Glycogen, Gluconeogenesis and Hexose Monophosphate Shunt Flashcards

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1
Q

Hallmark clinical feature of Pompe disease related with the cause of death, what is the cause of this disease?

A
  • cardiomegaly infantile onset, death without tx at 2 yrs

- lysosomal alfa 1-4 glucosidase deficiency

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2
Q

Difference between Von Gierke and Hers disease?

A
  • Von Gierke overall MORE severe (profound hypoglycemia), Hers MILD (hypoglycemia).
  • Hepatomegaly and normal collagen structure - sameness
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3
Q

What is the cause of hyperuricemia in Von Gierke disease?

A
  • ⬇️ Pi (“trap” in glucose 6-P) ▶️ ⬆️ AMP ▶️ Uric acid (⬆️ lactate ▶️ ⬇️ Uric acid excretion in kidney) ▶️ Gout
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3
Q

What are the glycogen storages disease that have inclusion or result abnormal glycogen structure?

A
  • Cori ▶️ single glc residues outer branch, short outer branches
  • Andersen ▶️ very few branches, especially toward periphery
  • Pompe ▶️ glycogen-like material in inclusion bodies
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5
Q

Which fatty acid is the exception that can rise a gluconeogenic molecule?

A
  • odd number carbon fatty acids ▶️ propionyl-CoA
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6
Q

What is the key control point in gluconeogenesis? What regulates it?

A
  • fructose 1,6 biphosphatase
  • (+) ▶️ ATP
  • (-) ▶️ AMP, F 2,6-BP (control glycolysis and gluconeogenesis);
  • glucagon ▶️ (-) PFK-2 ▶️ ⬇️ F 2,6-BP (+) gluconeo
  • insulin ▶️ (+) PFK-2 ▶️ ⬆️ F 2,6-BP (-) gluconeo
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7
Q

Why the skeletal muscle doesn’t have glucose 6 phosphatase?

A
  • muscle glycogen cannot serve as a source of blood glucose

- it’s only in the liver

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8
Q

HOW the B-oxidation of fatty acids contribute to gluconeogenesis besides the energy given as ATP/GTP?

A
  • produce acetyl-CoA
    ▶️ (+) Pyruvate carboxylase (go on gluconeo)
    ▶️ (-) PDH (avoid conversion of pyruvate, and use it for gluconeo)
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9
Q

What kind of fuel can give rise acetyl-CoA from fatty acids since that can’t be converted to glucose?

A

Ketone bodies - alternative fuel, ex; Brain

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10
Q

WHY the B-oxidation of fatty acids contribute to gluconeogenesis besides the energy given as ATP/GTP?

A
  • between meals ▶️ 🔛 gluconeo and (-) PDH to prevent lactate and alanine ▶️ acetyl CoA, need them as pyruvate only.
  • well fed state ▶️ ⬆ acetyl CoA ▶️ cytoplasm to do FA, need OAA for this. Same acetyl CoA (+) pyr carboxylase to form it from pyruvate.
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11
Q

In liver and skeletal muscle what regulates the glycogen synthase?

A
  • insulin (+) both tissues
  • glucagon, epinephrine (-) liver
  • epinephrine (-) skeletal muscle
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12
Q

What is the cori cycle?

A

Lactate (from RBC and muscle during exercise) ▶️ glucose (return to RBC and muscles), through gluconeo in liver

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13
Q

What is the alanine cycle?

A

Muscle release Alanine ▶️ pyruvate (gluconeo) and NH3 (urea)

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14
Q

Why alcoholism lead into hypoglycemia?

A

⬆️⬆️ NADH by alcohol DH and acetaldehyde DH to metabolize etanol:

  • ⬆️ lactate from pyruvate
  • ⬆️ malate from OAA
  • ⬆️ glycerol 3-P from DHAP
  • deviate gluconeo substrates from the pathway
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15
Q

Why after extreme exercise a high alcohol consumption can lead metabolic acidosis and hypoglycemia?

A

To realize gluconeo NAD is needed to lactate ▶️ pyruvate; it’s gone used in etanol metabolism, stay ⬆️ lactate ▶️ acidosis and hypoglycemia

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16
Q

What could be the mechanism to produce lipid accumulation in alcoholic liver disease?

A

⬆️⬆️ NADH (B-oxidation very slow) and ⬆️ glycerol 3-P + FA coming from adipose ▶️ store TG in liver

17
Q

Functions of NADPH in liver, RBC, neutrophils

A
  • liver ▶️ biosynthesis
  • Neutrophils ▶️ bactericidal activity
  • RBC ▶️ protect against ROS (helping supplying reduced glutathione)
18
Q

Why in Glucose 6-P DH deficiency is not impair the synthesis of pentoses? What enzyme is involved?

A
  • because there is a Shunt that allow convert glycolysis intermediates (fructose 6-P, glyceraldehyde 3-P) directly without G6PDH reaction into Ribose 5-P.
  • Transketolase (TPP require)
19
Q

How could you differentiate (differential Dx) between G6PDH deficiency (mutation that reduce activity less than 5%) and chronic granulomatous disease?

A
  • Differential Dx ▶️ hemolytic anemia (may be chronic) and Heinz bodies
  • both predispose an impair ability to kill microbes:
  • CGD ▶️ NADPH oxidase deficiency
  • G6PDH def ▶️ ⬇️ NADPH ▶️ NADPH oxidase doesn’t work
20
Q

How is regulated the glycogen phosphorylase in liver and muscle?

A
  • liver: epinephrine, glucagon (+), insulin (-)

- muscle: epinephrine, AMP, Ca (through calmodulin) (+), insulin, ATP (-)

20
Q

Why G6PDH deficiency confer protection against malaria?

A

Accumulates ROS in RBC (target of malaria) ▶️ plasmodium deficient in antioxidant mechanism

21
Q

What substances regulate G6PDH?

A
  • NADP, insulin (+)

- NADPH (-)

23
Q

Making conclusion, what substrate can control (as an axis) both gluconeogenesis and glycolysis?

A

Fructose 2,6 bisphosphate