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Welcome to thepacksurvives’s page.
Contributor score: 14

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 +0  (nbme21#50)
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uslme123  I did too ... but It looks like the timing fits better for denge. +

 +3  (nbme20#44)
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merpaperple  It's not necessarily late dumping syndrome, this is the dietary guideline for early dumping syndrome too. Based on UpToDate and ScienceDirect this is how it works: Absent or dysfunctional pyloric sphincter -> food is rapidly emptied from the stomach into the small bowel -> hypertonic solution forms in the jejunum -> rapid fluid shifts from the plasma into the bowel -> hypotension and SNS response (eg. colicky abdominal pain, diarrhea, nausea, tachycardia) Simple carbohydrates are more hypertonic, I think. +2
j44n  starches are complex carbs= more than 2-3 sugar molecules, if they have dumping syndrome they have decreased gastric transit time= more undigested carbs are delivered to the intestines and that gives you more carbs for bacteria to break down (flatulence and osmotic diarrhea) +

Subcomments ...

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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 +  
brasel  Also in general (FA 2018 pg 50) OI is from problems forming the triple helix which is secondary structure. Fortunately, they gave us something to reason with in the question (Gly->Ala) +2  

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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 +5  
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 +8  
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? +5  
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. +  
santal  @hungrybox You are me. +1  
neovanilla  @usmile1 I was thinking the exact same thing... +1  
happyhib_  I agree this is a trash question; I was like well if this is done yearly for new freshman the following year would be of the new class (but the word additional made me go against this). Also you could assume that they were treated and no longer have the disease... I dont like it honestly but know for incidence they want you to not include those with disease so i just went with dogma questions on incidence to get to 10% +  

submitted by ergogenic22(303),
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thepacksurvives  I think that there can also be a direct tear to the anal sphincter muscles +6  
sympathetikey  A better answer choice would have been "damage to the nerves innervating the anal sphincter" but eh, ok. +20  
nerdstewiegriffin  I it is due to actual tear of external and or internal anal sphincter Source uptodate +2  

submitted by celeste(79),
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johnthurtjr  I think it may actually be a keloid, not a hypertrophic scar, as it expands beyond the borders of the original incision. +5  
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  
bharatpillai  I literally ruled put collagen synthesis defect since this is not a collagen synthesis defect at all ( EDS, Scurvy) :/ hate these kind of questions +