Rejected at 10:41 p.m. Oct, 31, 2023 ] by dollajas
Author: thomas.holmes
Related Note: 1572623455160
Rationale for change

Endothelin-1 is a vasoconstrictor, not vasodilator. Additionally, the mechanism appears to be wrong (according to Amboss). Amboss lists the mechanism as occuring due to reduced metabolism of endotoxins from GI bacteria, stimulating production of cytokines and NO (vasodilator). See Hepatopulmonary Syndrome in Amboss for full mechanism.

Rejection reason

endothelin 1 is still increased according to amboss

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#PANCE::EOR::Family_med #AK_Step1_v12::#FirstAid::09_Gastrointestinal::04_Pathology::31_Cirrhosis_and_portal_hypertension::*Hepatopulmonary_Syndrome #AK_Step1_v12::!FLAG_THESE_CARDS::SketchyPathAdds #AK_Step1_v12::#OME_banner #AK_Step1_v12::^Other::^EXPN::JBadd #AK_Step1_v12::#SketchyPath::06_Hepatobiliary::02_Liver_Disease::01_Cirrhosis_-_Pathogenesis_&_Clinical_Manifestations #AK_Step2_v12::#FirstAid::06_Gastrointestinal::11_Liver_Disease::08_Hepatopulmonary_Syndrome #AK_Step1_v12::#Low/HighYield::4-LowerYield #AK_Step1_v12::#NBME::25 #AK_Other::#AK_Original_Decks::Step_1::Zanki_Step_Decks::Zanki_GI::GI_Pathology #AK_Step1_v12::^Systems::GI::JBadds #AK_Step1_v12::^Systems::GI::pathology