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PATHO based on study guide > test interpretations > Flashcards

test interpretations Flashcards

1
Q

high adipate, suberate and ethylmalonate

A

carnitine deficiency, anything that interferes with normal fatty acid oxidation may reveal high levels

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2
Q

associated with coenzyme Q10, biotin and lipoic acid deficiencies.

also: overwhelimng infection, hypoxia, high intake of acetaminophen, increased consumption of alcohol, cocaine, high iron levels, drug side effects, diabetes

if high consider supplementing with CoQ10, vitamin b1,2,3,5, lipoic acid and biotin

A

high lactate

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3
Q

elevated with B1, B5 and lipoic acid are insufficient

A

Pyruvate

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4
Q

combination of high lactate and pyruvate

A

lipoic acid deficiency

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5
Q

lactate elevations alone

A

Coq10 deficiency

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6
Q

H a-ketoglutarate, a-ketoisovalerate, a-ketomethulvalerate

A

impaired metabolism due to cofactor insufficiencys or toxic metals, low B1,3,5,lipoic acid

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7
Q

L- a-ketoglutarate, a-ketoisovalerate, a-ketomethulvalerate

A

Low b6 to low branched chain amino acids.

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8
Q

metabolic marker of blood sugar utilization and insulin function, by product of ketosis

A

b-hydroxybutyrate

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9
Q

H b-hydroxybutyrate

A

low chromium, vanadium or lipoic acid

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10
Q

Carnitine is needed to

A

move fatty acids into the mitochrondria where they are converted to energy using b2 (carnitine shuttle)

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11
Q

has been documented to improve Alzheimers, age related cognitive decline and cognitive function

A

carnitine

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12
Q

principal product of glucose metabolism in skeletal muscle and a major player in anaerobic energy production and gluconeogenesis

A

lactate

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13
Q

If high, impaired metabolism due to toxic metals (FL, HG, AS, SB) or low cofactors (Fe, GSH, depleted in oxidative stress)

high dietary citric acid

metallic acidosis

A

Citrate, cis-aconitate

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14
Q

Can indicate arginine insufficiency for ammonia clearance throught he urea cycle if high

A

citrate and cis-aconitate

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15
Q

Food sensitivity/leaky gut syndrome, elevated IGG

A

Low intestinal secretory IgA

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16
Q

Suspect ingestion of contaminated food, especially undercooked ground beef, raw milk, upasteurized apple juice, water and lattuce

A

EHEC (entero-hemorrhagic escherichia coli)

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17
Q

common source of contamination is swimming pools, outbreaks are associated with raw milk and meal - likely cause to travelers diarrhea

A

crytosporidium

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18
Q

fecal-oral transmission and water contaimination are common sources

A

dientamoeba fragilis

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19
Q

non-pathogenic amoeba

A

endolimax nana or entamoeba hartmanni

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20
Q

transmitted via skin contact with contaminated soil or oral ingrestion of larvae

A

strongyloides

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21
Q

taenia sp - via raw meat

A

tapeworm

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22
Q

transmitted from ingested feces, contimnated soil or underwashed vegetables

A

whipworm

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23
Q

come from dietary carbohydrates that have escaped digestion or absorption in the small bowel or from prebiotics that have undergone fermentation in the colon

A

SCFA or N-butyrate

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24
Q

fuel for colonycytes & protective against colon cancer

A

N-butyrate

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25
Q

Extremely elevated levels indicate underlying GI abnormalities and need to be evaluated in conjunction with other stool profile markers

A

elevated total SCFA or N-butyrate

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26
Q

caused by bacterial overgrowth, rapid transit time, malabsorption, pancreatic insufficiency resulting in carbohydrate maldigestion and increased bacterial fementation

A

elevated total SCFA or N-butyrate

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27
Q

caused by gluten enteropathy or sensitivity in colon

A

elevated anti-gliadin antibody

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28
Q

caused by bacterial overgrowth, carb maldigestion, lipid malabsorption, rapid transit time

A

decreassed PH

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29
Q

caused by decreased bacterial production of SCFA, insufficient flora, dietary fiber or water

A

elevated PH

30
Q

caused by bleedingin upper GI tract due to peptic ulcer, inflammatory bowel disease, parasite, colon cancer or hemorrhoids

A

positive occult blood

31
Q

suspect inadequate physical and immune barrier functions, antibiotics, nsalds, antacids, inadequate digestive and absorptive function

A

abnormal bacteria, fungi and/or parasites

32
Q

Causes peptic ulcer disease and associated with gastric cancer

A

H. pylori

33
Q

suspect recent antibiotic use, especially the cephalosporins, amoxicillin

A

C Diff

34
Q

Elevated lactoferrin, WBCs or Mucus

A

mucosal inflammation, bacterial or yeast overgrowth, parasite infection, inflammatory bowel disease such as chrohn’s

35
Q

decreased fecal sIgA

A

chronic stress, immunocompromise, dysbiosis, immunosupressing medication

36
Q

elevated fecal sigA

A

food sensitivities, immune response to eliminate pathogenic organisms in GI tract

37
Q

depressed elastase

A

suppresed pancreative function, gallstones, chronic pancreatitis, diabetes, hypochlorhydria, cystic fibrosis

38
Q

A digestive enzyme excreted by the pancreas exclusively and has a direct correlation with pancreatic function

A

Elastase 1

39
Q

elevated vegetable fibers, triglycerides

A

mal digestion, hypochlorhydria, pancreatic insuffiency, bile salt insuffiency, indaquate chewing

40
Q

elevated LCFA, total fat or cholesterol

A

indicates mal absorption, high dietary fat intake, medications designed to bind and eliminate fat,

41
Q

Elevated SCFA

A

bacterial overgrowth in small intestine

42
Q

magnesium, NADP (b3), FAD (b2), low homocysteine, oxidative stress, NAC

A

markers that may indicate glutathione depletion

43
Q

radioimmunoassay for undercarboxylated osteocalcin and the measurement of y-carboxylglutamate measure what vitamin

A

K

44
Q

low citrate and cis-aconitate

A

low or high pyruvic acid or low acetyl coa (from fatty acid oxidation)

45
Q

high isocitrate

A

arginine insuffiency, impared metabolism due to low cofactors (b3, MG, MN) inhibited by aluminum

46
Q

low isocitrate

A

Impaired metabolism due to toxic metals (Fl, Hg, As, Sb) OR low cofactors (Fe, GSH—
depleted in oxidative stress); OR high amounts of dietary citric acid; OR metabolic acidosis (if
mildly increased cisaconitic acid but markedly increased citric acid).

47
Q

are used in the body’s metabolic pathway that generates
cellular energy – the Citric Acid Cycle. Higher levels of these compounds in urine indicate
inefficiencies in energy production. If ketoglutarate is elevated along with succinate, malate,
and fumarate, you may need additional CoQ10.

A

succinate, fuumarate and malate

48
Q

e are metabolites of the amino acids leucine & isoleucine and phenylalanine &
tyrosine respectively.

A

succinate and fumarate

49
Q

low succinate, fumarate and malate

A

Consider over-utilization of the Citric Acid Cycle. Fatigue and weakness are common
symptoms.
Consider supplementing with L-Leucine, L-Isoleucine and Vitamin B12 with low succinate,
tyrosine & phenylalanine with low fumarate and balanced amino acid blend with low malate.

50
Q

is a metabolic precursor of cholesterol used by your cells to
make CoQ10, a nutrient that enables the body to use oxygen to generate large amounts of
energy.

A

hydroxymethylglutarate (HMG)

51
Q

HIgh levels of HMG

A

COq10 deficiency & use of chholesterol-lowering statin drugs

52
Q

e can reveal a block in your body’s synthesis of coenzyme Q10.
Other functional markers such as Lactate, Succinate, Fumarate, and Malate, indicate
whether your body is able to produce energy efficiently by utilizing coenzyme Q10.

A

HMG

53
Q

is a functional marker of B6 (Pyridoxine) and is a metabolite of the amino acid
tryptophan.

A

Xanthurenate

54
Q

High levels can indicate an insufficiency of B6, a vitamin critical for all protein
metabolism.

A

xanthurenate

55
Q

is a sensitive indicator of biotin deficiency and is a metabolite of the
amino acid isoleucine.

A

B-hydroxyisovalerate

56
Q

is a functional marker of vitamin B12 and a metabolite of the amino acid
valine. High levels indicate insufficient vitamin B12. Increased alcohol consumption, dysbiosis,
aging and HIV infection will all have a detrimental impact on B12 absorption.

A

Methylmalonate

57
Q

is a functional marker of insufficiency of folic acid and is a
compound made from the amino acid histidine. High levels indicate insufficient folic acid.
Increased alcohol consumption, excessive consumption of processed foods, oral
contraception, smoking and pregnancy will all have a detrimental impact on folic acid
absorption.

A

FIGLU/ formiminoglutamate

58
Q

p-Hydroxyphenyllactate i

A

is a metabolite of the amino acid Tyrosine.

59
Q

is a metabolite of the amino acid Tyrosine. It is a sensitive marker
for the depletion of methyl- p-hydroxyphenyllactate which is an important cell growth inhibiting
agent. Due to its pro-oxidative character high levels are associated with carcinogenesis.

A

p-Hydroxyphenyllactate

60
Q

is marker for oxidative damage to DNA. Causes of increased
levels of may be due to stress, smoking, chronic inflammation,
diabetes, air pollution, high polyunsaturated fat intake, irradiation, thermal injury, heavy metal
and pesticide toxic exposure.

A

8-Hydroxy-2-deoxyguanosine

61
Q

High levels of p-Hydroxyphenyllactate, 8-Hydroxy-2’-deoxyguanosine, Glucarate, and
Quinolinate are associated with

A

increased oxidative stress

62
Q

metabolite of phenylalanine - Excessive phenylalanine (dietary or PKU) or tyrosine; OR reduced oxygenation (e.g., iron
deficiency anemia, pulmonary disorder); OR low tetrahydrobiopterin (BH4), which may result in
low neurotransmitters and/or nitric oxide

A

2-hydroxyphenlactic acid

63
Q

metabolite of tyrosine – if high If HIGH
Impaired metabolism to homogentisic acid due to cofactor insufficiencies (copper, vitamin C,
O2); OR possible low iron (if homogentisic acid is markedly elevated);
Supplement vitamin C or Cu, improve oxygenation
(e.g., correct anemia, pulmonary problems, cardiac insufficiency, etc.)

A

4-hydroxphenlpyruvic acid

64
Q

IF HIGH

Impaired metabolism due to cofactor insufficiency (iron, vitamin C, O2); OR alkaptonuria (rare)

A

Homogentisic acid

65
Q

(Made from tryptophan and lysine via alpha-aminoadipic acid, also a byproduct of yeast;
precursor of glutaric acid)
If HIGH
May be secondary to high glutaric acid (check glutaric level); OR impaired metabolism due to
cofactor insufficiencies OR toxic metals (As, Hg, Sb, Cd); OR may be secondary to yeast or
fungal infection (derives from alphaaminoadipic acid)—see yeast markers.

A

a-ketoadipic acid (AKAA)

66
Q

Metabolite of lysine and tryptophan.
If HIGH
Possible low FAD (riboflavin) (cofactor for alternative metabolism of one of glutaric acid’s
precursors); OR inborn error of metabolism; may be associated with CETP genetic
polymorphism.

A

glutaric acid

67
Q

(Metabolite of aspartic acid.
If HIGH
Possible liver damage (e.g., from alcohol), urea cycle dysfunction, ammonia excess OR;
barbiturates; OR impaired metabolism due to cofactor insufficiencies (vitamins B3, B6, folate,
Mg, glutamine, glycine, serine); OR use of allopurinol or chemotherapy

A

Orotic acid

68
Q

Intermediate in the recycling of glutathione)
If HIGH
Impaired recycling to glutathione due to cofactor insufficiencies (Mg, cysteine, glycine, glutamic
acid); consistent with deficient GSH
Supplement Mg, N-acetylcysteine (NAC), possible glycine, L-glutamine, &/or GSH

A

Pyroglutamic acid

69
Q 
If LOW
Low glutathione (insufficient precursors, toxicity, or oxidant stress)
A

pyroglutamic acid

70
Q

(Formed from “omega” oxidation of fats when beta oxidation is impaired)
If HIGH
Impaired mitochondrial beta oxidation of fats; may be secondary to insufficient carnitine, B2, or
acetyl CoA, or to insulin excess; OR may be secondary to ketosis.
Consider supplementing with L-carnitine or acetyl-L-carnitine, riboflavin, acetyl CoA precursors

A

adipic acid

71
Q

from acetyl CoA, precursor of cholesterol and CoQ10)
If HIGH
Citric acid cycle impairment (anaerobic glycolysis); OR
carbohydrate unavailability (e.g., high-protein diet, fasting, diabetes); OR inhibited utilization of HMG
(e.g., from high cholesterol diet, yeast overgrowth, glucocorticoid excess, statins)

A

B-OH-b-methyglutaric acid

72
Q

If HIGH
Ketosis from carbohydrate unavailability (e.g., fasting, diabetes, strenuous exercise, ketogenic
diet)

A

B-oh-butyric

PATHO based on study guide (3 decks)

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