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IMF-089-02-0001-en	How does acetyl-CoA reach the cytosol for fatty-acid synthesis, and how does that route also supply NADPH?	When energy and carbon are abundant it is exported as citrate, which ATP-citrate lyase cleaves to acetyl-CoA and oxaloacetate; oxaloacetate returns via malate and pyruvate, with malic enzyme generating extra NADPH.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0002-en	How is acetyl-CoA carboxylase, the committed step of fatty-acid synthesis, matched to fuel status?	Citrate promotes its polymerisation and activity and long-chain acyl-CoA inhibits it; insulin favours its dephosphorylation and expression, while AMP-activated kinase phosphorylates and inhibits it during energy stress.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0003-en	Why are linoleic and alpha-linolenic acids essential, and why does dietary intake of long-chain forms still matter?	Humans insert double bonds only at selected positions and cannot make them; conversion to longer omega-6 and omega-3 forms is limited and competes for enzymes, so dietary long-chain forms shape membranes and mediators.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0004-en	Why do defects in cardiolipin remodelling affect heart and skeletal muscle?	Cardiolipin is enriched in the inner mitochondrial membrane and supports respiratory complexes, so remodelling defects cause cardiomyopathy and skeletal myopathy, along with neutropenia.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0005-en	Why can phosphatidylserine on the outer leaflet act as a signal?	Membrane leaflets are asymmetric and enzymes actively preserve that distribution, so external phosphatidylserine marks apoptotic cells and activated platelets.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0006-en	How does a single phospholipase C cleavage generate two intracellular signals?	Cleaving phosphatidylinositol 4,5-bisphosphate yields diacylglycerol, which activates protein kinase C, and inositol trisphosphate, which triggers calcium release.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0007-en	What distinguishes where NSAIDs, glucocorticoids and leukotriene modifiers act on eicosanoid production?	Nonsteroidal anti-inflammatory drugs inhibit cyclooxygenases, glucocorticoids suppress upstream and transcriptional components, and leukotriene modifiers target selected pathways.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0008-en	Why do statins increase low-density-lipoprotein receptors?	Inhibiting HMG-CoA reductase lowers hepatic cholesterol; with sterols low, SREBP moves from endoplasmic reticulum to Golgi for activating cleavage and induces synthesis and uptake genes.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0009-en	Why does cholesterol elimination depend on bile?	Humans cannot degrade the sterol ring to carbon dioxide, so elimination relies on biliary cholesterol and bile-acid excretion, and bile acids are themselves reabsorbed in ileum and returned via the portal vein.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0010-en	Why does apolipoprotein B estimate atherogenic particle number, and when does it disagree with LDL cholesterol?	Each VLDL, IDL and LDL particle carries one nonexchangeable apoB-100, so apoB tracks particle number while LDL cholesterol estimates carried cholesterol; they diverge when particles are unusually cholesterol-poor or rich.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0011-en	Why has pharmacologically raising HDL cholesterol not reliably improved outcomes?	HDL cholesterol concentration is an epidemiological marker that does not fully measure particle function in accepting cellular cholesterol and returning it.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0012-en	Why does deficiency of lipoprotein lipase or apolipoprotein C-II produce chylomicronaemia?	Apolipoprotein C-II activates lipoprotein lipase, so loss of either prevents triacylglycerol hydrolysis, causing severe hypertriglyceridaemia with chylomicronaemia and pancreatitis risk.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0013-en	Why is lipoprotein(a) measured in selected risk assessment rather than managed mainly through lifestyle?	Its concentration is largely inherited and lifestyle has limited effect, yet it adds atherosclerotic and calcific-valve risk through particle retention and prothrombotic or inflammatory properties.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending
IMF-089-02-0014-en	Why can choline deficiency contribute to fatty liver?	Steatosis arises when fatty-acid uptake and synthesis exceed oxidation and export, and choline deficiency impairs phosphatidylcholine and lipoprotein export.	Integrated Medical Foundations; chapter 89, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 3ff6215e87e81029e9b202bcf0b82878fa98fd026115cb5f240478cc5b6c7c72; editorial review pending	imf lang::en chapter::089 module::089-02 review::pending