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Intraductal papillomas are also under the areola
... pyruvate is shunted over and is used by LDH (lactate dehydrogenase) to generate lactate*.
It's hinted in the answer, but I would like to clarify: max O2 consumption is decreased because O2 is consumed in the Electron Transport Chain, which occurs in the mitochondria. With the mitochondria not working, the ETC cannot work, and thus there is less demand for Oxygen.
Apparently ragged red fibers are the result of coarse subsarcolemmal or intermyofibrillar mitochondrial accumulations.. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/mitochondrial-myopathy
As @chris07 said, less O2 is being consumed in the ETC... but I also was thinking that the diaphragm is a muscle and if the mitochondria in her diaphragm are also not functioning, then she's not breathing properly and less O2 is being inhaled and therefore decreasing her oxygen consumption. Is that totally off base or am I just grasping at straws here?
How did you know that this wasnt oral hairy leukoplakia? just from the picture?
To piggyback off of @hpkrazydesi, you ruled out oral hairy leukoplakia because the patient was seeing the doctor for normal health maintenance, i.e. not immunocompromised, I'm assuming.
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Why wouldn't this be similar to a Type 2 RTA where urinary pH <5.5?
I can't remember exactly what the question was asking off the top of my head, I think it was asking about relative to normal? But I think you're right in that the alpha intercalated cells (AIC) can still dump H+ into the urine and acidify it to an extent. And, like in RTA2, I don't know that the action of the AIC would be able to overcome the bicarb and acidify the urine enough for it to be the usual pH, so the urine should still be more alkaline compared to baseline. Kinda sucks, pH less than 5.5 should technically be acidic but it's alkaline for pee.
JK, normal urine pH is around 4-8, but I guess they consider closer to 5.5 on the more alkaline side...? I guess I would go more off that the alpha intercalated cells can't completely compensate for the amount of bicarb in the pee due to the CA inhibitor, not so much the actual pH.
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