Intro to metabolic disease Flashcards

1
Q

def. metabolics

A

sum total of al chemical rxns in a cell which include ysnthesis and breakdown of organic molecules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are diseases of metabolism

A

inborn errors of metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is basic chemical rxn

A

substrate>enzyme>product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what happens if no enzyme

A

incr. substrate and dec. product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is basic PKU (phenyketonuria) rxn

A

phenyalalnine> phen. hydroxylase>tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes PKU

A

auto recessive due to mutation in PAH gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

prob. in PKU

A
  • high phenylalanine
  • low tyrosine leads low serotonin and dopa
  • defective myelnation, cog. probs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are sig. phenylalanine levels

A

normal - 120

  • in PKU if can maintain 400 - near normal IQ
  • each incr. of 300 leads to loss of 0.5SD of IQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why are PKU light

A

tyrosine is also converted into melanin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is PKU treatment

A

substrate reduction therapy - reduce all protein and take protein supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how is PKU tested for

A

all infants screened by tandem mass spectroscopy - used to be guthrie test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is antoher PKU treatment

A

product replacement - give large AAs that compete for crossing over into brain of phenyalalnine

  • reduces brain phenyl
  • increased brain tyrosine and tryptophan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is new PKU treatment

A

enzyme enhancement - BH4 - helps PAH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is another new treatment

A

alternative routes of metabolism - PAL phenylalanine lyase turns Phe into cinammic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are 3 main saccharides and makeup

A

maltose - glu +glu
lactose - glu + galactose
sucrose - glu + fructose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is glycogne

A

highly branched polymer of glucose molecules

17
Q

what causes glycogen storage disease

A

lack of glucose 6 phosphatase

- can’t create glucose from glycogen and gluconeogenisis to put into blood stream

18
Q

phsyio effect of GSD

A
  • low glocuse
  • large liver with glycogen
  • high triglycerides
  • high lactate
19
Q

clinical probs with GSD

A
  • hepatomegaly
  • hypoglycemia
  • high triglycerides
  • high uric acid
20
Q

how to treat GSD

A

dependent on cornstarch feeds

21
Q

what else needs to be managed

A
  • fibrates for hyperlipiemia
  • treat stones - ;ithroscopy
  • monitor liver for adenomas
22
Q

what is gene therapy for GSD

A

improvement of G6Pase activity and reduction of glycogen in liver

23
Q

other therapy

A

hepatocyte transplant - may last up to a year

24
Q

2 main types of metabolism disorders

A
  1. probs with intermediary metabolism

2. problems affectin organelles

25
what are organelle disease
conidtions involving macromolecules
26
how do organelle disorders present (3)
1. pregressive 2. permaent 3. indep. of food intake
27
2 gen. clinical features of organelle dis.
1. features correlate with organ where accumulation happens | 2. features will affect organs where organelles are pref. utilized
28
what is lysozomal storage diseases
def. in one or more lysosomal hydrolases | - get substrate buildup
29
3 examples
1. heparine sulfate - in brain 2. dermatan sulfate - brain 3. keratan sulfate - bone
30
what is mucopolysaccharidosis (MPS) type 1
hurlers syndrome
31
features of hurler
1. runny nose and otitits 2. hernias 3. coarse face and cornela clouding 4. large liver and spleen 5. dev. slowed by year 2
32
what causes hurler
defect in iduonidase enzyme
33
what causes effects of hurlers
buildup and depends where it accummulates
34
3 treatments of hurler
1. enzyme replacement therapy (ERT) 2. bone marrow trnasplant (source of enzyme) 3. treat syndromic complications
35
what is ERT effects for hurler
- improved joint ROM - cardiac and pulm. function - liver size reduced
36
what are limits of ERT (4)
1. safelty - allergies common 2. hard to reahc sx - brain 3. know when to start/stop 4. cost
37
when to do marrow trans
early and before IQ drops
38
3 reasons with think organelle
1. regression 2. chronic course 3. dysmorphism