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@panjshiri_0113: #شهیداحمدشاه_مسعود_قهرمان_ملی_کشور

Mir Panjshiri ོ
Mir Panjshiri ོ
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Wednesday 02 September 2026 20:46:43 GMT
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user1973439172029
ویتی نینی :
جانم هستن تاجک❤️❤️❤️❤️❤️
2026-09-03 05:25:37
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samet_kafari
samet :
🥰🥰🥰
2026-09-03 11:16:46
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loy_p4rw4ni
خمـٜ۪ྱོارِی :
❤️
2026-09-03 01:44:47
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bizhan_omar
ادریــــــس :
🫶♥️
2026-09-03 00:26:39
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zekrya.azizi
ساقی شار :
❤️❤️❤️
2026-09-03 00:05:38
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drxkhili
𝑬𝒅𝒓𝒊𝒔 :
🖤
2026-09-02 23:51:04
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ivv_84
ᗩ Y ᗩ ᑎ𓍼ོ :
♥️♥️
2026-09-02 21:35:56
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panjshiry877
Baes :
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2026-09-02 20:54:27
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fe3d0us
﮼فردوس :
♥️
2026-09-02 20:53:58
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.m83417
:Ŧáĵìķ Ŧàbàŕ: :
❤️❤️❤️
2026-09-02 20:50:15
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hasibullah_muradi01
𝐒𝐡𝐚𝐡𝐢𝐧 :
♥️♥️♥️
2026-09-02 20:47:44
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.pjryaqoob
𓆩.PJR乂YAQOOB.𓆪 :
🥰🥰🥰
2026-09-09 08:51:36
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Other Videos

HY Pulm . . . . A) Antibodies to postsynaptic acetylcholine receptors ❌ Associated with myasthenia gravis, not lung cancer Myasthenia shows fluctuating weakness with repetitive use; this patient has progressive weakness from malignancy Clinical context (smoker + lung mass) = paraneoplastic syndrome, not autoimmune neuromuscular disorder B) Parathyroid hormone-related peptide (PTHrP) secretion ❌ Associated with squamous cell lung cancer, not small cell PTHrP causes hypercalcemia (would raise potassium, not lower it) This patient's electrolyte pattern (high sodium, low potassium, metabolic alkalosis) doesn't fit PTHrP C) Prior occupational asbestos exposure ❌ Asbestos is primarily associated with mesothelioma This patient has a central hilar mass (small cell), not the pleural-based tumors seen with mesothelioma D) Elevated urinary 5-hydroxyindoleacetic acid (5-HIAA) ❌ Associated with bronchogenic carcinoid tumors (young patients, indolent course) This elderly patient has aggressive disease with proximal weakness + electrolyte abnormalities, not carcinoid syndrome (flushing, diarrhea) E) Autoantibodies to voltage-gated calcium channels ✅ SCLC is the classic malignancy for Lambert-Eaton myasthenic syndrome Weakness improves with repetitive muscle use (opposite of myasthenia gravis) Electrolyte pattern (high sodium 151, low K 2.9, high bicarb 32) = KEY: ACTH-secreting SCLC. Excess cortisol acts like aldosterone → sodium retention, potassium wasting, metabolic alkalosis (cortisol drives H+ excretion) Teaching: SCLC has MULTIPLE paraneoplastic syndromes — ACTH-secretion (Cushing electrolytes) + Lambert-Eaton antibodies (proximal weakness) #USMLE #meded #Step1 #Step2CK #medstudent
HY Pulm . . . . A) Antibodies to postsynaptic acetylcholine receptors ❌ Associated with myasthenia gravis, not lung cancer Myasthenia shows fluctuating weakness with repetitive use; this patient has progressive weakness from malignancy Clinical context (smoker + lung mass) = paraneoplastic syndrome, not autoimmune neuromuscular disorder B) Parathyroid hormone-related peptide (PTHrP) secretion ❌ Associated with squamous cell lung cancer, not small cell PTHrP causes hypercalcemia (would raise potassium, not lower it) This patient's electrolyte pattern (high sodium, low potassium, metabolic alkalosis) doesn't fit PTHrP C) Prior occupational asbestos exposure ❌ Asbestos is primarily associated with mesothelioma This patient has a central hilar mass (small cell), not the pleural-based tumors seen with mesothelioma D) Elevated urinary 5-hydroxyindoleacetic acid (5-HIAA) ❌ Associated with bronchogenic carcinoid tumors (young patients, indolent course) This elderly patient has aggressive disease with proximal weakness + electrolyte abnormalities, not carcinoid syndrome (flushing, diarrhea) E) Autoantibodies to voltage-gated calcium channels ✅ SCLC is the classic malignancy for Lambert-Eaton myasthenic syndrome Weakness improves with repetitive muscle use (opposite of myasthenia gravis) Electrolyte pattern (high sodium 151, low K 2.9, high bicarb 32) = KEY: ACTH-secreting SCLC. Excess cortisol acts like aldosterone → sodium retention, potassium wasting, metabolic alkalosis (cortisol drives H+ excretion) Teaching: SCLC has MULTIPLE paraneoplastic syndromes — ACTH-secretion (Cushing electrolytes) + Lambert-Eaton antibodies (proximal weakness) #USMLE #meded #Step1 #Step2CK #medstudent
#mobile #videomakermobile #marketingdigital #audiovisual
#mobile #videomakermobile #marketingdigital #audiovisual
Taca fogo em tudo, diva! 💅🏻 #fyp #foryou
Taca fogo em tudo, diva! 💅🏻 #fyp #foryou
Robô aspirador para auxiliar no dia a dia. #roboaspirador
Robô aspirador para auxiliar no dia a dia. #roboaspirador
i‘ll be here #lyrics #song #alessiacara #here #fyp
i‘ll be here #lyrics #song #alessiacara #here #fyp
Lên con mã đoạn rap Song: Đẹp Mã - Hùng Huỳnh Dc: me and @Thế Ngọc Trân #dance #trending #geminihunghuynh #depma #tiemgaudepmachallenge
Lên con mã đoạn rap Song: Đẹp Mã - Hùng Huỳnh Dc: me and @Thế Ngọc Trân #dance #trending #geminihunghuynh #depma #tiemgaudepmachallenge

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