Biochem Flashcards

1
Q

Fabry’s disease

A

lysosomal storage disease
a-galactosidase A def->ceramide trihexoside
peripheral neuropathy, cardiovascular/renal disease
angiokeratomas on butt

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2
Q

Gaucher’s disease

A
lysosomal storage
glucocerebrosidase def->glucocerebroside
most common
hepatosplenomegally, aseptic necrosis, anemia, thrombocytopenia
Gaucher's cells (macrophages)
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3
Q

Niemann-Pick disease

A

lysosomal storage
phingomyelinase->sphingomyelin
progressive neurodegeneration, cherry red spot on macular foam cells
thrombocytopenia and worsening cognitive decline

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4
Q

Tay-Sachs

A

lysosomal
hexosaminidase A->GM2 ganglioside
progressice neurodegeneration, cheey red spot on macula, lysosomes with onion skin,
no hepatosplenomegaly

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5
Q

Krabbe’s disease

A

lysosomal
galactocerebrosidase->galactocerebroside
peripheral neuropathy, optic atrophy
affects myelin sheaths and occurs in very young

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6
Q

Metachromatic leukodystrophy

A

lysosomal
arylsulfatase A->cerebroside sulfate
central and peripheral demyelination with ataxia and dementia

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7
Q

Hurler’s syndrome

A

lysosomal
a-L-iduronidase->heparin sulfate, dermatan sulfate
gargoylism, corneal clouding
resembles dwarfism

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8
Q

Hunter’s syndrome

A

lysosomal
iduronate sulfatase->heparan sulfate, dermatan sulfate
mild Hurler’s and aggressive behavior, no corneal clouding

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9
Q

Von Gierkes (type I)

A

glycogen storage
glucose-6-phosphatase
severe fasting hypoglycemia, increased glycogen in liver and increased blood lactate

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10
Q

Pompe’s (type II)

A

glycogen
lysosomal a-1,4-glucosidase
cardiomegaly (Pompe’s trashes the pump)

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11
Q

Cori’s (type III)

A
glycogen
debranching enzyme (a-1,6-glucosidase)
milder form of type I with normal blood lactate
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12
Q

McArdle’s (type IV)

A

glycogen
skeletal muscle glycogen phosphorylase
increased glycogen in muscle, painful muscle cramps

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13
Q

5 substances needed to make a purine

A

glycine, aspartate, glutamine (GAG AAs)
tetrahydrofolate, CO2
purines are Pure As Gold (A, G)

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14
Q

4 substances needed to make a pyrimidine

A

aspartate, glutamate, CO2 and ATP (last 3 from carbamoyl phosphate)
CUT the PY

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15
Q

what is the rate limiting step in purine synthesis

A

carbamoyl phophate synthetase II

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16
Q

what is the rate limiting step in pyrimidine synthesis

A

glutamine PRPP amidotransferase

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17
Q

what are the carbon sources in purine and pyrimidine synthesis

A

purine: glycine, tetrahydrofolate, CO2
pyrimidine: aspartate and CO2

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18
Q

inhibits ribonucleotide reductase in purine synthesis

A

hydroxyurea

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19
Q

inhibits dihydrofolate reductase in purine synthesis

A

methotrexate and trimethoprim

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20
Q

inhibits thymidylate synthase in purine synthesis

A

5-fluorouracil

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21
Q

inhibits inosine monophosphate dehydrogenase in pyrimidine syntheses if guanine

A

mycophenolate

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22
Q

inhibits PRPP amidotransferase in pyrimidine synthesis

A

6-mercaptopurine

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23
Q

characteristic findings in orotic aciduria

A

inability to convert orotic acid to UMP
increase orotic acid in urine
no increase in ammonia (no hyperammonemia)
failure to thrive
megaloblastic anemia that cannot be corrected with B12 or folate
Tx: oral uridine administration

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24
Q

a boy with self mutilating behavior, intellectual disability and gout

A

Lesch-Nyhan syndrome
deficiency in HGPRT that increases uric acid
TX: allopurinol

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25
Q

orotic acid in the urine plus elevations in serum ammonia

A

OTC deficiency

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26
Q

megaloblastic anemia does not improve with B12 or folate

A

orotic aciduria

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27
Q

deficiency causes SCID

A

adenosine deaminase

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28
Q

silent mutation in DNA

A

tRNA wobble, same amino acid

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29
Q

missense DNA mutation

A

changed AA but similar protein structure

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30
Q

nonsense DNA mutation

A

early stop codon

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31
Q

DNA polymerase III reads and proofreads

A

reads: 5’-3’

proofreads 3’-5’ exonuclease

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32
Q

nucleotide excision repair

A

endonucleases repairs damaged bases due to UV light (pyrimidine dimers)
mutated in xeroderma pigmentosum

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33
Q

base excision repair

A

glycosylases recognize and remove damaged bases, then endonucleases remove sugar, polymerase adds new base, ligase joins

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34
Q

mismatch repair

A

corrects mismatch in newly synthesized strands

defect causes hereditary nonpolyposis colorectal cancer (HNPCC)

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35
Q

bloom syndrome

A

mutation of helicase

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36
Q

ataxia telangiectasia

A

dsDNA repair defect

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37
Q

stop codons

A

UGA
UAA
UAG

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38
Q

polyadenylation signal

A

AAUAAA

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39
Q

what amino acid frequently has more coding sequences in mRNA than are represented in final peptide

A

methionine (start codon normally spliced out)

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40
Q

lac operon regulation

A

CAP: binds when glucose is absent and promotes B-galactosidase transcription
lac operon: bound unless lactose is present. prevents transcription

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41
Q

where does aminoacyl-tRNA synthetase bind tRNA

A

the CCA at 3’ end

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42
Q

hypophosphatemic rickets

A

formerly vit D resistant rickets. x-linked dominant disorder where proximal tubule cannot reabsorb phosphate, so you get a rickets like presentation

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43
Q

myopathy and CNS disease with muscle biopsy that shows ragged red fibers. Seen in the maternal family line

A

mitochondrial myopathies

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44
Q

blotting procedures

A

Down South: southern is DNA with DNA probe
rude yankees: northern is RNA with DNA probe
western cattle: protein with Ab probe

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45
Q

ELISA

A

direct: known Ab to identify Ag
indirect: known Ag to identify Ab
target present = color change

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46
Q

promoter region

A
  • 25 TATA box (Hogness)

- 75 CAAT box

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47
Q

Kluver-Bucy syndrome

A

bilateral amygdala lesion that leads to hyperorality, hypersexuality, and disinhibited behavior. hyperdocility and curiosity also seen

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48
Q

enzyme that catalyzes peptide bond formation in ribosome

A

peptidyl trasnferase

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49
Q

ATP yield

A

32 ATP if malate-aspartate shuttle is used (heart and liver)

30 ATP if glycerol-3-phosphate shuttle is used (muscle and brain)

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50
Q

clinical consequence of glycolytic enzyme deficiency

A

hemolytic anemia (RBC swelling and lysing)

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51
Q

enzymes responsible for increasing and decreasing intracellular levels of fructose-2,6-bisphosphotase

A

phosphofructokinase-2 (increases F-2,6-BP)
induced by insulin
fructose bisphosphotase (decreases F-2,6-BP)
induced by glucagon

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52
Q

regulators of pyruvate kinase

A

ATP and alanine are negative

F-1,6-BP is positive

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53
Q

RLS glycolysis

A

phosphofructokinase-1 (PFK-1)
+ AMP and F-2,6-BP
- ATP and citrate

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54
Q

RLS gluconeogenesis

A

F-1,6-BP
+ATP
- AMP and F-2,6-BP

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55
Q

RLS TCA cycle

A

isocitrate dehydrogenase
+ ADP
- ATP and NADH

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56
Q

RLS glycogen synthesis

A

glycogen synthase
+ glucose, insulin
- epinephrine, glucagon

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57
Q

RLS glycogenolysis

A

glycogen phosphorylase
+ AMP, epinephrine, glucagon
- insulin, ATP

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58
Q

RLS HMP shunt

A

G-6-PD
+ NADP+
- NADPH

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59
Q

RLS de novo pyrimidine synthesis

A

carbamoyl phosphate synthetase II

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60
Q

RLS de novo purine synthesis

A

glutamine-PRPP amidotransferase

- AMP, IMP, GMP

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61
Q

RLS urea cycle

A

carbamoyl phosphate synthetase I (mitochondria)

+ N-acetylglutamate

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62
Q

RLS fatty acid synthesis

A

acetyl-CoA carboxylase (ACC)
+ insulin, citrate
- glucagon, palmitoyl-CoA

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63
Q

RLS fatty acid oxidation

A

carnitine acyltransferase I (carnitine palmitoyl transferase-I)
- malonyl-CoA

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64
Q

RLS ketogenesis

A

HMG-CoA synthase

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65
Q

RLS cholesterol synthesis

A

HMG-CoA reductase
+ insulin, thyroxine
- glucagon, cholesterol

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66
Q

irreversible enzymes in gluconeogenesis

A

pyruvate carboxylase
PEP carboxykinase
F-1,6-BP (RLS)
glucose-6-phophatase

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67
Q

energy available to fuel endergonic reactions

A

glucose>pyruvate>ATP>AMP>adenosine

68
Q

Gibbs free energy

A

dG = dH-TdS

69
Q

how does glucagon increase glycogenolysis

A

glucagon-> cAMP -> protein kinase A -> + glucagon phosphorylase kinase -> + glycogen phosphorylase (RLS)

70
Q

glycogen phosphorylase deficiency

A

McArdle’s

71
Q

glucose-6-phophatase deficiency

A

Von Gierke’s

72
Q

lactic acidosis, hyperlipidemia, hyperuricemia (gout)

A

Von Gierke’s

73
Q

a-1,6-glucosidase deficiency

A

Cori’s

74
Q

a-1,4-glucosidase deficiency

A

Pompe’s

75
Q

cardiomegaly

A

Pompe’s (infantile)

76
Q

diaphragm weakness leading to respiratory failure

A

Pompe’s (adult)

77
Q

increased glycogen in liver, severe fasting hypoglycemia

A

Von Gierke’s

78
Q

hepatomegaly, hypoglycemia, hyperlipidemia (normal kidneys, lactate, and uric acid)

A

Cori’s

79
Q

painful muscle cramps, myoglobinuria with strenuous exercise

A

McArdle’s

80
Q

severe hepatosplenomegaly, enlarged kidneys

A

Von Gierke’s

81
Q

what is potential fates of pyruvate

A

acetyl CoA
oxaloacetate
alanine
lactate

82
Q

what is purpose of Cori cycle

A

take lactate from RBC and muscles to liver to regenerate glucose. requires 6 ATP

83
Q

what is purpose of alanine cycle

A

transport amine groups to the liver

ALT and AST play a role here

84
Q

what is required by all aminotransferases

A

B6 (pyridoxal phosphate)

85
Q

major regulatory enzymes in TCA

A

citrate synthase
isocitrate dehydrogenase
a-ketoglutarate dehydrogenase

86
Q

energy output of TCA

A

3 NADH, 1 FADH2, 1 GTP = 10 ATP for each acetyl CoA

multiply by 2 for each glucose molecule

87
Q

what substances cause uncoupling of ATP synthesis by increasing the permeability of the inner mitochondrial membrane

A

aspirin
2,4-DNP
thermogenin

88
Q

what tissues use the pentose phosphate shunt

A

RBC
liver
adrenal cortex
mammary glands

89
Q

symptoms of classic galactosemia

A

failure to thrive, mental retardation, jaundice, hepatomegaly, infantile cataracts

90
Q

deficiency of galactokinase

A

galactokinase deficiency

results in build up of galactitol in blood and urine-> infantile cataracts

91
Q

deficiency of aldolase B

A

fructose intolerance
F-1-P accumulates and causes a decrease in phosphate -> inhibition of glycogenolysis and gluconeogenesis
hypoglycemia, jaundice, cirrhosis, vomiting

92
Q

deficiency of lactase

A

lactose intolerance

93
Q

deficiency of galactose-1-phosphate uridyltransferase

A

classic galactosemia

accumulation of toxic substances

94
Q

deficiency of fructokinase

A

essential fructosuria
asymptomatic
fructose in blood and urine

95
Q

why does ethanol metabolism cause hypoglycemia

A

NAD+ is regenerated by the liver by transferring pyruvate -> lactate and oxaloacetate -> malate
this shuts down gluconeogenesis

96
Q

hallmark features of kwashiokar

A
FLAME
fatty liver
anemia
malnutrition
edema
97
Q

when does synthesis of ketone bodies occur

A

when production of acetyl CoA exceeds the capacity of the TCA cycle

98
Q

refeeding syndrome

A

drop in Mg, K and phosphate due to cells taking up these vitamins from the blood. can cause arrhythmias

99
Q

which deficiency causes familial hypercholesterolemia

A

def of LDL receptors

100
Q

which deficiency causes hyperchylomicronemia

A

lipoprotein lipase def or altered C-II

101
Q

abetalipoproteinuria

A

mutation in microsomal triglyceride transfer protein (MTP) decreases B-48 and B-100

102
Q

activates LCAT

A

apo A-1

103
Q

mediates chylomicron secretion

A

apo B-48

104
Q

mediates VLDL secretion

A

apo B-100

105
Q

binds to LDL receptor

A

apo B-100

106
Q

cofactor for lipoprotein lipase

A

apo C-II

107
Q

mediates uptake of remnant particles

A

apo E

108
Q

repository for apoC and apoE

A

HDL

109
Q

basic AA

A

Arg, Lys, His

Histidine is actually neutral at body pH

110
Q

acidic AA

A

Asp and Glu

111
Q

what is most common urea cycle deficiency

A

orntithin transcarboxylase deficiency: first enzyme in loop. Buildup of carbamoyl phosphate that leads to hepatoencephalopathy (tremor, slurring speech, somnolence, cerebral edema, blurring vision)

112
Q

vit B6 is needed as a cofactor to make

A

dopamine, niacin, histamine, porphyrin (heme) and GABA

113
Q
what AA is precursor for:
histamine
porphyrin
NO
GABA
s-adenosyl-methionine
creatine
niacin/serotonin
A
histidine
glycine
arginine
glutamate
methionine
arginine
tryptophan
114
Q

PKU

A

deficiency of phenylalanine hydroxylase or the tetrahydrobiopterin cofactor
musty odor due to aromatic amino acid buildup (phenylalanine)
mental retardation, growth retardation, seizures, fair skin, eczema

115
Q

Alkaptonuria

A

deficiency of homogentisic acid oxidase
buildup of tyrosine: dark urine and connective tissue
brown pigmented sclera

116
Q

albinism

A

defect in tyrosinase (melanin production) or defective tyrosine transporters
can also be a failure of neural crest cells to migrate

117
Q

homocystinuria

A

3 forms:
cystathionine synthase def.
decreased affinity of cystathionine synthase for pyridoxal phosphate (B6)
homocysteine methyltransferase def (requires B12)
mental retardation, downward lens subluxation, atherosclerosis

118
Q

SAM

A

transfers methyl units
needed for conversion of NE to epi
requires B12 and folate

119
Q

cystinuria

A

renal amino acid transporter defect: staghorn calculi in kidney from excess AA.

120
Q

maple syrup urine disease

A

blocked branched amino acid breakdown (isoluecine, leucine, valine) due to a-ketoiacud dehydrogenase deficiency
severe CNS defects

121
Q

Hartnup disease

A

defective neutral amino acid transporter on renal and intestinal cells. tryptophan excretion
leads to pellagra (niacin deficiency)

122
Q

G- rods in a neonate with pneumonia

A

E. coli

123
Q

G+ cocci in neonate with pneumonia

A

group B strep

124
Q

G+ cocci in pairs

A

strep pneunomiae

125
Q

G+ cocci in clusters

A

s. aureus

126
Q

iron poisoning

A

peroxidation of membrane lipids

acute: gastric bleeding, hypovolemic shock
chronic: metabolic acidosis, scarring of GI system (obstruction)

127
Q

zinc deficiency

A

lack of zing fingers, a transcription factor motif
delayed wound healing, decreased adult hair, anosmia, dysgeusia
rash around eyes, mouth, anus (acrodermatitis enteropathica)
impaired night vision and infertility

128
Q

lead poisoning

A

inhibits ferrochelatase
decrased IQ, hearing problems, lead lines, wrist and foot drop, anemia
treat with succimer and EDTA
dimercaprol if really bad

129
Q

mercury poisoning

A

accumulates in kidney and brain
acrodynia: peeling of fingertips
abdominal pain

130
Q

bluish-colored lines on the gingivae

A

lead poisoning (Burton’s lines)

131
Q

fat soluble vitamins are dependent on what for absorption

A

ileum and pancreas

132
Q

vit D

A

D2 = orgocalciferol (plants)
D3 = cholecalciferol (milk and sun exposure)
25-hydroxycholecalciferol (converted by 25 hydroxylase)
1,25-(OH)2D3 (calcitriol) is active form (converted by 1ahydroxylase)

133
Q

vit A use

A

measles and AML, subtype M3 in developing world

134
Q

high levels of vit A

A

liver and leafy vegetables

135
Q

vit E

A

alpha tocopherol
prevents non-enzymatic oxidation
def: muscle weakness, posterior column and spinocerebellar tract demyelination

136
Q

symptoms of vit A toxicity

A

visual impairment, fatigue, ataxia, HA, increased intracranial pressure, dry skin, alopecia, hepatotoxicity, athralgia

137
Q

scurvy symptoms

A

sore, spongy gums, loose teeth
fragile blood vessels: hemorrhages
swollen joints, impaired wound healing
anemia

138
Q

vit c hydroxylates which AA

A

lysine and proline

139
Q

vit B1 needed as cofactor for

A

pyruvate dehydrogenase (glycolysis to TCA)
a-ketoglutarate dehydrogenase
transketolase (HMP shunt)
branched chain amino acid dehrydrogenase

140
Q

thiamine deficiency

A

damage to medial thalamus and mammillary bodies
cerebral atrophy
Wernicke-Korsakoff syndrome
Wernicke: acute encephalopathy, oculomotor dysfunction, gait ataxia
Korsakoff: memory loss, confabulation, apathy
long term consequence of Wernicke

141
Q

beriberi

A

thiamine deficiency

wet: heart: high-ouput cardiac failure, edema
dry: polyneuritis, muscle wasting (wrist drop)

142
Q

riboflavin

A
B2
cofactor for oxidation and reduction
2 forms:
flavin mononucleotide (FMN)
flavin adenine dinucleotide (FAD)
def: cheolosis
143
Q

niacin

A
B3
2 forms: NAD and NADP
derived from tryptophan
def: pellagra (dermatitis, dementia, diarrhea)
INH causes deficiency
144
Q

vit B6

A

pyridoxal phosphate
cofactor in transamination, decarboxylation, and glycogen phosphorylase
def: convulsions, neuropathy, sideroblastic anemia
INH causes def

145
Q

vit B7

A

biotin

carboxylation enzymes

146
Q

B9

A

folic acid
converted to tetrahydrofolate (THF)
deficiency: alcoholism and pregnancy, medications
most common def. in US

147
Q

B12

A

cobalamin
cofactor for homocysteine methyltransferase and methylmalonyl-CoA mutase
abnormal myelination in deficiency
use Schilling test to detect etiology of def.

148
Q

pernicious anemia

A

immune destruction of parietal cells and Ab to IF that leads to decrease in B12 levels

149
Q

pt presents with convulsions and irritability. what vit def?

A

vitamin B6

150
Q

peripheral neuropathy, glossitis

A

B12, B6

151
Q

neural tube defects

A

folate

152
Q

dermatitis, diarrhea, dementia

A

B3 (niacin)

153
Q

megaloblastic anemia

A

B12, folate

154
Q

pernicious anemia

A

B12

155
Q

used in oxidation/reduction rxns

A

B2 (riboflavin), B3

156
Q

used in carboxylation rxns

A

biotin

157
Q

requires intrinsic factor for absorption

A

B12

158
Q

used by pyruvate dehydrogenase and a-ketoglutarate dehydrogenase

A

B1 (thiamine)

159
Q

can be used to elevate HDL and lower LDL

A

B3 (niacin)

160
Q

deficiency can be caused by isoniazid use

A

B6 (pyridoxine), B3 (niacin)

161
Q

cobalt is found in vitamin

A

B12 (cobalamin)

162
Q

critical for DNA synthesis

A

folate (B9), B12

163
Q

most common vit def in US

A

folate

164
Q

hypersegmented neutrophils

A

B12 or folate def

165
Q

dilated cardiomyopathy, edema, and polyneuropathy

A

B1 (wet beriberi thiamine def)