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Functional Med > Mid term > Flashcards

Mid term Flashcards

1
Q

deficiency test for Vitamin A

A

vitamin A serum, (L)

beta-carotene -serum(L)

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2
Q

deficiency test for B1 (thiamin)

A

alpha-keto acids - urine, (H)

Erythrocyte transketolase index - RBC (H)

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3
Q

deficiency test for B2 (riboflavin)

A

(H)
alpha-keto acids - urine,
Ethylmalonate - urine
EGR active coefficient - RBC

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4
Q

deficiency test for B3 (niacin)

A

n-methylnicontinamide -urine (H)

lactate and pyruvate - urine (H)

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5
Q

deficiency test for B5 (pantothenate)

A

alpha-keto-acids - urine (H)

pantothenic acid - urine(L)

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6
Q

deficiency test for B6 (pyridoxine)

A 
(H)
xanthurenate - urine 
kynurenate - urine
homocysteine - plasma
EGOT index - RBC
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7
Q

deficiency test for Vitamin B12 (cyanocobalamin)

A

methylmalonate - urine (H)
homocysteine - plasma (H)
vitamin B12 serum (L)

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8
Q

deficiency test for tetrahydrobiopterin (BH4)

dihydrobiopterin (BH2)

A

Bh4 - plasma (L)
Phe or Phe/Tyr ratio - plasma (H)
BH4 loading test plasma (drop >50%)

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9
Q

deficiency test for Vitamin C

A

(L) Vitamin C Serum, leukocyte or urine after 500 mg of oral load

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10
Q

deficiency test for Vitamin K

A

PIVKAII - serum (L)
undercarboxylated osteocalcin - serum (H)
Vitamin K serum - (L)
Prothrombin plasma (H)

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11
Q

deficiency test for Vitamin D

A

25-hydroxyvitamin D serum (L)

bone specific collagen fragments - urine (H)

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12
Q

deficiency test for Vitamin E

A

tocopherol - serum (L)

tocopherol/triglyceride serum (L)

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13
Q

deficiency test for Biotin

A

beta-hydroxyisovalerate -urine (H)

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14
Q

deficiency test for folate

A 
homocysteine plasma (H)
folate serum (L)
folacin RBC (L)
macrocytic anemia whole blood (positive)
neutrophil hypersegmentation - whole blood (positive)
Formiminoglutamate (FIGLU) urine (H)
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15
Q

deficiency test for caritine

A

adipate, suberate ethylmalonate - urine (H)

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16
Q

deficiency test for coenzyme Q10

A 
coenzyme Q10 serum (L)
succinate urine (H)
hydroxymethylglutarate urine (H)
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17
Q

deficiency test for lipoic acid

A

lactate and pyruvate serum or urine (H)

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18
Q

deficiency test for choline

A

choline plasma (L)

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19
Q

assessment of calcium

A

hair, urine

bone resorption markers, serum 25-hydroxyvitamin D, PTH

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20
Q

assessment of magnesium

A

RBC, whole blood, plasma, serum, urine

Refractory hypokalemia

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21
Q

assessment of potassium

A

RBC, serum, hair

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22
Q

assessment of iron

A

ferritin

total iron binding capacity, transferrin saturation, hemoglobin, hematocrit

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23
Q

assessment of zinc

A

RBC, hair, plasma

delta 6 desaturase activity (LA:GLA) Zn metallothionein

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24
Q

assessment of copper

A

RBC, serum ceruloplasmin

elevated urinary HVA/VMAratio; bone resorption markers

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25
Q

assessment of maganese

A

RBC

abnormal urinary ammonia markers, elevated arginine: ornithine ratio

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26
Q

assessment of selenuim

A

serum, whole blood, hair

selenoprotein P, urinary selenosugars

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27
Q

assessment of molybdenum

A

hair

elevated xanthine uric acid ratio

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28
Q

assessment of chromium

A

RBC, urine, hair

insulin, blood glucose

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29
Q

assessment of iodine

A

urine,

serum T3, T4, TSH, blood spot thyroglobulin

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30
Q

assessment of boron

A

serum, urine, hair

bone resorption markers

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31
Q

assessment of nickel

A

urine, plasma hair

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32
Q

assessment of lithium

A

serum, plasma, urine, hair

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33
Q

assessment of vanadium

A

whole blood, serum, urine

blood glucose, blood lipids

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34
Q

assessment of strontium

A

serum, urine, hair

bone resorption markers

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35
Q

H glutamic acid (Glu) give:

A

alpha KG

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36
Q

H glutamine (Gln) give:

A

alpha KG, B6

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37
Q

H arginine (Arg) give:

A

Mn

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38
Q

L arginine (Arf) give:

A

Arg

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39
Q

H asymmetric dimethylargininge give

A

Arg

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40
Q

H citrulline give

A

Mg, alpha KG,

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41
Q

H ornithine (Orn) give

A

Mg, alpha KG

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42
Q

L aspartic acid (Asp) give

A

alpha KG

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43
Q

H aspartic acid (Asp) give

A

Mg, Zn

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44
Q

Urea cycle and nitrogen management AA;s

A

Arg, asymmetric dimethylarginine, citrulline, ornithine, aspartic acid, asparagine

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45
Q

EAA for proteins and energy

A

isoleucine, leucine, valine, threonine, histidine, lysine, alpha aminoadipic acid

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46
Q

H isoleucine ((Ile) give

A

B6, check for insulin insensitivity

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47
Q

H leucine (Leu) give

A

B6, check for insulin insensitivity

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48
Q

H valine (Val) give

A

B6, check for insulin insensitivity

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49
Q

H threonine (Thr) giver

A

B6

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50
Q

H histidine (His) give

A

B6

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51
Q

L histidine (His) give

A

folate, His

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52
Q

H lysine (lys) give

A

Vitamin C, niacin (B3), B6, Fe (confirm with ferritin),

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53
Q

L lysine (lys) give

A

carnitine (check for excessive Arg intake)

54
Q

H alpha aminoadipic acid give

A

B6, alpha KG,

55
Q

Neurotransmitters and precursors (AAs)

A

phenylalanine, tyrosine, tryptophan, alpha amino n butyric acid, gamma aminovutyric acid (GABA)

56
Q

H phenylalanine (Phe) give

A

Fe, tetrahydrobiopterin, Vitamin C, Low Phe diet

57
Q

H tyrosine (Tyr) give

A

cu, Fe, vitamin C

58
Q

L tyrosine (tyr) give

A

Fe, Tyr

59
Q

L tryptophan (Trp) give

A

5-HTP

60
Q

H tryptophan (Trp) give

A

Niacin, B6, Fe, Cu

61
Q

L alpha-Amino-N-butyric acid give

A

alpha KG, B6

62
Q

H Methionine (Met) give

A

B6, alpha KG

63
Q

L cystine (Cys) give

A

NAC

64
Q

H homocystine (Hcys) give

A

B6, folate, B12, Betaine

65
Q

H Cystathionine give

A

B6

66
Q

L Taurine (Tau) give

A

B6

67
Q

H Taurine (Tau) give

A

multiple antioxidants

68
Q

AA precursors of heme Nucleotides and cell membranes

A

Gly, Ser, Sarcosine

69
Q

H Glycine (Gly) give

A

folate, B6, B2, B5

70
Q

L Serine (Ser) give

A

B6, folate, Mn

71
Q

H Serine give

A

Thr, BCAAs

72
Q

H sarcosine give

A

Thr, BCAA’s

73
Q

H Alanine (Ala) give

A

B6

74
Q

H Ethanolamine give

A

Mg

75
Q

H Phosphoethanolamine give

A

S-Adenosylmethionine

76
Q

H Phosphoserine give

A

Mg

77
Q

L Proline (Pro) give

A

alpha KG, His

78
Q

H Hydroxyproline (HPro) give

A

Vitamin C, Fe

79
Q

H Proline (Pro) give

A

Vitamin C, Niacin

80
Q

H Hydroxylysine (HLys) give

A

Vitamin C, Fe

81
Q

H beta alanine give

A

lactobacillus and bifidobacteria sp, B6

82
Q

H beta aminosbutyric acid

A

B6, B12

83
Q

H Anserine give

A

Zn

84
Q

H carnosine give

A

Zn

85
Q

H 1-mthylhistidine give

A

vitamin E

86
Q

H 3-methylhistidine give

A

BCAA, antioxidants (if evident muscle wasting)

87
Q

Organic Acids of fatty acid oxidation

A

adipate, suberate, ethylmalonate

88
Q

H Adipate, suberate, or ethylmalonate give

A

l-carnitine
L-lysine (if low)
B2

89
Q

Aerobic/anaerobic energy production organic acids

A

pyruvate, lactate,

90
Q

H pyruvate give

A

B1, B complex,

with high lactate give lipoic acid

91
Q

H lactate give

A

CoQ10

92
Q

H beta hydroxybutyrate give

A

chromium picolinate

93
Q

H Citrate give

A

arginine

94
Q

L citrate give

A

aspartic acid, magnesium

95
Q

H cis-asonitate give

A

cysteine, check for iron deficiency

96
Q

H isocitrate give

A

lipoic acid, Mg, Mn

97
Q

H alpha ketoglutarate

A

give B complex, lipoic acid

98
Q

H succinate give

A

CoQ10, lipoic acid

99
Q

H fumarate give

A

CoQ10, Mg

100
Q

H malate give

A

CoQ10, B3

101
Q

H/L Hydroxymethylglutarate

A

CoQ10,

102
Q

citric acid cycle intermediates

A

citrate, cis-aconitate, isocitrate, alpha KG, succinate, fumarate, malate

103
Q

H alpha ketoisovalerate give

A

B complex, lipoic acid

104
Q

H alpha ketoisocaproate give

A

B complex, lipoic acid

105
Q

H alpha - keto - beta - methylvalerate give

A

B complex, lipoic acid

106
Q

H formiminoglutamate (FIGLU) give

A

folic acid

107
Q

H beta hydroxyisovalerate give

A

biotin, Mg

108
Q

H methylmalonate or propionate give

A

B12

109
Q

L,H Vanilmandelate give

A

tyrosine, phenylalanine hydroxylase cofactors as needed

contraindicated for patients taking MAO inhibitors

110
Q

L,H homovanillate give

A

tyrosine, phenylalanine hydroxylase cofactors as needed

contraindicated for patients taking MAO inhibitors

111
Q

L,H 5- Hydroxyindolacetate

A

5-hydroxytryptophan (5-HTP), Mg, B6

112
Q

H kynurenate give

A

B6, Mg

113
Q

H Quinolinate give

A

Mg

114
Q

H p-Hydroxyphenyllactate give

A

Vitamin C to bowel tolerance

115
Q

8-hydroxy-2’-deoxyguanosine give

A

antioxidants (C,E, lipoic acid)

116
Q

H homogentisate give

A

low protein diet, vitamin C

117
Q

H 2-methylhippurate give

A

avoidance of xylene;
glycine
B5

118
Q

H orotate give

A

arginine, a-KG, Aspartic acid, magnesium

119
Q

H glucarate give

A

glysine, GSH, NAC

120
Q

H alpha hydroxybutyrate, pyroglutamate give

A

NAC, glutathione, Taurine

121
Q

L sulfate give

A

NAC, glutathione, Taurine

122
Q

detoxification indicators (organic acids)

A

2-methylhippurate, orotate, glucarate, alpha hydroxybutyrate, pyroglutamate, sulfate

123
Q

2-methylhippurate, what metabolic pathway?

A

hepatic conjugation

124
Q

orotate what metabolic pathway?

A

ammonia clearance, pyrimidine synthesis

125
Q

glucarate what metabolic pathway?

A

detox, liver enzyme induction

126
Q

alpha hydroxybutyrate, pyroglutamate what metabolic pathway?

A

hepatic GSH synthesis

127
Q

sulfate what metabolic pathway?

A

Renal amino acid recovery

128
Q

detoxification what metabolic pathway?

A

detox and anti-oxidant functions

129
Q

H benzoate give

A

glycine, vitamin B5, glutamine, digestive aids and free form amino acids to help normalize gut permeability

130
Q

H hippurate, phenylacetate, phenylpropionate, p-cresol, p-hydroxybenzoate, p-hydraxyphenylacetate, tricarballylate, D-lactate, 3,4 dihydroxyphenylpropionate or D-arbinitol give

A

glutamine, digestive aids and free form amino acids to help normalize gut permeability

Functional Med (2 decks)

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