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What is the biochemical explanation for why G6PD deficiencies are so prevalent in Africa?G6PD deficiencies result in elevated cellular ROS because of limiting NADPH; malarial parasites cannot survive in a high ROS environmentG6PD deficiencies result in elevated cellular ROS because of limiting NADH; malarial parasites cannot survive in a low ROS environment.G6PD deficiencies result in elevated NADPH levels, which are toxic to malarial parasites because the reducing power of NADPH is elevated.G6PD deficiencies result in elevated cellular ROS because of limiting NADPH; malarial parasites cannot survive with high levels of NADP+.G6PD deficiencies result in elevated levels of reduced glutathione; malarial parasites can only survive when GS-SG levels are elevated.

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Bertil, 55 år, har tidigare vid några tillfällen sista månaderna i samband med måltid haft känsla av att maten fastnar när han skall svälja. Det har dock inte varit allvarligare än att han har kunnat avvakta en stund och så känns det bättre. På julafton äter han sin lutfisk och sill, så fastnar tuggan mitt i matstrupen och hur än Bertil harklar sig så går tuggan varken ned eller upp. Han söker därför upp dig i egenskap av julaftonsjour på ÖNH-kliniken. Han är klart besvärad av obehaget, men kan dock svälja sin saliv. Du noterar i status: AT, opåverkad. MoS, retningsfritt. Hypofarynx/larynx, vänstersidig stämbandspares. Ingen synlig främmande kropp. Inga slemsjöar i sinus piriformis.a) Tycker du att det finns anledning att utföra någon vidare diagnostisk undersökning akut på julaftonskvällen? I så fall, vilken och varför?Man esofagoskoperar därefter Bertil akut och finner då en stor bit lutfisk i proximala esofagus. Området strax nedanför där främmande kroppen suttit, ser trångt och irriterat ut. Slemhinnan är rodnad och lättblödande.b) Vilken bakomliggande sjukdom är troligt med ledning av ovanstående statusfynd och skopifynd?På juldagsmorgonen får Bertil tilltagande ont retrosternalt och feber. Akut CRP är 97. c) Vilken allvarlig komplikation bör man utesluta att Bertil drabbats av?

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