30:38 [Step_1] good job....that usually gets people, but it didnt fool you all. the 2nd most common is colon cancer because men dont typically die of breat CA and women dont have prostates, so it does to the next one which is colon.

22:31:25 [amen] exlpain the patho of all 3 syndromes?

22:31:30 [perch30] ash...it is yolk sac tumor?

22:31:36 [Step_1] amen, the most common gyn cancer mortality is ovarian, but overall cancer mortality is lung, which is much more common than ovarian

22:32:06 [ash] perch i cant read can you change your color?

22:32:40 [Step_1] amen and perch, can you pick brighter colors from the rainbow on right....its hard to read the text

22:32:54 [ash] good .it is yolk sac tumor

22:33:16 [ash] good perch!!

22:33:39 [perch30] better?

22:33:53 [amen] yes but the most common female cancer is lung while most common gyn cancer is ovarian as per mortality but note that breast cancer is a more common female ca than lung aggreed?

22:34:07 [ash] marantic vegetations in heart are seen in ?

22:34:22 [perch30] ash...colon cancer?

22:34:28 [ash] yes perch better

22:34:36 [ash] good

22:34:45 [drkittu] colon cancer

22:34:47 [acestep1] my God u guys r going fast today

22:34:57 [Hmmmmmm] yeah i know

22:35:04 [Step_1] yes breast is more common female incidence, but not mortality. i agree

22:35:08 [acestep1] infective endocarditis ?- ash

22:35:09 [ash] hypoglycemia +secondary polycythemia are seen in?

22:35:14 [amen] no its endocarditis or?

22:35:17 kmonica26 enters this room

22:35:48 [amen] hey hey hey too many qs few answers with explanations

22:36:11 [acestep1] yes plz can we slow down a bit

22:36:17 [acestep1] plzzzzzzzzzz

22:36:21 [ash] sure

22:36:26 [acestep1]

22:36:27 [amen] back to the hyperhtroid boy i need conection pls.

22:36:45 [ash] marantic vegetations are seen in colon ca.

22:37:04 [acestep1] y

22:37:48 [drkittu] Insulinoma

22:37:55 [ash] boy with hyperthyroidism,precautious puberty and mass in left testis.diagnosis is germ cell tumor of testis

22:38:21 [acestep1] agree wuth kittu

22:38:41 [amen] germ cell tumour isn't it a variant of ovarian tumour?

22:38:54 [ash] the diagnosis is hepatocellular carcinoma

22:39:39 [ash] a boy doesnt have ovaries but germ cell tumor can be seen in ovaries

22:39:58 [ash] and testis both

22:40:16 [amen] okay

22:40:31 [acestep1] k

22:40:43 [amen] but what is the connection?

22:40:51 [ash] what is the sign of lesser trelat?

22:41:21 [amen] ash lesser ???

22:41:31 [ash] germ cell tumor produces beta hcg which gives rise to these findings

22:41:34 patho enters this room

22:42:00 [ash] leser trelat.spelling mistake sorry

22:42:02 grillovillegas enters this room

22:42:05 [hutals] seborrheic keratoses , but that is not high yield. where are you getting these questions because i doubt that gol jan has that

22:42:19 [perch30] man, 20 yo. Multiple nodular lesions in lungs, unilateral genicomasty, testes not enlarged. Dx?

22:42:36 [ash] all are from g o l j a n hutals

22:43:18 [hutals] really, wow.....i dont remember seeing that there. that shows i have to read some more

22:43:19 [acestep1] sarcoidosis ? im not sure

22:43:46 [kmonica26] Are these from his HY 36 pages?

22:44:01 [grillovillegas] Hola hay alguien .... latino

22:44:05 [Step_1] real question had an x *** which looked emphysema-like in an 85 yo and asked what most was most likely cause? choices were normal aging process, bronchiectasis, etc.

22:44:08 [ash] no from his book.patho review

22:44:32 [kmonica26] the red and grey book?

22:44:49 [grillovillegas] How is the best way to prepare the USMLE step 1

22:44:49 [ash] yes

22:44:50 [acestep1] hmm . gd q step1 i dunno but brochiectasis

22:44:51 [perch30] choriocarcinoma. Testes may not be enlarged.

22:45:06 [ash] perch is the ans sarcoidosis?

22:45:16 [ash] oh thanx!!!

22:45:20 [grillovillegas] Please i need help i dont know how to start !!!!

22:45:23 [acestep1] lol. gd one but tht happens in females only- perch

22:45:27 [kmonica26] I s it good ash I was thinking of buying it? Sorry to interupt the discussion

22:45:39 [ash] right and choriocarcinoma first mets to lungs

22:45:52 [acestep1] hey step1 whts the ans

22:45:54 [Step_1] i think that the correct answer was normal aging process because or senile emphesema (age dependent finding in lungs), but not sure

22:45:58 [ash] yes monica it is worth all the money

22:45:58 [perch30] ash...choriocarcinoma. Testes are not enlarged in choriocarcinoma

22:46:01 [erum] corio ca in females only

22:46:01 [drkittu] Multiple Bilateral Renal cell carcinomas is charecterstic of which disease?

22:46:08 [acestep1] k . thnx

22:46:08 [kmonica26] Thanks

22:46:27 [Hmmmmmm] von hipple lindau

22:46:39 [Step_1] hi grillo, welcome

22:46:48 [drkittu] Yup

22:46:53 [ash] le fraumani syndrome .dont mind the spelling

22:47:14 [ash] hi grillo

22:47:49 [grillovillegas] Hi man i really need help ....

22:48:04 [amen] how?

22:48:13 [ash] placental alkaline phosphatase is a tumor marker for?

22:48:18 [drkittu] Its Von Hippel Lindau

22:48:21 [grillovillegas] i dont know how to start to prepare the usmle.... whit what material

22:48:43 [ash] thanx drkittu

22:48:56 [Step_1] here was another real one. pt climbing tall mountain gets headache, lethargic....what treatment?

22:48:57 [grillovillegas] I am really confused ... i cant afford &lt;a target=new href=http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10002441&type=3 &subid=0 >Kaplan&lt;/a><IMG border=0 width=1 height=1 src=http://ad.linksynergy.com/fs-bin/show?id=c97WUMRO5hY&bids=47491.10002441&type=3&sub id=0 > i will prepare by myself

22:49:39 [Hmmmmmm] grilloville give me ur email i can help u with the kap thingy (give me any email)

22:49:43 [Step_1] grillo, try not to type words like kap lan, amaxon, first aid, gol jan, etc, or you will get a link instead

22:50:02 [grillovillegas] Thanks grillo_villegas@hotmail.com

22:50:23 [grillovillegas] ah ok thanks for the advise

22:50:37 [Hmmmmmm] are u online?

22:50:43 [kmonica26] pt is hyperventilating

22:50:55 [amen] ok?

22:50:56 [grillovillegas] Yes i am

22:51:04 [kmonica26] I think pt is hyperventilating

22:51:18 [patho] a person coming from rocky mountains,he was cyanotic,they gave him 100% oxygen,but he was still cynotic ,reason?

22:51:27 [amen] which pt is hyperventilating?

22:51:29 [acestep1] ok. give him acetazoilamide

22:51:31 [ash] which pt is hyperventillating?

22:51:40 [drkittu] Ash what was answer for you Q?

22:51:44 Lorena enters this room

22:51:52 [ash] patho he had a shunt

22:52:04 [kmonica26] climbing mountain?

22:52:06 [Step_1] the pt has acute mountain sickness. a couple of treatments available including immediate descenct, increase fluid intake, oxygen. the only choice on there was acetazolamide, a CA inhib which produces met acidosis which can offset the resp alk cause by ascent

22:52:10 [acestep1] hey lorena

22:52:30 [ash] placental alkaline phosphatase is a tumor marker for seminoma

22:52:35 [acestep1]

22:52:44 [Lorena] i had an electricity problem

22:52:48 [ash] hi lorena

22:52:59 [acestep1] np

22:53:06 [Lorena] hi again

22:53:22 [ash] first step in endometrial cancer development?

22:53:22 [acestep1] welcome 2 the room

22:53:31 [grillovillegas] Hi peaople.. !!!! hiiiiiiiiii i am from south america

22:53:33 [acestep1] :0

22:53:34 [patho] no the ans is not shunt,it is methemoglobinemia

22:53:38 [Lorena] thanks

22:53:45 [acestep1]

22:53:49 [ash] ok

22:53:58 [acestep1] ur welcome. anytime

22:54:09 [acestep1] hyperplasia_ ash

22:54:18 [ash] right ace

22:54:19 [hutals] hey grillovillegas, great to have you here with us

22:54:43 [hutals] what do you mean in development?

22:54:51 [grillovillegas] thanks man ... thanks ..... finally i find a real time forum for USMLE ...step1

22:54:51 [ash] what has mammography done to the incidence of breast ca.?

22:55:21 [ash] hutals i mean the first stage

22:55:27 [acestep1] k

22:55:33 [erum] DYSPLASIA

22:55:35 [kmonica26] increased?

22:55:36 [hutals] it is dysplasia

22:55:49 [acestep1] it has helped us in screening teh ba ca pts

22:56:00 [ash] no hutals it is hyperplasia

22:56:02 [erum] NO EFFECT ON INCIDENCE

22:56:03 [Lorena] mamography has helped in the early dx

22:56:09 [drkittu] increases

22:56:10 [ash] monica right

22:56:18 [acestep1] i mean early detection

22:56:19 [hutals] ash, mamography has increased the incidence because now we know about it sooner

22:56:35 [ash] it has increased the incidence

22:56:56 [ash] what has pap smear done to ca, cervix incidence?

22:57:20 [amen] decresed incidence

22:57:22 [acestep1] inc

22:57:38 [Lorena] decreased

22:57:39 [hutals] decreased i think because we catch it before it becomes full blown cancer

22:57:48 [ash] good amen. why?

22:57:51 [erum] DECREASE INCIDENCE

22:58:00 [Lorena] agree with hutals

22:58:04 [grillovillegas] Hi people .... hiiiiiiiiiiiiiiiiii i want to know everything about the usmle secrets

22:58:08 [ash] right pap smear detects dysplasia

22:58:16 [amen] also incresed incidence of precancer

22:58:33 [acestep1] ic

22:58:40 [ash] what about stool guiac test?

22:58:40 [hutals] ash, i knew that dysplasia was in my head for something....just couldnt figure out what it was

22:58:48 [patho] the person came from rocky mountains,the water there is rich in nitrates and nitrites,these are oxidising agents and they oxidise hemoglobin,iron becomes +# instead of +@,so eventhough we give 100% O2 the person is still cyanotic then it is metHB ,treatment is with iv methylene blue,ancillary treat

22:59:04 [Lorena] therefore i asume it has increased incidence of cervical dysplasia but decreased cervical cancer incidence

22:59:05 [ash] thanx patho

22:59:10 kiranadi enters this room

22:59:17 [amen] ash stool guaic test for colon ca

22:59:21 [ash] right guys good thinking

22:59:32 [patho] iron becomes + 3 instead of +2

22:59:34 [amen] lorena excellent

22:59:45 [hutals] good one patho

22:59:47 [ash] right amen .but what has it done to its incidence?

23:00:09 [erum] what bout polycythemia sec. to hypoxia

23:00:22 [amen] increased i guess

23:00:26 [erum] causing duskiness

23:00:29 [acestep1] hey patho isnt teh meth hb method used 2 tx na nitroprusside tx as well

23:00:39 [hutals] grillovillegas, you might get better answers if you ask in the forum

23:00:49 [Lorena] high altitudes, polycithemia

23:00:59 [hutals] but i think there are better books available that that

23:01:48 [ash] guaiac test has reduced the incidence of colon ca.

23:01:55 [amen] ans to the iron q pls?

23:02:15 [amen] ash how pls?

23:02:39 [ash] same funda as ca. cervix

23:03:00 [Lorena] very good q's ash

23:03:26 [Lorena] thank you

23:03:34 [amen] ok commonest cause of post menopausal bleding?

23:03:43 [ash] thanx lorena

23:04:00 [erum] ca cx

23:04:01 [ash] amen dub?

23:04:19 [Step_1] endometriosis

23:04:34 [Step_1] no endometrial ca

23:04:44 [erum] how step 1

23:04:48 [acestep1] agree with step1

23:04:51 [amen] endometrial ca correct

23:04:53 [Lorena] yes

23:05:32 [ash] ok guys i have to go now .thanx for spending the time with me.see you on sunday and hmmmmmm tomorrow at 9 pm

23:05:40 [acestep1] hey guys i gtg now

23:05:41 [amen] commonest cause of endometrial ca in a reproductive age

23:05:54 [ash] bye ace

23:06:01 [acestep1]

23:06:07 [Lorena] bye ace and ash

23:06:12 [acestep1] bye ash

23:06:24 [acestep1] bye lorena n take care

23:06:24 [ash] bye all

23:06:25 [Hmmmmmm] oh ash bye ash

23:06:33 [acestep1]

23:06:37 [Lorena] you too bye

23:06:45 [Step_1] atrophic vaginitis is actually the most common cause of post menopausal bleeding, but must rule out endo CA

23:06:46 [Hmmmmmm] sorry bout that im helping grillo but yeah ill see u tomroow for sure

23:07:09 [Step_1] thanks for great chat ash

23:07:26 [hutals] great questions ash, see ya sat

23:07:49 [amen] step 1 that's true

23:07:58 [drkittu] Thanks to all

23:08:04 [Hmmmmmm] bye ash lovlely questions

23:08:39 [amen] ans is polycystic ovarian syndrome.

23:09:24 [amen] well i got to roll.I have to go to work. Funny but have to

23:09:37 [amen] bye bye bye

23:09:39 crusher enters this room

23:09:42 [Step_1] amen, i didnt even see that question....but i knew it....darn

23:09:54 [Hmmmmmm] im out to ppl latez

23:09:56 [Hmmmmmm] bye

23:09:58 [Step_1] by amen, thanks for the chat

23:09:58 [Lorena] bye amen

23:10:08 [Step_1] hi crush

23:10:11 [Lorena] hi crusher

23:10:17 [Step_1] bye hmmm

23:10:21 [crusher] hello everyone,,wow so many ppl

23:10:45 [amen] last q b4 i go commest cause of endometrial ca in post menopausal

23:10:53 [hutals] wow....like grand central with people coming and going....great chat tonight

23:11:42 [amen] it's hormone replacement therapy

23:11:43 [kmonica26] Bye guys...

23:12:18 [crusher] i think excess of estrogen either OCp form or any other cause

23:12:25 [amen] while in the menopausal it's obessity all these cos of unopposed estrogen

23:12:52 [Lorena] ERT , not hormone replacement therapy ....estrogen with no oposition of progesterone

23:14:25 [Step_1] agree, its estrogen. if you give progesterone with the estrogen than the chances decrease

23:15:37 [Step_1] How is prostatic adenocarcinoma most commonly diagnosed?

23:16:05 [erum] 18yrs old with breast lump what test

23:16:52 [hutals] not a mamogram because too young

23:17:04 [hutals] rectal exam for step 1 question

23:17:53 [hutals] maybe ultrasound or biopsy?

23:17:54 [crusher] digital rectal exam,,most conveniet and ist step

23:18:00 [erum] biopsy

23:18:04 [Lorena] agree rectal exam

23:18:36 [crusher] no test may be fibroadenoma..

23:19:00 [erum] ultrasound

23:19:12 [Step_1] always think cheap for treatment. so Digital rectal exam (detect hard nodule) first, then by prostate biopsy

23:19:38 [Lorena] i would go for ultrasound first

23:19:56 [erum] right

23:20:16 [hutals] In which age group is prostatic adenocarcinoma most common?

23:20:24 [Lorena] agree with step 1, think cheap and no invasive first

23:20:30 [erum] what will the ultrasound show

23:20:49 [Step_1] >50

23:21:33 [hutals] ultrasound can show if cystic or solid

23:22:01 [hutals] yep, Men over the age of 50

23:22:51 [Step_1] name most common primary brain tumors in children? in adults?

23:23:26 [erum] astrocytoma4 kids

23:24:50 [hutals] meduloblastoma for kid i think

23:25:01 [Lorena] meningioma in adults

23:25:16 [Step_1] sorry, this subject was suposed to be for sat. but answer is Medulloblastoma in children and Meningioma in adults

23:26:29 [Step_1] what are malignant tumors called when they arise from epith tissue? what about from mesenchymal tissue? Bone marrow? lymph nodes?

23:27:01 [hutals] epithelium derived are carcinomas

23:27:13 [hutals] leukemia for BM

23:27:15 [Lorena] leukemia- tumor of stem cells of bone marrow, lymph nodes lymphoma

23:27:31 [Lorena] mesenchymal sarcoma

23:27:40 [hutals] lymph is lymphoma

23:27:54 [hutals] not sure about mesenchyme?

23:29:14 [Step_1] yes....very good. epith = carcinoma, mesencymal = sarcoma, bone marrow= leukemia, lymph nodes = lymphoma

23:30:28 [Lorena] spread of carcinoma vs sarcoma?

23:31:48 [Step_1] sarcomas are hematogenous spread

23:32:06 [Lorena] yes

23:33:28 [Lorena] carcinomas are lymphatic spread mostly

23:33:30 [Step_1] what is the gene translocation involved in the most common malignant lymphoma?

23:33:35 [crusher] carcinoma ,lymphatics fist??

23:34:06 [Lorena] yes crusher

23:34:38 [crusher] follicular,,,,,,bcl2?

23:34:47 [Lorena] burkitts "translocation 8:14?

23:35:35 [Step_1] this was a real question, and I always get it confused with burkitts (t8;14). the most common malignant lymphoma is B cell follicular lymphoma caused by overexpression of bcl-2. but answer is t14;18

23:36:06 [Lorena] thank you

23:36:53 [Step_1] what type of herpes causes kaposi sarcoma?

23:37:10 [crusher] is there any pnomonic to remmeber i also mixed..i apply the rule of goljian..so remeber burkitt 8L14 other one is other one

23:37:18 [hutals] hsv 8

23:37:22 [Lorena] 8

23:37:23 [crusher] HH8

23:37:48 [Step_1] good point crush....the other is the other

23:37:58 [Step_1] yes, its herpes 8

23:38:04 [Step_1] good job

23:38:15 [Lorena] thanks crusher

23:38:56 [Step_1] whichis only vaccine which prevents tumors?

23:39:12 [hutals] hep B

23:39:17 [crusher] HEPB

23:39:20 [Lorena] hep B

23:39:32 [crusher] PREVENT FROM HEPATOCELLUALR CA

23:39:48 [Step_1] ah, you all have been studying gol jan

23:39:59 [Step_1] yes, its hepatitis B vaccine

23:40:04 [Lorena]

23:40:22 [Lorena]>[Step_1] thanks to you

23:40:27 [crusher] we sure do step1

23:41:04 vandan_15 enters this room

23:41:08 [Step_1] he is the man....wait until you take the test and remember how many answers he gave you

23:41:19 [Step_1] hi vandan

23:41:37 [vandan_15] hi

23:41:52 [Lorena] seminoma...metastasis where?

23:41:55 [Step_1] which marker is present in both breast and ovarian tumors?

23:41:58 [Lorena] hi vandan

23:42:03 [vandan_15] testis

23:42:16 [vandan_15] hi lorena

23:42:22 [vandan_15] how are you

23:42:31 [crusher] paraaortic lymph nodes

23:42:41 [hutals] hey vandan

23:43:01 [Lorena] fine thanks

23:43:01 [vandan_15] hi htal

23:43:08 [Lorena] excellent crusher

23:43:50 [crusher] BCR2 or 1 i mixed

23:44:12 [vandan_15] those r enes isn't it??

23:44:20 [Step_1] i cant remember the exact question, but it was a real one involving BRCA-1

23:44:36 [Lorena] tahts the gene..not a marker

23:44:41 [Lorena] BRCA1

23:44:46 [Step_1] oops, i should have said genes...sorry

23:45:01 [Lorena] no problem

23:45:11 [vandan_15] ok

23:45:44 [Lorena] BRCA 2 is for breast cancer only , BRCA 1 for both ovarian and breast

23:46:03 [Step_1] another real one mentioned vincristine and asked which drug acts in the same cell cycle phase?

23:46:25 [vandan_15] good lorena great

23:46:36 [Step_1] good point lorena, maybe real question had something to do with that, i cant remember now

23:47:10 [Lorena] thanks van ,step

23:47:22 [crusher] viblastin and paclitaxel?

23:48:04 [Lorena]

23:48:13 [Step_1] wow, pretty good crush, i didnt even provide options and you got it. its pacltaxel which both work in M phase

23:48:43 [Lorena] wow

23:48:44 [vandan_15] its used for breast cancer

23:49:12 [crusher] PNOMONIC is VViP.vincrestine,vinblastin and paclitaxel

23:49:22 [vandan_15] what other drugs u use for breast ca

23:49:34 [Step_1] good one crusher

23:50:14 [crusher] tamoxifen..ralxifen

23:50:25 [vandan_15] and??

23:50:53 [hutals] tamoxifen was my guess too

23:51:13 [vandan_15] and taxol

23:51:26 [Lorena] ic

23:52:19 [hutals] thanks

23:52:50 [hutals] ok, getting close to quitting time, anything specific that anyone wants to cover?

23:53:19 [Step_1] thats true, almost at the end

23:54:02 [Step_1] i think we covered alot tonight, so unless anyone has anything else, i think we should call it a night

23:54:12 [crusher] i think i missed the myeloperoxidases system Q,s

23:54:37 [Lorena] i'll have to read the trabnscript since i lost my conection for a long time

23:54:57 [crusher] but anyway i will read the transcript

23:55:36 [Lorena] i practically missed the entire chat tonight

23:55:38 [Step_1] i mentioned the pt with current bacterial infections with staph aureus who had a negative NBT dye test (real question). what does this indicate and what diagnosis?

23:55:59 [Step_1] as far as MPO system

23:56:32 [crusher] CGD of child hood and lacking NADPH oxidases enzyme

23:56:40 [Lorena] Chronic granulomatous d.

23:56:52 [Lorena] yes

23:57:26 [Step_1] i had mentioned that it was kinda tricky because "negative" is usually a good thing in medicine except here. negative test indicateds absent resp burst most likely from absent of NADPH oxidase (CGD)

23:57:50 [crusher] he is unable to make bleech right step1..as staph aures is catalase and coagulase pos.

23:58:22 [Step_1] right, so pts can kill strep, but not staph aureus

23:59:26 [vandan_15] when u guys r taking step 1.step,lorena and crshr..

23:59:31 [Lorena] he can make bleach because he still has myeloperoxidase ....

23:59:36 [crusher] roxinata once put some Q,s which were from NB those were good practice.do someone still have ,em

23:59:39 [Step_1] funny because the question had stuff like, PPD negative, NBT negative, etc and kinda just hid it in there

23:59:56 [Lorena] i do

--------- The messages that have been sent today start below ---------

00:00:06 [Lorena] i will post them

00:00:18 [crusher] can u kindly send to me lori?

00:00:31 [crusher] thanks lorena

00:00:35 [Lorena] sure

00:01:16 [Step_1] ok, so our next chat is on sat for the remainder of gol jan path? or did we decide something different?

00:01:30 [Lorena] thats it

00:01:55 [crusher] vandam,i will appear whenever i wll feel comfortable to sit for,which i,m not at this point

00:01:56 [Lorena] some people will come tomorrow too , but i doubt i will be able to make it

00:02:29 [Lorena] i dont have a date yet, i feel the same way crusher does

00:02:40 [Step_1] ok, thanks for another great chat everyone. see everyone on sat (or in the step 1 forum before then )

00:02:57 [vandan_15] sure

00:03:06 [Lorena] thank you step 1 , see you

00:03:20 [crusher] thanks for coming step1.i cannot believe someone still comes after passing exams,,God bless you

00:03:33 [Lorena] i can stay longer if anybody wants to continue

00:04:00 [crusher] well i can continue too,

00:04:01 [vandan_15] i wanna discuss micro a bit anyone int

00:04:06 [Step_1] i'm just trying to pay it forward like others did for me

00:04:30 [hutals] thanks all, good nite

00:04:39 [crusher] but i,m out of Q,s right now..as my daughters are sleeping now

00:04:45 [Lorena] thanks hutals, good night

00:04:54 [vandan_15] step ty so much good nite see you soon

00:04:59 [crusher] good night hutals

00:05:12 [Step_1] i'll post transcript up till now. can one of you post the remainder if you decide to continue? just reply to the chat post

[Nami]

nami Testing