RENAL, STD, FEMALE TRACT PATHOLOGY

[Lorena]

SORRY GUYS, I LOST THE BEGINNING OF THE TRANSCRIPT BUT NOT MUCH.....HERE IT IS THE REST...

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20:25:04 [Lorena] only with proteinuria

20:25:07 [hutals] hyaline casts signify protein in urine and can be seen in normal person ...sorry ....trick question mentioned by golijan

20:26:27 [Lorena] Loss of which of the following renal functions is most likely to be identified by laboratory measurement of the urine specific gravity?

20:26:48 [Lorena] A Filtration

20:27:05 [Lorena] B Reabsorbtion

20:27:17 [Lorena] D Concentration

20:27:41 [Lorena] C Secretion

20:27:51 [jwls29] concentration

20:27:55 [ninadnashua] concenteration

20:27:55 [Lorena] or blood flow?

20:28:03 [kmonica26] i would say D

20:28:12 [hutals] concentration

20:28:15 [kmonica26] concentration

20:28:18 [Lorena] excellent

20:30:00 [hutals] pt has adult polycytic kidney disease and complains of headache. what could be complication causing this?

20:30:00 [kmonica26] A 6-year-old girl is admitted for evaluation of anasarca. Findings include: serum creatinine, 0.5 mg/dL; albumin, 1.8 g/dL; cholesterol, 300 mg/dL; triglycerides, 350 mg/dL; C3 complement, 100 mg/dL (normal, >80 mg/dL); antinuclear antibody, negative; and urinalysis, 5 to 10 red blood cells per hig

20:31:35 [kmonica26] 5 to 10 red blood cells per high-power field and urine protein, 300 mg/dL.

20:31:45 [jwls29] berry aneurysm...subarachnoid hemorrhage

20:32:05 [kmonica26] berry aneurysm

20:32:06 [ninadnashua] berry a

20:32:28 [kmonica26] These findings are MOST consistent with the diagnosis of

20:32:54 [Lorena] agree

20:33:03 [kmonica26] A. membranous nephropathy

20:33:19 [kmonica26] B. membranoproliferative glomerulonephritis

20:33:34 [kmonica26] C. minimal change nephrotic syndrome

20:33:49 [kmonica26] D. postinfectious acute glomerulonephritis

20:34:04 [kmonica26] E. systemic lupus erythematosus

20:34:05 [hutals] yep, berry aneurysm is right....very good everyone

20:34:28 docak enters this room

20:34:30 [jwls29] e

20:34:40 acestep1 enters this room

20:34:53 [ninadnashua] minimal

20:34:56 [hutals] i was going to guess minimal change, but the RBCs are throwing me off, so it might be post strep GN??

20:35:04 [jwls29] hi doc and ace

20:35:19 [acestep1] hi guys

20:35:23 [Lorena] c or d

20:35:24 [kmonica26] right hutal

20:35:29 [hutals] hey doc, hey ace

20:35:31 [jwls29] sorry guys i read the antibodies were positive

20:35:34 [docak] hi guys

20:35:43 [Lorena] hi doc and ace!

20:35:56 [docak] hi lorena

20:36:17 [acestep1] hi lor , hutals n jwls

20:36:17 [kmonica26] The child described in the vignette has proteinuria, hypoproteinemia, hyperlipidemia, and edema, a constellation of findings that is most consistent with nephrotic syndrome.

20:36:47 [jwls29] so it would be minimal change disease?

20:37:00 [kmonica26] yep

20:37:13 [Lorena] ok, the red blood cells confused me

20:37:19 [hutals] what about the RBCs, that was the only thing that didnt make sense with nephrotic

20:38:45 [kmonica26] i am not sure

20:39:00 [hutals] i guess it said red blood cells and didnt mention RBC "casts". the latter would mean it is from the kidneys so that would make it nephritic. but RBCs alone can be anything, including nephrotic....does that sound right?

20:39:01 [kmonica26] about rbcs]

20:39:50 [Lorena] yes hutals , tahts sounds right

20:40:28 [acestep1] agree

20:40:31 [Lorena] Which of the following renal lesions is most likely to have been present in this girl?

20:40:38 [Lorena] Mesangial immune complex deposition

20:40:44 [hutals] i guess that is a lesson for us all. it was a clear cut case of nephrotic and we let the RBC word distract us from the real answer....good question

20:40:50 [Lorena] Fusion of podocyte foot processes

20:41:11 [hutals] fusion of foot processes

20:41:22 [acestep1] minimal change d/s?

20:41:35 [jwls29] minimal change

20:42:05 [ninadnashua] fusion of the podocyte

20:42:08 [hutals] minimal change....agree

20:42:48 [Lorena] yes hutals....fusion of podocyte foot processes is the only pathologic finding

20:43:01 [Lorena] in minimal change disease

20:43:27 [Lorena] what are the podocytes?

20:44:27 [ninadnashua] i think they r same as footprocess

20:45:00 [acestep1] i think parietal layer of the bowmans capsule

20:45:24 [ninadnashua] lining cell

20:45:50 [Lorena] yes, podocytes have foot process and they are the visceral layer of epithelial cells that line the capillary wall

20:46:52 [ninadnashua] k

20:46:58 [acestep1] ok sorry

20:47:56 [hutals] a febrile 23 yo female presents with acute onset right flank pain, suprapubic discomfort, dysuria, and inc frequency of urination. urinary sed exam reveals clumps of leukocytes, WBC casts, occasional RBCs, numberous motile bact. mech closely related to....

20:48:56 [hutals] a renal stone. B ascending infection. C immunocomplex disease. D drug induced interstitial nephritis. E hematogenous spread of infection to kidneys

20:49:17 [ninadnashua] pyelonephritis

20:49:23 [jwls29] b

20:49:29 [acestep1] b

20:49:31 [Lorena] ascending infection

20:49:37 [ninadnashua] so ascen

20:50:02 [hutals] yep, its B ascending infection (acute pyelonephritis)

20:50:07 [docak] b

20:50:24 [docak] by e coli?

20:50:45 [docak] mcc is Ecoli

20:51:02 [docak] virulence factor p pili

20:51:03 [acestep1] agree

20:51:07 [hutals] e coli is the MCC, group B strep is 2nd MCC

20:51:08 [ninadnashua] ya

20:51:55 [Lorena] what type of hypersensitivity is drug induced nephritis?

20:52:40 [jwls29] combo of type IV and type I

20:52:44 [hutals] is that type 3??

20:52:51 [ninadnashua] type 1

20:53:06 [Lorena] very good jwls

20:53:31 [docak] how?

20:53:47 [Lorena] type 3 are the glomerulonephritis except Goodpasture

20:53:47 [jwls29] type IV is a cellular immune reaction

20:53:50 [hutals] 4 - 1 = 3....any partial credit

20:53:56 [jwls29] lol

20:54:08 [jwls29] and type I is a hypersensitivity reaction

20:54:13 [Lorena] lol

20:54:54 [Lorena] yes, in interstitial nephritis you have eosinophilia too (type I)

20:55:27 [hutals] what is the MCC of neprotic syndrome in adults? what about in children?

20:55:50 [Lorena] it is not dependent of dose because it is an allergic reaction

20:56:44 [Lorena] minimal change in children , in adults is membranous GN

20:56:47 [jwls29] in adults it's diffuse membranous gn

20:56:59 [jwls29] and in kids it's minimal change dx

20:57:58 [ninadnashua] ya

20:58:27 [hutals] adults = membranous GN. children = minimal change disease

20:58:40 [hutals] what about in IV drug users?

20:59:14 [jwls29] focal segmentaal glomerulosclerosis

20:59:36 [jwls29] also the mc in HIV

20:59:37 [Lorena] agree, same in HIV patients

21:00:07 [hutals] IV drug users assoc with focal segmental glomerulosclerosis....also assoc with HIV and renal transplant pts....very good

21:02:25 [hutals] 25 yo man has had type 1 DM for 5 yrs. what is best early indicator for diabetic neuropathy?

21:03:12 [jwls29] do you mean nephropathy?

21:03:12 [hutals] a. albunemia. B HTN. C incr BUN. D inc Cr. E ETI

21:03:20 [hutals] oops E is UTI

21:03:32 [jwls29] a

21:03:58 [hutals] yes, sorry, i meant nephropathy.

21:03:58 [Lorena] for nephropathy?

21:04:09 [ninadnashua] a

21:04:11 [Lorena] agree a

21:04:18 [acestep1] u guys there?

21:04:41 [jwls29] yes

21:04:42 [hutals] yep still here ace

21:04:52 [jwls29] we lost ace

21:05:24 [hutals] yep, everyone is correct. microalbuminuria is first sign of nephropathy (begins after about 10 yrs)

21:05:56 acestep1 enters this room

21:06:29 [hutals] welcome back ace

21:06:39 [acestep1] sorry guys my comp freezes

21:06:55 [acestep1] thnx hutals

21:07:09 [hutals] no prob ace. good to have you back

21:07:28 [acestep1]

21:07:49 [hutals] how to differentiate between prerental azotemia and acute tubular necrosis?

21:09:07 [Lorena] BUN creatinine ratio is > 15:1 in prerenal

21:09:19 [jwls29] by the bun/creatinine raito

21:09:25 [jwls29] agree with lore

21:09:39 [jwls29] and atn ratio is <15/1

21:10:10 [Lorena] in intrinsic renal disease BUN and creatinine are elevated proportionally

21:10:25 [jwls29] agree

21:10:41 [hutals] yep, very good and very high yield concept. it will help you narrow the cause by simply looking at the ratio, regardless of what the actual numbers are

21:11:17 [Lorena] thank you hutals

21:12:22 [hutals] waxy and broad cast are seen in what?

21:12:39 [Lorena] kidney stones what are the nost common ones? radiopaques or radiolucid?

21:13:06 [jwls29] chronic renal failure

21:13:23 dr_mihir_shah enters this room

21:13:45 [Lorena] agree

21:13:47 [hutals] hey dr mihir

21:13:56 dr_mihir_shah exits from this room

21:14:06 [acestep1] radioopaque

21:14:09 [hutals] yep its chronic renal failure....very good

21:14:30 [hutals] i agree with ace, but just a guess

21:15:13 [Lorena] yes , they are radiopaque -made of calcium oxalate

21:15:18 [hutals] calcium is opaque....right?

21:15:38 [Lorena] Mg ammonia and phosphate are also radiopaque

21:15:47 [Lorena] yes hutals

21:16:03 [Lorena] and uric acid stones are radiolucid

21:17:03 [hutals] 60 yo pt smoker presents with flank mass, hematuria, and pain. what should you try to rule out?

21:17:49 [acestep1] ca?

21:18:07 [Lorena] cancer.

21:18:24 [jwls29] cancer

21:18:27 [hutals] what type of Cancer would produce a triad of flank pain, hematuria, and pain?

21:19:00 [ninadnashua] rena

21:19:13 [acestep1] renal carcinoma?

21:19:24 [hutals] the triad describes renal adenocarcinoma which is most commonly caused by smoking...very good

21:19:29 [ninadnashua] clear cell

21:20:30 [acestep1] ty

21:20:34 [hutals] 5 yo male presents with HTN, unilateral palpable mass, hematuria, pain. diagnosis?

21:21:02 [ninadnashua] wilms

21:21:26 [acestep1] nephritic syn. im not sure

21:21:28 [jwls29] wilm's

21:21:46 [Lorena] willms tumor

21:22:10 [hutals] yep, a unilateral mass in a child, especially with blood in urine, is a giveaway for Wilms tumor....very heavily asked. relationship with chrom 11.

21:22:35 [acestep1] k

21:22:57 [hutals] what is a common complication of cylophosphamide? what can you give for this?

21:23:20 [jwls29] hemorrhagic cystitis and you give mesna

21:23:31 [acestep1] cystitis - mesna

21:23:35 [Lorena] cystytis and transitionla carcinoma of the bladder

21:24:01 [hutals] hemorragic cystitis and can give mesna....very good. the other complication is transitional caricoma of bladded, but mesna wont help with that

21:24:22 [acestep1] k

21:25:02 [Lorena] A 55-year-old man complains of dull flank pain for the past month.microscopic hematuria but no proteinuria or glucosuria

21:25:26 [Lorena] Hgb 21.1 g/dL, Hct 63.5%, MCV 94 fL, and platelet count 195,000/microliter. His serum urea nitrogen is 17 mg/dL and creatinine 1.2 mg/dL.

21:26:14 [Lorena] what is the diagnosis?

21:26:45 [acestep1] hey guys i gtg illsee u guys tom . tc

21:26:55 [jwls29] bye ace

21:26:58 [hutals] can it be a UTI?

21:27:04 [hutals] nite ace

21:27:19 [Lorena] bye ace, see you tomorrow

21:27:49 [hutals] maybe prostate cancer??

21:28:48 [Lorena] this one is tricky ...the patient has polycythemia

21:29:25 [jwls29] renal cancer?

21:29:37 [Lorena] hematuria, flank pain + polychytemia?

21:29:51 [Lorena] yes

21:29:52 [docak] adult polycystic

21:30:10 [Lorena] The polycythemia suggests a paraneoplastic syndrome, and a renal cell carcinoma is a likely candidate

21:30:11 [docak] sorry guys my comp froze

21:30:27 [docak] k RCC

21:30:49 [hutals] hmmm....i had just brought that up and forgot already....my short term memory loss

21:31:42 [Lorena] just dont forget to look at all the tests....first i didnt even look at Hb , Hto, etc ...

21:32:00 [jwls29] that was a good question

21:32:08 [hutals] now that i look at it better, the Hg and Hct are way high....missed that one

21:32:22 [hutals] very good question

21:32:48 [jwls29] what is the most common bacteria that causes chronic prostatitis?

21:35:27 [hutals] E coli??

21:35:46 [jwls29] e coli is for acute

21:36:04 [jwls29] there is no bacteria very chronic prostatitis...it's commonly abacterial

21:36:19 [jwls29] sorry...for chronic prostatitis

21:37:40 [hutals] confused about answer?

21:37:53 [Lorena] so no bacteria at all?

21:38:12 [jwls29] lol...sorry...i made that up...there is no bacteria for chronic

21:38:23 [jwls29] just bacteria for acute

21:38:38 [Lorena] ok

21:38:46 [jwls29] chronic is usually abacterial...has no bacteria

21:38:58 [hutals] ah....my brain cells were looking in the deepest corner of my brain for an answer but came up with nothing

21:39:05 [jwls29] lol

21:39:24 [jwls29] i wanted to see what answers i got...if everyone would just give me a bug

21:39:26 [Lorena] i was dying //lol

21:39:49 [jwls29] sorry if i confused anyone

21:40:15 [hutals] lol, you got me

21:40:21 [Lorena] good point jwls

21:40:52 [Lorena] another cause of hemorragic cystitis besides cyclophosphamide?

21:42:42 [Lorena] it is adenovirus

21:43:05 [jwls29] good question

21:43:21 [hutals] i couldnt remember that....good one

21:43:49 [hutals] i didnt get past this chapter (actually only half way through it). was there anything else we were supposed to cover besides renal?

21:43:59 [jwls29] female path

21:44:23 [Lorena] STD and female path

21:44:28 [jwls29] female tract

21:44:52 [Lorena] ok lets move on to that

21:44:53 [hutals] want to go through that since we are almost outta time?

21:45:26 [jwls29] ok

21:45:34 [Lorena] ye

21:45:39 [Lorena] s

21:45:54 [hutals] ok....what are the common types of HPV?

21:46:33 [jwls29] 6 and 11 associated with genital warts

21:46:49 [Lorena] 6 and 11 for common warts ; 16, 18 for dysplasia and cervical ca

21:46:55 [jwls29] 16,18,31 assoc with cervical c

21:47:10 [hutals] yep, very good

21:47:32 [hutals] what is the MCC of STDs?

21:47:51 [Lorena] chlamydia t.

21:47:53 [hutals] hint....they cannot make ATP

21:48:01 [jwls29] chlamydia

21:48:28 [hutals] yep, chlamydia is MCC. often associated with GC

21:48:35 [jwls29] when we treat for chlamydia we treat for gonorrhea also

21:48:40 [Lorena] why is it called non specific urethritis?

21:50:27 [hutals] not sure, good question??

21:50:37 [Lorena] because because the standard cultures are negative , "steryle"

21:50:50 [jwls29] me neither

21:51:21 [hutals] interesting....i didnt know that. knew it was called nonspecific, but never knew why

21:51:30 [jwls29] good question

21:52:03 [hutals] which chanchroid causes pain? which is painless?

21:52:04 [Lorena] treatment?

21:52:25 [jwls29] hemophilus ducreyi cause pain

21:52:28 [hutals] erythromycin

21:52:41 [Lorena] h. ducreiyi causes pain , painless is syphillis

21:52:51 [jwls29] and syphyllis doesn't cause pain

21:53:11 [jwls29] you do cry with ducreyi

21:53:15 [hutals] "you do cry" sounds like ducreyi, so that one causes pain and "the other is the other".....very good

21:54:20 [jwls29] what is clear cell adenoca of the vagina associated with?

21:54:33 [Lorena] treatment for h ducreiyi?

21:54:56 [hutals] DES exposure??

21:55:04 [Lorena] dietylbestrol

21:55:17 [jwls29] yes

21:55:28 [hutals] ceftriaxone

21:56:37 [jwls29] what is rokitansky kuster hauser sdme?

21:56:48 [Lorena] very good

21:58:10 [hutals] short or nonexistent vagina, no cervix, and a partial or absent uterus

21:58:14 [jwls29] rkh is absencoe of the vagina and the uterus

21:58:27 [Lorena] ok

21:58:40 [jwls29] mullerian agenesis

21:59:44 [Lorena] thanx

22:00:00 [hutals] sorry guys, i dont have any questions prepared because i didnt go over this chapter yet

22:00:14 [jwls29] that's ok

22:01:13 [Lorena] MC COD in cervical cancer?

22:01:15 [hutals] pregnant pt has HTN, proteinuria, pitting edema. diagnosis?

22:01:38 [Lorena] pre eclampsia

22:01:57 [jwls29] agree

22:02:21 [hutals] oliguria from obstruction??

22:02:59 [Lorena] yes hutals.... renal failure

22:03:16 [hutals] yep, pre eclampsia. but an important part of question would be the trimester because if in 1st trimester, think of hydrtidiform mole

22:03:21 [Lorena] very good

22:03:26 [jwls29] how can you tell the difference between a hypothalamic pituitary problem, a primary ovarian problem and an end organ defect in regards to FSH/LH?

22:04:59 [Lorena] hypothalamic FSH/LH would be decreased ; ovarian would be increased .......

22:05:01 [hutals] ovarian would have LH/FSH >3/1

22:05:48 [hutals] nope, sorry....that was polycystic ovary...oops

22:06:04 [jwls29] and end organ defect FSH/LH would be normal

22:06:11 [Lorena] end organ i guess normal? but not sure

22:06:12 [jwls29] very good

22:06:27 [Lorena] ok

22:06:50 [jwls29] what is the mcc of secondary amenorrhea?

22:07:00 [Lorena] pregnancy

22:07:03 [hutals] pregnancy

22:07:20 [jwls29] no, that's primary amenorrhea

22:08:02 [jwls29] no no you are right

22:08:14 [jwls29] sorry

22:08:41 [hutals] no prob

22:08:47 [jwls29] ok what i meant was second mcc of secondary amenorrhea?

22:08:51 [Lorena] ok

22:08:52 [hutals] what is MCC of ectopic pregnancy?

22:09:33 [hutals] i would be thinking something like stress, anorexia or something like that

22:09:44 [jwls29] a prior ectopic pregnancy

22:09:59 [Lorena] PID

22:10:06 [jwls29] the second mcc of secondary amenorrhea is endometriosis

22:10:31 [Lorena] thanx jwls

22:10:45 [hutals] good point jwls, hadnt thought about that.

22:10:48 [jwls29] lorena is right

22:10:56 [jwls29] it's PID

22:11:04 [hutals] the MCC of ectopic preg is previous PID

22:11:26 [jwls29] he said a sure way to tell if they have endometriosis is by asking them if it hurts to defecate when they have their period

22:11:35 [ninadnashua] endometriosis causes dysmenorrhoea as given in golijan

22:11:39 [jwls29] if they say yes then ask if it goes away after their period

22:12:01 [Lorena] i didnt know it causes amenorrhea

22:12:04 [ninadnashua] not amenorrhoea

22:12:41 [jwls29] i'm sorry that's what i meant

22:12:49 [jwls29] i guess it's time for bed for me

22:12:59 [hutals] endometriosis causes post menopausal bleeding i think

22:13:13 [jwls29] no

22:13:28 [jwls29] he said endometriosis goes away once they are menopausal

22:13:30 [Lorena] ok jwls, got confused

22:14:08 [ninadnashua] endometrial ca is cause of postmenopausal bleeding

22:14:19 [hutals] nevermind, its endometrial ca that causes post menopausal bleeding

22:14:24 [jwls29] yeah the cancer but not the endometriosis

22:14:36 [hutals] i think we are all a bit tired

22:14:46 [jwls29] lol

22:14:53 [jwls29] i'm usually very good at gyn

22:15:00 [jwls29] renal has me flustered

22:15:26 [jwls29] we should go over the ovarian tumors

22:15:32 [Lorena] you are good

22:15:57 [jwls29] i will read from notes and not try to remember

22:16:07 [Lorena] ok, those are hard so it is good to review them ...there are so many

22:16:18 [hutals] i agree, we are just making minor spelling mistakes and stuff because its late....but you know your stuff well

22:16:18 [jwls29] yes

22:16:30 [jwls29] thank you

22:16:48 [jwls29] mc overall benign tumor of the ovary?

22:17:15 [Lorena] cystadenoma?

22:17:36 [jwls29] yes...serous cystadenoma

22:17:51 [hutals] serous cystadenoma

22:17:51 [jwls29] mc ovarian cancer with psammoma bodies?

22:17:59 [Lorena] and maligant is cystadenoacarcinoma....right?

22:18:12 [hutals] serous cystadenocarcinoma

22:18:21 [jwls29] yes...and that's the one with the psammoma bodies

22:18:30 [Lorena] agree

22:18:36 [jwls29] largest ovarian tumor?

22:18:53 [Lorena] mucionous

22:19:24 [jwls29] yes...mucinous cystadenoca

22:19:46 [Lorena] what are most commonly bilateral?

22:19:52 [jwls29] increased AFP in this tumor?

22:19:59 [hutals] mucinous cystadenocarcinoma

22:20:35 [hutals] increased AFP in yolk sac tumor

22:20:54 [jwls29] serous cystadenoma mc bilateral

22:20:56 [Lorena] agree

22:21:02 [hutals] serous cystadenoma bilat

22:21:05 [jwls29] yes hutals and lore...good

22:21:36 [jwls29] xray shows calcification of this tumor?

22:21:46 [Lorena] schiller duval bodies...where?

22:21:46 [hutals] i'm concentrating on my spelling now because they are all very similar

22:22:33 [hutals] cystic teratoma for calcifications

22:22:41 [Lorena] teratoma probably?

22:22:51 [jwls29] yes

22:23:06 [jwls29] trying to remember where those bodies are?

22:23:43 [Lorena] yolk sac

22:24:00 [hutals] endodermal sinus tumours

22:24:42 [hutals] those bodies are seen in yolk sac....or was that the answer for something else?

22:25:08 [Lorena] thats right , seen in yolk sac

22:25:17 [jwls29] that's right hutals

22:25:19 [hutals] thanks

22:25:35 [jwls29] call exner bodies

22:26:17 [jwls29] seen where?

22:26:31 [Lorena] granulosa

22:26:38 [hutals] Granulosa Cell Tumor??

22:26:50 [jwls29] yes

22:27:12 [jwls29] benign masculinizing tumor?

22:27:26 [Lorena] tumors that secrete hormons.name them

22:27:36 [hutals] which is painful bleeding and which is painless? placenta previa vs abruptio placenta?

22:27:51 [hutals] prolactinoma

22:28:04 [hutals] ovarian??

22:28:12 [Lorena] placenta previa is painless, abruptio is with pain

22:28:26 [Lorena] sorry hutals, i meant ovarian

22:28:41 [jwls29] agree with lore

22:28:43 [Lorena] good to remember though , thanx

22:29:20 [Lorena] sertoly laydi are masculinizing

22:29:36 [jwls29] yes lorena

22:30:21 [jwls29] difference between complete mole and partial mole?

22:30:30 [hutals] yep, painless is placenta previa and painful is abrupto

22:30:35 [Lorena] the ones that produce hormones are sex cord tumors : sertoli leydig, granulosa, thecoma

22:31:41 [hutals] complete is 46 XX and from paternal. parial is 69 XXY from both parents

22:31:54 [Lorena] granulosa and thecoma produce strogens so they are feminizing , and leydi sertoli produce testosterone so masculinizing

22:32:00 [jwls29] ok

22:32:16 [jwls29] which has a fetus and which doesn't?

22:32:17 [Lorena] agree

22:32:42 [jwls29] and which one is associated with choriocarcinoma?

22:35:47 [jwls29] partial has an embryo and complete doesn't

22:36:17 [jwls29] and choriocarcinoma is associated with complete mole

22:36:59 hutals enters this room

22:37:41 [jwls29] apparently this froze and kicked everyone out

22:38:07 [hutals] still there? the computer froze

22:38:20 [jwls29] hutals are you rther?

22:38:30 [jwls29] yes

22:38:33 [Lorena] hi

22:38:40 [Lorena] my computer froze too

22:38:48 [hutals] i guess that was our cue to call it a night??

22:38:55 [jwls29] lol

22:39:00 [jwls29] i guess

22:39:06 [Lorena] yes

22:39:30 [hutals] does anyone have the whole transcript?

22:39:30 [Lorena] before we go , hutals i dont remember...are we going to have a week break?

22:39:36 [jwls29] everyone else got kicked out

22:39:59 [Lorena] i have the transcript, i will post it

22:40:21 [hutals] i haven't even thought about it. maybe it would be good to take our break during thansgiving instead

22:40:31 [Lorena] i would prefer if we dont have a break

22:40:43 [jwls29] i would prefer no break too

22:40:45 [Lorena] good idea

22:40:57 [jwls29] my test is soon and i need all the help i can get

22:41:00 [Lorena] thanks giving is a good time for a break , but not now

22:41:09 [Lorena] same here

22:41:14 [jwls29] agree

22:41:41 [hutals] so we'll go on with biochem right after next week

22:42:01 [Lorena] cool

22:42:15 [jwls29] yes right after pharm

22:42:24 [jwls29] thanks, i appreciate it

22:42:40 [hutals] ok, nite everyone....c ya all tomorrow

22:42:44 [Lorena] ok, i better get going, it was an excellent chat guys thank you!

22:42:53 [jwls29] what are tomorrow's subjects?

22:43:21 [Lorena] endocrine and muscoloskeletal

22:43:38 [jwls29] ok

22:43:46 [jwls29] goodnite...great chat

22:43:50 ninadnashua enters this room

22:44:08 [Lorena] see you tomorrow, thanks hutals for the schedule

22:44:31 [jwls29] goodnite nina

22:44:37 [Lorena] i will post trranscript now

22:44:45 [hutals] no prob. nite.

22:44:59 [jwls29] bye

22:44:59 [ninadnashua] --------------goodnight

22:45:11 [Lorena] hi nina, we got server problems i guess , you werre not the only one who got disconnected

22:45:17 hutals exits from this room

22:45:26 [ninadnashua] ya

22:45:48 [ninadnashua] anyways i will check transcript

22:46:12 [Lorena] ok byeee

22:46:22 [ninadnashua] byeeeeeeeeeeeee