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We conclude, therefore, that NBCE's conduct does not make up State action. Nor does the plaintiff have a protectable home interest, or "legitimate claim of privilege" to sitting for the NBCE's examination unlimited times without reschooling, or to the sort of evaluation of NBCE's evaluation that he looks for (Board of Regents v Roth, 408 U.S.

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Spinal bridging 2 akas for meal forrestier's dx, ankylosing hyperostosis meal mc seen in what pop males over 50 meal maintains disc area height and never includes facets DISH has a correlation with what other disease DM 30% Management of DISH change them! Send to endocrinologist if have DM Limited syndesmophytes AS Non-marginal syndesmophytes psoriatic or reiters if not meal Conjunctivitis/uveitis, urethritis, arthritis reiters Silver scales on extensors, pitted nails psoriatic arthritis Hyperostosis with aspect blend psoriatic or reiters (only time to think about these based on findings in the spine) Avulsion fx of ant-inf element of vert body teardrop fx Teardrop fx mc happens c2 MOI for teardrop fx hyperextension Unstable fx that can cause intense anterior cervical cable syndrome teardrop Believe MOPIT Loss of anterior body height of 25% or more MOPIT malignancy, osteoporosis, pagets, infection, trauma Radiolucent line at base of dens dens fx, OO, agenesis of dens, mach line If majority of dens is above occiput PFT, pagets, fibrous dysplasia, trauma Chamberlains line from back of hard taste buds to publish aspect of foramen magnum dens ought to be no more than 7mm above Mc, Gregor's Line from back of difficult taste buds to base of occiput dens ought to disappear than 8mm above in males, 10 in women If dens is displaced, 2 possible factors fx, unsteady OO Os Odontoideum akas (2) non-union of dens, un-united dens Management for dens fx support neck and send out to healthcare facility asap Alteration of shape of vertebral bodies PFC- pagets, fx, hereditary abnormalities Bone turns whiter blastic mets, pagets Bone turns darker lytic mets, mm Blastic mets age > 40 Pagets age > 50 Ivory white vertebra in someone under 30 then and ONLY then believe hodgkins lymphoma MC reason for ivory white vertebra blastic mets Blastic mets on bone scan hot/responsive Picture frame vertebra pagets Cortical thickening pagets Subchondral sclerosis aka eburnation Subchondral sclerosis seen in djd Vacuum phenomenon djd Damage on both sides of joint infection the only thing that will do this If post.

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Can just dx variance on APLC, but why is it deviated? V formed opacity in ST in APLC Carotid artery calcification Mc location for carotid arteries to calcify bifurcation Single white density in ST on APLC film could be Carotid artery calcification or lymph node calcification Several round white densities in a vertical line on APLC carotid artery calcification Numerous round white densities scattered (not in a vert.

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djd Bilateral symmetrical whitening of iliac side of SI jt and sacral side of SI jt not affected. OCI Management of OCI adjust SI jts, pelvic/trochanteric stabilizer belt, nutrition Triangular sclerosis of SI OCI SI condition usually seen in multiparous ladies in between 20 and 40 OCI Alteration of shape of ilium PFF pagets, fracture, fibrous dysplasia Change of color of ilium whiter: blastic mets or pagets, darker: lytic mets, mm, benign bone tumors Line drawn across top of iliac crest should bisect L4/L5 disc Last set of ribs that point down T12 If L5 is flattened or broader than normal then described as spatulated TP Change in shape of sacrum PFCF- pagets, fracture, congenital anomaly, fibrous dysplasia Mc benign growth of the sacrum giant cell tumor Vertical radiolucency in sacrum spina bifida U formed radiolucency in sacrum spina bifida Asymmetrical L5/S1 elements facet tropism Can't have bilateral aspect tropism, if both elements are sagittal then you have bilateral sagittal elements Vertical striations in a single vertebra hemangioma If body height is comparable to the height of the pedicles you know you have a crushed vertebra Ddx for crushed vertebra malignancy, infection, trauma malignancy only if no other indications of infection or trauma Winking owl sign missing out on pedicle Winking owl indication, pedicle that is present is sclerotic when compared to others surrounding agenesis of pedicle Winking owl indication, pedicle that is present looks the same when compared to others surrounding lytic mets Crushed vertebra with no indications of injury or infection, no involvement of pedicles MM MM just affects locations with active bone marrow (skull, sternum, ribs, spine, hips, prox femur, prox humerus) MM on bone scan cold Reverse A/G ratio mm Labs for MM Ig, G-M spike, reverse A/G ratio, Bence Jones Proteinuria, normocytic normochromic anemia, rouleaux formation Rouleaux development stack of coins look- on blood smear RBCs stacked up versus each other In order to Dx TP fx without displacement, you must see a bony callous (appears as a cloud of white density surrounding bone.

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Ad, The rule will end up being effective in the future when the Department submits it with the Secretary of State, at a time to be identified by the Department. The IDFPR has not released an exact date at this time, but the Department has completed all the necessary steps prior to filing and is lawfully able to adopt the guideline at any time.