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DHN - Quiz 5
Terms in this set (78)
If the carbons of amino acids are produced from glucose, are they essential or non-essential amino acids?
Are amino acids that produce acetyl-CoA or ketone bodies glucogenic or ketogenic? Are amino acids that produce pyruvate or intermediates of the TCA cycle glucogenic or ketogenic?
Glycine can be metabolized by D-amino acid oxidase, where ammonia is released and glyoxylate is produced. This glyoxylate can be transaminated back into glycine. This transamination reaction can be defective and can cause what disease? What symptom/clinical finding will be seen?
Primary oxaluria type 1, oxalate stones in the kidney
A deficiency of which enzyme causes cystathioninuria? This is the enzyme that converts cystathione to what?
What is the name of the disorder in which there is a defective carrier that normally transports cystine across the lysosomal membrane from lysosomal vesicles into the cytosol? This causes a cystine accumulation in what organelle? What happens to intracellular cysteine levels? Children with this disorder develop what problem by 6-12 years of age?
Cystinosis, lysosome, decreases, renal failure
Glutamate can be converted into glutamate semialdehyde. Glutamate semialdehyde can be converted into which two amino acids?
Proline and arginine
Histidine can form what other amino acid? In the process you produce one card for what pool?
Glutamate, tetrahydrofolate (FH4)
What disorder is caused by deficiencies in the enzymes cystathionine beta-synthase and cystathionase as well as deficiencies of methyltetrahydrofolate or methyl-B12?
Methionine can be used to make what? This can be converted down to what? In the process you have enzymes that require what co-factor? Deficiencies in these enzymes can cause what disorder?
Homocysteine, cysteine, B6, Homocystinuria
Elevations in plasma _______________ levels promote oxidative damage, inflammation, and endothelial dysfunction, and are in independent risk factor for occlusive vascular diseases such as cardiovascular disease and stroke?
What are the three branched-chain amino acids?
Leucine, isoleucine, valine
What disease is associated with a defective branched-chain alpha-ketoacid dehydrogenase? This decarboxylates what type of amino acids? Which amino acids are they?
Maple syrup urine disease, branched-chain amino acids, leucine, isoleucine, valine
What disease will give urine a burnt sugar smell and can lead to neurologic complications?
Maple syrup urine disease
Which disorder is caused by a genetic deficiency of tyrosine aminotransferase (TAT) and may lead to lesions of the eye and skin as well as neurologic problems? Patients with this are treated with a low-tyrosine, low-phenylalanine diet.
What disorder is associated with discoloration of urine and staining of diapers of infants? These patients later in life will have chronic accumulation of homogentisate (dark pigment) and will have arthritic joint pain.
Which disorder is caused by a genetic deficiency of fumarylacetoacetate hydrolase? In this condition, the acute form is associated with liver failure, a cabbage-like body odor, and death within the first year of life.
What disease results from deficiencies of phenylalanine hydroxylase? This converts what to what? This also turns what to what?
Classic PKU, Phenylalanine to tyrosine, BH4 to BH2
What disease results from deficiencies of dihydropteridine reductase? This turns what to what?
Non-classical PKU, BH2 to BH4
Severe intellectual disability, developmental delay, microcephaly, and seizures are characteristic findings of what?
Albinism occurs due a defect in the conversion of what to what?
Tyrosine to melanin
What are the solely ketogenic amino acids?
Leucine and lysine
What are the amino acids that are both glucogenic and ketogenic?
Phenylalanine, Isoleucine, Tryptophan, Tyrosine
What nutritional supplement is used for menopausal and pre-menopausal symptoms?
What nutritional supplement is used for pain, psoriasis, and osteoarthritis? What are the side effects?
Cayenne, decrease in GI motility and GI mucus damage
What nutritional supplement is used for GI spasms, indigestion, and bloating? What side effects?
What nutritional supplement is known as an anti-diabetic only?
What nutritional supplement is a diuretic and is used to reduce UTIs? What side effects?
Cranberry, kidney stones and renal insufficiency
What nutritional supplement is used for colds and URIs? What side effects?
What nutritional supplement is used for hyperlipidemia, atherosclerosis, breast cancer, and osteoporosis?
What nutritional supplement is used for hypercholesterolemia, hypertension, improvement of circulation, and prevention of stomach and colon cancer? What side effects?
Garlic, interactions with anticoagulants and oral contraceptives
What nutritional supplement is used for nausea and indigestion? What side effects?
Ginger, drug interactions with anticoagulants
What nutritional supplement is used for memory loss, vertigo, depression, and peripheral vascular disease? What side effects?
What nutritional supplement is used for diabetes, to increase respiratory endurance in exercise, and immunomodulation? What side effects?
Ginseng, hypertension with high coffee intake
What nutritional supplement is used for cancer and allergies?
Grape seed extract
What nutritional supplement is used for liver disease?
What nutritional supplement is used as an anti-aging supplement?
What nutritional supplement is used for depression, wound healing, burn, and myalgias? What side effects?
St John's wart, drug interactions
What nutritional supplement is used for CVD, oncology, osteoporosis, digestive health and weight loss? What side effects?
Black and green tea, decreased heme absorption
What nutritional supplement is used for osteoarthritis only? What side effects?
Glucosamine, drug interactions with anticoagulants and chemotherapy
What nutritional supplement is used for hyperlipidemia, antiinflammatory conditions, and osteoporosis? What side effects?
Fish oil, high doses with vitamins are teratogenic
What nutritional supplement is used for osteoarthritis and alzheimer's? What side effects?
SAM, increased homocysteine levels
A BMI under what is considered underweight? You should be concerned about a child being too thin if their BMI falls below what percentile? How do you calculate BMI?
18.5, 10%, Weight in kilograms/height in meters
What are the four classifications of eating disorders in DSM V?
Anorexia nervosa (restricting and binge/purge), bulimia nervosa, binge eating disorder, other specified eating disorder
What type of eating disorder is characterized by a very thin person who typically seem to be unaffected by food ads and cravings, have an intense fear of gaining weight, and a disturbance in the way they seen their own body?
What type of eating disorder is characterized by the person losing weight primarily through dieting, fasting, and/or excessively exercising without binging or purging episodes?
Anorexia nervosa restricting type
What type of eating disorder is characterized by the person, in the last 3 months, engaging in recurrent episodes of binge eating or purging behavior, and who is of underweight size?
Anorexia nervosa binge/purge type
What type of eating disorder is characterized by the person, within a 2 hour period but also within an average of once a week for three months, eating amount of food much larger than most people would eat during a similar period, with a sense of lack of control, and compensatory behavior in order to prevent weight gain - usually this person is of normal weight?
What type of eating disorder is characterized by the person having recurrent episodes of binge eating, with a sense of lack of control, WITHOUT compensatory behavior such as purging to prevent weight gain?
Binge eating disorder
What type of eating disorder occurs when all criteria for anorexia nervosa are met, except that the despite significant weight loss, the individual's weight is within or above the normal range?
Atypical anorexia nervosa
What type of eating disorder occurs when a person binge eats and has an inappropriate compensatory behavior that on average is less than once week for less than 3 months?
Bulimia nervosa of low frequency and/or limited duration
What type of eating disorder occurs when a person meets all the criteria for binge-eating disorder but the binge eating occurs less than once a week for less than 3 months?
Binge-eating disorder of low frequency and/or limited duration
What type of eating disorder occurs when a person has recurrent purging behavior to influence weight or shape in the absence of binge eating?
What type of eating disorder occurs when a person repeatedly gets up in the middle of the night and is aware of the food he or she is eating?
Night eating syndrome
In a person with an eating disorder, zinc deficiency will lead to what condition? What condition involves fine hair growth on the body? What is Russell's sign? What is the name of the condition where there is darkening of the area of the body to which the patient constantly applies heat? What about a dark, flaky rash over the front of the lower extremities? Blue/purple hue at ends of extremities? Yellowish color of body with eyes remaining white? What facial problems will the patient have?
Acrodermatitis, lanugo, scars on back of hand from teeth while using hand to vomit, erythema ab igne, pellagra, acrocyanosis, hypercarotenemia, parotid hypertrophy
In a person with an eating disorder would you see a high or low bone mineral density? What is this called? This is caused by low levels of what? Will you see hypocholesterolemia or hypercholesterolemia? Would you see normal or abnormal menstrual periods? Would you see hypocortisolism or hypercortisolism? Would you see normal, low, or high T4? Normal, low or high T3? Normal, low, or high TSH?
Low, osteopenia, estrogen, hypercholesterolemia, abnormal, hypercortisolism, normal, low, normal
Somatostatin is stimulated by what type of environment? Somatostatin inhibits what two cells? To reduce levels of what? Does this stimulate or inhibit acid secretion?
Acidic, ECL cells and G cells, histamine and gastrin, inhibit
Are proton pump inhibitors reversible or irreversible? Do they have a short or long half life? A short or long duration of action? Is it a prodrug? This means that it needs to be combined with what in order to be effective?
Irreversible, short, long, yes, enteric coating
Which PPI is known for inhibiting CYP2C19, the same cytochrome system that metabolizes Plavix? What would you change the drug to?
Do PPIs increase or decrease gastric pH? What will happen to gastrin levels with use of PPIs? What happens to somatostatin release? Does this increase or decrease G cell activity? Will this increase or decrease histamine release? What will the person get if PPIs are used for a long time? If you take them off PPIs abruptly what will they have?
Increase, increase, decrease, increase, increase, hypergastrinemia, acid rebound
Does iron and B12 absorption increase or decrease with chronic use of PPIs? Why do you increase the risk of respiratory and enteric infections with chronic PPI use?
Decrease, acidic gastric contents play a role in killing pathogens
What is the suffix for H2 receptor antagonists? Which specific one inhibits CYPs more than other ones? What is an unwanted side effect of these drugs? Will you have hypergastrinemia? What type?
-tidine, Cimetidine, gynecomastia, yes, secondary
Do PPIs show tolerance? What about H2 receptor antagonists?
What are the main prostaglandins made by the gastric mucosa? What receptor do they bind on the parietal and epithelial cells? In the parietal cells what do they do to acid secretion? Through what type of G-protein system? What do they do on superficial epithelial cells? Use of what type of drugs inhibits all of this? What drug can you use if a patient NEEDS to be on an NSAID but still wants the protective effects of prostaglandins? It's a synthetic analog of what? It can cause what side effect? It is contraindicated in what type of people?
PGE2 and PGI2, EP3, decrease, Gi, increase mucosa and bicarbonate secretion, NSAIDs, Misoprostol, PGE1, diarrhea, pregnancy
What drug is an octasulfate of sucrose with aluminum hydroxide? In the acidic environment, aluminum is released and you have polymer with negative charges that binds what in cells? Overall, what does this do to the ulcerated region? You need to have what type of environment for this to work? Therefore they shouldn't be used with what other drugs?
Sucralfate, positively charged proteins in cells, coats it, acidic, antacids
Which type of drugs neturalize protons, which increases pH? What does this do to activation of pepsin? Sodium bicarbonate and calcium bicarbonate are effective antacids, but they are not really great because they are both what? Is magnesium hydroxide pro-diarrheal or pro-constipation? Is aluminum hydroxide pro-diarrheal or pro-constipation?
Antacids, decreases, absorbed, pro-diarrheal, pro-constipation
What are the two options you have for h. pylori infection?
Triple therapy (PPI, clarithromycin, amoxicillin/metronidazole), Quadruple therapy (PPI, metronidazole, bismuth, tetracycline)
Does dopamine stimulate or inhibit ACh release? Via which receptor? Do dopamine receptor antagonists increase or decrease ACh release? What are two DA receptor antagonists? Which one is selective D2? Which one acts on the brain? Which one also works on the serotonin receptor? Why does fluoxetine (SSRI) cause diarrhea?
Inhibit, D2, increase, Metoclopramide and Domperidone, Domperidone, Metoclopramide, Metoclopramide, because serotonin is pro-kinetic
What are 2 serotonin receptor agonists that trigger peristalsis?
Cisapride and Prucalopride
In de novo synthesis of purines, you first combine what two molecules? The R-5-P comes from where? To make what? That is combined with what amino acid? To eventually make what? This can be converted to what?
Ribose-5-phosphate and ATP, pentose phosphate pathway, PRPP, glutamine, IMP, AMP or GMP
What is the first committed step in de novo purine synthesis?
Combination of PRPP and glutamine to make 5-phosphoribosyl 1-amine
In de novo purine synthesis, conversion of IMP to AMP uses a nitrogen from what amino acid? What is released once AMP is formed? In de novo purine synthesis, conversion of IMP to GMP uses a nitrogen from which amino acid? What is released once GMP is formed?
Aspartate, fumarate, glutamine, glutamate
In the purine salvage pathway, you have a purine base (such as inosine and guanosine) and those are converted back into hypoxanthine or guanine via which enzyme? What is released in this reaction? People who have a deficiency in this enzyme have what type of disorder? What type of cells does it affect specifically?
Purine nucleoside phosphorylase, Ribose-1-Phosphate, immune, T-cells
HGPRT uses what two things as its substrate? A defective HGPRT causes a condition called what? Can purine bases be salvaged? They form a lot of what? What type of presentation do they have?
Hypoxanthine and guanine, Lesch-Nyhan Syndrome, No, uric acid, mental retardation
The first step in de novo pyrimidine synthesis is catalyzed by which enzyme? This is analogous to the rate-limiting step in production of what? What is this enzyme activated by? Inhibited by?
Carbamoyl phosphate synthetase II, urea, PRPP, UTP
Compared to the urea cycle, which uses free ammonia as the source of nitrogen, de novo pyrimidine synthesis uses what as the source of nitrogen?
In the pyrimidine de novo pathway, the last two enzymes of the pathway in the formation of UMP are defective in which disorder? You will have a build up of what? How do you treat this?
Hereditary orotic aciduria, orotate, oral uridine
What disorder arises as a consequence of overproduction of uric acid? What drug can you use to treat it? It blocks what enzyme?
Gout, Allopurinol, xanthine oxidase
In the purine salvage pathway, what enzyme converts adenosine to inosine? A deficiency in this enzyme causes what condition?
Adenosine deaminase, Severe Combined Immunodeficiency Disease (SCID)
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