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View Full Version : Peds Chat: GI, renal



Asclepius1
02-25-2005, 10:57 AM
02/23/05 19:10:55 [USMLE_Step_2] dua_frank: lets start
02/23/05 19:11:00 [USMLE_Step_2] ash: ok
02/23/05 19:11:18 [USMLE_Step_2] lanny: ride on dua
02/23/05 19:11:18 [USMLE_Step_2] ash: most common cause of abdominal pain?
02/23/05 19:11:34 [USMLE_Step_2] ash: acute
02/23/05 19:11:39 sargum Logs in
02/23/05 19:11:46 [USMLE_Step_2] lanny: gaatroenteritis
02/23/05 19:11:53 [USMLE_Step_2] ash: right lanny
02/23/05 19:12:18 [USMLE_Step_2] samantha: acute gastro enteritis
02/23/05 19:12:18 [USMLE_Step_2] dua_frank: MC esophageal problem during infancy?
02/23/05 19:12:35 [USMLE_Step_2] ash: if the child has abd. pain,constipation,mental changes and peripheral neuropathies?
02/23/05 19:12:49 [USMLE_Step_2] ash: hiatal hernia
02/23/05 19:13:03 [USMLE_Step_2] dua_frank: GER(chalasia)
02/23/05 19:13:12 [USMLE_Step_2] Jee: lead poisoning
02/23/05 19:13:24 [USMLE_Step_2] ash: right gee
02/23/05 19:13:36 [USMLE_Step_2] ash: what will be seen on blood picture?
02/23/05 19:13:52 [USMLE_Step_2] Jee: basophilic stipling
02/23/05 19:13:57 [USMLE_Step_2] ash: and what is the treatment?
02/23/05 19:13:59 [USMLE_Step_2] lanny: basophilic s
02/23/05 19:14:03 [USMLE_Step_2] ash: right again
02/23/05 19:14:20 [USMLE_Step_2] dua_frank: chelation
02/23/05 19:14:33 [USMLE_Step_2] dua_frank: EDTA
02/23/05 19:14:50 [USMLE_Step_2] samantha: EDTA and penicilamine
02/23/05 19:14:52 [USMLE_Step_2] ash: right dua
02/23/05 19:14:59 [USMLE_Step_2] ash: and samantha
02/23/05 19:15:04 [USMLE_Step_2] dua_frank: what kind of metabolic abnormality in GER?
02/23/05 19:15:16 fero Logs in
02/23/05 19:15:17 fero Joins Subroom USMLE_Step_2
02/23/05 19:15:41 [USMLE_Step_2] samantha: is it GERD?
02/23/05 19:15:46 [USMLE_Step_2] dua_frank: yes
02/23/05 19:15:48 [USMLE_Step_2] ash: child with abdominal pain,rash over buttocks which is palpable.diagnosis?
02/23/05 19:16:01 [USMLE_Step_2] lanny: metabolic alkalosis
02/23/05 19:16:25 [USMLE_Step_2] samantha: henock scholein
02/23/05 19:16:25 [USMLE_Step_2] dua_frank: right lanny, hypochlroremic hypokalemic MALK
02/23/05 19:16:32 [USMLE_Step_2] dua_frank: HSP
02/23/05 19:16:35 [USMLE_Step_2] ash: hypokalemic,hypochloremic
02/23/05 19:16:37 [USMLE_Step_2] Jee: Henoch Schonlein purpura
02/23/05 19:16:40 [USMLE_Step_2] dua_frank: good ash
02/23/05 19:16:43 [USMLE_Step_2] ash: metab.alkalosis
02/23/05 19:17:02 [USMLE_Step_2] ash: right samantha and dua
02/23/05 19:17:03 [USMLE_Step_2] dua_frank: DX?
02/23/05 19:17:07 [USMLE_Step_2] ash: and jee
02/23/05 19:17:24 shreya Logs in
02/23/05 19:17:40 shreya Joins Subroom USMLE_Step_2
02/23/05 19:17:43 [USMLE_Step_2] ash: dua dx of?
02/23/05 19:17:49 [USMLE_Step_2] dua_frank: GERD
02/23/05 19:17:52 [USMLE_Step_2] dua_frank: how do you diag?
02/23/05 19:18:04 [USMLE_Step_2] lanny: PH probe
02/23/05 19:18:10 [USMLE_Step_2] ash: oh
02/23/05 19:18:11 [USMLE_Step_2] fero: 24 hrph
02/23/05 19:18:21 [USMLE_Step_2] ash: the gold std.is 24 hr. ph
02/23/05 19:18:22 [USMLE_Step_2] Jee: esophageal manometry
02/23/05 19:18:24 [USMLE_Step_2] dua_frank: thats one yes
02/23/05 19:18:31 [USMLE_Step_2] dua_frank: most sensitive test is?
02/23/05 19:19:13 [USMLE_Step_2] lanny: i thought ph probe is the diag for
02/23/05 19:19:18 [USMLE_Step_2] lanny: GERD
02/23/05 19:19:29 [USMLE_Step_2] dua_frank: it is but the most sensitive test is technetium scan
02/23/05 19:19:37 megs Logs in
02/23/05 19:19:39 megs Joins Subroom USMLE_Step_2
02/23/05 19:19:41 [USMLE_Step_2] ash: oh i didnt know that
02/23/05 19:19:41 [USMLE_Step_2] lanny: cause gastric acid lowers ph in loser esoph
02/23/05 19:19:47 [USMLE_Step_2] dua_frank: other tests are barrium swollow and upper GI xrat
02/23/05 19:19:49 [USMLE_Step_2] dua_frank: ray
02/23/05 19:19:50 [USMLE_Step_2] ash: for kids milk tec.scan
02/23/05 19:20:00 [USMLE_Step_2] megs: hi all
02/23/05 19:20:05 [USMLE_Step_2] dua_frank: hi megs
02/23/05 19:20:11 [USMLE_Step_2] ash: hi megs
02/23/05 19:20:17 [USMLE_Step_2] megs: whats going on pals
02/23/05 19:20:20 [USMLE_Step_2] lanny: hello megs
02/23/05 19:20:36 [USMLE_Step_2] lanny: going with the flow....
02/23/05 19:20:42 [USMLE_Step_2] dua_frank: what drugs increase LES tone and relieve GERD?
02/23/05 19:20:51 [USMLE_Step_2] dua_frank: GE and renal today megs
02/23/05 19:20:53 [USMLE_Step_2] fero: nitrates
02/23/05 19:20:59 [USMLE_Step_2] megs: yup dua
02/23/05 19:21:11 [USMLE_Step_2] samantha: ca channel blockers
02/23/05 19:21:16 [USMLE_Step_2] shreya: agree
02/23/05 19:21:16 [USMLE_Step_2] megs: metoclorpropamide dua
02/23/05 19:21:19 [USMLE_Step_2] Jee: metclopromdie
02/23/05 19:21:22 [USMLE_Step_2] dua_frank: right megs and jee
02/23/05 19:21:24 [USMLE_Step_2] megs: cisapride
02/23/05 19:21:30 [USMLE_Step_2] dua_frank: also bethanechol and cisapride
02/23/05 19:21:35 [USMLE_Step_2] megs: yup
02/23/05 19:21:37 [USMLE_Step_2] ash: domperidone
02/23/05 19:22:16 [USMLE_Step_2] dua_frank: if such a child is not responding to meds, you go surgery, what happens if you do not do surgery?
02/23/05 19:22:45 [USMLE_Step_2] ash: dangerous side effect of cisapride?
02/23/05 19:22:47 [USMLE_Step_2] shreya: stricture.
02/23/05 19:22:55 [USMLE_Step_2] fero: torsades
02/23/05 19:22:57 [USMLE_Step_2] megs: what metabolic derrangements dua,hypocloremic acidosis hypokalemai
02/23/05 19:23:03 [USMLE_Step_2] dua_frank: yes megs
02/23/05 19:23:08 [USMLE_Step_2] shreya: barrets eso
02/23/05 19:23:08 [USMLE_Step_2] lanny: predispose to barrets
02/23/05 19:23:14 [USMLE_Step_2] ash: right fero .so it is not used in usa
02/23/05 19:23:14 [USMLE_Step_2] dua_frank: what happens is brain damage
02/23/05 19:23:18 [USMLE_Step_2] fero: prolongation of QT
02/23/05 19:23:36 [USMLE_Step_2] lanny: can you explain dua
02/23/05 19:23:50 [USMLE_Step_2] megs: how brain damage
02/23/05 19:23:57 [USMLE_Step_2] dua_frank: whats the name of the surgery where a part of the gastric fundus is wrapped around the distal esophagus to create a high pressure zone?
02/23/05 19:24:11 [USMLE_Step_2] dua_frank: guys MALK can cause brain damage in kids
02/23/05 19:24:12 [USMLE_Step_2] ash: nissans
02/23/05 19:24:14 [USMLE_Step_2] fero: nissen fundaplication
02/23/05 19:24:15 [USMLE_Step_2] samantha: nissen fundoplication'
02/23/05 19:24:15 [USMLE_Step_2] lanny: nissse n fundoplication
02/23/05 19:24:18 [USMLE_Step_2] megs: nissan s fundoplication
02/23/05 19:24:21 [USMLE_Step_2] dua_frank: right right right
02/23/05 19:24:29 [USMLE_Step_2] dua_frank: man you guys bombarded me with that answer
02/23/05 19:24:30 [USMLE_Step_2] lanny: yes dua
02/23/05 19:24:40 [USMLE_Step_2] lanny: cause its easy lol
02/23/05 19:24:45 [USMLE_Step_2] dua_frank: lol
02/23/05 19:25:04 [USMLE_Step_2] ash: infant fails to pass meconium on the 1st day.top 3 causes?
02/23/05 19:25:06 [USMLE_Step_2] dua_frank: whats down's synd asso with?
02/23/05 19:25:12 [USMLE_Step_2] megs: ok most common cause for surgery in a child???
02/23/05 19:25:15 [USMLE_Step_2] dua_frank: volvulus
02/23/05 19:25:19 [USMLE_Step_2] megs: duodenal atresia
02/23/05 19:25:21 [USMLE_Step_2] dua_frank: intussesption
02/23/05 19:25:25 [USMLE_Step_2] ash: hirshprungs dua
02/23/05 19:25:27 [USMLE_Step_2] fero: imperforate annus
02/23/05 19:25:29 [USMLE_Step_2] dua_frank: oh
02/23/05 19:25:37 [USMLE_Step_2] dua_frank: yes megs
02/23/05 19:25:43 [USMLE_Step_2] lanny: tough one megs
02/23/05 19:25:57 [USMLE_Step_2] megs: anybody
02/23/05 19:26:05 [USMLE_Step_2] dua_frank: jejunal atresia?
02/23/05 19:26:10 [USMLE_Step_2] ash: pyloric stenosis
02/23/05 19:26:16 [USMLE_Step_2] megs: its appendicitis.
02/23/05 19:26:19 [USMLE_Step_2] dua_frank: yikes
02/23/05 19:26:26 [USMLE_Step_2] ash: *)
02/23/05 19:26:36 [USMLE_Step_2] dua_frank: never even knew kids that young had appendicitis
02/23/05 19:26:48 [USMLE_Step_2] dua_frank: likewise ash *)
02/23/05 19:27:05 [USMLE_Step_2] dua_frank: i thought appendicitis is after 5-6 years
02/23/05 19:27:06 [USMLE_Step_2] ash: top 3 causes-imperforate anus,hirshprungs,cystic fibrosis
02/23/05 19:27:10 [USMLE_Step_2] lanny: duodenal atresia seen most comm in what cong dz
02/23/05 19:27:27 [USMLE_Step_2] ash: downs
02/23/05 19:27:35 [USMLE_Step_2] megs: agree
02/23/05 19:27:45 [USMLE_Step_2] lanny: right trisomy21
02/23/05 19:27:54 [USMLE_Step_2] dua_frank: be right back
02/23/05 19:27:56 [USMLE_Step_2] lanny: ash top 3 causes of surgery?
02/23/05 19:28:02 [USMLE_Step_2] ash: downs also has hirshprungs
02/23/05 19:28:11 [USMLE_Step_2] lanny: yes
02/23/05 19:28:20 [USMLE_Step_2] dua_frank: back
02/23/05 19:28:22 [USMLE_Step_2] fero: Dx of hirshprung?
02/23/05 19:28:41 [USMLE_Step_2] megs: what is comonest cause of constipation in neonate??
02/23/05 19:28:42 [USMLE_Step_2] shreya: ba, swallow.
02/23/05 19:28:48 [USMLE_Step_2] fero: one more?
02/23/05 19:28:57 [USMLE_Step_2] dua_frank: ba meal?
02/23/05 19:29:02 [USMLE_Step_2] megs: rectal mucosal biopsy
02/23/05 19:29:02 [USMLE_Step_2] samantha: volvulus intusseseption and pyloric stenosis?
02/23/05 19:29:03 [USMLE_Step_2] ash: lanny top 3 causes for not passing meconium on the 1st day was the question.ans-cystic fibrosis,hirschprungs and imperforate anus
02/23/05 19:29:15 [USMLE_Step_2] lanny: oh thanks did nt see it
02/23/05 19:29:22 [USMLE_Step_2] ash: yrw
02/23/05 19:29:23 [USMLE_Step_2] fero: ya mes
02/23/05 19:29:28 [USMLE_Step_2] dua_frank: yeah biopsy
02/23/05 19:29:33 [USMLE_Step_2] megs: in neonates its hirshsprung
02/23/05 19:29:51 kmk Logs in
02/23/05 19:29:53 [USMLE_Step_2] lanny: biopst of nerve cells
02/23/05 19:30:02 kmk Joins Subroom USMLE_Step_2
02/23/05 19:30:11 [USMLE_Step_2] megs: after 1 yr functinal or voluntery canstipation commonest
02/23/05 19:30:13 [USMLE_Step_2] dua_frank: so hirsh affects rectum more
02/23/05 19:30:15 [USMLE_Step_2] lanny: ash whats yrw?
02/23/05 19:30:27 [USMLE_Step_2] ash: you are welcome
02/23/05 19:30:28 [USMLE_Step_2] dua_frank: lol lanny
02/23/05 19:30:39 [USMLE_Step_2] ash: :)
02/23/05 19:30:51 [USMLE_Step_2] lanny: boy these abbrevs lol
02/23/05 19:30:58 [USMLE_Step_2] ash: yeah!
02/23/05 19:31:01 [USMLE_Step_2] kmk: hi, are you guys doing pediatrics , may i join in
02/23/05 19:31:15 [USMLE_Step_2] megs: u r welcome kmk
02/23/05 19:31:25 [USMLE_Step_2] lanny: dua its distal colon actuall
02/23/05 19:31:27 [USMLE_Step_2] ash: m.c. cause of nonbilious vomiting at the age of 2 to 4 weeks?
02/23/05 19:31:29 [USMLE_Step_2] megs: git and renal today
02/23/05 19:31:35 [USMLE_Step_2] fero: whats APTS test?
02/23/05 19:31:35 [USMLE_Step_2] ash: hi kmk
02/23/05 19:31:47 [USMLE_Step_2] megs: pyloric stenosis ash
02/23/05 19:31:49 [USMLE_Step_2] fero: apt*
02/23/05 19:31:50 [USMLE_Step_2] kmk: hi, thanks
02/23/05 19:31:52 [USMLE_Step_2] dua_frank: pyl stenosis
02/23/05 19:31:57 [USMLE_Step_2] ash: good megs
02/23/05 19:31:59 [USMLE_Step_2] dua_frank: lanny my book says rectum
02/23/05 19:32:04 [USMLE_Step_2] ash: and dua
02/23/05 19:32:08 [USMLE_Step_2] dua_frank: and that it extends proximally
02/23/05 19:32:40 [USMLE_Step_2] megs: fero apts test to distinguish bet maternal and fetal blod...in case of rectal bleeding
02/23/05 19:32:48 [USMLE_Step_2] dua_frank: whats the clinical picture like in HD?
02/23/05 19:32:49 [USMLE_Step_2] lanny: isnt pyloric stenosis after 1 mth.
02/23/05 19:32:58 [USMLE_Step_2] megs: i too agree with dua
02/23/05 19:33:04 [USMLE_Step_2] ash: :) fero what is the full form of apts?
02/23/05 19:33:12 [USMLE_Step_2] dua_frank: 2-3 weeks is nearly a month lanny
02/23/05 19:33:14 [USMLE_Step_2] lanny: ie 4 wks when the pylorus is strong
02/23/05 19:33:33 [USMLE_Step_2] lanny: think 2 wks is too early
02/23/05 19:33:37 [USMLE_Step_2] fero: donno?
02/23/05 19:34:03 [USMLE_Step_2] ash: well ***** dear thats what k notes say and so does love and bailey
02/23/05 19:34:25 [USMLE_Step_2] dua_frank: constipation
02/23/05 19:34:40 [USMLE_Step_2] kmk: even i was wondering what apts was
02/23/05 19:34:46 [USMLE_Step_2] dua_frank: and you can feel the stool over the abdomen, i mean you can palpate full colon but empty rectum per rectal
02/23/05 19:35:00 [USMLE_Step_2] megs: yup dua
02/23/05 19:35:25 [USMLE_Step_2] dua_frank: PS is from 2 weeks to 2 months anytime lanny
02/23/05 19:35:43 [USMLE_Step_2] lanny: ok dua
02/23/05 19:35:45 [USMLE_Step_2] dua_frank: meckels is symptomatic anytime
02/23/05 19:35:50 [USMLE_Step_2] dua_frank: how about volvulus?
02/23/05 19:36:14 [USMLE_Step_2] megs: what is commonest presentation of meckels???
02/23/05 19:36:33 [USMLE_Step_2] fero: painless bld
02/23/05 19:36:41 [USMLE_Step_2] megs: volvulus during first month dua
02/23/05 19:36:44 [USMLE_Step_2] dua_frank: rectal bleeding
02/23/05 19:36:46 [USMLE_Step_2] shreya: painless rectal bleed.
02/23/05 19:37:00 [USMLE_Step_2] megs: yupp dua shreya correct
02/23/05 19:37:03 [USMLE_Step_2] lanny: dua volvulus is usu in young like under 1 mth not sure exact what age
02/23/05 19:37:05 [USMLE_Step_2] dua_frank: volvulus 6 months
02/23/05 19:37:16 [USMLE_Step_2] megs: agree lanny
02/23/05 19:37:17 [USMLE_Step_2] dua_frank: intusseception?
02/23/05 19:37:21 [USMLE_Step_2] megs: dua r u sure??/
02/23/05 19:37:27 [USMLE_Step_2] ash: this neonate of 4weeks has very small black ,very dry stools and vomiting.he is the first born male in the family.likely diagnosis?
02/23/05 19:38:01 [USMLE_Step_2] lanny: meckels
02/23/05 19:38:06 [USMLE_Step_2] Jee: hps
02/23/05 19:38:16 [USMLE_Step_2] dua_frank: says here 8% manifest in first month
02/23/05 19:38:21 [USMLE_Step_2] ash: why do you see such a high number of patients with volvulus at 6 months of age?
02/23/05 19:38:22 [USMLE_Step_2] dua_frank: so that means majority in 6 months
02/23/05 19:38:32 [USMLE_Step_2] fero: vaccine asso with Intussesception?
02/23/05 19:38:51 [USMLE_Step_2] megs: cystic fibrosis ash
02/23/05 19:38:56 [USMLE_Step_2] shreya: polio??
02/23/05 19:39:17 [USMLE_Step_2] ash: sorry i meant intussusception
02/23/05 19:39:34 [USMLE_Step_2] lanny: yes dunno which vacc though
02/23/05 19:39:47 [USMLE_Step_2] shreya: oral polio vaccine?
02/23/05 19:39:52 [USMLE_Step_2] ash: the male child of 4 weeks has most likely pyloric stenosis
02/23/05 19:39:53 [USMLE_Step_2] fero: infec r vacc with rota virus
02/23/05 19:39:54 [USMLE_Step_2] megs: ash what is the ans to ur q
02/23/05 19:39:54 [USMLE_Step_2] shreya: or typhoid?
02/23/05 19:40:16 [USMLE_Step_2] megs: ok
02/23/05 19:40:35 [USMLE_Step_2] lanny: ash whats the answer
02/23/05 19:41:09 [USMLE_Step_2] ash: intussusception is so commonly seen at 6 months as weaning is usually done at this age and therefore there is a big chance of lymphoid hyperplasia causing it
02/23/05 19:41:41 [USMLE_Step_2] megs: oh...i thought u r telling about volvulus
02/23/05 19:42:01 [USMLE_Step_2] megs: its intusucception
02/23/05 19:42:13 [USMLE_Step_2] megs: :(
02/23/05 19:42:15 [USMLE_Step_2] ash: sorry i wrote the wrong question and then corrected it
02/23/05 19:42:18 [USMLE_Step_2] lanny: fero what vacc is associated?
02/23/05 19:42:24 [USMLE_Step_2] dua_frank: thanks ash
02/23/05 19:42:37 [USMLE_Step_2] fero: rota..i did mention ,lol
02/23/05 19:42:42 [USMLE_Step_2] ash: dua yrw!!!!!!
02/23/05 19:42:59 [USMLE_Step_2] fero: rota virus
02/23/05 19:43:15 [USMLE_Step_2] dua_frank: when does celiac disease manifest?
02/23/05 19:44:13 [USMLE_Step_2] shreya: ash , wht is the ans to ur prev question?, 1st born male
02/23/05 19:44:19 [USMLE_Step_2] ash: claw hand sign is seen on barium enema in?
02/23/05 19:44:37 [USMLE_Step_2] ash: shreya the answer is pyloric stenosis
02/23/05 19:44:49 [USMLE_Step_2] shreya: thanks.
02/23/05 19:44:53 [USMLE_Step_2] megs: when baby starts forming its own antibodies dua :)
02/23/05 19:44:59 [USMLE_Step_2] ash: dua .aftel weaning so after 6 months
02/23/05 19:45:10 [USMLE_Step_2] dua_frank: megs no when baby starts eating wheat :P ten months :P
02/23/05 19:45:21 [USMLE_Step_2] dua_frank: tricky huh :P
02/23/05 19:45:26 [USMLE_Step_2] megs: ok dua
02/23/05 19:45:30 [USMLE_Step_2] megs: nice q
02/23/05 19:45:37 [USMLE_Step_2] lanny: but it can vary
02/23/05 19:45:46 [USMLE_Step_2] dua_frank: yes lanny
02/23/05 19:46:03 [USMLE_Step_2] dua_frank: what are the complications of celiac disease?
02/23/05 19:46:17 [USMLE_Step_2] lanny: best is when consumption of gluten starts hweat barley...
02/23/05 19:46:17 [USMLE_Step_2] fero: vit def
02/23/05 19:46:19 [USMLE_Step_2] megs: malabsorption.
02/23/05 19:46:26 [USMLE_Step_2] lanny: malabs
02/23/05 19:46:27 [USMLE_Step_2] samantha: malabsorption
02/23/05 19:46:38 [USMLE_Step_2] lanny: vit ADEK deficiency
02/23/05 19:46:48 [USMLE_Step_2] dua_frank: those are all clinical features
02/23/05 19:47:08 [USMLE_Step_2] lanny: dermatitis herpitiformis
02/23/05 19:47:11 [USMLE_Step_2] dua_frank: by complications i mean lymphoma, cancer, intestinal ulcers and strictures and dermatitis herpetiformis
02/23/05 19:47:16 [USMLE_Step_2] ash: lymphoma and adenocarcinoma
02/23/05 19:47:17 [USMLE_Step_2] Jee: failure to thrive
02/23/05 19:47:28 [USMLE_Step_2] megs: ok dua
02/23/05 19:47:33 [USMLE_Step_2] dua_frank: how do you diagnose CD?
02/23/05 19:47:50 [USMLE_Step_2] ash: biopsy
02/23/05 19:47:58 [USMLE_Step_2] shreya: ash whts ur ans?
02/23/05 19:48:02 [USMLE_Step_2] dua_frank: good answer but i want to know how exactly do they confirm it?
02/23/05 19:48:09 [USMLE_Step_2] shreya: claw hand sign?
02/23/05 19:48:09 an_bo_al Disconnects
02/23/05 19:48:23 [USMLE_Step_2] ash: destruction of villi and anto endomycial antibodies
02/23/05 19:48:24 [USMLE_Step_2] lanny: stool for fats
02/23/05 19:48:25 [USMLE_Step_2] samantha: barium enema
02/23/05 19:48:27 [USMLE_Step_2] megs: villous atrophy
02/23/05 19:48:27 [USMLE_Step_2] fero: granulomas> transmural inflamm
02/23/05 19:48:53 [USMLE_Step_2] dua_frank: no
02/23/05 19:48:55 [USMLE_Step_2] ash: claw hand sign is seen in intussusception
02/23/05 19:49:06 [USMLE_Step_2] megs: what is that ash???
02/23/05 19:49:10 [USMLE_Step_2] fero: CD,, > u mean crohn r celiac...
02/23/05 19:49:11 [USMLE_Step_2] shreya: thanks.
02/23/05 19:49:16 [USMLE_Step_2] shreya: thanks.
02/23/05 19:49:30 [USMLE_Step_2] samantha: antigliadin antibody test
02/23/05 19:49:32 [USMLE_Step_2] ash: if anyone has read love and bailey for surgery in med school they have a nice xray given
02/23/05 19:49:37 [USMLE_Step_2] dua_frank: do biopsy first, will show atrophya nd all that, then stop gluten and lactose in diet, second biopsy comes normal, start gluten diet again, take biopsy- abnormal
02/23/05 19:49:45 [USMLE_Step_2] megs: ok ash
02/23/05 19:49:46 [USMLE_Step_2] dua_frank: yeah ash, i remember now
02/23/05 19:49:48 [USMLE_Step_2] dua_frank: thanks
02/23/05 19:50:33 [USMLE_Step_2] dua_frank: ofcourse antigliadin antibodies are also confirmatory
02/23/05 19:50:40 [USMLE_Step_2] megs: thanx dua nice to know
02/23/05 19:50:51 [USMLE_Step_2] dua_frank: welcome megs
02/23/05 19:50:58 [USMLE_Step_2] ash: antigliaden antibody is not very sensitive so best is transglutaminase antibody or antiendomycial antibody
02/23/05 19:51:12 [USMLE_Step_2] megs: agree ash
02/23/05 19:51:15 [USMLE_Step_2] kmk: what about D-xylose test?
02/23/05 19:51:30 [USMLE_Step_2] fero: whipples dis??
02/23/05 19:51:48 [USMLE_Step_2] ash: d-xylose only tells you that there is malabsorption not the disease causing it
02/23/05 19:51:56 [USMLE_Step_2] kmk: oh, thanks
02/23/05 19:52:05 [USMLE_Step_2] ash: whipples has pas positive organisms
02/23/05 19:52:06 [USMLE_Step_2] samantha: PAS positive
02/23/05 19:52:26 [USMLE_Step_2] ash: what is the treatment for whipples?
02/23/05 19:52:47 [USMLE_Step_2] fero: Trimeth sulpha
02/23/05 19:52:55 [USMLE_Step_2] megs: trimeth+ sulpha
02/23/05 19:53:03 [USMLE_Step_2] samantha: antibiotics
02/23/05 19:53:17 [USMLE_Step_2] ash: i think tetracycline and metronidazole
02/23/05 19:53:22 [USMLE_Step_2] samantha: because it is caused by tropherima whippeli
02/23/05 19:53:27 [USMLE_Step_2] fero: d-xylose test is also abnormal in whipple
02/23/05 19:54:01 [USMLE_Step_2] ash: what disease can be confused with whipples disease on biopsy ?especially if i say that this patient has aids?
02/23/05 19:54:28 [USMLE_Step_2] dua_frank: crytosporodium?
02/23/05 19:54:36 [USMLE_Step_2] shreya: cryptosporidiosis
02/23/05 19:54:44 [USMLE_Step_2] ash: nope
02/23/05 19:54:50 [USMLE_Step_2] ash: think
02/23/05 19:54:57 [USMLE_Step_2] lanny: gastric lymphoma
02/23/05 19:54:59 [USMLE_Step_2] ash: biopsy
02/23/05 19:55:06 [USMLE_Step_2] ash: nope
02/23/05 19:55:09 [USMLE_Step_2] dua_frank: TB?
02/23/05 19:55:18 [USMLE_Step_2] ash: very good dua
02/23/05 19:55:26 [USMLE_Step_2] ash: causative organism?
02/23/05 19:55:26 [USMLE_Step_2] lanny: oh potts dz
02/23/05 19:55:28 [USMLE_Step_2] dua_frank: wow really? *)
02/23/05 19:55:34 [USMLE_Step_2] dua_frank: wild guess :))
02/23/05 19:55:36 [USMLE_Step_2] dua_frank: lol
02/23/05 19:55:41 [USMLE_Step_2] ash: great guess then
02/23/05 19:55:44 [USMLE_Step_2] megs: mycobact.bovis ash
02/23/05 19:56:19 [USMLE_Step_2] ash: very good megs.but more likely is avium intracellulare
02/23/05 19:56:20 [USMLE_Step_2] dua_frank: diagnosis of carb intolerance?
02/23/05 19:56:32 [USMLE_Step_2] ash: dua d-xylose
02/23/05 19:56:37 [USMLE_Step_2] dua_frank: lanny its potts when it affects the spine
02/23/05 19:57:23 [USMLE_Step_2] dua_frank: how about breath test and stool reducing substance determination?
02/23/05 19:57:54 [USMLE_Step_2] megs: whats that dua
02/23/05 19:58:22 [USMLE_Step_2] dua_frank: dx for carb intolerance
02/23/05 19:58:28 [USMLE_Step_2] ash: there are a lot of other reducing substances so not specific
02/23/05 19:58:31 [USMLE_Step_2] shreya: reducing subst in stool
02/23/05 19:58:34 [USMLE_Step_2] dua_frank: i always though d xylose test was for adults
02/23/05 19:58:41 [USMLE_Step_2] ash: eg.vit c
02/23/05 19:58:50 [USMLE_Step_2] ash: oh ok
02/23/05 19:58:50 [USMLE_Step_2] dua_frank: good point ash
02/23/05 19:59:02 [USMLE_Step_2] dua_frank: should check for this one
02/23/05 19:59:57 [USMLE_Step_2] lanny: what seen on biopsy that makesMAI and whipples similar ash?
02/23/05 20:00:54 [USMLE_Step_2] ash: this child has a large vol. diarrhea and has grossblood in stools.on microscopy gram negative curved rods with polar flagellum were seen.(gull wing appearance).diagnosis?
02/23/05 20:01:18 [USMLE_Step_2] fero: vibrio
02/23/05 20:01:22 [USMLE_Step_2] ash: the pas positive rod shaped organisms lanny
02/23/05 20:01:22 [USMLE_Step_2] samantha: giadiasis
02/23/05 20:01:25 [USMLE_Step_2] dua_frank: abd pain, distension and bilious vomiting dx?
02/23/05 20:01:40 [USMLE_Step_2] dua_frank: vibrio
02/23/05 20:01:45 [USMLE_Step_2] dua_frank: oh
02/23/05 20:01:45 [USMLE_Step_2] megs: intracellular organismcamphyloo jejuni ash
02/23/05 20:01:57 [USMLE_Step_2] dua_frank: giardia
02/23/05 20:01:57 [USMLE_Step_2] ash: very good megs
02/23/05 20:02:07 [USMLE_Step_2] lanny: vibrio has no blood stool
02/23/05 20:02:16 [USMLE_Step_2] ash: dua duodenal atresia?
02/23/05 20:02:22 [USMLE_Step_2] dua_frank: giardia has flagellum too right?
02/23/05 20:02:33 [USMLE_Step_2] ash: no sorry small bowel obstruction
02/23/05 20:02:34 [USMLE_Step_2] megs: intestinal onstruction dua??
02/23/05 20:02:34 [USMLE_Step_2] dua_frank: gulwing is campylo yes
02/23/05 20:02:43 [USMLE_Step_2] dua_frank: volvulus
02/23/05 20:03:06 [USMLE_Step_2] dua_frank: what structure does volvulus usually twist around?
02/23/05 20:03:17 [USMLE_Step_2] megs: mesentry dua
02/23/05 20:03:19 [USMLE_Step_2] lanny: mesentery
02/23/05 20:03:24 kmk Logs Out
02/23/05 20:03:33 [USMLE_Step_2] dua_frank: superior messenteric artery
02/23/05 20:03:39 [USMLE_Step_2] fero: messentry compressing its vessels
02/23/05 20:03:40 [USMLE_Step_2] dua_frank: thats why ischemia, infacrtion
02/23/05 20:03:41 [USMLE_Step_2] ash: giardia has a flagellum but it is a parasite and not a bacteria .moreover it doesnt give bloody diarrhea but has malabsorption so the stools are bulky and foul smelling
02/23/05 20:03:46 [USMLE_Step_2] dua_frank: yes fero
02/23/05 20:03:55 [USMLE_Step_2] dua_frank: oh right, thanks ash
02/23/05 20:04:03 [USMLE_Step_2] dua_frank: gul's wing was a give away
02/23/05 20:04:12 [USMLE_Step_2] ash: yeah
02/23/05 20:04:57 [USMLE_Step_2] lanny: i remember from step 1 gulls are seen when you go camping
02/23/05 20:04:58 [USMLE_Step_2] dua_frank: dx of volulus?
02/23/05 20:05:14 [USMLE_Step_2] lanny: this chat is good makes you remember easily
02/23/05 20:05:23 [USMLE_Step_2] dua_frank: exactly lanny
02/23/05 20:05:27 [USMLE_Step_2] megs: agree
02/23/05 20:05:38 [USMLE_Step_2] dua_frank: helps form those associations in your brain neurons
02/23/05 20:05:43 [USMLE_Step_2] ash: patient has diarrhea +arthritis +rashand has had exposure to unpasteurized milk.most likely cause?
02/23/05 20:05:45 [USMLE_Step_2] dua_frank: new circuits and new memories
02/23/05 20:05:54 [USMLE_Step_2] lanny: abdom x ray
02/23/05 20:05:59 [USMLE_Step_2] dua_frank: whipples
02/23/05 20:06:10 [USMLE_Step_2] megs: brucelosis ash
02/23/05 20:06:10 [USMLE_Step_2] ash: nope
02/23/05 20:06:12 [USMLE_Step_2] dua_frank: upper gi series with small bowel follow through
02/23/05 20:06:18 [USMLE_Step_2] lanny: listeriosis
02/23/05 20:06:29 [USMLE_Step_2] dua_frank: brucellosis
02/23/05 20:06:37 [USMLE_Step_2] dua_frank: listeriosis
02/23/05 20:06:50 [USMLE_Step_2] dua_frank: don't know :an
02/23/05 20:06:59 [USMLE_Step_2] megs: hey ash tell us
02/23/05 20:07:21 [USMLE_Step_2] ash: yersinia enterocolitica
02/23/05 20:07:35 [USMLE_Step_2] dua_frank: man
02/23/05 20:07:37 [USMLE_Step_2] lanny: with milk ingestion
02/23/05 20:07:41 [USMLE_Step_2] fero: yersenia is via pets
02/23/05 20:07:44 [USMLE_Step_2] lanny: sure ash?
02/23/05 20:07:54 [USMLE_Step_2] dua_frank: enterocolitis is oral
02/23/05 20:07:55 [USMLE_Step_2] ash: brucellosis causes fever and arthritis but not diarrhea
02/23/05 20:08:12 [USMLE_Step_2] lanny: agree ash
02/23/05 20:08:13 [USMLE_Step_2] dua_frank: why not whipples ash?
02/23/05 20:08:14 [USMLE_Step_2] ash: yes lanny sure
02/23/05 20:08:27 [USMLE_Step_2] dua_frank: whipples has associated arthritis too
02/23/05 20:08:53 [USMLE_Step_2] lanny: dua think exposure to milk is the key
02/23/05 20:09:13 [USMLE_Step_2] lanny: not see such exposure in whipples right?
02/23/05 20:09:21 [USMLE_Step_2] dua_frank: most gliadin intolerant are also intolerant to milk
02/23/05 20:09:39 [USMLE_Step_2] ash: dua whipples gives arthritis but not diarrhea and not caused by exposure to unpasturized milk
02/23/05 20:09:50 [USMLE_Step_2] ash: right lanny
02/23/05 20:10:02 [USMLE_Step_2] dua_frank: no diarrhea in whipples?
02/23/05 20:10:33 [USMLE_Step_2] fero: whipples does have dia,,its a malabsorbtion syn
02/23/05 20:10:48 [USMLE_Step_2] ash: dua the key here is unpasturized milk.trick question.if both these choices are given always go for the most obvious one
02/23/05 20:11:07 [USMLE_Step_2] dua_frank: ok
02/23/05 20:11:22 [USMLE_Step_2] lanny: ash i think there is diarrhea in whipples
02/23/05 20:11:24 [USMLE_Step_2] dua_frank: ash yersinia entero by far is not an obvious answer at all :(
02/23/05 20:11:46 [USMLE_Step_2] dua_frank: i would have still picked whipples *)
02/23/05 20:12:10 [USMLE_Step_2] ash: dua very few things cause arthritis +diarrhea+exposure to unpasturized milk
02/23/05 20:12:25 [USMLE_Step_2] dua_frank: milk yes i guess so
02/23/05 20:12:33 [USMLE_Step_2] dua_frank: but i still need more than that for enterocolitis ash
02/23/05 20:12:47 fero Logs Out
02/23/05 20:12:58 [USMLE_Step_2] ash: whipples question would be something like this -bulky foul smelling stools+arthritis
02/23/05 20:13:33 [USMLE_Step_2] ash: and not UNPASTURISED milk
02/23/05 20:13:37 [USMLE_Step_2] dua_frank: are you sure about yernia and milk?
02/23/05 20:13:50 [USMLE_Step_2] ash: given in kap lan notes
02/23/05 20:13:50 [USMLE_Step_2] dua_frank: is that the only mode to infect with yersinia?
02/23/05 20:13:56 [USMLE_Step_2] dua_frank: ok ash
02/23/05 20:13:59 [USMLE_Step_2] dua_frank: thanks anyway :)
02/23/05 20:14:00 [USMLE_Step_2] lanny: have doubts with that too dua
02/23/05 20:14:12 [USMLE_Step_2] ash: also exposure to pork and slaughter houses
02/23/05 20:14:18 [USMLE_Step_2] dua_frank: ok
02/23/05 20:14:37 [USMLE_Step_2] samantha: transmitted by pets and contaminated pets also
02/23/05 20:14:53 [USMLE_Step_2] samantha: sorry contaminated foods
02/23/05 20:15:03 [USMLE_Step_2] megs: yersenia=food milk water contamineted
02/23/05 20:15:14 [USMLE_Step_2] ash: yes also pets
02/23/05 20:15:18 [USMLE_Step_2] dua_frank: ok
02/23/05 20:15:20 [USMLE_Step_2] megs: yup
02/23/05 20:15:33 [USMLE_Step_2] dua_frank: good to distinguish the two
02/23/05 20:15:42 [USMLE_Step_2] dua_frank: coz both are bacterial infections
02/23/05 20:15:51 [USMLE_Step_2] dua_frank: so milk is the key
02/23/05 20:15:59 [USMLE_Step_2] ash: sorry dua i should have made it more obvious by saying blood and pus in stools
02/23/05 20:16:19 [USMLE_Step_2] dua_frank: yes thats the most obvious difference
02/23/05 20:16:27 [USMLE_Step_2] ash: dua not just milk it should be unpasturised
02/23/05 20:16:27 [USMLE_Step_2] dua_frank: whipples would never cause bloody stools
02/23/05 20:16:33 [USMLE_Step_2] dua_frank: right
02/23/05 20:16:41 [USMLE_Step_2] lanny: yes dua
02/23/05 20:16:42 [USMLE_Step_2] dua_frank: and neither would brucellosis right?
02/23/05 20:16:45 fero Logs in
02/23/05 20:16:46 fero Joins Subroom USMLE_Step_2
02/23/05 20:16:48 [USMLE_Step_2] lanny: but there is diarrhoea
02/23/05 20:16:55 malak1993 Logs Out
02/23/05 20:16:57 [USMLE_Step_2] lanny: yes
02/23/05 20:17:10 [USMLE_Step_2] ash: right but our usmle guys love to make it less obvious .they will not give good clues only some sidy ones
02/23/05 20:17:23 [USMLE_Step_2] dua_frank: if a patient with extreme and acute abdominal pain due to appendicitis starts looking and feeling better suddenly, what could it mean?
02/23/05 20:17:27 [USMLE_Step_2] dua_frank: right ash
02/23/05 20:17:42 [USMLE_Step_2] samantha: perforated
02/23/05 20:17:48 [USMLE_Step_2] dua_frank: right sammy
02/23/05 20:18:06 [USMLE_Step_2] lanny: yes be afraid
02/23/05 20:18:10 [USMLE_Step_2] dua_frank: it has ruptured and in course of diffuse peritonitis or intra abd abcess
02/23/05 20:18:15 [USMLE_Step_2] megs: which apeendix do not have pain until perforated
02/23/05 20:18:20 [USMLE_Step_2] ash: brucella cause is the same as yersinia but it causes undulant fever+arthralgia+backache not diarrhea
02/23/05 20:18:25 [USMLE_Step_2] dua_frank: retro?
02/23/05 20:18:40 [USMLE_Step_2] dua_frank: thanks ash, no diarrhea
02/23/05 20:18:43 [USMLE_Step_2] dua_frank: i'm clear now
02/23/05 20:18:46 [USMLE_Step_2] megs: yup dua retrocecal appendix
02/23/05 20:19:30 [USMLE_Step_2] lanny: what abdom dz can mimic appendicitis?
02/23/05 20:19:44 [USMLE_Step_2] lanny: infectious dz?
02/23/05 20:19:59 [USMLE_Step_2] fero: yersenia enterocolitis
02/23/05 20:20:08 [USMLE_Step_2] dua_frank: tx of intussption?
02/23/05 20:20:10 [USMLE_Step_2] lanny: right fero
02/23/05 20:20:30 [USMLE_Step_2] ash: ectopic pregnancy,pid,yersinia
02/23/05 20:20:35 [USMLE_Step_2] fero: air enema
02/23/05 20:20:39 [USMLE_Step_2] dua_frank: yes fero
02/23/05 20:20:53 [USMLE_Step_2] dua_frank: hydrostatic reduction by barium enema as well as by air or co2
02/23/05 20:22:19 [USMLE_Step_2] lanny: ash youre right all can mimic append
02/23/05 20:22:39 [USMLE_Step_2] dua_frank: also diverticulosis lanny
02/23/05 20:22:48 [USMLE_Step_2] ash: this infant was given honey.got constipation,became floppy,reflexes reduced .cause?
02/23/05 20:22:57 [USMLE_Step_2] dua_frank: boti
02/23/05 20:23:00 [USMLE_Step_2] fero: botulism
02/23/05 20:23:06 [USMLE_Step_2] ash: right
02/23/05 20:23:15 [USMLE_Step_2] lanny: botulism
02/23/05 20:23:44 [USMLE_Step_2] megs: how do u treat necrotising enterocolitis??/
02/23/05 20:23:50 [USMLE_Step_2] lanny: what diag modality can diag and trat an intestinal disorder?
02/23/05 20:23:51 [USMLE_Step_2] ash: this aids patient had acid fast cysts in stools.cause?
02/23/05 20:23:58 [USMLE_Step_2] shreya: ab.
02/23/05 20:24:11 [USMLE_Step_2] ash: megs o2
02/23/05 20:24:21 [USMLE_Step_2] megs: nope
02/23/05 20:24:24 [USMLE_Step_2] samantha: surgery
02/23/05 20:24:32 [USMLE_Step_2] dua_frank: cryptosporidium
02/23/05 20:24:32 sargum Logs Out
02/23/05 20:24:38 [USMLE_Step_2] fero: criptospor for AIDS
02/23/05 20:24:40 [USMLE_Step_2] shreya: intususseption.
02/23/05 20:24:44 jwls29 Logs Out
02/23/05 20:24:52 jwls29 Logs in
02/23/05 20:24:55 [USMLE_Step_2] dua_frank: surgery?
02/23/05 20:24:58 jwls29 Joins Subroom USMLE_Step_1
02/23/05 20:25:00 [USMLE_Step_2] lanny: agree with crypto
02/23/05 20:25:13 [USMLE_Step_2] dua_frank: whats your ans lanny/
02/23/05 20:25:34 [USMLE_Step_2] lanny: crypto for acid fast in aids
02/23/05 20:25:42 [USMLE_Step_2] megs: u resect the necrosed bowel
02/23/05 20:25:43 [USMLE_Step_2] fero: b enema can treat and diag intuss
02/23/05 20:25:44 [USMLE_Step_2] ash: right crypto
02/23/05 20:25:48 [USMLE_Step_2] shreya: ba enema for intussuseption
02/23/05 20:26:05 [USMLE_Step_2] lanny: right barium enema can diag and trt intussuception
02/23/05 20:26:26 [USMLE_Step_2] dua_frank: oh
02/23/05 20:26:29 [USMLE_Step_2] ash: megs what is the answer?
02/23/05 20:26:32 an_bo_al Disconnects
02/23/05 20:26:37 [USMLE_Step_2] ash: oh saw it
02/23/05 20:26:40 [USMLE_Step_2] dua_frank: how do you diag nephrotic synd?
02/23/05 20:26:51 [USMLE_Step_2] megs: already gave ash, recection of necrosed bowel
02/23/05 20:27:02 an_bo_al Logs in
02/23/05 20:27:04 an_bo_al Joins Subroom USMLE_Step_1
02/23/05 20:27:11 [USMLE_Step_2] ash: proteinuria+edema+hyproteinemia+hyperlipidemia
02/23/05 20:27:23 [USMLE_Step_2] shreya: clinicAL diag
02/23/05 20:27:29 [USMLE_Step_2] megs: and hypercholesteremia
02/23/05 20:27:29 [USMLE_Step_2] ash: saw it megs.thnx
02/23/05 20:27:30 [USMLE_Step_2] samantha: hypoproteinemia protenuria and hypercholesterl
02/23/05 20:28:06 [USMLE_Step_2] dua_frank: > 1g/m2/day of protenuria and needle biopsy after trial of steroid therapy
02/23/05 20:28:13 [USMLE_Step_2] megs: ore than 40 g alb in urine per day dua
02/23/05 20:28:21 [USMLE_Step_2] dua_frank: if its a child older than 13 yrs do biopsy first then give steroids
02/23/05 20:28:26 [USMLE_Step_2] dua_frank: yes megs
02/23/05 20:28:54 [USMLE_Step_2] megs: what is nil disease??
02/23/05 20:29:08 [USMLE_Step_2] ash: minimal change
02/23/05 20:29:11 [USMLE_Step_2] shreya: mcd
02/23/05 20:29:12 [USMLE_Step_2] samantha: minimal lesion
02/23/05 20:29:13 [USMLE_Step_2] megs: minimal change disease...nil lesion
02/23/05 20:29:24 [USMLE_Step_2] fero: also called lipiod nephrosis
02/23/05 20:29:32 mitochondria Logs in
02/23/05 20:29:32 [USMLE_Step_2] dua_frank: how will you differentiate between nephrotic syndrome caused by nils disease or memb prolif GN apart from Electron microscopy study?
02/23/05 20:29:41 [USMLE_Step_2] megs: how do u diagnose vesicoureteric reflex???
02/23/05 20:29:49 [USMLE_Step_2] ash: foot process obliteration
02/23/05 20:29:52 [USMLE_Step_2] ash: in nils
02/23/05 20:29:57 [USMLE_Step_2] fero: vcug
02/23/05 20:30:03 mitochondria: hello everyone
02/23/05 20:30:11 [USMLE_Step_2] megs: flat foot preocees in nil
02/23/05 20:30:14 [USMLE_Step_2] lanny: biopsy dua
02/23/05 20:30:29 [USMLE_Step_2] megs: right fero
02/23/05 20:30:36 [USMLE_Step_2] dua_frank: apart from EM study guys
02/23/05 20:30:40 [USMLE_Step_2] dua_frank: its dec c3 levels
02/23/05 20:30:42 [USMLE_Step_2] ash: IvP AND USG
02/23/05 20:30:46 [USMLE_Step_2] dua_frank: normal c3 in nils disease
02/23/05 20:31:03 [USMLE_Step_2] ash: for reflux
02/23/05 20:31:04 [USMLE_Step_2] megs: respoce to steroids dua???
02/23/05 20:31:13 [USMLE_Step_2] megs: ok
02/23/05 20:31:28 [USMLE_Step_2] dua_frank: i'm going to name pathology, you name type of GN ok?
02/23/05 20:31:36 [USMLE_Step_2] ash: ok
02/23/05 20:31:36 [USMLE_Step_2] dua_frank: fusion of podocytes
02/23/05 20:31:40 [USMLE_Step_2] ash: nils
02/23/05 20:31:43 [USMLE_Step_2] dua_frank: yes
02/23/05 20:31:51 [USMLE_Step_2] dua_frank: thickening of Gl. BM
02/23/05 20:31:57 [USMLE_Step_2] ash: sclerosis
02/23/05 20:32:04 [USMLE_Step_2] megs: fsgsc
02/23/05 20:32:05 [USMLE_Step_2] dua_frank: membranous
02/23/05 20:32:14 [USMLE_Step_2] megs: ok
02/23/05 20:32:18 [USMLE_Step_2] ash: oh
02/23/05 20:32:26 mitochondria: where r u geniuses
02/23/05 20:32:28 [USMLE_Step_2] dua_frank: increase in mesangial cells, capillary walls split and dec c3 levels
02/23/05 20:32:44 [USMLE_Step_2] ash: mesangial proliferative
02/23/05 20:32:48 [USMLE_Step_2] megs: mesagial proliferative
02/23/05 20:32:53 [USMLE_Step_2] samantha: sle
02/23/05 20:32:55 [USMLE_Step_2] dua_frank: membranoproliferative GN
02/23/05 20:33:12 [USMLE_Step_2] ash: ???
02/23/05 20:33:12 [USMLE_Step_2] dua_frank: deposits of immune complex in mesangium is your ans megs and ash
02/23/05 20:33:32 [USMLE_Step_2] megs: ok dua
02/23/05 20:33:32 [USMLE_Step_2] ash: ok thanks
02/23/05 20:33:47 [USMLE_Step_2] lanny: seen in sickle cell dz?
02/23/05 20:33:57 [USMLE_Step_2] dua_frank: proliferation of parietal epithelial cells, crescents
02/23/05 20:34:05 [USMLE_Step_2] megs: arpgn
02/23/05 20:34:06 [USMLE_Step_2] dua_frank: RPGM
02/23/05 20:34:10 [USMLE_Step_2] megs: RPGN
02/23/05 20:34:17 [USMLE_Step_2] dua_frank: both qs same ans yes :P
02/23/05 20:34:24 [USMLE_Step_2] dua_frank: that concludes stupid GNs :P
02/23/05 20:34:30 [USMLE_Step_2] dua_frank: i hate them :P
02/23/05 20:34:44 [USMLE_Step_2] megs: i too :an
02/23/05 20:34:54 malak1993 Disconnects
02/23/05 20:34:59 [USMLE_Step_2] dua_frank: MCC of urinary tract infection?
02/23/05 20:35:07 [USMLE_Step_2] fero: e coli
02/23/05 20:35:15 [USMLE_Step_2] dua_frank: yes fero
02/23/05 20:35:21 [USMLE_Step_2] lanny: e coli
02/23/05 20:35:29 [USMLE_Step_2] megs: weak urine stream+ distended bladder in a boy?? dx most common??/
02/23/05 20:35:58 [USMLE_Step_2] ash: valves?
02/23/05 20:36:05 [USMLE_Step_2] megs: posterior urethral vale correct ash
02/23/05 20:36:07 [USMLE_Step_2] fero: must b epi r hypo spidia
02/23/05 20:36:13 [USMLE_Step_2] lanny: ppost urethral valve
02/23/05 20:36:17 [USMLE_Step_2] fero: k
02/23/05 20:36:19 [USMLE_Step_2] megs: tx???
02/23/05 20:36:37 [USMLE_Step_2] dua_frank: surgical?
02/23/05 20:36:43 [USMLE_Step_2] megs: transuretrhal ablasion of the valve
02/23/05 20:37:02 [USMLE_Step_2] megs: what is epi and hypospadius??
02/23/05 20:37:38 [USMLE_Step_2] lanny: urethral opening anterior
02/23/05 20:37:38 [USMLE_Step_2] fero: abnormal urethral opening epi>dorsal, hypo ventral opening
02/23/05 20:37:40 [USMLE_Step_2] ash: epi is urethral opeinig on the dorsal surface of penis
02/23/05 20:37:50 [USMLE_Step_2] megs: epi=dorsal urethral opening and hypo ventral
02/23/05 20:37:52 [USMLE_Step_2] ash: and hypo is on the ventral surface
02/23/05 20:37:55 [USMLE_Step_2] lanny: hypo is ventral
02/23/05 20:37:57 [USMLE_Step_2] megs: ash fero right
02/23/05 20:38:01 [USMLE_Step_2] lanny: epi is dorsal
02/23/05 20:38:09 [USMLE_Step_2] megs: lanny too
02/23/05 20:38:19 [USMLE_Step_2] ash: what can epispadius be associated with?
02/23/05 20:38:28 [USMLE_Step_2] lanny: phimosis
02/23/05 20:38:36 [USMLE_Step_2] fero: renal congen anamolies
02/23/05 20:38:37 [USMLE_Step_2] megs: cryptorchism in a boy of 7 month what next???
02/23/05 20:38:55 [USMLE_Step_2] megs: epispadius bladder exophy
02/23/05 20:38:56 [USMLE_Step_2] lanny: tell us ash
02/23/05 20:39:09 [USMLE_Step_2] fero: after 1 yr..do surgery
02/23/05 20:39:19 [USMLE_Step_2] megs: right feroo
02/23/05 20:39:20 [USMLE_Step_2] ash: bladder extrophy
02/23/05 20:39:42 [USMLE_Step_2] ash: renal anomalies and cryptorchidism correct too
02/23/05 20:40:09 [USMLE_Step_2] dua_frank: surgery?
02/23/05 20:40:15 [USMLE_Step_2] ash: inguinal hernias can also be seen
02/23/05 20:40:19 [USMLE_Step_2] fero: risk of testicular cancer dec after correcting chripto..true r false?
02/23/05 20:40:31 [USMLE_Step_2] dua_frank: true
02/23/05 20:40:33 [USMLE_Step_2] ash: fero true
02/23/05 20:40:34 [USMLE_Step_2] dua_frank: no
02/23/05 20:40:35 [USMLE_Step_2] dua_frank: false
02/23/05 20:40:36 [USMLE_Step_2] lanny: false
02/23/05 20:40:44 [USMLE_Step_2] fero: false
02/23/05 20:40:45 [USMLE_Step_2] lanny: does not change
02/23/05 20:40:47 [USMLE_Step_2] ash: why?
02/23/05 20:40:50 [USMLE_Step_2] fero: risk does not dec
02/23/05 20:40:56 [USMLE_Step_2] ash: ok
02/23/05 20:41:06 [USMLE_Step_2] ash: it just doesnt increase further
02/23/05 20:41:13 [USMLE_Step_2] lanny: some embronic stuff forgot
02/23/05 20:41:49 [USMLE_Step_2] ash: ok guys gotta go now.thnx for a great chat.see you tomorrow
02/23/05 20:42:01 [USMLE_Step_2] lanny: good night ash
02/23/05 20:42:03 [USMLE_Step_2] megs: bye ash
02/23/05 20:42:05 [USMLE_Step_2] fero: bye
02/23/05 20:42:08 [USMLE_Step_2] ash: bye
02/23/05 20:42:22 [USMLE_Step_2] megs: fero r u sure of ur statement
02/23/05 20:42:27 [USMLE_Step_2] fero: yes
02/23/05 20:42:29 ash Logs Out
02/23/05 20:42:44 [USMLE_Step_2] fero: will check it out for u guys again tomorrow
02/23/05 20:42:51 [USMLE_Step_2] megs: b cause i have read that regarding correction of crypt before 1 yr
02/23/05 20:43:31 [USMLE_Step_2] fero: v sure i have the info,,will post it on usmle.net
02/23/05 20:43:31 [USMLE_Step_2] dua_frank: i want to discuss anion gap guys
02/23/05 20:43:40 [USMLE_Step_2] dua_frank: who's good at it?
02/23/05 20:43:54 [USMLE_Step_2] megs: not me :(
02/23/05 20:44:02 [USMLE_Step_2] fero: not me either..lol
02/23/05 20:44:08 [USMLE_Step_2] megs: lanny ...then
02/23/05 20:44:15 [USMLE_Step_2] megs: come on lanny
02/23/05 20:44:20 [USMLE_Step_2] dua_frank: lanny lanny lanny
02/23/05 20:44:44 [USMLE_Step_2] dua_frank: its one of the toughest topics for me
02/23/05 20:44:53 [USMLE_Step_2] fero: 2 cond in which u can give asprin in kids?
02/23/05 20:45:08 [USMLE_Step_2] dua_frank: kawasaki
02/23/05 20:45:11 [USMLE_Step_2] megs: kawasaki and itp fero
02/23/05 20:45:17 [USMLE_Step_2] dua_frank: not itp
02/23/05 20:45:19 [USMLE_Step_2] dua_frank: something else
02/23/05 20:45:23 [USMLE_Step_2] fero: kawaski and JRA
02/23/05 20:45:24 [USMLE_Step_2] dua_frank: itp too
02/23/05 20:45:28 [USMLE_Step_2] dua_frank: ah yes JRA
02/23/05 20:45:40 [USMLE_Step_2] dua_frank: fero we're doing renal and GI today :P
02/23/05 20:46:00 jwls29 Logs Out
02/23/05 20:46:01 [USMLE_Step_2] fero: WELL ya that comes with the ryes syn in renal..lol
02/23/05 20:46:04 [USMLE_Step_2] dua_frank: i can explain anion gap
02/23/05 20:46:04 [USMLE_Step_2] megs: ok how do u calculate anion gap??
02/23/05 20:46:17 [USMLE_Step_2] dua_frank: but only upto a certain point
02/23/05 20:46:23 [USMLE_Step_2] dua_frank: after that, its twilight zone in my head
02/23/05 20:46:37 [USMLE_Step_2] dua_frank: na+k-cl+hco3
02/23/05 20:46:38 [USMLE_Step_2] fero: Na+ k)-(cli+hco3)
02/23/05 20:46:40 [USMLE_Step_2] lanny: i had to chk crypto guys risk of infertility dec if descends before 2 yrs but risk of malignancy is unchanged there is still risk even if brought down by 1 year
02/23/05 20:46:54 [USMLE_Step_2] megs: yup ferro
02/23/05 20:46:55 [USMLE_Step_2] dua_frank: thanks lanny
02/23/05 20:46:59 [USMLE_Step_2] fero: i was right then
02/23/05 20:47:00 shreya Disconnects
02/23/05 20:47:09 [USMLE_Step_2] lanny: so we were right
02/23/05 20:47:16 [USMLE_Step_2] megs: agree lanny thanx
02/23/05 20:47:19 [USMLE_Step_2] dua_frank: ok conditions with increased anion gap?
02/23/05 20:47:19 [USMLE_Step_2] lanny: remember to tell ash tomorrow
02/23/05 20:47:20 [USMLE_Step_2] fero: :)
02/23/05 20:47:29 [USMLE_Step_2] dua_frank: there must be some mnemonic for this
02/23/05 20:47:46 [USMLE_Step_2] fero: for what?
02/23/05 20:47:54 [USMLE_Step_2] dua_frank: increase anion gap
02/23/05 20:47:58 [USMLE_Step_2] dua_frank: conditions
02/23/05 20:48:02 [USMLE_Step_2] fero: MUD PILES
02/23/05 20:48:06 [USMLE_Step_2] dua_frank: oh yeah
02/23/05 20:48:10 Roxanita Logs Out
02/23/05 20:48:13 [USMLE_Step_2] dua_frank: what are the conditions in that fero?
02/23/05 20:48:17 [USMLE_Step_2] fero: ok
02/23/05 20:48:18 an_bo_al Logs Out
02/23/05 20:48:21 [USMLE_Step_2] megs: ethanol,aspirin,renal failure
02/23/05 20:48:27 [USMLE_Step_2] fero: methanol, urema, dka
02/23/05 20:48:32 [USMLE_Step_2] megs: dka
02/23/05 20:48:33 [USMLE_Step_2] fero: paraldehye
02/23/05 20:48:39 [USMLE_Step_2] fero: INH
02/23/05 20:48:42 an_bo_al Logs in
02/23/05 20:48:43 [USMLE_Step_2] lanny: inc anion gap acidosis lactic aspirin ingestion
02/23/05 20:48:46 [USMLE_Step_2] fero: lactic aci
02/23/05 20:48:55 [USMLE_Step_2] lanny: DKM too
02/23/05 20:48:58 [USMLE_Step_2] fero: ethanol, salisi
02/23/05 20:49:04 [USMLE_Step_2] lanny: sorry DKA
02/23/05 20:49:13 [USMLE_Step_2] megs: ok
02/23/05 20:49:19 [USMLE_Step_2] lanny: renal insufficiency too
02/23/05 20:49:31 [USMLE_Step_2] dua_frank: thanks fero
02/23/05 20:49:44 [USMLE_Step_2] fero: normal value> 8 -14
02/23/05 20:50:01 [USMLE_Step_2] dua_frank: why won't diarrhea cause increased anion gap?
02/23/05 20:50:28 [USMLE_Step_2] megs: loss of k+
02/23/05 20:50:30 [USMLE_Step_2] lanny: cause you are loosing the bases
02/23/05 20:50:45 [USMLE_Step_2] dua_frank: coz chloride compensates hco3 loss
02/23/05 20:51:05 [USMLE_Step_2] lanny: and K is getting smaller
02/23/05 20:51:18 [USMLE_Step_2] lanny: megs right and loss of K
02/23/05 20:52:06 [USMLE_Step_2] dua_frank: so gap remains normal
02/23/05 20:52:11 [USMLE_Step_2] lanny: guys im stepping off will return
02/23/05 20:52:24 [USMLE_Step_2] lanny: yes it balances out
02/23/05 20:52:29 mitochondria Joins Subroom USMLE_Step_1
02/23/05 20:52:33 [USMLE_Step_2] dua_frank: anions are positive or negative charged?
02/23/05 20:52:38 [USMLE_Step_2] lanny: normal gap is 8-12
02/23/05 20:52:45 [USMLE_Step_2] dua_frank: ok lanny
02/23/05 20:52:48 mitochondria Joins Subroom USMLE_Step_2
02/23/05 20:52:55 [USMLE_Step_2] lanny: anions are pos
02/23/05 20:52:58 [USMLE_Step_2] dua_frank: right
02/23/05 20:53:02 [USMLE_Step_2] fero: neuro+gen for tomorrow
02/23/05 20:53:05 [USMLE_Step_2] dua_frank: ok i figured it out
02/23/05 20:53:06 [USMLE_Step_2] fero: ?
02/23/05 20:53:13 [USMLE_Step_2] mitochondria: anions r negative
02/23/05 20:53:21 [USMLE_Step_2] dua_frank: anion gap increases when it cannot be compensated anymore
02/23/05 20:53:34 [USMLE_Step_2] megs: yeah dua
02/23/05 20:53:38 [USMLE_Step_2] dua_frank: by other cations (apart from chlorides)
02/23/05 20:53:54 [USMLE_Step_2] lanny: i thought catons are neg
02/23/05 20:53:59 [USMLE_Step_2] lanny: cations
02/23/05 20:54:09 [USMLE_Step_2] dua_frank: anion positive yes
02/23/05 20:54:19 [USMLE_Step_2] megs: cations+ anions -
02/23/05 20:54:23 [USMLE_Step_2] lanny: mitochondria yuore sure?
02/23/05 20:54:25 [USMLE_Step_2] dua_frank: so thats why in DKA you have an anion overload
02/23/05 20:54:30 [USMLE_Step_2] mitochondria: yes
02/23/05 20:54:31 rsandhu Logs in
02/23/05 20:54:37 rsandhu Joins Subroom USMLE_Step_1
02/23/05 20:54:37 [USMLE_Step_2] mitochondria: anions r negative
02/23/05 20:54:41 [USMLE_Step_2] dua_frank: oh ok
02/23/05 20:54:45 rsandhu Logs Out
02/23/05 20:54:47 [USMLE_Step_2] dua_frank: so the gap is shifted?
02/23/05 20:54:51 [USMLE_Step_2] dua_frank: too many anions
02/23/05 20:55:01 an_bo_al Joins Subroom USMLE_Step_1
02/23/05 20:55:10 an_bo_al Leaves Subroom
02/23/05 20:55:18 [USMLE_Step_2] mitochondria: bqz,,,,,,,,,,,,,,a lot of ketoacids r produced
02/23/05 20:55:24 [USMLE_Step_2] lanny: well im confused now but too many positive chagre
02/23/05 20:55:32 [USMLE_Step_2] mitochondria: and
02/23/05 20:55:43 [USMLE_Step_2] mitochondria: ketoacdis have positive charge
02/23/05 20:55:52 [USMLE_Step_2] dua_frank: so?
02/23/05 20:55:58 [USMLE_Step_2] dua_frank: thats too much positive charge
02/23/05 20:56:01 [USMLE_Step_2] dua_frank: which cannot be compensated
02/23/05 20:56:09 [USMLE_Step_2] dua_frank: isn't that too much anions then?
02/23/05 20:56:50 [USMLE_Step_2] megs: hey guys i am all confused want to get it cleared
02/23/05 20:57:05 [USMLE_Step_2] lanny: what charge is the cathode electrode?
02/23/05 20:57:14 [USMLE_Step_2] dua_frank: i thought negative lanny
02/23/05 20:57:23 [USMLE_Step_2] lanny: thought so too dua
02/23/05 20:57:47 [USMLE_Step_2] lanny: so pos charges anions move to the neg electrode cathode
02/23/05 20:58:46 [USMLE_Step_2] dua_frank: just checked
02/23/05 20:58:50 [USMLE_Step_2] dua_frank: negatives are anions
02/23/05 20:59:06 [USMLE_Step_2] dua_frank: its on the net lanny :(
02/23/05 20:59:19 [USMLE_Step_2] dua_frank: ok then anionic gap still remains a mystery to me
02/23/05 20:59:25 [USMLE_Step_2] dua_frank: thought i had it
02/23/05 20:59:26 [USMLE_Step_2] lanny: oh so i mixed up the other way round
02/23/05 20:59:46 [USMLE_Step_2] dua_frank: maybe its different in blood
02/23/05 20:59:49 [USMLE_Step_2] lanny: thx for checking
02/23/05 20:59:54 [USMLE_Step_2] dua_frank: i always thought H+ is an anion :(
02/23/05 21:00:14 [USMLE_Step_2] dua_frank: so in DKA we have too much H+ which increases anionic gap
02/23/05 21:00:23 [USMLE_Step_2] dua_frank: this is how i had remembered it
02/23/05 21:00:25 [USMLE_Step_2] lanny: yes too much cation
02/23/05 21:00:48 [USMLE_Step_2] lanny: the NA and K is high
02/23/05 21:00:53 [USMLE_Step_2] lanny: so the gap inc
02/23/05 21:01:08 [USMLE_Step_2] fero: ok guys see to kal then
02/23/05 21:01:13 [USMLE_Step_2] fero: byee
02/23/05 21:01:19 [USMLE_Step_2] fero: thx everyone
02/23/05 21:01:22 [USMLE_Step_2] dua_frank: bye
02/23/05 21:01:36 [USMLE_Step_2] lanny: bye fero
02/23/05 21:01:45 fero Logs Out
02/23/05 21:01:48 [USMLE_Step_2] dua_frank: lets rack our head with this tomorrow after a little more reading lanny
02/23/05 21:01:53 [USMLE_Step_2] dua_frank: lets finish renal today
02/23/05 21:02:03 [USMLE_Step_2] dua_frank: deafness with nephritis. dx?
02/23/05 21:02:16 [USMLE_Step_2] samantha: alports
02/23/05 21:02:20 [USMLE_Step_2] Jee: alports
02/23/05 21:02:22 [USMLE_Step_2] lanny: will do so absulutely will discuss DKA patho before we start tom its imo to know
02/23/05 21:02:24 [USMLE_Step_2] dua_frank: yes
02/23/05 21:02:28 [USMLE_Step_2] dua_frank: ok
02/23/05 21:02:46 [USMLE_Step_2] lanny: agree
02/23/05 21:03:16 [USMLE_Step_2] megs: dua gap increased means= increased cations that is positive ions and decreased negative ions
02/23/05 21:03:37 [USMLE_Step_2] lanny: yes megs we cleared it now thanks
02/23/05 21:04:01 [USMLE_Step_2] megs: we will again read and discuss it tomorrow
02/23/05 21:04:08 [USMLE_Step_2] megs: anion gap acidoaid
02/23/05 21:04:19 [USMLE_Step_2] lanny: megs we will go thru patho tom in DKA to be quite clear
02/23/05 21:04:23 [USMLE_Step_2] dua_frank: ok
02/23/05 21:04:34 [USMLE_Step_2] megs: ok
02/23/05 21:04:41 [USMLE_Step_2] lanny: agree first 10 mins tomorrow
02/23/05 21:04:54 [USMLE_Step_2] lanny: ok guys im leaving now see you all morow
02/23/05 21:04:55 [USMLE_Step_2] megs: ok boss :)
02/23/05 21:04:59 [USMLE_Step_2] dua_frank: ok lanny bye
02/23/05 21:05:10 [USMLE_Step_2] lanny: youre the boss megs lol
02/23/05 21:05:12 [USMLE_Step_2] dua_frank: what does aldosterone do?
02/23/05 21:05:33 [USMLE_Step_2] lanny: reabs Na
02/23/05 21:05:35 [USMLE_Step_2] megs: NA tetention k excretion
02/23/05 21:05:37 [USMLE_Step_2] lanny: secr K
02/23/05 21:05:58 [USMLE_Step_2] lanny: in distal loop
02/23/05 21:06:07 [USMLE_Step_2] lanny: and collecting duct
02/23/05 21:06:40 [USMLE_Step_2] dua_frank: ok so in type 4 RTA there is hyporenin
02/23/05 21:06:48 [USMLE_Step_2] dua_frank: and hypoaldo
02/23/05 21:06:55 [USMLE_Step_2] dua_frank: so dec na retention
02/23/05 21:07:02 [USMLE_Step_2] dua_frank: meaning anion gap dec :(
02/23/05 21:07:12 [USMLE_Step_2] dua_frank: so if positives are lost how is it compensated?
02/23/05 21:07:18 [USMLE_Step_2] dua_frank: by adding more H+ ions?
02/23/05 21:07:52 [USMLE_Step_2] dua_frank: oh k+ is retained
02/23/05 21:07:53 [USMLE_Step_2] dua_frank: too
02/23/05 21:08:07 [USMLE_Step_2] dua_frank: fine i'm done with this stupid topic now, leave it :an
02/23/05 21:08:33 [USMLE_Step_2] megs: dua :cl
02/23/05 21:08:37 Jee Logs Out
02/23/05 21:08:38 mitochondria Leaves Subroom
02/23/05 21:08:47 [USMLE_Step_2] megs: i am going to read it
02/23/05 21:08:51 [USMLE_Step_2] dua_frank: whats fanconi syndrome?
02/23/05 21:08:57 [USMLE_Step_2] megs: my head is hevy now
02/23/05 21:09:10 [USMLE_Step_2] dua_frank: yeah mine too lol
02/23/05 21:09:14 [USMLE_Step_2] megs: fanconis is proximal tubular defect
02/23/05 21:09:18 mitochondria Logs Out
02/23/05 21:09:42 [USMLE_Step_2] megs: hco3 aminoacid lost
02/23/05 21:10:06 [USMLE_Step_2] dua_frank: so in a way can i say that its exaggerated RTA type 2 with glucose, phosphate, amino acid loss too?
02/23/05 21:10:09 [USMLE_Step_2] megs: small prt glucoes and electrolytes loss
02/23/05 21:10:39 [USMLE_Step_2] megs: dua tomorow we will come 10 min early and sort out all this
02/23/05 21:10:44 [USMLE_Step_2] dua_frank: ok megs
02/23/05 21:10:57 [USMLE_Step_2] megs: ok then bye
02/23/05 21:11:04 [USMLE_Step_2] dua_frank: bye megs







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