Metabolism
What is the rate limiting enzyme in fatty acid synthesis
Acetylcoa carboxylase (ACC)
Relaxation of the BLANK leads to GERD and maybe even intestinal metaplasia/adenocarcinoma of the esophagus?
Lower Esophageal Sphincter
What is the round ligament a remnant of?
the fetal umbilical vein
From what artery do the inferior pancreaticoduodenal branches arise?
SMA
What diabetes drug is a K+ channel blocker and causes the release of insulin from pancreatic beta cells?
Sulfonylurea
Increased breakdown of what causes gout
purines, makes increased uric acid
Where does squamous cell carcinoma of the esophagus typically present
upper/middle esophagus
What metabolizes both ethanol and tylenol?
CYP2E1
What two enzymes are secreted in their active form from the pancreas
amylase and lipase
How does metformin, a complex 1 inhibitor, increase glucose uptake into muscles?
lowers ATP, which increases AMP, this activates AMPK, which causes GLUT4 to translocate to the membrane and take up glucose into muscles
What enzyme do statins inhibit and what is the effect
HMGCoA reductase, increases LDL receptor density to lower LDL
Name the three molecular mechanisms that cause release of HCL from parietal cells and where they come from
Gastrin from G cells
Ach from the vagus nerve
Histamine from ECL cells
What are two consequences of liver failure that are also contraindications for TIPS?
encephalopathy and coagulopathy
What type of injury do you have when AlkPhos is elevated to a greater magnitude than AST/ALT?
Cholestatic injury
What two drugs can be used to lower cholesterol in an LDL receptor independent manner?
lomitapide (MTP inhibitor)
evanicumab (ANGPLT3 inhibitor, disinhibits LPL)
What glycogen storage disease presents with early liver failure and abnormally long glycogen molecules?
Anderson, defect in branching enzyme
What test is used to diagnose Zollinger-Ellison syndrome?
Secretin stimulation test, usually should lower gastrin levels but does not in a gastrinoma (it actually increases). Secretin is secreted by S cells in the duodenum in response to a high acid content
What is the condition where you have a backup of blood into Zone 3 due to a thrombus in the hepatic veins?
Budd-Chiari syndrome
What activates the acinar cells and the ductal cells in the pancreas and what cells do these signals come from?
acinar= CCK I cells of the duodenum
ductal= secretin S cells of the duodenum
What drug is used to treat tyrosinemia type 1?
nitisinone
A deficiency in what enzyme causes Alkaptonuria
homogentisate oxidase
Which cancer of the stomach has a molecular marker like lobular carcinoma of the breast and what is the marker?
Loss of E-cadherin; diffuse gastric adenocarcinoma
What are the two values considered in the Maddrey score?
PT and total bilirubin
What type of gallstones does sickle cell cause?
Pigmented due to high unconjugated bilirubin
This drug causes the relaxation of muscles and may be used to treat malignant hyperthermia in a DNP overdose.
Dantrolene