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Comments ...

 +0  (nbme21#50)

My thought was that this is endemic typhus from louse [on a cruise, rash only on the trunk, arthralgia]


Honestly, even if it is dengue was the same answer shrug emoji

uslme123  I did too ... but It looks like the timing fits better for denge.

 +4  (nbme20#44)

I think this one has to do with "late dumping syndrome"-- basically, starchy foods cause hyperglycemia --> release of insulin --> catecholamine surge --> diarrhea, etc.

Subcomments ...

I think it has something to do with glycine (due to its small size it can fit in many places where other amino acids can not and hence it provides “structural compactness” to the collagen, i.e. put a kink in the alpha helix). If glycine is misplaced by something else, I don’t think pro-collagen can form its correct secondary structure.

jotajota94  True! also, glycine is 1/3 of collagen alfa chains, so it makes sense that substitution with alanine (which is much bigger) would lead to disruption in the alpha helix formation. +  
jotajota94  True! also, glycine is 1/3 of collagen alfa chains, so it makes sense that substitution with alanine (which is much bigger) would lead to disruption in the alpha helix formation. +  
thepacksurvives  Glycine is small and bendy, which allows it to form the fibrils for the triple helix +  

Ok I get that if 500 already have the disease then the risk pool is dropped to 2000 students but the question specifically says that the test is done a year later...if 500 people had chlamydia, you would treat them. You don't become immune to chlamydia after infection so they would go back into the risk pool, meaning the pool would return to 2500. The answer should be 8%, this was a bad question.

thepacksurvives  Yeah, this was my issue. I got it wrong because of this-- still don't understand the logic bc you can get chlamydia multiple times +1  
hungrybox  FUCK you're right. Damn I didn't even think about that. That's fucking dumb. I guess this is why nobody gets perfect scores on this exam lol. Once you get smart enough, the errors in the questions start tripping you up. Lucky for me I'm lightyears behind that stage lmao +3  
usmile1  to make it even more poorly written, it says they are doing a screening program for FIRST YEAR women college students. So one year later, are they following this same group of students, or would they be screening the incoming first years? +3  
dashou19  I think the same at first, but after a second read, the question stem said "additional" 200 students, which means the first 500 students don't count. +  

submitted by ergogenic22(55),

A stretch injury during childbirth will result in damage to the external uretheral and anal sphincters and damage to the pudendal nerve (S2-S4). This can lead to decreased sensation in the perineal and genital area and fecal or urinary incontinence

thepacksurvives  I think that there can also be a direct tear to the anal sphincter muscles +  
sympathetikey  A better answer choice would have been "damage to the nerves innervating the anal sphincter" but eh, ok. +4  

submitted by celeste(38),

Sounds like a hypertrophic scar. "Hypertrophic scars contain primarily type III collagen oriented parallel to the epidermal surface with abundant nodules containing myofibroblasts, large extracellular collagen filaments and plentiful acidic mucopolysaccharides." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022978/

johnthurtjr  I think it may actually be a keloid, not a hypertrophic scar, as it expands beyond the borders of the original incision. +2  
thepacksurvives  I believe this is a keloid; a hypertrophic scar does not extend past the borders of it's original incision, while a keloid does. regardless, the answer to this question is the same :) +  
breis  First AID pg 219 Scar formation: Hypertrophic vs. Keloid +  
charcot_bouchard  They give granulation tissue is a option which is type 3 collagen. so if it was hypertrophic scar it would be ap problem since its only excessive growth of Type 3. while keloid is excessive growth of both 1 and 3 +3