Nitrogen Metabolism Flashcards
0
Q
Intake > Excretion
Net accumulation of proteins as in growth and pregnancy
A
Positive Nitrogen Balance
1
Q
Nitrogen intake equal nitrogen excretion
A
Nitrogen Balance
2
Q
Intake < Excretion
Net breakdown of proteins as in surgery, advanced cancer, kwashiorkor or marasmus, starvation
A
Negative Nitrogen Balance
3
Q
Amount of protein degraded and resynthesized from amino acids
A
Protein Turnover
4
Q
Normal Protein Turnover
A
300-400 g/day
5
Q
Protein Degradation Mechanisms
A
Energy-dependent ubiquitin-proteosome mechanism
Non-energy dependent degradative enzyme
6
Q
Sum of all free amino acids in cells and ECF
A
Amino Acid Pool
7
Q
3 Possible Sources of Amino Acid Pool
A
Degradation and turnover of body protein
Dietary intake
Synthesis of nonessential amino acids
8
Q
Protein digestion begins in the
A
Stomach
9
Q
What is another substance important in vit. B12 metabolism that is also produced by parietal cells?
A
Intrinsic Factor
10
Q
Can you name other substances absorbed by secondary active transport in the small intestines?
A
Glucose and
Galactose
11
Q
Amino Acid Metabolism: Removal of alpha-amino group (a process called deamunation) formina ammonia and a corresponding alpha-ketoacid
A
First Phase
12
Q
What happens to ammonia?
A
Excreted as free ammonia in urine and stool
Majority is still converted to urea before being excreted in the urine
13
Q
Major disposal form of nitrogen
A
Urea
14
Q
Amino Acid Metabolism: Carbon skeletons of alpha-ketoacids are converted to common intermediates of energy-producing metabolic pathways
A
Second Phase
15
Q
Seen in telostean fish, which excrete highly toxic ammonia
A
Ammonotelic
16
Q
Seen in land animals, including humans who excrete non-toxic, water-soluble urea
A
Ureotelic
17
Q
Seen in birds, which excrete uric acid as semisolid guano
A
Uricotelic
18
Q
Removal of Nitrogen: First Phase
A
1) Transamination
2) Oxidative Deamination
19
Q
Occurs in all cells of body; All amino acids must transfer their amino groups to alpha-ketoglutarate to form glutamate
A
Transamination
20
Q
Transamination: Enzymes
A
Aminotransferases
Alanine aminotransferase
Aspartate aminotransferase
21
Q
Transamination: Co-enzyme
A
Pyridoxal phosphate (Vit. B6)
22
Q
ALT is also known as
A
SGPT (serum glutamate: pyruvate transferase)
Pyruvate and alanine interconvert with transamination
23
Q
AST is also known as
A
SGOT (serum glutamate: OAA transferase)
Aspartate and oxaloacetate interconvert with transamination
24
Occurs in the liver and kidney only; Only for glutamate; Glutamate is oxidized and deaminated to yield free ammonia which is used to make urea
Oxidative Deamination
25
Oxidative Deamination: Enzyme
Glutamate dehydrogenase
26
Removal of excess nitrogen from peripheral tissues: Synthesized from glutamate and ammonia; occurs in most tissues, including muscle
Through Glutamine
27
Removal of excess nitrogen from peripheral tissues: Excess nitrogen from the peripheral tissues can reach the liver through transamination of pyruvate to produce alanine; occurs in muscle
Through Alanine aka Glucose-Alanine Cycle
28
What do you call the metabolic pathway whereby lactate produced during anaerobic respiration in muscles is reconverted to glucose in the liver?
Cori Cycle
29
Deaminates glutamine to produce ammonium ion which is excreted from the body; Present in kidneys and small intestines
Glutaminase
30
Pathway for removal of Nitrogenous waste products in the body; Present only in the liver; Major disposal form of amino groups; Donors of the atoms of urea
Urea Cycle
31
Reactions in Urea Cycle: Step 1
Formation of Carbamoyl phosphate
| Enzyme: Carbamoyl phosphate synthetase I
32
Reactions in Urea Cycle: Step 2
Formation of Citrulline
| Enzyme: Ornithine transcarbamoylase
33
Reactions in Urea Cycle: Step 3
Synthesis of Arginosuccinate
| Enzyme: Argininosuccinate synthetase
34
Reactions in Urea Cycle: Step 4
Cleavage of Argininosuccinate to form Arginine
| Enzyme: Argininosuccinase
35
Reactions in Urea Cycle: Step 5
Arginine cleavage to yield Urea and Ornithine
| Enzyme: Arginase
36
Mnemonic: Ordinary Careless Crappers Are Also Frivolous About Urination
Ornithine + Carbamoyl Phosphate = Citrulline. + Aspartate = Argininosuccinate. = Fumarate + Arginine. = Urea + Ornithine
37
Rate Limiting Step of Urea Cycle
Reaction: CO2 + NH3➡️carbamoyl phosphate
Enzyme: Carbamoyl phosphate synthetase I (CPS-I)
Energy requirement: 4 ATP
Co-factors: N-acetylglutamate, Biotin
38
Causes hyperammonemia, elevated blood glutamine, decreased BUN; Presents with lethargy, vomiting, hyperventilation, convulsions, cerebral edema, coma, death
Hereditary Hyperammonemia
Type 1: Carbamoyl phosphate synthetase I deficiency
Type 2: Ornithine transcarbamoylase deficiency
39
Compromised liver function; Presents with tremors, slurring of speech, somnolence, vomiting, cerebral edema and blurring of vision
Acquired Hyperammonemia
40
Amino acid whose catabolism yields acetoacetate or acetyl-CoA or acetoacetyl-CoA
Ketogenic Amino Acid
41
Amino acid whose catabolism yields pyruvate or intermediates of Krebs Cycle like glucose via gluconeogenesis or glycogen in muscle or liver
Glucogenic Amino Acid
42
Ketogenic Amino Acid
Leucine
| Lysine
43
Glucogenic and Ketogenic Amino Acid
Phenylalanine
Tyrosine
Tryptophan
Isoleucine
44
Entry point of Amino Acids: Glutamine, Glutamate, Proline, Arginine, Histidine
Alpha-ketoglutarate
45
Entry point of Amino Acids: Alanine, Serine, Glycine, Cysteine, Threonine, Tryptophan
Pyruvate
46
Entry point of Amino Acids: Phenylalanine, Tyrosine
Fumarate
47
Entry point of Amino Acids: Methionine, Valine, Isoleucine, Threonine
Succinyl CoA
48
Entry point of Amino Acids: Aspartate, Asparagine
Oxaloacetate
49
Synthesis of Non-essential Amino Acid: Transamination of alpha-ketoacids
Alanine
Aspartate
Glutamate
50
Synthesis of Non-essential Amino Acid: Amidation of glutamate and aspartate
Glutamine
| Asparagine
51
Synthesis of Non-essential Amino Acid: Synthesized from Glutamate
Proline
52
Synthesis of Non-essential Amino Acid: Made from Methionine and Serine
Cysteine
53
Synthesis of Non-essential Amino Acid: Made from 3-phosphoglycerate
Serine
54
Synthesis of Non-essential Amino Acid: Made from serine
Glycine
55
Synthesis of Non-essential Amino Acid: Made from phenylalanine
Tyrosine
56
Conversion of Amino Acid to Specialized Products: Glycine
Heme
Purines
Creatine
Also conjugated to bile acids
57
Conversion of Amino Acid to Specialized Products: Serine
Phospholipid and sphingolipid
Purines
Thymine
58
Conversion of Amino Acid to Specialized Products: Glutamate
GABA
59
Conversion of Amino Acid to Specialized Products: Cysteine
Thioethanolamine of CoA
| Taurine
60
Conversion of Amino Acid to Specialized Products: Histidine
Histamine
61
Conversion of Amino Acid to Specialized Products: Arginine
Creatinine
Polyamines
Nitric oxide
62
Conversion of Amino Acid to Specialized Products: Tryptophan
```
Serotonin
NAD+
NADP+
Melatonin
Vit. B3 (Niacin)
```
63
Conversion of Amino Acid to Specialized Products: Tyrosine
Catecholamines
Thyroid hormones (T3 & T4)
Melanin
64
There is decreased phenylalanine hydroxylase or decreased tetrahydrobiopterine cofactor; Tyrosine becomes essential and phenylalanine builds up, leading to excess phenylketones in urine: phenylacetate, phenyllactate, phenylpyruvate
Phenylketonuria
65
Congenital deficiency of homogenistic acid oxidase in the degradative pathway of tyrosine; Resulting alkapton bodies cause urine to turn black on standing
Alkaptonuria
66
Congenital deficiency of either Tyrosinase or defective tyrosine transporters; Lack of melanin results in increased risk of Skin Ca; Can result from a lack of migration of neural crest cells
Albinism
67
All autosomal recessive; Cystathionine synthase deficiency, decreased affinity for cystathione synthase for pyridoxal phosphate, homocysteine methyltransferase deficiency
Homocystinuria
68
Common inherited defect of renal tubular amino acid transporter for cystine, ornithine, lysine, and arginine in the PCT o kidneys
Cystinuria
69
Blocked degradation of branched amino acids due to a deficiency in alpha-ketoacid dehydrogenase; Causes an increased alpha-ketoacid in the blood, especially leucine
Maple Syrup Urine Disease
70
Cyclic compounds formed by the linkage of four pyrrole rings through methyne bridges; Form complexes with metal ions bound to nitrogen atom of the pyrrole rings
Porphyrins
71
Heme Synthesis: Step 1
```
Formation of δ-Aminolevulinic Acid
Rate limiting step
Reaction: Glycine + Succinyl CoA➡️δ-Aminolevulinic Acid
Enzyme: ALA synthase
Co-factor: Pyridoxine
```
72
Heme Synthesis: Step 2
Formation of Porphobilinogen
| Condensation of two molecules of ALA by zinc-containing ALA dehydratase
73
Heme Synthesis: Step 3
Formation of Uroporphyrinogen
74
Heme Synthesis: Step 4
Formation of heme
| Introduction of iron into protoporphyrin IX occurs spontaneously but the rate is enhanced by ferrochelatase
75
In which of the following reactions or pathways is vitamin B6 (pyridoxine) not a co-factor?
Oxidation of pyruvate to acetyl CoA
76
Genetic or acquired disorders due to abnormalities in the pathway of biosynthesis of heme; Most common: Porphyria Cutanea Tarda
Porphyrias
77
Pyridoxine deficiency associated with Isoniazid therapy
Sideroblastic Anemia with Ringed Sideroblasts
78
Heme synthase introduces the Fe2+ into protoporphyrin IX to make the heme ring
Iron Deficiency
79
Inactivates many enzymes in heme synthesis: ALA dehydratase or Ferrochelatase
Lead Poisoning
80
Common Patterns of Anemia: Microcytic, Hypochromic
Iron deficiency anemia
Thalassemias
Lead poisoning
81
Common Patterns of Anemia: Megaloblastic
Folate or vitamin B12 deficiency
| Pernicious anemia
82
Common Patterns of Anemia: Normocytic, Normochromic
Anemia of Chronic Illness
| Chronic Kidney Disease
83
Common Patterns of Anemia: Increased MCHC
Spherocytosis
84
After 120 days, RBCs are taken up and degraded by the reticuloendothelial system, particularly in the liver and spleen
Degradation of Heme
85
Heme Degradation: Step 1
Enzyme: heme oxygenase system of reticuloendothelial cells
86
Heme Degradation: Step 2
Uptake of bilirubin by the liver
87
Heme Degradation: Step 3
Formation of bilirubin diglucoronide
88
Heme Degradation: Step 4
Secretion of bilirubin into bile
89
Heme Degradation: Step 5
Formation of urobilins in the intestine
90
```
Jaundice: Hemolytic anemias
Neonatal "physiologic" jaundice
Crigler-Najjar Syndrome Types I and II
Gilbert Syndrome
Toxic Hyperbilirubenemia
```
Unconjugated Hyperbilirubinemia
91
Jaundice: Biliary tree obstruction
Dubin-Johnson Syndrome
Rotor Syndrome
Conjugated Hyperbilirubinemia
92
Test used to measure total and direct bilirubin
Van Den Bergh Reaction
93
Long, unbranched heteropolysaccharide chains generally composed of a Repeating Saccharide unit: amino sugar and acidic sugar
Glycosaminoglycans
94
All of the GAGs are covalently attached to proteins to form proteoglycans EXCEPT
Hyaluronic Acid (occurs independently)
95
Important role in permitting cell migration during morphogenesis and wound repair; Attracts water into the extracellular matrix
Hyaluronic Acid
96
Located at sites of calcification in endochondral bone and are also found in cartilage
Chondroitin sulfate
97
Play a critical role in corneal transparency
Keratan sulfate I and Dermatan sulfate
98
May have a structural role in sclera
Dermatan sulfate
99
Important anti-coagulant; Binds with factors IX and XI, but its most important interaction is with plasma antithrombin III
Heparin
100
Components of plasma membranes, where they may act as receptors and participate in cell adhesion and cell-cell interactions
Heparan sulfate
101
Accumulation of GAGs in lysosomes due to deficiency in hydrolases
Mucopolysaccharidoses
102
Mucopolysaccharidoses: ALL are autosomal recessive EXCEPT
Hunter's Syndrome
103
α-L-iduronidase deficiency; corneal clouding, cardiomyopathy, mental retardation
Type IH: Hurler's Syndrome
| Type IS: Scheie's Syndrome
104
Iduronate sulfatase; No corneal clouding, cardiomyopathy, mental retardation
Type II: Hunter's Syndrome
105
Heparan sulfamidase deficiency; Spasticity then loss of motor function, mental retardation, hyperactivity
Type IIIa Sanfilippo Syndrome
106
N-acetylglucosaminidase deficiency; Spasticity then loss of motor function, mental retardation, hyperactivity
Type IIIb Sanfilippo Syndrome
107
N-acetylglucosamine sulfatase deficiency; Spasticity then loss of motor function, mental retardation, hyperactivity
Type IIIc Sanfilippo Syndrome
108
N-acetylglucosamine deficiency; Spasticity then loss of motor function, mental retardation, hyperactivity
Type IIId Sanfilippo Syndrome
109
Galactose-6-sulfatase deficiency; No CNS involvement, skeletal dysplasia, short stature
Type IV Morquio's Syndrome
110
β-glucuronidase deficiency; corneal clouding, hepatomegaly, skeletal dysplasia and short stature, mental retardation
Type VII Sly Syndrome
111
Proteins to which oligosaccharides are covalently attached
Glycoproteins
112
Carbohydrate chains shorter
Carbohydrate chains branched
No repeating sugar units
Glycoproteins
113
Carbohydrate chains longer
Carbohydrate chains linear
With repeating sugar units
Proteoglycans
114
Bound to Serine or Threonine; Hydroxyl group
O-Linked Glycoproteins
115
Bound to Asparagine; Amide group
N-Linked Glycoproteins
116
Occurs through interaction of ZP3, an O-linked glycoprotein in the zone pellucida with a surface protein on the sperm surface, possibly galactosyl transferase
Fertilization
117
Circulating leukocytes adhere to the endothelium through selectins on the latter's cell surface
Inflammation
118
Deficient phosphorylation of mannose residues in N-linked glycoprotein pre-enzymes
I-cell Disease
119
Glycoprotein that allows nee viruses to exit infected cells
Influenza Virus
120
Polypeptide hormone secreted by the β-cells of the islets of Langerhans of the endocrine pancreas
Insulin
121
Polypeptide hormone secreted by the α-cells of the islets of Langerhans of the endocrine pancreas
Glucagon
122
Hormones that counteract the actions of Insulin
Glucagon
Cortisol
Growth hormone
Epinephrine
123
Low blood sugar (Glucose <40mg/dL)
Hypoglycemia
124
Increase level of Glucose
Increase Insulin
Decrease Glucagon secretion
Absorptive State or Fed State
125
Decrease level of Glucose
Decrease Insulin
Increase Glucagon secretion
Increase Epinephrine
Fasting State
126
Energy-rich molecules larger than that of the other dietary nutrients; Fats, carbohydrates, protein and in some diets, ethanol
Macronutrients
127
Nutrients needed in lesser amounts; Vitamins and minerals
Micronutrients
128
Average daily nutrient intake level estimated to meet the requirement of 50% of healthy individuals in a particular life stage and gender group
Estimated Average Requirement (EAR)
129
Average daily dietary intake level that is sufficient to meet the requirements of >95% of all individuals in a life stage and gender group
Recommended Daily Allowance (RDA)
130
Arbitrarily set in the absence of scientific evidence to calculate an EAR or RDA
Adequate Intake
131
Highest average nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population
Tolerable Upper Intake Level
132
Average dietary energy intake predicted to maintain an energy balance in a healthy adult of a defined age, gender and height, whose weight and level of physical activity are consistent with good health
Estimated Energy Requirement
133
Energy Requirements in Humans
Fat: 20-35%
Carbohydrate: 45-65%
Protein: 10-35%
134
Energy Content: Fats
9 kcal/gram
135
Energy Content: Carbohydrates, Proteins, Ketones
4 kcal/gram
136
Energy Content: Alcohol (Empty calories)
7 kcal/gram
137
Energy expenditure at rest but not asleep
60% Resting (Basal) Metabolic Rate
138
Increase metabolic rate after a meal
10% Diet-Induced Thermogenesis (Thermic effect of Food)
139
Most variable at all metabolic rate
30% Physical Activity
140
Food intake in excess of energy expenditure
Obesity
141
Food intake less than energy expenditure
Undernutrition
142
Protein deprivation is relatively greater than the reduction in total calories
Kwashiorkor
143
Calorie deprivation is relatively greater than the reduction in protein
Marasmus
144
Fat Soluble Vitamins
Vitamin A,D,E,K
145
3 Forms of Vitamin A
Retinol - Vit. A alcohol
Retinal - Vit. A aldehyde
Retinoic Acid - Vit. A acid
146
Growth regulators in the epithelium
Retinoic Acid
147
Supports gametogenesis in gonads
Retinol
148
Present in rod and cone cells for vision
Retinal
149
Nyctalopia (night blindness) - earliest manifestation
Xerophthalmia: eye and corneal dryness
Impotence
Growth retardation
Vitamin A Deficiency
150
```
Hyperkeratosis
Hepatomegaly
Pseudotumor cerebri (h ICP)
Increased fractures
Teratogenic
```
Toxicity (Hypervitaminosis A)
151
Vitamin D2, milk, plant sources
Ergocalciferol
152
Vitamin D3, skin, animal sources
Cholecalciferol
153
1,25-(OH)2 Vitamin D3
Calcitriol
154
Precursor of Vitamin D
7-dehydrocholesterol
155
Storage form of Vitamin D
25-(OH) Vitamin D3
156
Active form of Vitamin D
1,25-(OH)2 Vitamin D3
157
Responds to Hypocalcemia and PTH
Vitamin D
158
End Goal of Vitamin D
Increase calcium
| Increase PO4
159
In children only, before growth plate closes; Vit. D deficiency
Rickets
160
In adults only, after growth plate closes; Vit. D deficiency
Osteomalacia
161
Most toxic vitamin; Hypercalcemia, Anorexia, nausea, Thirst, Stupor
Hypervitaminosis D
162
Tetany and seizures
Chvostek's Sign
Trousseau's Sign
Long QT
Hypocalcemia
163
Stones (urolithiasis)
Bones (pain, osteoporosis)
Abdominal groans (constipation, PUD, pancreatitis)
Psychic overtones (depression, anxiety, psc)
Short QT
Hypercalcemia
164
Antioxidant in the lipid phase
| Protects membrane lipids from peroxidation
Vitamin E
165
RBC fragility, Neurologic dysfunction (neuropathy)
Vitamin E deficiency
166
Least toxic vitamin
Vitamin E
167
Vitamin K1
Phylloquinone
168
Vitamin K2
Menaquinone
169
Synthetic Vitamin K
Menadione
170
Carboxylation of glutamic acid residues in many calcium-binding proteins;
Coagulation factors X, IX, VII, and II;
Protein C and S
Vitamin K
171
Presents as bleeding (including intracranial bleeds); Neonates at risk because of sterile GIT and low vitamin K content of breast milk
Hemorrhagic Disease of the Newborn
172
Water soluble vitamins
```
Vitamin B1 (Thiamine)
Vitamin B2 (Riboflavin: FAD, FMN)
Vitamin B3 (Niacin: NAD+)
Vitamin B5 (Pantothenic Acid: CoA)
Vitamin B6 (Pyridoxine: Pyridoxal phosphate)
Vitamin B12 (Cobalamin)
Vitamin C (Ascorbic Acid)
Biotin
Folate
```
173
Generally non-toxic compared to the oil-solubles; Excesses just was out of the body in urine; EXCEPTIONS: Vit. B6 & B12
Water soluble vitamins
174
Active form: Thiamine pyrophosphate (TPP)
| Used as co-factor in pyruvate, α-ketoglutarate, branched chain amino acid dehydrogenase
Vitamin B1 - Thiamine
175
Vit. B1 Deficiency: No heart failure, polyneuritis, symmetrical muscle wasting
Dry Beriberi
176
Vit. B1 Deficiency: With heart failure, high-output cardiac failure (dilated cardiomyopathy), edema
Wet Beriberi
177
Active forms: Flavin Mononucleotide (FMN), Flavin Adenine Dinucleotide (FAD)
Used as co-factors in redox reactions, as electron carrier
Vitamin B2 - Riboflavin
178
No deficiency state but with signs and symptoms; Stomatitis (inflammation of oral mucosa), Cheilosis (inflammation of lips and angle of mouth); Dermatitis; Corneal vascularization
Vit. B2 - Riboflavin deficiency
179
Active form: Nicotinamide adenine dinucleotide phosphate (NAD+ and NADP+)
Used as coenzymes in redox reactions
Vitamin B3 - Niacin
180
Diarrhea
Dermatitis
Dementia
Death
Pellagra
181
Decreased Tryptophan
Hartnup Disease Absorption
182
Active form: Constituent of Coenzyme A
| Used as cofactor for acyl transfers
Vitamin B5 - Pantothenate
183
Dermatitis
Enteritis
Alopecia
Vit. B5 - Pantothenate Deficiency
184
Active form: Pyrodixal phosphate
| Used as coenzyme for: glycogen phosphorylase, cystathionine synthase, ALA synthase, synthesis of niacin from tryptophan
Vitamin B6 - Pyridoxine
185
Isoniazid toxicity
Vit. B6 - Pyridoxine deficiency
186
Active form: 5-deoxyadenosylcobalamin and Methylcobalamin
Vitamin B12 - Cobalamin
187
Autoimmune destruction of parietal cells leading to decrease IF secretion and decrease Vit. B12 absorption
Early ssx: Megaloblastic anemia
Late ssx: Neuropsychiatric
Pernicious Anemia
188
Structure: pterin ring + para-aminobenzoic acid (PABA) + glutamate residues
Active form: tetrahydrofolate (THF)
Used as cofactor for 1-carbon transfer
Folic Acid
189
Megaloblastic Anemia with no neurologic symptoms
Folic Acid Deficiency
190
Used as cofactor for carboxylation reactions pyruvate carboxylase, acetyl CoA, propionyl CoA
Biotin
191
Induced by avidin in egg whites
Dermatitis
Enteritis
Biotin Deficiency
192
Used as a cofactor in hydroxylation of proline and lysine, dopamine β-hydroxylase
Vitamin C - Ascorbic Acid
193
About 3-4 grams present in the body, 2/3 of which is in hemoglobin
Iron
194
Loose teeth and sore gums, swollen joints, fragile vessels, anemia
Scurvy
195
Storage form of iron in liver, spleen, bone marrow, intestinal mucosa, pancreas, myocardium
Ferritin
196
Partially denatured derivative of ferritin; Predominates when tissue stores are high
Hemosiderin
197
Iron transport protein in plasma
Transferrin
198
```
Most common micronutrient deficiency worldwide:
Decreased Total plasma iron
Decreased Transferrin saturation
Decreased Serum ferritin
Increased Total iron binding capacity
```
Iron Deficiency Anemia
199
```
Iron overload Syndrome:
Increased Total plasma iron
Increased Transferrin saturation
Increased Serum ferritin
Increased Total iron binding capacity
```
Hemochromatosis
200
Most abundant trace mineral in the body after iron;
| Total body stores: 1.5-2.5 grams
Zinc
201
Leads to dermatitis and poor wound healing, hair loss, neuropsychiatric impairements, decreased taste acuity, and in children, poor growth and testicular atrophy
Zinc deficiency
202
Rare recessively inherited disease with dermatitis, diarrhea, and alopecia due to impaired intestinal zinc absorption
Acrodermatitis enteropathica
203
About 80-110 mg in the adult human body; Major cofactor of enzymes that use either molecular oxygen or an oxygen derivative as one of their substrates
Copper
204
Presents with microcytic hypochromic anemia, leukopenia, hemorrhagic vascular changes, bone demineralization, hypercholesterolemia and neurological problems
Copper deficiency
205
X-linked recessive disorder caused by the deficiency of an ATP-dependent membrane transporter for copper
Menkes Syndrome
206
Hepatolenticular degeneration; Intestinal absorption of copper is intact but its biliary excretion is blocked; Copper accumulation in liver and brain with resulting liver damage, neurological deterioration; Kayser-Fleischer Rings
Wilson Disease
207
Stimulates the activity of many enzymes but can be replaced by magnesium in most cases
Manganese
208
Excess can cause psychosis and parkinsonism
Manganese Madness
209
Occurs in a few oxidase enzymes, including xanthine oxidase
Molybdenum
210
In the form of selenocysteine, occurs in about in about 20 human proteins, including the antioxidant enzyme glutathione peroxidase
Selenium
211
Low selenium content causing cardiomyopathy
Keshan Disease
212
Halogen needed for synthesis of thyroid hormones
Iodine
