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1
Q

indomethicin

A

prevents preterm labor, close PDA, treat gout

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2
Q

steady state reached at how many half lives

A

5

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3
Q

cyp-450 inhibitors

A

isoniazid, ketoconazole, erythromycin, fluoroquin, flagyl, allopurinol, verapamil, amiodarone, MAOIs, disulfiram

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4
Q

best test for colovesicular fistula

A

CT scan

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5
Q

SE mafenide

A

metabolic acidosis

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6
Q

SE silver nitrate

A

hypochlor, hyponatremia

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7
Q

SE silvadene

A

neutropenia, increased risk of kernicterus

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8
Q

GI CMV treatment

A

ganciclovir

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9
Q

SE tacrolimus

A

htn

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10
Q

SE sirolimus

A

poor wound healing

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11
Q

annular pancreas tx

A

duodenojejunostomy

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12
Q

AVF needs

A

vein >3mm artery >2mm

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13
Q

most sensitive phase of cell cycle for radiation

A

M phase

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14
Q

respiratory quotient

A

CO2 prod/O2 consumed

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15
Q

gold std for bladder injury

A

CT cystography

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16
Q

appendicitis visceral pain

A

periumb pain

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17
Q

appendicitis somatic pain

A

RLQ pain

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18
Q

Pulm sequestration extralobar blood supply

A

systemic arterial and venous

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19
Q

pulm sequestration intralobar blood supply

A

aorta, pulm vein

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20
Q

1 presentation of pulm sequestration

A

infection

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21
Q

copper def

A

neutropenia, pigment change, arrhythmia

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22
Q

iron def

A

anemia, glossitis, brittle nails, cardiomeg

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23
Q

Mg def

A

nausea, weakness, AMS

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24
Q

selenium def

A

cardiomyopathy, growth retardation, pain, weakness

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25
Q

zinc def

A

poor wound healing, hair loss, testicular atrophy , diarrhea, dermatitis

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26
Q

best initial test to diagnose esophageal perf

A

gastrograffin

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27
Q

contrast enhancement during arterial phase with prominent central scar

A

FNH

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28
Q

sarcoma spreads via

A

hematogenous usual

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29
Q

spread via lymph nodes

A

clear cell, angiosarcoma, rhabdomyosarc, synovial, epitheliod

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30
Q

arterial enhancement with portal venous washout

A

HCC

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31
Q

Milan

A

3 < 3cm, 1 <5cm

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32
Q

UCSF criteria

A

1 <6cm, 3 <4.5cm total <8cm

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33
Q

ablation size cutoff

A

< 2 cm

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34
Q

amebic abscess treatment

A

flagyl

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35
Q

VHL

A

CNS hemangioblastoma, pheo, clear cell renal, cystadenoma of pancreas, papillary cystadenoma of epidid/broad ligament

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36
Q

atropine mechanism

A

competitive inhibitor of acetylcholine muscarinic R

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37
Q

most radiosensitive

A

seminoma

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38
Q

adenoid cystic carcinoma of salivary gland

A

slow, insidious onset, late presentation of distant mets, high avidity for nerves

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39
Q

fuel for colonic cells

A

short chain FA - acetate, butyrate, propionate

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40
Q

tx of undiff spindle cell (malignant fibrous histiocytoma of bone)

A

neoadj chemo and excision with wide margins

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41
Q

langerhans cells (aka dendritic cells) are derived from

A

monocytes

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42
Q

langerhans cells require stim by

A

colony stim factor 1

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43
Q

deep pressure and high freq vibration

A

pacinian corpuscle

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44
Q

warmth, skin stretch

A

ruffinis

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45
Q

cold, low freq vib

A

krause end bulb

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46
Q

light pressure and tactile sense

A

meissners

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47
Q

thermal regulation and hypotonic sweat

A

accrine

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48
Q

palms and soles

A

apocrine sweat (via sympathetic NS and acetylcholine)

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49
Q

predominant collagen type

A

type I

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50
Q

melanoma markers

A

S100, HMB-45

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51
Q

systemic treatment for melanoma

A

dacarbazine for + nodes or mets, stage IIIB or IV

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52
Q

treatment for >4 nodes + melanoma

A

XRT - also used for palliation

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53
Q

basal cell margins

A

0.3-0.5cm

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54
Q

lip cancer basal (top lip)

A

0.75cm margin

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55
Q

SCC margin

A

1 cm, Mohs for cosmetic area

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56
Q

needs 2 cm margin SCC

A

Marjolin, penile, vulvar

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57
Q

node dissection for SCC if

A

> 2cm or >4mm deep

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58
Q

parotid basin lesions (ear, temple, etc.)

A

superficial parotidectomy, if + will need total parotidectomy and MRND

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59
Q

SCC need for chemo XRT

A

if neuro, nodal, vessel involvement or + margins

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60
Q

cholangiocarcinoma type I

A

common hepatic duct

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61
Q

cholangio type II

A

confluence of R + L hep ducts

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62
Q

cholangio type IIIa

A

spread to bifurc of R hep

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63
Q

cholangio type IIIb

A

spread to bifurc of L hep

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64
Q

cholangio type IV

A

extends to bifurc of both R and L or multifocal involvement

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65
Q

colangio type V

A

stricture @ jxn of CBD and cystic duct

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66
Q

increases risk of T cell lymphoma in small bowel

A

Celiac

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67
Q

marker for rhabdomyosarc

A

desmin

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68
Q

usual soft tissue sarcoma spread

A

hematogenous

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69
Q

soft tissue sarcoma usually mets to

A

lung

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70
Q

does not usually met to bone

A

colon cancer

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71
Q

most important factor in sarcoma

A

tumor grade

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72
Q

type of biopsy in soft tissue sarcoma

A

longitudinal excisional if < 4cm or longitudinal incisional if > 4cm

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73
Q

margin for soft tissue sarcoma

A

2 cm

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74
Q

chemo used if trying to limb spare in soft tissue sarcoma

A

doxorubicin based, also do XRT

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75
Q

post op chemo XRT for which soft tissue sarcoma

A

high grade, close margins, tumor > 5cm

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76
Q

soft tissue sarcoma MAID

A

mesna, doxarubicin, ifosfamide, dacarbazine

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77
Q

5 year survival for soft tissue sarcoma with resection

A

40%

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78
Q

NF1

A

CNS, peripheral nerve sheath, pheochromocytoma

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79
Q

gene in NF1

A

neurofibromin

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80
Q

gene in NF2

A

merlin

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81
Q

NF2

A

acoustic nerve tumor

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82
Q

LiFraumeni gene

A

p53

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83
Q

LiFrau cancers

A

breast, brain, acute leukemia, soft tissue sarcoma, adrenal cortical carcinoma

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84
Q

hereditary retinoblastoma gene

A

RB1

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85
Q

retinoblastoma tx

A

chemo, cryotherapy, radioactive plaques, laser treatment, XRT, surgery

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86
Q

tuberous sclerosis genes

A

TSC-1 : hamartin (tumor suppressor gene)

TSC-2 tuberin (mTor pathway)

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87
Q

manifestation of TS

A

hamartoma, angiomyolipoma, brain, kidney, heart, eyes, lungs, skin. Have seizures, dev delay, skin abn, lung and kidney tumors

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88
Q

Gardners

A

Au Dom - FAP + extracolonic manifestation

89
Q

manifestations in Gardners

A

abd desmoid, osteoma of skull, thyroid ca, epidermoid cysts, fibromas

90
Q

APC gene

A

binds GSK = glycogensysthasekinase

91
Q

Merkel cell carcinoma

A

neuroendocrine, aggressive, spreads via skin and LN, mets to bone

92
Q

stains for Merkel cell carcinoma

A

NSE -neuron specific enolase, cytokeratin, NF protein

93
Q

tx merkel cell

A

SLN biopsy or LND, 2-3 cm margin, post op chemoXRT

94
Q

5 year survival merkel

A

60%

95
Q

dermatofibrosarcoma protuber RF

A

arsenic

96
Q

margin for DFP

A

3cm

97
Q

glomus tumor is benign T/F?

A

T

98
Q

where to ligate if need sympathectomy for hyperhid

A

T2-T4

99
Q

crossing nerve of kuntz

A

2nd rib

100
Q

HPV cancer types

A

16 and 18

101
Q

Gleevec used in

A

GIST, CML, recurrent or metastatic DFP

102
Q

all thymomas require resection T/F

A

T

103
Q

pleomorphic (mixed) parotid tumor

A

benign

104
Q

warthin tumor

A

benign

105
Q

mucoepidermoid or adenoid cystic carcinoma

A

malignant

106
Q

acinic cell carcinoma

A

malignant

107
Q

no risk of transmission of hepatitis with transfusion of

A

albumin

108
Q

branched AA

A

leucine, isoleucine, valine

109
Q

essential AA

A

leucine, isoleucine, valine

110
Q

where are essential AA metabolized?

A

skeletal muscle

111
Q

fibroblasts are stim by

A

macrophages

112
Q

central cord injury

A

ext weak arms>legs

113
Q

posterior cord injury

A

paraplegia with loss of propriocept and vibration, pain and temp are preserved

114
Q

can enhance immune fxn

A

arginine

115
Q

involved in collagen formation

A

proline

116
Q

involved in signal transduction

A

tyrosine

117
Q

involved in protein metab and citric acid cycle

A

glutamine

118
Q

muscle protein synthesis AA

A

leucine

119
Q

echo in blunt cardiac injury if

A

HD unstable

120
Q

abnormal EKG in blunt cardiac injury mandates

A

24-48 hr stay

121
Q

calcitonin

A

decreased Ca and Phos levels

122
Q

calcitonin increased in which thyroid cancer?

A

medullary

123
Q

calcitonin ____osteoclast activity

A

inhibits

124
Q

where is calcitonin produced?

A

C cells in thyroid

125
Q

Colon cancer T1

A

submuc

126
Q

colon cancer T2

A

muscularis prop

127
Q

colon cancer T3

A

subserosa

128
Q

colon cancer T4a

A

visc peritoneum

129
Q

colon cancer T4b

A

other organs

130
Q

colon cancer N1

A

1-3 nodes

131
Q

colon cancer stage 1

A

T1N0M0 or T2N0M0

132
Q

colon cancer stage 2

A

A: T3 N0M0
B: T4 N0M0

133
Q

colon cancer stage 3

A

A: T1N1M0 or T2N1M0
B: T3N1M0 or T4 N1M0
C: any T, N2, M0

134
Q

colon cancer stage 4

A

any T any N M1

135
Q

hereditary spherocyt

A

splenect after age 5, Au Dom, eval if need chole, Coombs will be negative

136
Q

CPP=

A

MAP- ICP

137
Q

risk of SSI with dirty case

A

30%

138
Q

risk of SSI with clean

A

2%

139
Q

risk of SSI with clean contam

A

4%

140
Q

risk of SSI with contaminated

A

8%

141
Q

splenic abscess tx

A

splenectomy

142
Q

panc abscess tx

A

open drainage

143
Q

lung abscess tx

A

antibiotics alone

144
Q

perirectal abscess tx

A

open drainage

145
Q

epidural abscess tx

A

open drainage

146
Q

gold std for diagnosing C diff

A

stool cytotox assay, but takes 24-48

147
Q

aspergillosis tx

A

voriconazole or amphotericin

148
Q

actinomyces tx

A

PCN- G

149
Q

nocardia tx

A

bactrim

150
Q

SBP is usually ___microbial

A

mono - E coli, pneumoco, klebsiella

151
Q

PD cath infections

A

Staph aureus

152
Q

tx PD cath infection

A

vanc + gent, remove catheter if fungal, pseudomonas, TB

153
Q

tetanus tx if clean wound and vaccinated

A

No TIG, no TD

154
Q

digoxin mech

A

inhibits Na/K to increase myocardial Ca, slows AV conduction, inotropic effect

155
Q

SE of digoxin

A

hypokalemia, arrhythmia, visual changes, decreased blood flow to intestines

156
Q

ASA OD

A

first respiratory alkalosis then metabolic acidosis

157
Q

Ambien mech

A

zolpidem GABA R agonist

158
Q

tramadol SE

A

seizure

159
Q

duloxetine mech

A

SNRI

160
Q

_____ can facilitate closure of fistulas in Crohns

A

infliximab

161
Q

tx benzo OD

A

flumazenil

162
Q

Wilsons/Cu OD

A

penicillamine

163
Q

hemachromotosis/Iron

A

deferasirox

164
Q

lead poisoning tx

A

dimercaptosuccinic acid

165
Q

drotecogin alfa activated

A

activated prot C used to prevent thrombosis in septic patients

166
Q

fast onset, less myocardial depression, less laryngospasm

A

sevoflurane

167
Q

pungent and airway irritation

A

desflurane and isoflurane

168
Q

enoflurance SE

A

seizure

169
Q

halothane

A

slow onset, highest myocardial depression and arrhythmias, least pungent

170
Q

halothane SE

A

hepatitis, fever, eosinophilia, jaundice, increased LFTs

171
Q 
caloric requirement
a. 0-1
b. 1-7
c. 7-12
d. 12-18
e >18
A

kcal/kg/day

a. 90-125
b. 75-90
c. 60-75
d. 30-60
e. 25-30

172
Q

FW deficit =

A

TBW x (serum Na-140)/140

173
Q

TBW =

A

in men weight x 0.6 in women weight x 0.5

174
Q

adrenocortical carcinoma stage I

A

< 5 cm no local invasion, no mets

175
Q

adrenocortical carcinoma stage 2

A

> 5cm, no local invasion, no mets

176
Q

adrenocortical carcinoma stage 3

A

any T, any N, M0

177
Q

adrenocortical carcinoma stage 4

A

M1

178
Q

potency of steroids

A

hydrocort < predni < methylpred < dexameth

179
Q

finasteride mech

A

5 alpha reductase inhibitor

180
Q

tx of mediastinitis

A

debridement and flaps

181
Q

hepatoblastoma

A

6 mo - 3 yrs, increased AFP, most p/w unresectable disease, associated with Beckwith-Wiedemann

182
Q

malignant phyllodes mets to

A

lungs

183
Q

Tetralogy of Fallot

A

overriding aorta, VSD, R vent outflow obst, RVH

184
Q

highest MAC

A

NO

185
Q

CI to using NO

A

PTX, SBO

186
Q

Ranson criteria

A

WBC > 16, age >55, glucose >200 Hct decrease 10%, Ca <8 fluid >6L

187
Q

avoid this anesthesia agent if egg allergy

A

propofol

188
Q

paralysis first to go

A

face

189
Q

paralysis last to go

A

diaphragm

190
Q

paralysis first to recover

A

diaphragm

191
Q

paralysis last to recover

A

face

192
Q

undergoes hoffman elimination

A

cisatracuronium

193
Q

rocuronium metab in

A

liver

194
Q

pancuronium metab in

A

kidney

195
Q

max dose lidocaine

A

5mg/kg

196
Q

max dose marcaine/bupiv

A

3mg/kg

197
Q

avoid this benzo in pregnancy

A

versed (midazolam)

198
Q

calories needed in burn patient

A

25kcal/kg/day + 30kcal/day x %burn

199
Q

protein needed in burn patient

A

1-1.5 g/kg/day + 3gx % burn

200
Q

harris benedict equation

A

calculates basal metabolic rate from weight, age, height and gender

201
Q

medium and short chain FA enter

A

portal system after entering enterocytes by simple diffusion

202
Q

long chain FA enter

A

lymphatics (they enter along with chylomicrons)

203
Q

FA synthesis occurs where

A

cytoplasm

204
Q

saturated FA are used by

A

liver and heart

205
Q

majority of body total cholesterol

A

is synthesized, not dietary

206
Q

essential FAs

A

linoleic and linolenic

207
Q

sucrose=

A

fruc + gluc

208
Q

lactose =

A

galact + gluc

209
Q

maltose =

A

gluc + gluc

210
Q

Refeeding syndrome

A

decreased K, Mg, Phos

211
Q

S phase specific agents

A

MTX, 5FU, pemetrexed, gemcitabine, etoposide, doxorubicin

212
Q

SERMs

A

Tamoxifen - premenopausal, Raloxifene - post menopausal

213
Q

MEN1

A

pit adenoma, parathyroid hyperplasia, panc tumor

214
Q

MEN 2A

A

parathyroid hyperplasia, MTC, pheo

215
Q

MEN 2B

A

mucosal neuroma, marfanoid, MTC, pheo

216
Q

parathyroid hyperplasia, MTC, pheo

A

MEN 2A

217
Q

pituitary adenoma, parathyroid hyperplasia, panc tumor

A

MEN1

218
Q

mucosal neuroma, MTC, marfanoid, MTC, pheo

A

MEN2 B

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