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Unit 5 SIGS Review
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How does gluten cause dermatitis herpatiformis?
Genetically predisposed individuals develop IgA antibodies to gluten, which cross-reacts with reticulin in lamina propria. Injury and inflammation =blister
Explain the relationship between cirrhosis and ascites
Liver insufficiency→ portal hypertension→ ↑ pressure within hepatic circulation →fluid exudes from plasma in capillaries into interstitial tissues
Which hepatitis has reverse transcriptase as a virulence factor?
Hep B
Describe the biochemical pathway of lipid and carbohydrate metabolism and how it contributes to dyslipidemia
TG packaged as chylomicrons → Apo CII binds to LPL ↑FA deposition into adipose & muscle → remnant travels to liver endocytosed by LDLR →repackaged as vLDL
Compare and contrast how liver enzyme labs would differ between pancreatitis and NAFLD
Pancreatitis ↑Alk phos ↑GGT; NAFLD ↑AST<↑ALT
What is the relationship between GLP-1 receptor agonist and DDP-4 inhibitors?
GLP-1 binds to α-cells in the pancreas (and more) and prevents glucagon secretion (↓ catabolism). DPP-4 inhibits GLP-1
What protein is released with insulin from pancreatic ß-cells?
c-peptide
What demographic is most likely to precipitate cholestrol gallstones? (Remember the F's)
Female, Forty, Fat, Fertile
Hypocalcemia in the context of acute pancreatitis indicates
Fat necrosis (saponification)
What does Ranson's criteria evaluate? Is it better to have a high or a low score?
Assesses pancreatitis severity and risk of mortality; mortality liklihood increases w/ higher score
1) Describe Cullen's sign, Grey Turner's sign, or Fox's Sign 2) What do those findings indicate?
1) (C) periumbilical ecchymosis; (GT) flank ecchymosis; (F) ecchymosis over inguinal ligament. 2) Acute pancreatitis
What chapman point is at the right medial 5th and 6th intercostal space?
Liver (posterior TP = right T5 and T6 transverse processes)
What is the MOA of Rotatvirus's NSP4 protein?
Alters calcium ion influx into enterocytes and disrupts the tight junctions, causing water to leak into the bowel lumen
Outline the pathogenesis of Helicobacter pylori infection
bacteria ingested --> organism colonizes the stomach using urease to protect from gastric acid --> host inflammatory response damages mucosa --> bacteria invade
Name 2 risk factors for peptic ulcer disease
Helicobacter pylori, chronic NSAID use, Zollinger-ellison syndrome
What is the most clinically important sequalae of Barrett's esophagus?
esophageal adenocarcinoma
Name 4 out of 5 osteopathic models of care
Biomechanical, Neurological, Respiratory-circulatory, Metabolic, Behavioral
How does heat labile toxin exert its effects in Enterotoxogenic E. coli?
Catalyzes ADP ribosylation and stimulates adenylate cyclase to increase cAMP --> hypersecretion of water and electrolytes into bowel lumen
What is the MOA of loperamide?
Binds to mu-opioid receptors and decreases peristalsis


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