chat transcript goljans path (skin and cns)

[Anonymous]

20:06:35 [hutals] we'll start with skin and then cns

20:07:18 [ninadnashua] ok

20:07:20 [BlakeH] Silver scaling of the skin + pinpoint bleeding?????

20:08:13 [hutals] silver scaling sounds like psoriasis....but not sure about the bleeding

20:08:32 [ninadnashua] ya

20:08:40 [BlakeH] right , thats the auspitz sign

20:08:40 [ninadnashua] auspitz sign

20:08:44 [hutals] ah yes, auspitz sign

20:08:47 kmonica26 enters this room

20:08:53 Lorena enters this room

20:09:05 [BlakeH] it also has munro abcess

20:09:10 [hutals] hey mon and lor

20:09:22 [kmonica26] hi guys

20:09:26 [BlakeH] hello

20:09:33 [Lorena] hi guys, i just came to ask you in you want to come on sunday to discuss what we didnt finish?

20:09:53 [Lorena] i can't stay today

20:10:15 [hutals] that would be ok with me....what time?

20:10:30 [Lorena] same time?

20:10:58 [hutals] ok, what topics from golijan?

20:11:06 [ninadnashua] ya what abt saturday

20:11:24 [BlakeH] and that will be what topics??

20:11:30 [Lorena] we didnt discuss HIV, cardio, resp, breast pathology...

20:12:09 [Lorena] saturday or sunday ...whenever you prefer , i can both days:jwls told me she can only on sunday

20:12:30 [ninadnashua] ok sunday

20:12:33 [ninadnashua] better

20:12:41 [hutals] wow....thats alot to cover....we'll just hit the high yield points. i'm not sure i can make it sat night, but i will try. i can definitely make it sunday.

20:13:19 [Lorena] great! and we will continue with the schedule on monday (pharma)

20:13:32 [ninadnashua] ok

20:13:45 [hutals] sounds great lor

20:13:47 [Lorena] ok, have a great chat, i will read the transcript later . byeeee

20:14:03 [hutals] bye

20:14:12 [ninadnashua] byeeeeeee

20:14:18 [hutals] what type of Ab involved in atopic dermatitis?

20:14:33 [kmonica26] ig E

20:14:41 [ninadnashua] type 1 ig e

20:14:50 [kmonica26] You are examining a 6-month-old boy who has infantile spasms. There is a family history of tuberous sclerosis.

20:15:02 [BlakeH] IgE?

20:15:04 [kmonica26] Of the following, the cutaneous finding MOST likely to be present in this infant is

20:15:08 [hutals] yep IgE type ! hypersensitivity reaction....good

20:15:16 [kmonica26] A. adenoma sebaceum

20:15:26 [kmonica26] B. ash-leaf macule

20:15:43 [kmonica26] C. forehead plaque

20:15:49 [kmonica26] D. periungual fibroma

20:15:59 [kmonica26] E. shagreen patch

20:16:00 [ninadnashua] cause of seborrhoeic dermatitis

20:16:10 [BlakeH] a

20:16:14 [ninadnashua] shagreen patch

20:16:16 [hutals] A

20:16:47 [kmonica26] its a 6 month old so have to be careful,

20:17:02 [kmonica26] what is the sign which appears first

20:17:18 [kmonica26] A is usually seen in adolescent yrs

20:18:07 [hutals] i didnt know it was only adolscent....interesting

20:18:11 [kmonica26] answer is B The most commonly observed and the earliest lesions to appear are hypopigmented macules which are often present at birth.

20:18:27 [BlakeH] ok

20:18:40 [ninadnashua] ya

20:18:41 [kmonica26] Adenoma sebaceum are benign tumors (angiofibromas) that begin to appear in childhood or adolescence.

20:18:43 [hutals] i didnt know that....good one.

20:18:48 [BlakeH] pautrier microabscesses???

20:19:44 [hutals] seen in in mycosis fungoides

20:19:51 [BlakeH] right

20:20:31 [BlakeH] differences between pemphigus vulgaris and bullous pemphigoid???

20:20:41 [hutals] sample pic here http://tray.dermatology.uiowa.edu/DPT/Hist/MF-002.jpg

20:21:27 [hutals] pemphigous gets bigger, bullous doesnt

20:21:29 [BlakeH] also dermal cells with cerebriform nuclei

20:21:47 [BlakeH] antibodies???

20:22:01 [hutals] pos nikolsky sign in pemphigous and neg in bullous

20:22:33 [BlakeH] PV has anti-desmosomes ,,,BP has anti basement memn

20:22:41 [BlakeH] right hutals

20:22:43 [hutals] vesicles are intradermal in permphigus, but not bullous

20:23:05 [BlakeH] right

20:23:20 [hutals] good points blake

20:24:02 [BlakeH] Guy with anti- gliadin antibodies is at risk of developing what skin lesion????

20:24:25 [BlakeH] and what u see histologically???

20:24:33 [hutals] dermatitis herpetiformis

20:25:32 [hutals] subepidermal vesicles??

20:25:55 [BlakeH] right plus Microabscesses + IgA deposits at the tip of papillae

20:26:38 [hutals] what else (GI) will be seen with that?

20:27:05 [kmonica26] celiac ds

20:27:10 [BlakeH] Atrophy of villi????

20:27:22 [ninadnashua] celiac d

20:27:53 [hutals] yep, celiac disease and atrophy of villi in duodenum

20:28:07 [hutals] just reviewing from GI

20:28:31 [hutals] what has herald patch and christmas tree distribution?

20:29:06 [ninadnashua] pitryasis rosa

20:29:14 [BlakeH] pitiriasis rosae

20:29:16 [kmonica26] p rosea

20:29:41 [kmonica26] An adolescent is concerned about areas of discolored skin that he has had for the past 2 months. Physical examination reveals numerous hypopigmented scaling macules on his chest and back. In some areas, the macules have coalesced into hypopigmented patches.

20:29:56 [kmonica26] the MOST likely explanation for these findings is

20:29:57 [hutals] yep, pityriasis rosea

20:30:09 [kmonica26] A. pityriasis alba

20:30:22 [kmonica26] B. pityriasis rosea

20:30:36 [kmonica26] C. tinea corporis

20:30:47 [kmonica26] D. tinea versicolor

20:31:01 [kmonica26] E. vitiligo

20:31:11 [BlakeH] e

20:31:23 [BlakeH] oh no wait

20:32:01 [BlakeH] that scaling doesnt go wit vitiligo

20:32:10 [kmonica26] yep

20:32:15 [hutals] wel, versicolor are sunspots with hyper and hypo pigmentation....but probably not for 2 months

20:32:16 [ninadnashua] ya

20:32:49 [hutals] the vitiligo will be just hypopigmentation and can be assoc with hypothyroid

20:33:21 [BlakeH] graves and addison

20:33:33 [BlakeH] what was the answ kmon???

20:33:47 [kmonica26] answer is D Tinea versicolor occurs most commonly in adolescents and young adults and typically involves the chest, back, neck, upper arms, and occasionally the groin. Lesions may be hypo- or hyperpigmented and usually possess a fine, powdery scale.

20:34:16 [BlakeH] thxs

20:34:23 [kmonica26] np

20:34:27 [ninadnashua] k

20:34:34 [hutals] it would last 2 months

20:34:35 [BlakeH] leser trelat sign???

20:34:37 [hutals] ??

20:34:54 [kmonica26] i know it can last for a long time

20:35:25 [hutals] i guess if left untreated and more exposure to sun, it can probably continue or worsen

20:35:29 [hutals] interesting

20:35:34 [kmonica26] correct

20:37:25 [hutals] what is the MC malignant tumor of skin?

20:37:31 [BlakeH] leser-trelat is associated with malignancy and are multiple seborrheic keratosis

20:37:53 [kmonica26] eruption of multiple seborrheic keratoses caused by a malignancy

20:37:54 [hutals] hint: pearly papules, do not metatasize, upper lip

20:38:24 [kmonica26] squamous?

20:38:25 [BlakeH] BCC

20:38:45 [kmonica26] i guess basal

20:39:08 [ninadnashua] ya basa

20:39:11 [BlakeH] also with palisade arrangement

20:39:16 [hutals] remember "** coming from you lips" (top to bottom, so Basal upper and Squamous lower lip)

20:39:37 [hutals] the most common is BCC

20:39:45 [kmonica26] thx

20:39:56 [BlakeH] nice one

20:40:23 [BlakeH] premalignant lesion of SCC????

20:41:02 [BlakeH] looks like a sand paper rash

20:41:18 [kmonica26] actinic keratosis?

20:41:32 [BlakeH] right

20:41:50 [hutals] Actinic Keratosis

20:42:01 [hutals] oops, too late

20:42:09 [BlakeH] hyperpigm and acanthosis of flexural areas????

20:42:43 [hutals] is that acanthosis nigricans??

20:43:05 [BlakeH] right

20:43:13 [kmonica26] A 10-month-old African-American infant has a 4-month history of a pruritic, relapsing skin eruption. Physical examination reveals slightly erythematous, chapped-appearing patches on the cheeks and hypopigmented patches on the trunk. Gray, slightly scaling patches appear on extensor surfaces of the

20:43:33 [kmonica26] of the extremities. The scalp and diaper area are spared.

20:43:49 [kmonica26] MOST likely explanation for these findings is

20:44:06 [kmonica26] A. atopic dermatitis

20:44:19 [kmonica26] B. contact dermatitis

20:44:34 [kmonica26] C. psoriasis

20:44:46 [kmonica26] D. scabies

20:44:59 [kmonica26] E. seborrheic dermatitis

20:45:10 [ninadnashua] atopic

20:45:17 [hutals] atopic dermatitis

20:45:29 [kmonica26] correct nina hutals

20:45:44 [BlakeH] port wine stain of face, ipsilat glaucoma and multiple hemagiomas in meninges????

20:46:00 [kmonica26] sturge webers

20:46:15 [BlakeH] right

20:46:17 [ninadnashua] ya

20:46:17 [hutals] agree

20:46:56 [hutals] what is the most important prognostic factor in malignant melanoma?

20:47:26 [BlakeH] growth

20:47:38 [BlakeH] vertical has poorer Px

20:47:40 nne enters this room

20:48:15 [kmonica26] depth of invasion

20:48:50 [hutals] well, lets go through the ABCD....Asymetrical, irregular Border, Color change, forgot what D is....i hope depth, because thats the correct answer

20:49:10 [BlakeH] ok

20:49:23 [BlakeH] nodular has porrest Px

20:49:29 [hutals] saw that one twice on q bank

20:49:30 [BlakeH] poorest

20:50:03 [kmonica26] Of the following, the cutaneous finding that MOST warrants an immediate skin biopsy to exclude malignant changes is

20:50:14 [hutals] what is the most common type of malignant melanoma?

20:50:18 [kmonica26] A. a new round 2 mm brown mole on the back

20:50:29 [BlakeH] superficial

20:50:37 [kmonica26] B. a new round 4 mm red papule on the cheek

20:50:47 [hutals] yep superficial spreading

20:50:51 [kmonica26] C. an 8 mm mole with a firm nodule on one side

20:51:04 [kmonica26] D. bleeding and crusting of a repeatedly traumatized 3 mm mole

20:52:10 [hutals] there isn't a choice E i guess

20:52:19 [BlakeH] lol

20:52:39 [hutals] of those i would guess C i think

20:52:46 [BlakeH] c

20:52:50 [kmonica26] correct

20:53:23 [BlakeH] factors assoc wit SCC???

20:53:24 [kmonica26] Diameter greater than 6 mm in an acquired mole require further evaluation.

20:54:27 [hutals] also with depth greater than 1.7 mm

20:55:15 [hutals] what type of factors are you looking for?

20:55:30 [hutals] risk factors?

20:55:34 [BlakeH] predisponents

20:56:09 [hutals] arsenic, drugs that supress immune system

20:56:32 [hutals] i think sun exposure for all skin cancers

20:56:42 [hutals] radiation exposure

20:57:02 [BlakeH] also burns and xeroderma pigmentosum

20:58:02 [hutals] this one got me today on q bank.....what is the chance of developing skin cancer in ones lifetime?

20:58:32 [hutals] 1 in 25, 1 in 50, 1 in 70, 1 in 250, 1 in 1400?

20:58:49 [BlakeH] lol

20:58:59 ymunoz enters this room

20:59:10 [BlakeH] 1/1400???

20:59:23 [hutals] hey ymunoz

20:59:45 [ymunoz] hi

21:00:30 [hutals] thats what i thought...i cant be that common...right.... the answer was 1 in 70! docs detect it much earlier so highly documented, plus thinning ozone

21:02:07 [ymunoz] don't mean to interrupt but wondered what the discussion was about

21:02:34 [BlakeH] i have to go, guys...cya tomorrow

21:02:42 [hutals] a 52 yo man with congestive heart failure develops cough and swelling in the deep subcutaneous tissue....most likely taking what drug?

21:03:12 [ymunoz] ace inhb

21:03:24 [hutals] skin and cns path by jloijan

21:03:35 [hutals] sorry, golijan


21:03:57 [hutals] bye blake, c ya tomorrow

21:03:59 [ymunoz] gotcha

21:04:16 [hutals] yep, ace inhibitors is right....good job

21:04:53 hutals exits from this room

21:05:05 hutals enters this room

21:05:06 >[hutals] Welcome to our chat. Please obey the net etiquette while chatting: try to be pleasant and polite.

21:05:33 [hutals] oops, fell through that door again:lol;

21:06:19 [hutals] the most common fungal cause of tinea capitis with a negative woods lamp is?

21:07:09 [kmonica26] trichophyton?

21:08:02 [hutals] yep, trichophyton tonsurans is neg woods and M canis is positive woods

21:09:05 [hutals] a 43 yo woman has joint pains and butterfuly like rash on face. she is most likely taking what drug?

21:09:30 [kmonica26] procainamide

21:09:37 [kmonica26] hydralazine

21:10:04 [hutals] drugs that cause SLE like syndrome including butterfly rash on face include procainamide, hydralazine, INH....good

21:11:06 [hutals] sulfasalasine too....this will help with pharm next week too

21:11:24 [kmonica26]

21:11:30 [hutals] ready to move onto cns?

21:12:00 [ymunoz] actaully can I ask a quick q on pharm

21:12:53 [hutals] sure, but we'll be covering next week.....we'll try to answer if we can

21:13:04 ymunoz exits from this room

21:13:15 ymunoz enters this room

21:13:42 [hutals] you slipped through that door too

21:13:52 [ymunoz] yeah sorry

21:14:12 [ymunoz] give me one second to send the Q

21:14:28 [hutals] no prob, i'll be writing the cns question

21:15:24 [hutals] what is more common in a newborn....communicating or noncommunicating hydrocephalus? where is the site of obstruction?

21:16:06 [kmonica26] non communcating

21:16:13 [hutals] hmmmm.....i think i gave it away by saying site of OBSTRUCTION

21:16:15 [kmonica26] F of Munro?

21:16:31 [ninadnashua] nch stricture of aqedust of sylvius

21:17:31 [hutals] yep, if its obstructing, thats what they mean by non communicating....cant communciate from one area to the other. the site is the aqueduct of sylvius

21:17:54 [ymunoz] 37 yr male taking methysergide (prophylactic) for migraine begins experiencing Nausea, Vertigo, ataxia, hair loss fatigue also GI upsetwhich of the following describes LONG term complications Of Methysergide

21:18:50 [ymunoz] A. Perip Ischemia B. Great Vessel Fibrosis C. Pulm Fibrosis D. Pleural Fibrosis E. All f. None

21:20:40 [hutals] i think its pulm fibrosis

21:21:45 [ymunoz] actually all options are correct

21:21:45 [hutals] you'll also have peripheral vasoconstriction, but i dont think it would be enough to cause ischemia

21:22:48 [ymunoz] just wasn't sure where the pleural fibrosis came in...

21:23:20 [hutals] i should have probably known that since it causes fibrosis in many places

21:23:36 [ymunoz] anyways, forgive me please cont. w/ cns

21:23:51 [hutals] Retroperitoneal fibrosis, pulmonary fibrosis, or fibrosis in cardiac tissue can occur

21:24:20 [ymunoz] oh! ok

21:24:53 [hutals] i made the biggest mistake by stopping when i found the first correct answer instead of looking at the "all" option

21:25:40 [hutals] that will be a good one to bring up next week

21:26:03 [ymunoz] I certainly will.....

21:26:29 [ymunoz] got it from a free website

21:26:45 [hutals] really, which one?

21:27:17 [ymunoz] hold on I'll get it and then I promise to stop interrupting

21:27:49 [hutals] you're not interrupting....thats useful info

21:28:31 [hutals] what is MCC of meningitis <1 month old? what about 1 month to 18 yo? what about > 18 yo?

21:28:36 [ymunoz] http://www.blackwellusmle.com 350 free q's

21:29:00 [hutals] oh yes, blackwell has some pretty good questions

21:29:51 [ymunoz] Group B strep <1mos or E.coli

21:31:51 [hutals] so far so good. what about other age groups?

21:32:10 ymunoz exits from this room

21:32:26 [hutals] now that the H flu vaccine is given, that is no longer a big cause of meningitis. Under 1 month is Group B, E coli, then Listeria. 1 month to 18 yo is N Meningitis. >18 yo is strep pneumo

21:32:53 [hutals] anyone else still there?

21:33:37 [ninadnashua] ya me still

21:33:46 [ninadnashua] here

21:34:18 [hutals] did you want to go over anything in particular, or should we call it quits a little early tonight?

21:34:45 [ninadnashua] may be we can discuss

21:35:15 [ninadnashua] for another 1/2 hr

21:35:49 [hutals] ok, we'll try to hit just the high yield stuff

21:36:13 [ninadnashua] ok

21:36:21 [ninadnashua] fine with me

21:37:13 [hutals] pt in accident was unconscious when EMS arrived, but seems fine now. what do you need to rule out?

21:38:02 [ninadnashua] cerebral concussion

21:38:32 [ninadnashua] i think contusions

21:39:05 [hutals] concussion is a possibility, although they might still have confusion afterwards. you need to rule out an acute epidural bleed middle meningeal artery

21:39:16 [ninadnashua] ya i got it

21:40:02 [hutals] this often presents with loss of consciousness, then pt feels fine and wants to go home.....first get that CT without contrast

21:40:29 [ninadnashua] ya

21:41:33 [hutals] what would a venous bleed (common in elderly) be referred to as (arterial would be the epidural)

21:42:06 [ninadnashua] subdural

21:42:27 [hutals] subdural due to tearing of bridging veins. fluctuating levels of consciousness....very good

21:42:39 [ninadnashua] ya

21:42:49 [ninadnashua] ys

21:42:55 [hutals] which one is cns vs pns.....schwann or oligodendrocytes

21:44:07 [ninadnashua] oligoi is cns

21:44:13 [ninadnashua] schwann

21:44:32 [ninadnashua] pns

21:44:38 [hutals] oligo = cns , schwann = pms.....excellent!

21:44:57 [hutals] which ones effected in osmotic damage by diabetes mellitus?

21:45:09 [ninadnashua] shwann

21:45:37 [ninadnashua] oligo is affecrt by viruses

21:45:44 [hutals] yep schwann in the PNS which explains the peripheral neuropahy

21:46:09 [ninadnashua] ya

21:46:27 [hutals] oh, another important cranial hemorage is from rupture of berry aneurysm....what is this called?

21:46:58 [ninadnashua] subarachnoid

21:47:18 [hutals] yep, subarachnoid hemorrhage

21:47:30 [ninadnashua] aca site

21:47:35 [hutals] what is the MC demyelinating disease?

21:47:54 [ninadnashua] ms

21:48:02 [hutals] yep

21:48:39 [hutals] what is MCC of demetia....hint, associated with Downs pts

21:49:02 [ninadnashua] alzeihmers

21:49:23 [hutals] yep....you're doing great!

21:49:40 [ninadnashua] thanks

21:50:24 [hutals] pt has signs of chorea, extrapyramidal signs, dementia. where is the lesion located.?

21:51:13 [ninadnashua] huntingtons, so it is caudate

21:51:33 [ninadnashua] putamen

21:51:38 [hutals] now that i think about it, that wasnt very specific symptoms, but you got it

21:52:12 [ninadnashua] i think chorea so i figure it

21:52:16 [hutals] which is CNS disease that has both UMN and LMN symptoms?

21:53:20 [ninadnashua] amylotropic lateral sclerosis

21:53:36 [hutals] ALS or Lou Gehrig's disease is only one to have both, so it will be given away in the stem depending on signs....very good

21:53:57 [ninadnashua] thanku

21:54:27 [ninadnashua] where do u get mamilary bodies

21:54:43 [hutals] ms

21:55:16 [ninadnashua] i mean haemorrhage with hemosiderin pigmentation in mamilary bodies

21:56:01 [ninadnashua] lewy bodies

21:56:01 [hutals] wernicke's??

21:56:05 [ninadnashua] in ms

21:56:12 [ninadnashua] ya

21:56:36 [hutals] arent lewy bodies in parkinsonism?

21:56:45 [ninadnashua] no

21:57:06 [ninadnashua] ya

21:57:19 [ninadnashua] im sorry i got it wrong

21:57:22 [hutals] i thought that idiopathic parkinsonism had them

21:57:53 [hutals] i got the mamillary bodies wrong at first too (not in MS), so we're even

21:57:56 [ninadnashua] ya

21:58:08 [ninadnashua] i was mistaken

21:58:45 [hutals] i think i was having a little wernicke's myself from the wine i had with dinner last night

21:59:21 [ninadnashua] lol

21:59:43 [hutals] this was a real one. they described pt with low ceruloplasim, kayser fleisher ring (they described them). asked what treatment?

22:00:49 [ninadnashua] i think it is wilsons

22:01:11 [hutals] thats really a pharm question, but i had it written in my notes....but the answer was penicillamine for wilsons disease

22:01:12 [ninadnashua] +

22:01:18 [ninadnashua] encillamine

22:01:33 [ninadnashua] ya

22:01:55 [hutals] another freebie for next weeks pharm

22:03:25 ninadnashua exits from this room

22:03:45 ninadnashua enters this room

22:04:01 [ninadnashua] ya

22:04:11 [hutals] what is the MCC of acute peripheral neuropathy? hint: autoimmune demyelination syndrome with an ascending or descending paralysis?

22:04:13 [ninadnashua] u there

22:04:43 [ninadnashua] gb syndrome

22:04:47 [hutals] yep, looks like you fell thru the door too

22:05:08 [ninadnashua] ya

22:05:16 [hutals] that door looks like a wall....but them poof....ya slip thru

22:05:36 [ninadnashua] yy

22:06:06 [hutals] yep, GB syndrome. i think if it was chronic, DM mellitis would probably be MCC??

22:06:24 [hutals] but not sure about that last part

22:06:27 [ninadnashua] ok

22:07:09 [ninadnashua] cognitive abnormalities ataxia nystagmus opthamlmoplegis footdrop assoc with

22:07:15 [hutals] child often stares blankly into space.....what diagnosis?

22:07:42 [ninadnashua] folate defe ms alzeihmers alcholo parkinsons

22:07:43 [hutals] that sounds like it might be ms??

22:08:12 [ninadnashua] no it is alcohol

22:08:25 [ninadnashua] thiamine with

22:08:34 [hutals] the reason why i went with ms was because of the footdrop

22:08:36 [ninadnashua] wernicke

22:08:46 [ninadnashua] ya

22:09:38 [hutals] i suppose the cognitive part is more associated with wernickes....good point

22:10:15 [hutals] i still dont see how the footdrop would be associated?

22:11:31 [hutals] i always thought the ataxia with that was cerebellar cause

22:11:40 [ninadnashua] ya it is confusing

22:11:47 [hutals] oh well, i'll need to read up on that some more

22:11:54 [hutals] good questions

22:12:30 [hutals] the child staring into space was abscence seizures

22:12:43 [ninadnashua] ya

22:12:48 [ninadnashua] e do we get it

22:12:57 [hutals] treatment would be ethosuximide.....more pharm for next week

22:13:08 [ninadnashua] ya i know

22:13:33 [ninadnashua] i was wondering cause

22:13:58 [hutals] the cause of what?

22:14:17 [ninadnashua] absence seizures

22:14:48 [ninadnashua] i read up on taht

22:15:44 [hutals] yeah, i was looking it up. i will know next time

22:16:13 [ninadnashua] its ok

22:16:26 [ninadnashua] i ll read it in

22:16:33 [ninadnashua] pharma

22:16:49 [hutals] i think we covered all important stuff....anything else?

22:17:11 [ninadnashua] i think most of it we cover

22:18:28 [hutals] ok, thanks for great chat

22:18:37 [hutals] i'll c ya tommorrow

22:18:56 [ninadnashua] ya me too

22:19:00 [ninadnashua] tahnks

22:19:06 [ninadnashua] goodnite

22:19:14 [hutals] ok, good nite

22:19:22 [ninadnashua] will u post transcript i miss some

22:19:36 [hutals] sure, no prob

22:20:04 [ninadnashua] ok good

22:20:14 [ninadnashua] see u then byee

22:20:22 [hutals] bye