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How does heparin work?
activates antithrombin III which blocks the effects of thrombin
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how does Warfarin work?
Blocks the effects of Vit K, which is needed in all the boxed entries of the clotting cascade
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how does aspirin work as a blood thinner?
blocks platelet enzymes involved with the production of thromboxanes, preventing the recruitment of platelets into a platelet plug
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how does elevated gastrin result in elevated HCl secretion?
- -gastrin stimulates parietal cells
- -gastrin stimulates ECL cells to release histamine, which stimulates parietal cells to release HCl
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How does H. Pylori mess with stomach homeostasis?
- 1) they don't like acid, so they go the epithelial surface (in mucosal layer)
- 2) release urease to make it a more basic environment
- 3a) when in antrum: more basic environment stimulates G-cells to make gastrin, causing HCl hyposecretion
- 3b) when in corpus: they screw with the protective barrier, also cause hyposecretion
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Why ask about NSAIDS in stomach ulcer cases?
inhibit prostaglandins needed to mediate pain. However, these prostaglandins are also needed to produce mucosal barrier
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describe the formation and metabolization of bilirubin and where the process goes wrong in cirrhosis
- -formation: heme broken down by marcophage in spleen to make bilirubin. Albumin necessary to carry BR to the liver
- -metabolization: conjugated with glucoronic acid and glucoronal transferase to make it water soluble. Then it can be sent to the bile duct and SI
- -pathology: liver is damaged, so BR stays unconjugated and in the bloodstream, makes pee tea coloured.
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How does lasix work as a diuretic
inhibits the NaK2Cl cotransporter in the ascending LOH. This later translates into less H2O being reabsorbed
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How do thiazides work on the kidneys?
Inhibits the Na-Cl symporters in the DCT
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How does spironolactone work on the kidney?
It is an aldosterone atagonist. Therefore means a reduction in the Na-K antiporters in the late DCT.
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How does an ACE inihibitor work?
- -blocks the conversion of ANGI to ANG II
- -prevents vasoconstriction
- -lowers Na+ uptake in PCT directly
- -mostly lowers aldosterone production, which lowers the Na-K antiporters
- -may cause hyperkalemia
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How is bicarbonate generated and recycled in the kidney?
- recycled: filters out of glom freely, combines with H+, water and CO2 are reabsorbed and then convert back to
- generated: glutamate converted to NH3 and HCO3- in PCT
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How does excess cortisol account for the following symptoms: muscle atrophy, osteoporosis, easy bruising, increased appetite, central obesity
- muscle atrophy: increases proteolysis
- osteoporosis: decreases collagen synthesis, inhibits Vit D (decreasing Ca+ absorption)
- easy bruising: decreased collagen synthesis causes endothelium to rupture easily
- increased appetite: stimulated by cortisol
- central obesity: excess calories deposited centrally for unknown reasons
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What can cause cortisol hypersecretion?
- -exogenous steroid treatments usually (like pregnosone)
- -pituitary and pancreatic tumors (produce ACTH)
- -adrenal gland tumors
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What are the two main factors in the etiology of menopause?
- 1) decreased estrogen (because of decreased follicles)
- 2) The follicles that remain are increasingly resistant to FSH
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