Biochemical Disorders Flashcards
Deficiency in NADPH oxidase
Results in pyogenic infections since there is no respiratory burst
Chronic granulomatous disease
Insulin deficiency
Increased glucose level
Glucosuria
Increased ketogenesis
Diabetes Mellitus
Increased urine galactose
Autosomal recessive
Galactokinase deficiency
Deficiency in cystathionine synthetase
Homocysteinuria
Cannot methylate homocysteine into methionine
Treatment for homocysteinuria
Vitamin B6 (pyridoxine) and cysteine
Neonatal screening test for phenylketonuria
Guthric test
May show false negative if done at birth
Deficient phynylalanine hydroxylase
Phenylketonuria
Management for phenylketinuria
Eliminate phenylalanine from diet
Supplement with tyrosine
Amino acid disorder
Darkened urine when standing
Alkaptonuria
Ezyme deficient in alkaptonuria
Homogentisate oxidase
Urea cycle disorder
Hyperammonemia
CPS deficiency
Carbamoyl phosyphate synthetase deficiency
Amino acid disorder
Urea cycle disorder
Hyperammonemia
Orotic aciduria
Ornithine transcarbamoylase deficiency
Amino acid disorder
Deficient argininisuccinate synthetase
Citrullinemia
Increased citrulline level
Deficient argininosuccinase
Excretion of argininosuccinate in urine
Argininemia
Amino acid disorder
Sweet odor of urine
MSUD
Enzyme deficiency in MSUD
Keto-acid (branched chain) dehydrogenase
Amino acid disorder
Increased isoleucine, leucine, valine in urine
MSUD
these are brached chain AA
Absent ketoacid (branched chain) dehydrogenase in MSUD
Management for MSUD
Diet low in brached chain ketoacids
Most glycogen storage diseases are autosomal recessive except
Phosphorylase b kinase deficincy
Glycogen storage disease
Hepatomegaly
Deficient glucose 6 phosphatase
Von Gierke’s Disease
Aka Type I GSD
Type I GSD
Von Gierke’s Disease
Type II GSD
Pompe’s Disease
2 enzymes deficient in Pompes Dse
Alpha 1,4-glucosidase
Lysosomal acid maltase (debranching enzyme)
Debranching enzyme deficient in Pompes Dse
Lysosomal acid maltase
Also decreased in alpha 1,4-glucosidase
GSD
Cardiomegaly
Restrictive cardiomyopathy that occurs as the heart stores glycogen
Juvenile onset: hypotonia, death from heart failure
Adult onset: muscle dystrophy
Pompes Disease (Type II GSD)
GSD
Enzyme deificiency in Com’s disease
Amylo 1,6-glucosidase, a debranching enzyme
GSD
Effects limit dextrin conversion to glucose
Cori dse (Type IIIa) Deficient amylo 1,6 glucosidase
Type V GSD
McArdle’s diasease
Deficiency in muscle phosphorylase
Enzyme deficiency in McArdle’ s disease
Muscle phosphorylase
Sx cramps in the muscle
GSD
Weakness and cramps in muscle
Increased glycogen
McArdle aka Type V GSD
Def in muscle phosphorylase
GSD
Deficiency in liver phosphorylase
HERS dse
Increased in glycogen like McArdle
GSD
Increased glycogen due to inability to activate to phosphorylase a
Phosphorylase b kinase deficinecy
Lipid disx
Increased level of cholesterol due to mutated LDL receptor
Reduced binding of LDL
Familial hypercholesterolemia
Lipid disx
Increased chylomicron TAG
Familial lipoprotein lipase deficiency
Lipid disx
Deficiency of lecithin cholesterol acyltransferase
Familial LCAT deficiency
Lipid dsx
Defective HDL synthesis
Tangier’s dse
Lipid disx
Elevated cholesterol in tissue and decreased plasma HDL
Tangier’s dse
Lipid disx
Deficient Apo E 3
Familial dysbetalipoprotenemia
Lipid disx
Defective synthesis of Apo B lipid complex
Abetalipoproteinemia
Lsysosomal storage disease-Mucopolysaccharidoses
X-linked deficiency of iduronosulfate sulfatase
Hunter’s Syndrome
Lysosomal Storage Disease-mucopolysaccharidoses
Mental and physical retardation
NO corneal clouding
Hunters Syndrome
Increased level of dermatan and heparan sulfate
Lysosomal Storage Disease-mucopolysaccharidosis
Increased level of dermatan and heparan sulfate
Corneal clouding, mental and physical retardation
Early death
Hurler’s syndrome
Deficiency of alpha L idurodinase
Lysosomal storage disease-mucopolysaccharidosis
Inc heparan and dermatan sulfate
Deficiency of alpha L idurodinase
Early death
Hurler’s syndrome
Lysosomal storage disease-mucopolysaccharidosis Coneal clouding Joint degeneration Heart disease NO retardation NORMAL life expectancy
Schele’s syndrome
Lysosomal storage diseases with defricency in alpha L iduronidase
Hurler’s, Schele’s
Lysosomal Storage Disease- Mucopolysaccharidosis
Increased heparan sulfate
Severe mental retardation
Type III mucopolysaccharidosis
Sanfilippo’s syndrome
Type III Mucopolysaccharidosis
Sanfilippo’s syndrome
Enzyme deficiency in Sanfilippo’s Syndrome Type A
A: N-sulfatase
B: N-acetylglucosaminidase
C: N-acetylcoA, alphaglucosamine acetyletransferase
D: N-acetyl alpha D glucosamine 6 sulfatase
Enzyme def in Sanfilippo Syndrome Type B
A: N-sulfatase
B: N-acetylglucosaminidase
C: N-acetylcoA, alphaglucosamine acetyletransferase
D: N-acetyl alpha D glucosamine 6 sulfatase
Enzyme def in Sanfilippo Type C
A: N-sulfatase
B: N-acetylglucosaminidase
C: N-acetylcoA, alphaglucosamine acetyletransferase
D: N-acetyl alpha D glucosamine 6 sulfatase
Enzyme def in San Filippo Type D
A: N-sulfatase
B: N-acetylglucosaminidase
C: N-acetylcoA, alphaglucosamine acetyletransferase
D: N-acetyl alpha D glucosamine 6 sulfatase
Sphingolipidosis
Defective beta gangliosidase A
GM1 gangliosidosis
Sphingolipidosis
Deficiency of hexosaminidase A
Tay Sachs disease
Sphingolipidosis
Increased GM2 gangliosides
Tay Sachs disease
Sphingolipidosis Associated with Ashkenazi (Eastern European), Jews Macular cherry red spot Retardation Early death
Tay Sachs disease
Sphingolipidosis
Deficiency of glucocerebrosidase
Increased glucocerebrosides
Gaucher’s dse
Sphingolipidosis
Deficiency of sphingomyelinase
Mental retardation
Early death
Niemann-Pick’s Dse
Enzyme def in Gaucher’s dse
Glucocerebroside
Enzyme deficiency in Niemann-Pick’s dse
Sphingomyelinase
Sphingolipidosis
Def of a-galactocerebrosidase A
Fabry’s Dse
Sphingolipidosis
Increase ceramide trihexoside
Fabry’s dse
Deficiency of a-galactocerebrosidase
This is the only sex linked sulfatidosis
Fabry’s disease
Nitrogen base disorder
Deficiency of HGPRT
But has xanthine oxidase
Lesch Nyhan Syndrome
Nitrogen Base discorder Associated with Gout Increased serum Urate Increased PRPP Icreased hypoxanthine Self destruction Mental retardation
Lesch Nyhan
Due to dec HGPRT
Analogue of xanthine, used in the treatment of gout
Inhibits xanthine oxidase
Decreased hypoxanthine conversion to urate
Does not resolce neurologic problems
Allopurinol
Used in Lesch Nyhan
Enzyme involved in degradation of purines
Precursor of guanine
Xanthine oxidase
Hypoxanthine—> xanthine —> uric acid
Nitrogen base disx
Leads to severe combinced immunodeficiency disorder
Adenosine deaminase deficiency
The first gene transplanted into human cell DNA to develop tha immune system
Adenosine deaminase
Deficiency of this enzyme eill shut off deoxyribose productionand decreases immune system
Adenosine deaminase
Adenosine is converted to inosine (purine degradation)
Nitrigen base disorder
Deficiency of orotate phosphoribosyltransferase
Orotic aciduria
Nitrogen base disx
Megaloblastic anemia
Orotic aciduria
Nitrogen base disx
Deficiency of UV endonuclease
Xeroderma pigmentosum
Nitrogen base disorder
Loss of excision repair to remove thymine dimers (created by UV radiation) forming dimers in DNA
Xeroderma pigmentosum
3 enzymes involved in repair of dimers
Exonuclease
DNA polymerase I
DNA ligase
Enzyme involved in the repair of thymine dimers
DNA repair and synthesis
Formation of phosphodiester bonds between molecules
Ligase
Hepatolenticular degeneration
Dermatitis
Wilsons dse
Increased serum copper
Wilsons dse
Deficiency of ceruloplasmin
Wilsons dse
Enzyme def in acute intermittent porphyria
Porphobilinogen deaminase
Dse associated with increased delta aminolevulonic acid (d-ALA)
Acute intermittent porphyria
Defective formation of bilirubin glucuronide
Crigler-Najjar syndrome
Deficiency of hepatic bilirubin UDP glucoronyl transferase
Crigler Najjar Syndrome
Non-hemolytic jaundice,
Hyperbilirubinemia
Irreversible brain damage
Defective formation of bilirubin diglucoronide
Crigler Najjar syndrome
Excessive iron storage
Frequent blood transfusion-related
Hemosiderosis
Hemoglobinopathy
Glutamate—>Valine (less soluble) at position 6 on beta chain om hemoglobin
Sickle cell anemia
Abnormal hemoglobin S
Sickle cell disease
Sickle cell trait- Hgb S and A
Abnormal quantity of alpha and beta hemoglobin chains
Normal function of chains
Thalassemia
Alpha or Beta thalassemia?
- May produce hgb H
- Gene deletion, impaired processing of mRNA, premature chain termination
1 alpha
2 beta
Connective tissue disorder
Elastic skin loose joints
Collagen defects
Ehlers Danlos
Decreased lysyl oxidase or lysyl hydroxylase
Ehlers Danlos Syndrome
Deficiency of Type I collagen formation
Elastin defect
Marfan
Tall stature
Arachnodactyly
Weak arteries
Aortic aneurysm
Marfan
Decreased collagen synthesis
Osteogenesis imperfecta
Brittle bone syndrome
Osteogenesis imperfecta
Transport defect of tryptophan in intestinal and renal systems
Hartnup disease
Defective cystine, lysine, arginine, ornithine transport
Cystinuria
Cystine crystals and stone formation
X linked recessive
Factor 9 def
Hemophilia B
Christmas dse
Massive hemorrhage after trauma or operation
Normal bleeding time
Prolonged coagulation time
Factor 8 def, hemophilia a, x-linked recesive aka classic hemophilia
Tx: factor 8 concentrate
Deficiency of branching enzyme
Increase polysaccharide with few branch points
Death from heart or liver failure before age 5
Type IV
Andersen dse
Deficiency of branching enzyme
Increase polysaccharide with few branch points
Death from heart or liver failure before age 5
Type IV
Andersen dse