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PASS PROGRAM NOTES

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resexuwe's version from 2017-08-10 13:39

Biochemistry

Question Answer
Vitamin APromote Cell maturation AML has immature form so give Vit A to mature the cell up, Cofactor for PTH Hypoparathyroidism, Night vision Poor night driving, CSF production~Pseudotumor cerebri -> Due to Vit A toxicity
Vitamin DLateral bowing of legs Rickets, Adults Osteomalacia, Vitamin D resistant rickets -> Defect in renal absorption of phosphorus -> phosphorus pulls calcium with it Xlinked Dominant
Vitamin EAntioxidant in the blood -> Used to treat Cancer, Alzheimer, CAD, Hemolytic anemia(G6PD)
Vitamin KGama carboxylation 10,9,7(2DAYS),2,C(6HRS),S
Inhibit Vitamin KWarfain
Why Heparin first and then warfarinProteinc C runs out within 6 hrs causing the pt to form clots or even before if the pt has Protein C deficiency hence why Heparin first because it is an anti-thrombin which prevents future clots and then 2 days later start them on warfarin
B1, B3, B4, B5 needed byPyruvate dehdrogenase, Alpha-ketoglutarate dehydrogenase, Branched chain amino acids except b1 also needed for transketolase
B1 ThiamineWet Beri, Dry beri, Wernicke encephalopathy(posterior temporal lobe- written and spoken words), aphasia, korsakoff syndrome(mamillary bodies Confabulation- failure to move to short term to long term)
B2 ribolfalvinAngular cheilosis, Corneal vascularization
B3 NiacinPellegra -> Diarrhea, Dementia, Dermatitis, Death OR Hartnup -> Defective reabsorption of Tryptophan -> Niacin deficienc
B5Cofactor for 3 enzymes + Coenzyme A / CoA Helps absorb b12 because methylmalynol CoA mutase
B6 PyridoxineNeed b6 to make B3, Heme synthesis, Transaminases(ALP,GGT,AST), INH depletes pyridoxine -> Sx Neuropathy
B9 FolateNeural tube defects, Megaloblastic anemia without neuropathy
Hypersegmented neutrophilsFolate and B12 deficiency
B12 deficencyMegalobastic anemia with neuropathy(dorsal column pathways & corticospinal tracts), Needed by homocysteine methltransferase & methylmalonl CoA mutase, Cant recycle carbon factty chain-> needed for myelin-> Neuropathy
If pt has nephrotic condition where you lose anti-thrombin OR Liver disease where pt is not making Anti-thrombin OR Kwsahikor lack of protein intakeHeparin wont work and No change in PTT becuase heparin is a cofactor for Anti-thrombin III
Anti-thrombin is aProtein
If anyone on heparin STARTS having low platelets then look out forHeparin Induced Thrombocyopenia
Vitamin KClotting factors by the liver
PTH cofactorsMagnesium, Vitamin A -> Increase Calcium & Decrease Phosphorus
Vitamin DIncrease Calcium & Increase Phosphorus
Zinc deficencyHair, skin, sperm, taste METTALIC TASTE
CopperNeeded by lysin hydroxylase in collagen formation / Excess Cerulopasmin deficency ->Wilsons disease -> liver, lenticular nucleus, iris / DeficiencyMinkys kinky hair syndrome -> Lack of copper -> gets stuck in hair leading to an orange hair
Selenium deficiencyDilated cardiomyopathy
Necessary for release of all neurotransmitters?Presynaptic calcium
Smooth muscle uses what for second messenger systems?Calcium
Atria & Thalamus uses what for deplorization?Calcium
Cardiac ventricle depends on what extracellular to trigger off its calcium extracellular release?Extracellular Calcium
AR chance of being carrier to recessive parrents67% -> 2/3
AR chance of being diseased to recessive parents25%
AD chance of being diseased to both parents diseased75%
AD chance of being diseased to ONE parent diseased50%
PradervilliTrinucelotide repeat but not angelman
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Amino acids

Question Answer
Kinks,bends,twists, turnsProline ex-Hair,blood vessels, gi - More curly hair the more proline
HistidineBest buffer in the body
Myglobin (muscle protein) has an high affinity for kidney acidic protein so in crush injury always give IV firstBicarbonate to prevent myoglobin from damaging kidney(acute tubular necrosis) BEFORE YOU LIFT THE OBJECT OFF
Amino acid used for reinforcement of behavior like gambling/addicitonsAspartic acid
Found in active sites of many enzymesSerine
4 hormones with a lot of disulfide bonds alcohol breaks disulfide bondsPIGI Prolactin, Insuolin, Growth hormone, Inhibin
Lethargic, somnolentIncreased Gaba
Ammonia IncreaseGaba Increase
Gaba reversible or irreversibleIrreversible
When you are acidic fat steak, diabetic ketoacidosisToo much gaba -> lethargic or somnolent -> Brain less likely to depolarize
If your brain is hyperdepolarizing seizures then give something that will enhance the gaba likeBarbs or Benzos -> Enhance gaba in the brain
Trip to LATrypsin cuts to the right of Lysine & arginine(basic amino acids)
NMDA pathwayaddicition, gambling
What inhibits NMDA pathwayGlutamate through aspartate
MemantineUsed in Alzhemiers to blocks Glutamate -> Increase NMDA pathway
MCC amino acid in enzyme active siteSerine
Carcinoid syndrome can lead toPellegra because if tryptophan runs out -> you CANT make Niacin
What amino acid makes up disulfide bonds?Cysteine & Methionine
Energy UtilizationGlucose -> Liver Glycogen -> Protein breakdown into glucose Start of day 2 -> Lipolysis end of day 2-> Ketogenesis
Glucose2-4 hr hence why we get hungry every 4 hrs due to gi movement Glycogen storage disease feeding every 4 hrs / Regular insulin has 2-4hr peak
Liver Glycogen24-28hrs -> end of 2nd day of fasting no glucose
Proteolysis hormonesCortisol & GH(after 24 hrs) -> Increased Ammonia -> Increased GABA -> Starving african babies cannot even smack the fly
Increasing glucose in a patient increasesChances of sepsis -> bacteria over growth
Any time you are starving expectLow glucose, Low glycogen, low protein mass, High lipids & ketones (Kwashikor pt low protein but fatty liver)
Hypoglycemic pts will always hurtRBCs first because they cant switch from glucose -> (Kwashikor pts present with hemolytic anemia -> jaundice & anemia)
Clinical Correlation Blonde jokes started withPhenylketonuria(PKU) -> Lack of tyrosine -> which makes catecholamines mental retardation & melanin albinism, blue eyes, blonde hair
Increase phenylanine in PKU leads tophenylacetate(Attached to acetyl-CoA) or phenylpyruvate(attached to pyruvate)
Sweat test DOCPilocarpine
Michael Jackson vitiligo started in theHand uncommon hence why the gloves
AlkaptonuriaBuildup of tyrosine -> Increased melanin synthesis -> Urine turning black, black nasal septum, tendons, ear
Maple syrup urine diseaseSome are glucogenic amino acids taste like maple syrup urine disease OR smells like burnt sugar
Maple Syrup urine diseaseDefective renal transport of LIV in the collecting duct of the kidney
CysteinuraCoffin lid shaped crystal or something similar to that shape -> COLA -> Cysteine, Ornitine, Lysine, Arginine
Smallest Amino acidGlycine Inhibitory neurotransmitter for spinal cord
AromaticPhenyalanin, Tryptophan and tyrosine -> recognized by chylotrypisn
Basic amino acidLysine & Argine -> TRYPsin cut LA
Acid amino acidAspartic & Glutamic
Amino acid use in NMDA pathway(excitory or addiction)Aspartate
Branched Chain amino acidLeucine, Isoleucine, Valine
Amino acid used to make catecholamines (Dopaimine -> Norepinephrine -> Epinephrine)Tyrosine
What amino acid makes serotoninTryptophan -> Serotonin syndrome or carcinoid syndrome leads to Pellegra or B3 deficiency
Ketogenic amino acidsLeucine or lysine
Both glucogenic and ketogenicPITT Phe, Iso, Thro, Trp
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Miscellaneous

Question Answer
Na/K atpase3Na-> <- 2K
In every swellingNa & Cl goes together drawing fluids
Membrane movement meansAxonal Transport, Endocytosis, Absorption in the GI tract -> Needs Calcium, Atp, Mictrobulues
HormoneEpinephrine
NeuortransmitterNorepinephrine
First organ affected in every genetic or pediatric conditionKidney
What organ is sacrificed first hence why we doKIdney -> urine analysis on every pt
Organs sacrificed firstKidney, Heart, Brain
Low state energy bone marrowAnemia, Leukopenia, Thrombocytopenia
Low energy state of DiabetesLack of insulin or Insulin not working -> Not able to push glucose into cells -> Low energy state because glucose provides energy -> MC sign Dyspnea & Tachypnea -> MC sx is Muscle weakness & SOB -> Infections
Examples of Low energy stateDiabetes, Crohns, Ulcerative colitis, Vitamin deficiencies
3 MC cancersSkin Sunlight constant exposure, Gi Inhaling of toxins from air and eat food with radioactivity, Bone marrow Toxins circulate
3 ways to differentiate B12 from B9Methlmalonic acid in urine, Neuropathy, Chronic state
Cancer after chemotherapy is due toFree radicals caused from chemo -> free radicals mutate or kill cells
Vitamin C with iron tabletsC protects iron from oxidized in GI tract
Viruses cause free radicals to release hence whyVitamin C to fight colds & flu
Lateral bowing vs Anterior bowingVitamin D deficiency vs Syphilis
Chromium deficiencydiabetes -> tx Low carb, low fat, high chromium Mussels, pear, broccoli, grapejuice
3 family member have the disease but you have a different kind of the same diseaseVariable penetrance
3 family members have it but you dont have itIncomplete penetrance
Rapidly dividing time periods?Pregnancy, 0-2, 4-7, Puberty
Why do people who exercise first lose weight and then later stop losing weight or gain weight despite exercising?Over time you start building muscle -> holding onto water -> No "weightloss"
Majority of body is made ofProtein hence why your body is majority water
Ethinicty mortality with over cooked foodFolate missing -> Black, Hispanics, Whites, Asians
What muscles have a tendency to hold fat since they work all the time?Paraspinal & Heart
Take iron pills with orange juice to preventfree radical formation of iron Vit C antioxidant of Gi
Histidine applicationBuffers acid that comes in to GI in soda or orange juice format -> picks up protons -> takes it up to lungs -> since lungs alkalotic, histidine releases protons -> BURP in the format of CO2 & h20
GABA connectionAmmonia(Acid+urea) + a-ketoglutrate -> Glutamate or GABA
Increased GABA through diet?Ammonia increase in a high fat protein diet
Increased GABA in kidney?Kidney failure increases urea
Increased GABA in Liver?Hepatic encepalopathy -> Cant filter toxins lead to increase ammonia
Increased GABA in high acidKetones(DM I), Lactic acid(Extraneous workout)
Signs of GABALethargic, Somnolent
Red meat has what that leads to heart diseaseHomocysteine
Effects of AlcoholHyperkalemiaarrythemia, Increased Gaba blackouts/morality goes out, Kaussmal Breathing, Denature protein
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Question Answer
Drug abuseDespite losing wife, job and life you want to drink
Drug addictionGrandma comes in for UTI but starts having alcohol withdrawal
Drug DependenceNeed drug to feel normal
ToleranceSomeone drinking over time small amounts can tolerate large amounts
Cross toleranceBenzodiazepines are going to be given of higher dose to work on an alcoholic
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