560I Mid term Flashcards
deficiency test for Vitamin A
vitamin A serum, (L)
beta-carotene -serum(L)
deficiency test for B1 (thiamin)
alpha-keto acids - urine, (H)
Erythrocyte transketolase index - RBC (H)
deficiency test for B2 (riboflavin)
(H)
alpha-keto acids - urine,
Ethylmalonate - urine
EGR active coefficient - RBC
deficiency test for B3 (niacin)
n-methylnicontinamide -urine (H)
lactate and pyruvate - urine (H)
deficiency test for B5 (pantothenate)
alpha-keto-acids - urine (H)
pantothenic acid - urine(L)
deficiency test for B6 (pyridoxine)
(H) xanthurenate - urine kynurenate - urine homocysteine - plasma EGOT index - RBC
deficiency test for Vitamin B12 (cyanocobalamin)
methylmalonate - urine (H)
homocysteine - plasma (H)
vitamin B12 serum (L)
deficiency test for tetrahydrobiopterin (BH4)
dihydrobiopterin (BH2)
Bh4 - plasma (L)
Phe or Phe/Tyr ratio - plasma (H)
BH4 loading test plasma (drop >50%)
deficiency test for Vitamin C
(L) Vitamin C Serum, leukocyte or urine after 500 mg of oral load
deficiency test for Vitamin K
PIVKAII - serum (L)
undercarboxylated osteocalcin - serum (H)
Vitamin K serum - (L)
Prothrombin plasma (H)
deficiency test for Vitamin D
25-hydroxyvitamin D serum (L)
bone specific collagen fragments - urine (H)
deficiency test for Vitamin E
tocopherol - serum (L)
tocopherol/triglyceride serum (L)
deficiency test for Biotin
beta-hydroxyisovalerate -urine (H)
deficiency test for folate
homocysteine plasma (H) folate serum (L) folacin RBC (L) macrocytic anemia whole blood (positive) neutrophil hypersegmentation - whole blood (positive) Formiminoglutamate (FIGLU) urine (H)
deficiency test for caritine
adipate, suberate ethylmalonate - urine (H)
deficiency test for coenzyme Q10
coenzyme Q10 serum (L) succinate urine (H) hydroxymethylglutarate urine (H)
deficiency test for lipoic acid
lactate and pyruvate serum or urine (H)
deficiency test for choline
choline plasma (L)
assessment of calcium
hair, urine
bone resorption markers, serum 25-hydroxyvitamin D, PTH
assessment of magnesium
RBC, whole blood, plasma, serum, urine
Refractory hypokalemia
assessment of potassium
RBC, serum, hair
assessment of iron
ferritin
total iron binding capacity, transferrin saturation, hemoglobin, hematocrit
assessment of zinc
RBC, hair, plasma
delta 6 desaturase activity (LA:GLA) Zn metallothionein
assessment of copper
RBC, serum ceruloplasmin
elevated urinary HVA/VMAratio; bone resorption markers
assessment of maganese
RBC
abnormal urinary ammonia markers, elevated arginine: ornithine ratio
assessment of selenuim
serum, whole blood, hair
selenoprotein P, urinary selenosugars
assessment of molybdenum
hair
elevated xanthine uric acid ratio
assessment of chromium
RBC, urine, hair
insulin, blood glucose
assessment of iodine
urine,
serum T3, T4, TSH, blood spot thyroglobulin
assessment of boron
serum, urine, hair
bone resorption markers
assessment of nickel
urine, plasma hair
assessment of lithium
serum, plasma, urine, hair
assessment of vanadium
whole blood, serum, urine
blood glucose, blood lipids
assessment of strontium
serum, urine, hair
bone resorption markers
H glutamic acid (Glu) give:
alpha KG
H glutamine (Gln) give:
alpha KG, B6
H arginine (Arg) give:
Mn
L arginine (Arf) give:
Arg
H asymmetric dimethylargininge give
Arg
H citrulline give
Mg, alpha KG,
H ornithine (Orn) give
Mg, alpha KG
L aspartic acid (Asp) give
alpha KG
H aspartic acid (Asp) give
Mg, Zn
Urea cycle and nitrogen management AA;s
Arg, asymmetric dimethylarginine, citrulline, ornithine, aspartic acid, asparagine
EAA for proteins and energy
isoleucine, leucine, valine, threonine, histidine, lysine, alpha aminoadipic acid
H isoleucine ((Ile) give
B6, check for insulin insensitivity
H leucine (Leu) give
B6, check for insulin insensitivity
H valine (Val) give
B6, check for insulin insensitivity
H threonine (Thr) giver
B6
H histidine (His) give
B6
L histidine (His) give
folate, His
H lysine (lys) give
Vitamin C, niacin (B3), B6, Fe (confirm with ferritin),
L lysine (lys) give
carnitine (check for excessive Arg intake)
H alpha aminoadipic acid give
B6, alpha KG,
Neurotransmitters and precursors (AAs)
phenylalanine, tyrosine, tryptophan, alpha amino n butyric acid, gamma aminovutyric acid (GABA)
H phenylalanine (Phe) give
Fe, tetrahydrobiopterin, Vitamin C, Low Phe diet
H tyrosine (Tyr) give
cu, Fe, vitamin C
L tyrosine (tyr) give
Fe, Tyr
L tryptophan (Trp) give
5-HTP
H tryptophan (Trp) give
Niacin, B6, Fe, Cu
L alpha-Amino-N-butyric acid give
alpha KG, B6
H Methionine (Met) give
B6, alpha KG
L cystine (Cys) give
NAC
H homocystine (Hcys) give
B6, folate, B12, Betaine
H Cystathionine give
B6
L Taurine (Tau) give
B6
H Taurine (Tau) give
multiple antioxidants
AA precursors of heme Nucleotides and cell membranes
Gly, Ser, Sarcosine
H Glycine (Gly) give
folate, B6, B2, B5
L Serine (Ser) give
B6, folate, Mn
H Serine give
Thr, BCAAs
H sarcosine give
Thr, BCAA’s
H Alanine (Ala) give
B6
H Ethanolamine give
Mg
H Phosphoethanolamine give
S-Adenosylmethionine
H Phosphoserine give
Mg
L Proline (Pro) give
alpha KG, His
H Hydroxyproline (HPro) give
Vitamin C, Fe
H Proline (Pro) give
Vitamin C, Niacin
H Hydroxylysine (HLys) give
Vitamin C, Fe
H beta alanine give
lactobacillus and bifidobacteria sp, B6
H beta aminosbutyric acid
B6, B12
H Anserine give
Zn
H carnosine give
Zn
H 1-mthylhistidine give
vitamin E
H 3-methylhistidine give
BCAA, antioxidants (if evident muscle wasting)
Organic Acids of fatty acid oxidation
adipate, suberate, ethylmalonate
H Adipate, suberate, or ethylmalonate give
l-carnitine
L-lysine (if low)
B2
Aerobic/anaerobic energy production organic acids
pyruvate, lactate,
H pyruvate give
B1, B complex,
with high lactate give lipoic acid
H lactate give
CoQ10
H beta hydroxybutyrate give
chromium picolinate
H Citrate give
arginine
L citrate give
aspartic acid, magnesium
H cis-asonitate give
cysteine, check for iron deficiency
H isocitrate give
lipoic acid, Mg, Mn
H alpha ketoglutarate
give B complex, lipoic acid
H succinate give
CoQ10, lipoic acid
H fumarate give
CoQ10, Mg
H malate give
CoQ10, B3
H/L Hydroxymethylglutarate
CoQ10,
citric acid cycle intermediates
citrate, cis-aconitate, isocitrate, alpha KG, succinate, fumarate, malate
H alpha ketoisovalerate give
B complex, lipoic acid
H alpha ketoisocaproate give
B complex, lipoic acid
H alpha - keto - beta - methylvalerate give
B complex, lipoic acid
H formiminoglutamate (FIGLU) give
folic acid
H beta hydroxyisovalerate give
biotin, Mg
H methylmalonate or propionate give
B12
L,H Vanilmandelate give
tyrosine, phenylalanine hydroxylase cofactors as needed
contraindicated for patients taking MAO inhibitors
L,H homovanillate give
tyrosine, phenylalanine hydroxylase cofactors as needed
contraindicated for patients taking MAO inhibitors
L,H 5- Hydroxyindolacetate
5-hydroxytryptophan (5-HTP), Mg, B6
H kynurenate give
B6, Mg
H Quinolinate give
Mg
H p-Hydroxyphenyllactate give
Vitamin C to bowel tolerance
8-hydroxy-2’-deoxyguanosine give
antioxidants (C,E, lipoic acid)
H homogentisate give
low protein diet, vitamin C
H 2-methylhippurate give
avoidance of xylene;
glycine
B5
H orotate give
arginine, a-KG, Aspartic acid, magnesium
H glucarate give
glysine, GSH, NAC
H alpha hydroxybutyrate, pyroglutamate give
NAC, glutathione, Taurine
L sulfate give
NAC, glutathione, Taurine
detoxification indicators (organic acids)
2-methylhippurate, orotate, glucarate, alpha hydroxybutyrate, pyroglutamate, sulfate
2-methylhippurate, what metabolic pathway?
hepatic conjugation
orotate what metabolic pathway?
ammonia clearance, pyrimidine synthesis
glucarate what metabolic pathway?
detox, liver enzyme induction
alpha hydroxybutyrate, pyroglutamate what metabolic pathway?
hepatic GSH synthesis
sulfate what metabolic pathway?
Renal amino acid recovery
detoxification what metabolic pathway?
detox and anti-oxidant functions
H benzoate give
glycine, vitamin B5, glutamine, digestive aids and free form amino acids to help normalize gut permeability
H hippurate, phenylacetate, phenylpropionate, p-cresol, p-hydroxybenzoate, p-hydraxyphenylacetate, tricarballylate, D-lactate, 3,4 dihydroxyphenylpropionate or D-arbinitol give
glutamine, digestive aids and free form amino acids to help normalize gut permeability