Biochem Pathology Flashcards
Causes of high anion gap?
MUDPILES
methanol, uremia, diabetic ketoacidosis, paraldehyde, propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylates
Stops electron flow from substrate to oxygen
ETC inhibitor
NADH dehydrogenase inhibitors
Barbiturate,Piericidin A,Amytal,Rotenone
Roten ONE
Succinate dehydrogenase inhibitors
Malonate, Carboxin, TTFA
Blocks Ubiquinol: ferricytochrome oxidoreductase
Antimycin A, Dimercaprol
Increase permeability of the inner mitochondrial membrane to protons
Uncouplers
Examples of synthetic uncouplers include:
2,4 dinitrophenol, aspirin
Examples of uncoupling proteins
Thermogenin
Overdose of this drug can cause excessively high body temperature due to ETC uncouplig
Aspirin
Directly inhibit mitochondrial ATP synthase
ATP synthase inhibitor
Example of ATP synthase inhibitor
Oligomycin
Mitochondrial disease affecting all the complexes can cause
Fatal infantile mitochondrial myopathy
Mitochondrial disease affecting complex I
MELAS
Mitochondrial disease affecting complex II
Kearns-Sayre syndrome
Mitochondrial disease affecting complex III
Lebers Hereditary Optic Neuropathy
Mitochondrial disease affecting complex IV
Leighs Disease, Ragged Red Muscle Fiber disease
Mitochondrial disease are —- inherited
Maternally
Inhibits pyruvate dehydrogenase by binding to lipoic acid, competes with inorganic phosphatase as a substrate for glyceraldehyde-3-P dehydrogenase
Arsenic poisoning
Most common enzyme defect in glycolysis
Pyruvate kinase deficiency
Manifests as chronic hemolytic anemia/ intravascular hemolytic anemia , (-) Heinz
Pyruvate kinase deficiency
Present with intravascular hemolytic anemia, (+) Heinz bodies
G6PD
Low exercise capacity, particulary on high carbohydrate diets
Muscle phosphofructokinase deficiency
Most common biochemical cause of congenital lactic acidosis
Pyruvate dehydrogenase deficiency
Increased lactate and decreased acetyl coA leads to deprivation of acetyl coA in the brain causing psychomotor retardation amd death
Pyruvate dehydrogenase deficiency
Management for Pyruvate dehydrogenase deficiency
Ketogenic diet
Alcohol + nutritional deprivation can lead to deficiency of what vitamin
Thiamin deficiency
Occurs when venous blood glucose concentration exceeds 10mmol/L and GFR contains more glucose than can be reabsorbed
Glucosuria
Glycogen storage disease Type I
Von Gierke’s
Glycogen storage disease Type II
Pompe’s
Glycogen storage disease Type III
Cori’s
ABCD
Anderson- Branching
Cori- Debranching
Glycogen storage disease Type IV
Andersen’s
ABCD
Anderson- Branching
Cori- Debranching
What are the glycogen storage diseases?
Von gierk, Pompe, Cori, Andersen, McaArdle, Her, Tarui
Deficiency in glucose 6- phosphatase
Glycogen storage disease Type I
V(one) gierke
Acid maltase deficiency/ lysosomal alpha 1,4 glucosidase
glycogen storage disease type II
Pompe
THE POLYSE Arrest of 1 of the 4 Girls
(Police=pompe+ Lys alpha 1,4 Glucosidase
Debranchig enzyme deficiency
glycogen storage disease type III
Cori
ABCD
Anderson- Branching
Cori- Debranching
Branching enzyme deficiency
glycogen storage disease type IV
Anderson
ABCD
Anderson- Branching
Cori- Debranching
Skeletal muscle glycogen phosphorylase deficiency
glycogen storage disease type V
Hepatic glycogen phosphorylase deficienxy
glycogen storage disease type VI
PFK deficiency
glycogen storage disease type VII
Hepatic phosphoylase kinase deficiency
glycogen storage disease type VIII
Glycogen in liver and renal cells
glycogen storage disease type I
Glycogen in lysososomes, cardiomegaly and heart failure
glycogen storage disease type II
Early death from heart and liver failure
glycogen storage disease type IV
Glycogen in muscle, muscle cramps + myoglobinuria but no lactic acidosis
glycogen storage disease type v
Glycogen in liver cells, hypoglycemia
glycogen storage disease type VI
Causes galactosemia and galactosuria, causes cataracts in EARLY childhood
Galactokinase deficiency
Galactosuria,galactosemia, cataracts within a few days of birth, vomiting and diarrhea after milk ingestion, hypoglycemia, letharygy, hypotonia
Gal-1-P uridyltransferase deficiency
Also called classic galactosemia
Galactos-1-P uridyltransferase deficiency
GALIPUT
One of the few absolute contraindication to breastfeeding
Classic galactosemia
Defect in fructokinase
Essential fructosuria
Benign and asymptomatic whose only symptom is the appearance of fructose in blood and urine
Essential fructosuria
Deficiency in aldolase B
Fructose intolerance
Fructose intolerance is a deficiency in what aldolase?
Aldolase B
What substrate accumulates in fructose intolerance?
Fuctose 1-P
Leads to decr. Phosphate, decr. Glycogenolysis and decr gluconeogenesis. Manifests as hypoglycemia, jaundice, cirrhosis, and vomiting
Fructose intolerance
Aldolase B deficiency can lead to what type of renal disorder?
Proximal renal tubule disorder
After initiation of breastfeeding, Accumulation of what substance causes cataracts?
Galactitol
In DM, accumulation of what compound leads to formation of cataracts?
Sorbitol
Used in diagnosing thiamine deficiency
RBC Transketolase activity
Most common disease producing enzyme abnormality in humans
G6PD deficiency
Involves a decrease in NADPH in RBCs and decreased activity of glutathione reductase
G6PD deficiency
Most common cause of acute attack in G6PD deficiency
Infection
Drugs that can cause hemolysis in G6PD deficiency
Sulfonamides, chloramphenicol, primaquine, anti pyretics except ASA and paracetamol
Found in G6PD deficiency
Bite cells/ Heinz bodies
Deficiency in NADPH oxidase
Chronic Granulomatous Disease