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Contributor score: 7

 +0  (nbme20#2)

[moved to subcomment]

 +1  (nbme21#34)

"Excitatory amino acids" refers to glutamate, while "Biogenic" apparently refers to tyrosine, the precursor AA to dopamine and norepi.

 +0  (nbme20#21)

I also was thinking M. avium here, but hypersensitivity pneumonitis seems to fit with the reticulogranular changes.

 +0  (nbme20#44)

Thought this would be something regarding "bariatric surgery," but nope, just "no starchy foods, because you're pre-diabetic."

 +1  (nbme20#35)

Liver looks pretty normal-sized to me. Pic here for comparison

 +2  (nbme20#2)

How to differentiate between Norovirus and Rotavirus here? Must be related to the the contagious nature of the illness?

 +0  (nbme21#36)

This review suggests that enchondroma and chondrosarcoma are unable to be differentiated on histology alone. According to Orthobullets:

"unlike enchondroma, most chondrosarcomas have non-mechanical pain (rest pain and nocturnal pain)"

Guess this diagnosis is made on history.

 +0  (nbme21#4)

I might be the only person on earth who got this one wrong, but regardless:

"ITT analysis includes every subject who is randomized according to randomized treatment assignment. It ignores noncompliance, protocol deviations, withdrawal, and anything that happens after randomization."[1]

 +0  (nbme23#35)

The best I can understand, they're describing endometrial hyperplasia, a result of excess estrogen, a steroid hormone that translocates to the nucleus and binds its transcription factor.

 +1  (nbme20#36)

Apart from the line in FA referencing PMN infiltrate in Shigella, there is no way to differentiate here between it and E. Coli. Cheap shot.

 +1  (nbme21#42)

[moved to subcomment]

 +1  (nbme21#6)

This has been a tough concept for me to get, but I think I'm finally there:

The stem is describing primary adrenal insufficiency, or Addison's.

  • ACTH is being over-produced to stimulate the adrenals to produce cortisol, but they can't respond, either due to atrophy or destruction (TB, autoimmune: DR4, etc.)
  • The first 13 amino acids of ACTH can be cleaved to form α-MSH, which stimulates melanocytes, causing hyperpigmentation