Metabolic Disorder Defective Molecule Flashcards

1
Q

I-Cell Disease

A

N-acetylglucosaminyl-1-phosphotransferase

failure of Golgi to phosphorylate mannose residues

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2
Q

G6PD Deficiency

A

Glucose-6-Phosphate Dehydrogenase

(necessary for HMP shunt and reduction of Glutathione, which is important for detoxifying free radicals and peroxides–> leads to hemolytic anemia)

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3
Q

Essential Fructosuria

A

Fructokinase

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4
Q

Fructose Intolerance

A

Aldolase B

–> leads to accumulation of Fructose-1-Phosphate (hypoglycemia, jaundice, cirrhosis, vomiting)

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5
Q

Galactokinase Deficiency

A

Galactokinase

—> leads to accumulation of Galactitol

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6
Q

Classic Galactosemia

A

Galactose-1-phosphate-uridyltransferase

—> toxin buildup leads to failure to thrive, jaundice, hepatomegaly, infantile cataracts, intellectual disability, e. coli sepsis in neonates

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7
Q

PDC Deficiency

A

Pyruvate Dehydrogenase Complex

—> causes buildup of pyruvate, shunted to lactate (via LDH) and alanine (via ALT)- neurologic defects, lactic acidosis, high serum alanine

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8
Q

Lactose Intolerance

A

Lactase

Bloating, cramps, flatulence, osmotic diarrhea

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9
Q

Congenital Hyperammonemia

A

N-acetylglutamate synthase

Required co-factor for carbamoyl phosphate synthetase I

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10
Q

OTC Deficiency

A

Ornithine Transcarbamylase

most common urea cycle disorder, leads to increased blood and urine orotic acid, DECREASED BUN

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11
Q

Phenylketonuria

A

Phenylalanine Hydroxylase (enzyme) OR Tetrahydrobiopterin (cofactor for conversion to tyrosine)

intellectual disability, growth retardation, seizures, fair skin, eczema, “musty” body odor

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12
Q

Maple Syrup Urine Disease

A

a-ketoacid dehydrogenase

blocked degradation of isoleucine, leucine, and valine
severe CNS defects, intellectual disability, and death.

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13
Q

Alkaptonuria

A

Homogentisate oxidase

Buildup of homogentisic acid–> Dark connective tissue, brown pigmented sclerae, black urine upon prolonged air exposure, arthralgias

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14
Q

Homocystinuria

A

Cystathione synthase

Excess homocysteine buildup–> homocysteine in urine, intellectual disability, osteoporosis, marfanoid habitus, kyphosis, lens subluxation (downward and inward), thrombosis, atherosclerosis

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15
Q

Cystinuria

A

Defective Reabsorption in PCT of Cysteine, Ornithine, Lysine, and Arginine (COLA)

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16
Q

Von Gierke Disease (type I GSD)

A

Glucose-6-Phosphate

Severe fasting hypoglycemia, glycogen buildup, increased lactate, increased triglycerides, increased uric acid, hepatomegaly

17
Q

Pompe Disease (type II GSD)

A

Lysosomal a-1,4,-glucosidase (acid maltase)

Cardiomegaly, hypertrophic cardiomyopathy, exercise intolerance, death

18
Q

Cori Disease (type III GSD)

A

a-1,6-glucosidase (debranching enzyme)

symptomatically presents as milder form of Von Gierke- hypoglycemia, glycogen buildup, increased lactate, increased triglycerides, increased uric acid, hepatomegaly

19
Q

McArdle Disease (type V GSD)

A

Glycogen Phosphorylase (myophosphorylase)–> skeletal muscle

increased muscle glycogen, painful muscle cramps, myoglobinuria with strenuous exercise, arrhythmia (due to electrolyte abnormalities)

20
Q

Fabry Disease

A

a-galactoside A

Buildup of Ceramide trihexoside

X-linked recessive (only this and Hunter are XLR- all other board relevant LSDs are AR) Peripheral neuropathy, angiokeratomas, CV/Renal disease

21
Q

Gaucher Disease

A

Glucocerebrosidase (B-glucosidase)

Buildup of Glucocerebroside

Most common LSD- hepatosplenomegaly, pancytopenia, aseptic necrosis of femur, bone crises, lipid-laden macrophages

22
Q

Niemann-Pick Disease

A

Sphingomyelinase

Buildup of Sphingomyelin

Progressive neurodegeneration, hepatosplenomegaly, foam cells, “cherry-red” spot on macula

23
Q

Tay-Sachs Disease

A

Hexosaminidase A

Buildup of GM2 ganglioside

Progressive neurodegeneration, developmental delay, “cherry-red” spot on macula, lysosomes with onion skin, NO HEPATOSPLENOMEGALY, UNLIKE NIEMANN-PICK

24
Q

Krabbe Disease

A

Galactocerebrosidase

Buildup of Galactocerebroside and psychosine

Peripheral neuropathy, developmental delay, optic atrophy, globoid cells

25
Metachromatic leukodystrophy
Arylsulfatase A Buildup of Cerebroside sulfate Central and peripheral demyelination with ataxia and dementia.
26
Hurler Syndrome
a-L-iduronidase Buildup of heparan sulfate and dermatan sulfate Developmental delay, gargoylism, airway obstruction, corneal clouding, hepatosplenomegaly AUTOSOMAL RECESSIVE (Hunter-very similar disease is XLR)
27
Hunter Syndrome
Iduronate Sulfatase Buildup of heparan sulfate and dermatan sulfate Developmental delay, gargoylism, airway obstruction, hepatosplenomegaly, aggressive behavior NO CORNEAL CLOUDING---> HUNTERS NEED TO SEE THEIR PREY UNLIKE HURLER-> XLR UNLIKE MOST OTHER LSDS, WITH EXCEPTION OF FABRY
28
Systemic Primary Carnitine Deficiency
Defective Long Chain Fatty Acid transport --->leads to toxic accumulation of long chain fatty acids--> weakness, hypotonia, hypoketotic hypoglycemia
29
Medium chain acyl-CoA dehydrogenase deficiency
Medium chain acyl-CoA dehydrogenase- Defective fatty acid oxidation accumlation of 8-10 carbon fatty acyl carnitines in blood and hypoketotic hypoglycemia can present with vomiting, lethargy, seizures, coma, and liver dysfunction
30
Type I Dyslipidemia
Lipoprotein lipase deficiency OR altered Apo C-II Hyperchylomicronemia causes pancreatitis, hepatosplenomegaly, eruptive/pruritic xanthomas, creamy layer of blood
31
Type IIa Dyslipidemia
Absent or defective LDL receptors familial hypercholesterolemia accelerated athersclerosis (possible MI before age 20), Achilles xanthomas, corneal arcus
32
Type IV Dyslipidemia
Hepatic overproduction of VLDL Hypertriglyceridemia can cause acute pancreatitis