Biochem - clinical correlates Flashcards
Von Gierke Disease
Glucose 6 phosphatase deficiency
Pompe Disease
Lysosomal acid maltase deficiency
Cori Disease
Debranching enzyme deficiency
Andersen Disease
Branching enzyme deficiency
McArdle Syndrome
Muscle phosphorylase deficiency
Hers Disease
Liver Phosphorylase deficiency
Fasting hypoglycemia
Hepatomegaly in infancy
Increase in dextrin
Muscle weakness
Cori Disease
Poor exercise tolerance
Muscle cramps
Myoglobinuria but no lactic acidosis
Increase in muscle glycogen
McArdle Syndrome
Hepatomegaly
Mild hypoglycemia
Hers Disease
Hypotonia, death from heart failure by age 2
Pompe Disease (Juvenile)
Muscle dystrophy
Pompe Disease (Adult)
Fasting hypoglycemia Lactic acidosis Ketosis Hyperlipemia Increase glycogen in liver and renal tubule cells
Von Gierke Disease
Cataracts in early childhood
Galacotikinase deficiency
Premature ovarian failure in females Mental retardation Liver damage, Jaundice Diarrhea, Vomitting Galactosemia, Galactosuria
Classic Galactosemia (Galactose-1-phosphate-uridyl transferase deficiency)
Flatulence and diarrhea after ingestion of dairy products
Lactose intolerance (Lactase deficiency)
Intolerance of ingested sucrose
Sucrase-isomaltase complex deficiency
Increased xylulose in the urine due to deficiency of xylulose reductase
Essential Pentosuria (Xylulose reductase deficiency)
Hemolytic anemia after oxidative stress
G6PD deficiency
Precipitating factors of G6PD
Infection
Drugs
Fava beans
Histologic findings for G6PD
Heinz bodies
Bite cells
Severe persistent and chronic pyogenic infections caused by catalase positive bacteria
Chronic Granulomatous Disease
Deficiency in CGD
NADPH oxidase
Low LDL, Low HDL
Xanthomas
Recurrent pancreatitis
Familial Lipoprotein Lipase Deficiency
Lipoprotein lipase or Apo C-II
High LDL and cholesterol
Increased risk for atherosclerosis and coronary disease
Familial Hypercholesterolemia
Defective LDL receptor
Hypercholesterolemia
Xanthomas
Atherosclerosis
Familial Dysbetalipoproteinemia
Abnormal apo E
High VLDL, cholesterol
Subnormal LDL and HDL
Associated with CAD, T2DM, Obesity and alcoholism
Familial Hypertriacylglycerolemia
Overproduction of VLDL
Atherosclerosis leading to CAD
Thrombosis due to inhibition of fibrinolysis
Familial Lipoprotein excess
Elevated Lp (a) which is nearly identical to LDL
Beneficial to health and longevity
Familial hyperalpha lipoproteinemia
High HDL
Low triacylglycerol, accumulation of triacylglycerol in liver and intestines
Treated with large doses of fat-soluble vitamins, particularly vitamin E
Abetalipo proteinemia
(Defect in the loading of apo B with lipid)
(No chylomicrons or VLDL)
High triacylglycerol due to inactive LPL
Low LDL
Atherosclerosis in elderly
Familial alpha-lipoprotein deficiency
- Tangier disease
- Fish eye disease
- Apo A-1 deficiencies
(Low or near absence of HDL)
Tremors, slurring of speech, vomiting, BOV Cerebral Edema Elevated blood glutamine Decreased BUN Respiratory Alkalosis
Hyperammonemia
Severe mental retardation
Fair skin and eczema
Musty body odor
Phenylketonuria
Phenylalanine
Connective tissue is dark (ochronosis)
Debilitating arthralgias
Urine turns dark on standing
Osler’s sign
Alkaptonuria
Tyrosine
Absence of pigment from hair, eyes, skin
Increased risk for skin cancer
Albinism
Tyrosine
Ectopia lentis (displaced downward) Faulty bone development Mental retardation Tendency to form thrombi MI
Homocystinuria
Methionine
Kindey stones -> Staghorn calculi
Cystinuria
COLA - Cystine, Ornithine, Lysine, Arginine
Ssizure, encephalopathy, stroke at the age of 1 month to 1 year
Methylmalonyl CoA Mutase Deficiency
Isoleucine, Valine, Methinone, Threonine
Characteristic odor imparted to the urine
Ketoacidosis
Vomiting
Mentao retardation
Maple Syrup Urine Disease
Lesh-Nyhan Syndrome
HGRPT deficiency
Lymphocytopenia
Death before age 2
Severe Combined Immunodeficiency
Orotic aciduria
Orotidine phosphate decarboxylase deficiency
Gout, self mutilation, mental retardation
Lesh-Nyhan Syndrome
Severe Combined Immunodeficiency
Adenosine deaminase
Beta hydroxybutyric acidrua
Dihydropyrimidine dehydrogenase deficiency
Combined uraciluria-thyminuria
Beta hydroxybutyric acidrua
Poor growth, megaloblastic anemia, Orotate in the urine
Orotic aciduria
Xeroderma Pigmentosa
DNA lesion?
Pyrimidine dimers
Lynch Syndrome
DNA lesion?
Mismatched Strand
MUTYH associated polyposis
DNA lesion?
Base alterations
SCID
DNA lesion?
Double Strand breaks
Breast cancer susceptibility 1 and 2
DNA lesion?
Double Strand breaks
Contains peptide toxin which inhibits RNA polymerase II
Amanita Mushroom
Inactivates the eukaryotic elongation factor EF-2, preventing translocation
Diphtheria Toxin
Binds to 30s subunit and interferes with initiation
Streptomyocin and aminoglycosides
Prevents binding of aminoacyl-tRNA to the A site
Tetracycline
Binds to the DNA template and interferes with the movement of RNA polymerase during transcription
Dactinomycin
Binds to the beta subunit of bacterial DNA-dependent RNA polymerase
Rifampicin
Inhibits prokaryotic peptidyltransferase
Chloramphenicol
Binds to the 50s subunit and inhibits translocation
Clindamycin and macrolides
Inhibits dihydrofolate reductase
Methotrexate
Metabolically converted to 5-FdUMP
5-fluorouracil
Inhibits Xanthine Oxidase
Allopurinol
Inhibits dihydropteroate synthase
Sulfonamides
Selectively inhibits bacterial dihydrofolate reductase
Trimethoprim
Reversible inhibitor of IMP dehydrogenase
Mycophenolate
What mutation happens in Tay-Sachs?
Splice donor/acceptor
What mutation happens in Huntington Disease?
Triple Repeat Expansion
What mutation happens in Myotonic Dystrophy?
Triple Repeat Expansion
What mutation happens in Gaucher?
Splice donor/acceptor
What mutation happens in Fragile X Syndrome?
Triple Repeat Expansion
What mutation happens in beta thalassemia?
Splice donor/acceptor
Peripheral neuropathy and ataxia
Retinitis pigmentosa
Abnormalities of skin and bone
Refsum Disease
Liver dysfunction with jaundice
Marker mental retardation, weakness, hypotonia
Craniofacial dysmorphism
Early death
Zellweger Syndrome
Jamaican Vomiting Sickness
Toxin hypoglycin
- inactivate medium and short chain acyl CoA dehydrogenase
Adrenoleukodystrophy
Inability to transport VLCFAs across the peroxisomal membrane
Neurodegeneration (initial apathy and behavioral change, followed by visual loss, spasticity and ataxia)
Adrenocortical insuffiency
Hypogonadism
Adrenoleukodystrophy
Zellweger Syndrome
Absence of peroxisomes in all tissues
Accumulation of VLCFAs in the brain, adrenals and testes
Adrenoleukodystrophy
Refsum Disease
Deficiency of Phytanoyl-CoA-hydroxylase
Accumulation of Phytanic acid
Refsum Disease
Accumulation of very long chain, saturated, unbranched fatty acids in liver and CNS
Zellweger Syndrome
Reduced fatty acid oxidation -> sever hypoglycemia, coma and even death
(Affects liver)
Carnitine-Palmitoyl Transferase I deficiency
Affects cardiac and skeletal muscle
Cardiomyopathy, muscle weakness with myoglobinemia after prolonged exercise
Carnitine-Palmitoyl Transferase II deficiency
Can manifest as Sudden Infant Death Syndrome
Medium chain fatty acyl CoA dehydrogenase deficiency
Mental retardation Coarse facial features Hepatosplenomegaly Corneal clouding Death in childhood
Hurler Syndrome
Mental retardation
Coarse facial features
NO corneal clouding
Hunter Syndrome
GAGs affected in Hunter Syndrome and Hurler Syndrome
Dermatan Sulfate
Heparan Sulfate
Skeletal dysplasia and short stature
Odontoid hypoplasia
Corneal clouding
No CNS involvement
Morquio Syndrome
GAGs affected in Sly Syndrome
Dermatan Sulfate
Heparan Sulfate
Chondroitin Sulfate
Mental retardation
Hyperactivity
Sanfilippo Syndrome
GAGs affected in Sanfilippo Syndrome
Heparan Sulfate
Mental metardation
Corneal clouding
Hepatosplenomegaly
Skeletal dysplasia and short stature
Sanfilippo Syndrome
Mental retardation
Cherry red spot on macula
Hepatosplenomegaly
Niemann-Pick Disease
Lysosomes with onion skin
Tay-Sachs disease
Mental retardation
Cherry red spot on macula
NO hepatosplenomegaly
Tay-Sachs disease
Tay-Sachs disease
Hexosaminidase A deficiency
Foam cells
Niemann-Pick Disease
____ cells which are macrophages that resemble crumpled tissue paper
Gaucher disease
Gaucher disease
Beta glucosidase
Niemann-Pick disease
Sphingomyelinase
Reddish purple skin rash
Kidney and heart failure
Fabry disease
Most common lysosomal storage disease
Gaucher disease
Lipids accumulate in joints with tissue granulomas and subcutaneous nodules
Hoarse cry
Mental retardation
Early Death
Farber disease
Fabry disease
Alpha galactosidase
Farber disease
Ceramidase
Krabbe disease
Beta galactosidase
Loss of myelin leading to muscle weakness, feeding difficulties, vision loss, seizures
Krabbe disease
Sulfatides from granules that are metachromatic, nerves stain yellowish brown
Metachromatic leukodystrophy
Metachromatic leukodystrohpy
Arylsulfatase A