Easily forgettable diseases Flashcards
Hartnup disease
Auto recessive
deficiency in neutral a.a. transporters in proximal tubule and on enterocytes.
Neutral aminoaciduria (tryptophan) –> niacin deficiency
Pellagra-like symptoms (dementia, diarrhea, dermatitis)
Osler-Weber-Rendu syndrome
Aka hereditary hemorrhagic telangiectasia
auto dom
disorder of BV leading to telangiectasia, reccurent nose bleeds (epistaxis), skin discolration, AV molformations, GI bleeding, hematuria
Von recklinghausen’s disease AKA
NF1
tuberous sclerosis
neurocutaneous disorder with multi-organ system involvement. Numerous benign hamartomas. angiofibromas visceral cysts cutaneous angiofibromas auto dom ash leaf spots rhabdomyomas shagreen patches
Sturge-Weber syndrome
non inherited
congenital
anomaly of neural crest derivatives due to mutation in GNAQ gene. Affects small BV -> port wine stain on face. Ipsilateral leptomeningeal angioma
seizures, epilepsy
intellectual disability
episcleral hemangioma -> increased intraocular pressure -> early onset glaucoma
skull - tram track calcifications
Plummer-Vinson syndrome
triad of iron deficiency anemia, esophageal webs, and atrophic glossitis
(webs cause dysphagia, which is often seen in iron deficiency anemia)
issue with scurvy
no vitamin c to hydroxylate lysine and proline on collagen
Problem with osteogenesis imperfecta
problem with forming the triple helix of collagen during the glycosylation step
problem with ehlers danlos syndrome
problems with cross linking of collagen outside of the fibroblasts
menkes disease
connective tissue disease
impaired copper absorption and transport
decreased activity of lysyl oxidase (which needs Cu) for collagen synthesis
brittle, kinky hair, growth retardation, hypotonia
defect in marfan
defect in fibrillin which forms a sheath around elastin
Signs of Prader willi
hyperphagia, obesity, intellectual disability, hypogonadism, hypotonia
signs of angelman syndrome
inappropriate laughter, seizures, ataxia, intellectual disability
gene mutation in familial adenomatous polyposis
auto rec or dom?
APC gene
auto dom
hungtington disease - repeat? chromosome number?
CAG, chrom 4
CHromosome number for FAP
chromosome 5
gene association with MEN2A and B
Ret
NF1 chromosome and symptoms
Chrom 17
cafe au lait spots, cutaneous neurofibroms (schwann cells, neural crest)
Auto dom
NF2, chrom # and symtpoms
Chrom 22
bilateral acoustic schwannomas, juvenile cataracts, meningiomas, ependymomas
tuberous sclerosis, inheritance and symptoms
auto dom
hamartomas
what happens with the mutated protein of CF
misfolded protein due to impaired post translational processing –> protein retained in RER, not transported to cell membrane. May got to proteasome
TYpe of mutation for duchenne
x linked recessive, frameshift mutation of dystrophin protein
type of mutation for becker muscular dystrophy
x linked recesssive, point mutation in dystrophin.
repeat for mytonic type I MD. SYmptoms and characteristics
CTG
expansion of DMPK gene -> abnormal expression of myotonin protein kinase –> myotonia, muscle wasting, frontal balding, cataracts, testicular atrophy, arrhythmia
Fragile x
mutation, symptoms
CGG repeat of FMR1 gene, x linked
post pubertal macroorchidism, long face with large jaw, large everted ears, autism, MVP
Cri-du-chat
microdeletion of short arm of chrom 5
microcephaly, intellectual disability, high pitched crying, epicanthal folds, cardiac abnormalities (VSD)
Williams syndrome
Microdeletion of long arm chrom 7 elfin facies, intellectual disability, hypercalcemia well developed verbal skills extreme friendliness with strangers CV problems
22q11 deletion
catch -22 Cleft palate abnormal facies thymic aplasia cardiac defects hypocalcemia (parathyroid aplasia)
seen with Digeorge
CHronic granulomatous disesase enzyme
NADPH oxidase (converts O2 to superoxide)
what are people with CGD more susceptible to?
Bacteria with catalase. Patients can still make H2O2 to destory bacteria, unless the bacteria have catalase which can destory H2O2
most common human enzyme deficiency
G6PD
what types of cells are seen in G6PD deficiency
bite cells (phagolytic removal of heinz bodies by splenic macrophages)
how are heinz bodies produced
G6PD deficiency -> increased hemolysis and ROS damage –> oxidized Hb in RBCs
essential fructokinase
not as bad as fructose intolerance. Defect in fructokinase -> no conversion of fructose to frucose1P.
Auto recessive
benign, increased fructose in urine and blood
frucotse intolerance
no aldolase B -> no conversion of fructose 1P to downstream molecules.
Increased fructose 1p -> wasted phosphates -> less available for gluconeogenesis and glycogenolysis.
hypoglycemia, jaundice
what substance need decreased intake in frucotse intolereance
fructose and sucrose (frucoste + glucose)
subunits of lactose
galactose + glucose
subunits of maltose
2 glucose molecules
galactokinase deficiency
no conversion of galactose to galctose 1P. Increased levels of galactitol (by aldose reductase). fairly benign infantile cataracts (no social smile or tracking of objects)
Classic galactosemia
No galactose 1 phosphage uridyltransferase. No conversion of galactose1p to glucose 1 p.
Accumulation of galactitiol -> cataracts
FTT, jaundice, hepatospleno, intellectual disability.
Increased waste of phosphate -> no gluconeogenesis or glycogenolysis
treatment for classic galactosemia
decreased galactose and lactose (galactose + glucose) from diet
Hyperammonemia causes what with the energy cycles?
Increased NH4 leadsto depletion of alpha-ketoglutarate -> inhibition of TCA cycle
Required cofactor for CPSI of the urea cycle
N-acetylglutamate
Ornithine transcarbamylase deficiency
Urea cycle enzyme.
X linked recessive
can’t eliminate NH3
carbamoyl gets converted to orotic acid instead of citruiline. Orotic acid part of pyrimidine synthesis pathway.
Increased orotic acid in blood and urine. Decreased BUN, increased NH3
orotic aciduria
inability to convert orotic acid to UMP (pyrimidine synthesis pathway) due to defect in UMP synthase. autosomal recessive megaloblastic anemia No hyperammonemia (unlike OTC deficiency)
Phenylketonuria
decreased phenylalanine hydroxylase (phenyl -> tyrosine) or due to decreased tetrahydrobiopterin cofactor.
intell. disability, growth retard, seizures, fair skin, eczema, musty body odor.
what compound must PKU patients avoid
aspartame, artificial sweetener
alkpatonuria
deficiency in homogentisate oxidase (tyrosine –> homogentisic acid -> maleylacetoacetic acid.
Increased homogentisic acid.
dark connective tissues, brown sclera, black urine
arthralgias
three ways to get homocystinuria
- cystathionine synthase deficiency (homocysteine -> cystationine –> cysteine)
- Decreased affinity of the synthase for B6
- Homocysteine methyltransferase deficiency (homocysteine –> methionine)
symptoms of homocytinuria
intellectual disability osteoporosis tall stature kyphoisis lens subluxation thrombosis, atheroslcerosis
Cystinuria
defect in renal PCT and intestinal amino acid transporter for COLA (cysteine, ornithine, lysine, arginine)
excess cysteine in urine -> hexagonal cysine stones.
treatment of cystinuria
urinary alkalinization (azetazolamide)
chelating agents to increase solubility of stones.
good hydration
Lynch syndrome
aka HNPCC - hereditary non-polyposis colorectal cancer. Mutation in DNA mismatch repair genes
Maple syrup urine disease
no degradation of branched amino acids (isoleucine, leucine, valine) due to decreased alpha-ketodehydrogenase or B1.
severe CNS defects and death
Von Gierke disease
glycogen storage disease -> increased glycogen stores in kidney and liver -> hepatomegaly.
Due to glucose-6-phosphatase deficiency (no degradation of glucose6P to glucose).
hypoglycemia
increased blood lactate
must eat often to avoid hypoglycemia, corn starch before bed
pompe disease
glycogen storage disease. defect in lysosomal alpha-1,4-glucosidase. leads to cardiomyopathy
Cori disease
milder form of von gierke disease. Hepatomegaly and increased glycogen stores without increased lactate.
due to defect in debranching enzyme (alpha 1,6 glucosidase)
McArdle disease
glycogen storage disease. Defect in skeletal muscle glucogen phosphorylase (myophosphorylase). Unable to breakdown glycogen in muscle cells. Painful muscle cramps, esp when exercising. Arrhythmias from electrolyte imbalances.
osmosis draws water into muscle cells -> burst- > increased myoglobin in serum and urine -> myoglobinuria