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 +0  (free120#5)

Formation of granulation tissue (Day 3-7 of healing): Fibroplasia leads to the synthesis and deposition of type III collagen. Growth factors (ie- VEGF) from fibroblasts and epithelial cells promote angiogenesis. (Credit- Amboss)

 +0  (free120#37)

https://www.youtube.com/watch?v=VsMw7DwwSPU This video explains it really well!

 +0  (nbme21#48)

Pyridostigmine is an acetylcholineserase inhibitor used long term for MG (Sketchy). Put pyridostigmine as my answer because it does treat MS. But yes baclofen is a classic anti-spasm drug.

 +0  (nbme20#16)

Per boards and beyond, in the lateral pons is there is the spinal V nucleus which carries contralateral pain and temperature. Knowing that + CN V arises it in the pons, I went with pons. The only other option I had left not crossed out was cerebral hemisphere but that seemed to broad.

Subcomments ...

confused why this is not autonomic dysfunction or hyponatremia due to sweating and why is this orthostatic hypotension?

mdmofongo  This one is tricky and come downs to choosing the “best” option. I can see why you were confused. However do note that in an autonomic dysfunction you will never present tachycardia as this patient does. I guess the key here is seeing how her BP normalizes once she is laying down? Sorry, this one is a kinda unusual presentation of Orthostatic hypo. +  
mamed  Not sure if this is correct thinking but how I got this right was: 1. She is hypovolemic 2. Likely retaining salt so water follows (ADH or just renal dynamics in general). This is how I ruled our hypokalemia and hyponatremia 3. If she is hyponatremic b/c sweating then why wouldn't she also be hypokalemic? so both have to wrong because both can't be right 4. Volume depletion ==> orthostatic hypotension +  

While E coli is normal gut flora, your body would prefer it stay intraluminal.

tallerthanmymom  Just remember that E.Coli and Bacteriodes Fragilis (sp?) are the 2 main gutys that cause intraperitoneal infections from the gut. +2  
bharatpillai  Why not citrobacter though? +2  
mamed  Common organisms involved in gangrenous and perforated appendicitis include Escherichia coli, Peptostreptococcus, Bacteroides fragilis, and Pseudomonas species (UpToDate) +  

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