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Biochemistry Flashcards

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1
Q

Vitamin D
*Purpose?:
*Acquired from:
*Storage & Active form?

A

*Purpose: Proper intestinal absorption of calcium & phosphate
- Estt’l for bone and teeth growth
- Stimulates osteoblastic activity

*Acquired from Sun + Food

*Storage: 25-OH-D3 (in liver)

*Active form: 1,25-OH2(D3) (in kidney)

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2
Q

Vitamin D XS

A

Stones, Thrones, Groans, Psychiatric Overtones

Tx: Saline + Calcitonin

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3
Q

Calcitonin
*Produced by what?

A

*A hormone produced by parafollicular C cells
in the thyroid
- Inhibits osteoclast activity and renal reabsorption of Ca2+ & phosphate to reduce serum Ca2+

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4
Q

Vitamin D Deficiency

A
  • Osteomalacia
  • Rickets
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5
Q

Rickets
*What?
*Findings

A

*What?: Genetic Defect in renal absorption of phosphate, leads to deficiency in vitamin D

*Findings: Bowing of legs

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6
Q

Osteomalacia
*What?:
*Findings?:

A

*What?: Deficiency of Vit. D
*Findings: bone + joint pain, muscle weakness, gait difficulties, muscle spasm/cramping
*Tx: Vit. D Supplement

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7
Q

Vitamin E
*What enzymes does it help with?
*Role in what function?
*Deficiency:
*XS:

A

*Glutathione pathway to make NADPH

*Role in neurologic function
- Deficiency = dec. proprioception, dec. vibration

*Deficiency:
- Dec. proprioception, Dec. Vibration
- Presents similar to Vitamin B12

*XS: Enterocolitis

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8
Q

Warfarin
- MOA:
- Reverse effects
- Monitor:

A
  • MOA: Inhibits Vitamin K dependent Co-factors: 2, 7, 9, 10
  • Reverse effects: Fresh frozen plasma & Vitamin K
  • Monitor: PT
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9
Q

Heparin
- MOA:
- Monitor:

A
  • MOA: Inhibits antithrombin 3 and activated factor X
  • Reverse effects:
  • Monitor: PTT
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10
Q

Factor V Leiden

*Description

*Mutation

A

*Clotting factor amplifies the production of thrombin

*Mutation: uncontrolled clotting

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11
Q

Vitamin A
*Role
*XS
*Deficiency
*Tx

A

*Role:
- Helps with vision
- Helps epithelial cells differentiate into specialized cells

*XS:
- N/V
- Dizziness
- Alopecia, Dry Skin,Liver toxicity, hyperlipidemia, renal failure
- Teratogenic effects

*Deficiency:
- Poor skin health
- Bitot spots (keratin spots in the eye)
- Dec. CSF production

*Tx:
- Help treat AML!

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12
Q

Pseudotumor Cerebri
*Cause:
*Findings:

A

*Cause: XS CSF Production

*Finding: Papilledema (increased intracranial pressure that leads to eye issues)
- Headache
- CT Scan demonstrates enlargement of ventricles

*Tx: Carbonic Anhydrase Inhibitors

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13
Q

Vitamin B1 (Thiamine)

*Reactions?:
*Deficiency

A

*Reactions: Dehydrogenase reactions

*Deficiency: seen in alcoholics
- Dry Beriberi : Peripheral neuropathy

  • Wet Beriberi: Neurologic findings + Cardiac Findings (CHF, edema, cardiomegaly)
  • Wernicke Korsakoff Syndromes:
    Acutely: Wernicke – Ophthalmoplegia, Nystagmus, Ataxia
    Chronically: Korsakoff – Memory loss, confabulations, nystagmus, ataxia
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14
Q

Vitamin B2 (Riboflavin)
*What Co-Factor is this?
*Deficiency

A

*What co-factor is this?: FAD
*Deficiency: Chelitis, Photosensitivity, Skin Dryness

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15
Q

Vitamin B3 (Niacin)
*Precursor to?:
*Treatment
*Deficiency

A

*Precursor to NAD, NADH, NADPH, NADP

*Tx: Can treat dyslipidemia = increases HDL, dec. VLDL, TGs,

*Deficiency:
- Pellagra: (4D’s) Dementia, Dermatitis, Diarrhea, Death
- Fatigue, restlessness, irritability, decreased concentration, anxiety, depression

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16
Q

Hartnup Disease
*Mutation?
*What is it?:

A

*Mutation in SCL6A19
- Gene encodes for neutral amino acid transporter

*Loss of Neutral amino acids in the urine = dec. amount of tryptophan leads to dec. niacin –> pellagra
- shift of remaining tryptophan produces XS serotonin

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17
Q

Vitamin B5 (Pantathoic Acid)
*Role?
*Deficiency:

A

*Role:
- Helps synthesize fatty acids, amino acids, cholesterol, steroids, plays a role in 1st step of citric acid cycle

*Deficiency:
- Burning feet syndrome (5 toes = burning feet)
- Disruption of vitamin, cholesterol, amino acids
- Impaired Heme Synthesis

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18
Q

Vitamin B6 (Pyridoxine)
*Rxns?:
*Deficiency

A

*Role in decarboxylation rxn’s

*Helps synthesize neurotransmitters, sphingolipids, converts tryptophan to niacin, homocysteine –> Cysteine

*Deficiency: isoniazid causes B6 deficiency & peripheral neuropathy

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19
Q

Vitamin B9 (Folic Acid)
*Reactions:
*Esst’l for?
*Deficiency

A

*Reactions: Can make tetrahydrofolate
*Esst’l for neural tube development
*Deficiency: can cause megloblastic anemia

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20
Q

Vitamin B12 Deficiency what acids are elevated?

A

Elevated Homocysteine & methylmalonyl CoA Levels

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21
Q

Vitamin B12
*Reactions
*Failure to reabsorb B12 leads to?

A

*Reactions:
- Helps odd-chain FA recycling, when it’s deficient causes issues with myelin = issues w/ corticospinal & dorsal columns
- Needed to produce mehionine & THF

*Pernicious Anemia

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22
Q

Vitamin C (Ascorbic Acid)
*What?:

A

*Vitamin C needed for hydroxylation of lysin & proline

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23
Q

How do you treat Iron XS

A

Deferoxamine

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24
Q

Hypokalemia
*Cause
*Signs + Sx’s

A

*Caused:
- Vomiting, diarrhea, Diuretic use, Renal disease

*Sx’s:
- Fatigue
- Muscle weakness
- Constipation
- Cardiac Arrhythmia
- Paralysis

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25
Bartter Syndrome
*Defect in TAL, NKCC2 co-transporter (looks like Loop diuretic) - Loss of NaCl ---> aldosterone stimulation --> loss of K+ and H+ - Causes Metabolic Alkalosis
26
Digoxin MOA *What does Digoxin compete w/?
Inhibits the Na+/K+ ATPase, traps Na+ reverse the Na+/ Ca2+ exchangers, increases intracellular Ca2+ = slows HR and ^ contractility - Digoxin competes with K+ for the same site on the ATPase, - So ^ Digoxin = ^ K+ levels
27
What can you get hyperkalemia from? - How can you treat hyperkalemia
*Acidosis, burns, leukocytosis, crush injury, lack of insulin *Treat: - Insulin - Glucose - Beta-2 Agonist - Thiazide diuretics - Loop diuretics - Cation exchange resin - Metabolic acidosis: give Na+ Bicarb -
28
Cell Cycle - What makes up metaphase? - What inhibits metaphase?
Interphase: G1 (protein), S (DNA synthesis), G2 (make more proteins), M (mitosis) *Mitosis = prophase, metaphase, anaphase, telophase - Inhibited by: vincristine, vinblastine, colchicine
29
Prophase, Metaphase, Anaphase, Telophase, Cytokinesis
*Prophase: Chromosomes pair up *Metaphase: Chromosomes line up at the midline plate *Anaphase: Chromosomes pull apart *Telophase: Chromosomes start to create membrane *Cytokineses: Separate cell membranes are made
30
PCR *Use *Steps
*Use: Amplifies DNA *Steps: (1) Denatures protein-- strand separation (2) Annealing--binding of primers upon cooling (3) Elongation (DNA polymerase works in 5' --> 3' direction)
31
What is on th 5' end? - What does it require?
7-methylguanosine cap - GTP
32
What is on the 3' end? - What does it require?
Poly-A tail - ATP
33
Glycine *Size *Charge *MOA
*Size: Small *Charge: Negative *MOA: Opens chloride channels & leads to the influx of chloride channels
34
What does the restriction enzyme, chymotrypsin, recognize?
Aromatic Amino Acids: Phenylalanine, Tryptophan, Tyrosine
35
Tryptophan is a precursor for...
Niacin and Serotonin (5HTP --> serotonin needs Vit. B6) - Serotonin can be converted into melatonin
36
Basic AA's *Move towards anode or cathode?
Lysine & Arginine - Move towards cathode
37
Acidic AA's *Move towards anode or cathode? *Stimulate what type of receptor?
Glutamate or aspartate (have COOH-) - Move towards anode - NMDA receptor (leads to Ca2+ influx) -- glutamate stimulates NMDA stronger
38
Sulfur AA's - Help build?
Cysteine & Methionine - Help build: Insulin, GH, prolactin, inhibin
39
Nitrogen contining AA's
Glutamine + Asparagine - Helps build muscle
40
What is maple syrup urine disease?
Absence of Branched-chain alpha-keto acid DH, causes body to not be able to break down branched chain AA's
41
Methylmalonic Acidemia
Occurs with Vitamin B12 or Methylmalonyl CoA defficiency! Can't make Succinyl CoA.
42
Tyrosine is a precuror to...
NE, E (does have a methyl group), Dopamine
43
Ketogenic AA's
Lysine + Leucine - Broken down to yield Acetyl CoA --> Ketones
44
GLucogenic + Ketogenic AA's
PITTT: - Phenylalanine - Isoleucine - Tyrosine - Tryptophan - Threonine
45
Essential AA's
PVT TIM HALL *Phenylalanine *Valine *Threonine *Tryptophan *Isoleucine *Methionine *Histidine *Arginine *Lysine *Leucine
46
PKU *Involves? *Deficiency of?
*Involves?: Phenylalanine *Deficiency of?: Phenylalanine Hydroxylase (can't make tyrosine)
47
Albinism *Involves? *Deficiency of?
*Involves?: Tyrosine *Deficiency of?: Tyrosinase
48
Alkaptonuria *Involves? *Deficiency of?
*Involves?: Tyrosine & Phenylalanine *Deficiency of?: Homogentistic Acid Oxidase - AR - Blue/Black discoloration of CT
49
Maple Syrup Urine Disease *Involves? *Deficiency of?
*Involves?: Build up of branched-chain AA's - Maple trees have branches = branched chain AA's *Deficiency of?: - Branched chain Alpha Keto Acid DH
50
G-protein S activates what? (say whole cascase)
Gs --> Adenylyl cyclase --> cAMP --> Protein Kinase A - Protein Kinase A: phosphorylates serine & threonine - Magnesium = Co-Factor
51
Gq cascade
Gq --> phospholipase C --> PIP2 --> DAG & IP3 --> allows movement of Ca2+ into cytosol --> actions
52
Receptors & their G-Proteins & Receptors action "qiss & qiq siq sqs" = kiss & kick until you're sick of sex Alpha1 Alpha2 Beta1 Beta 2 M1 M2 M3 D1 D2 H1 H2 V1 V2
Alpha1: Gq ; SM contraction Alpha2: Gi; Dec. NE release from pre-synpatic membrane Beta1: Gs; ^ CO, HR, SV, Renin Release Beta 2: Gs; SM relaxation M1: Gq; Autonomic ganglia, CNS & Gastric Glands M2: Gi; Heart & CNS M3: Gq; SM of eye, viscera, exocrine glands + epithelium D1: Gs; CNS D2: Gi; Brain + Periphery H1: Gq; SM, Vascular endothelial cells, heart, CNS H2: Gs; Heart, CNS, PMN's, vascular SM, Parietal Cells V1: Gq; Vascular SM, platelets, heart, kidneys V2: Gs; Kidney
53
Nitrates MOA
Increase cyclic GMP --> vasodilation, intracellular cGMP = vascular relaxation *Veins & Arteries both dilate = decrease preload
54
Collagen Types
4 Types: SCAB - Type 1: Skin - Type 2: Cartilage / Connective Tissue - Type 3: Arteries - Type 4: Basement Membrane
55
What is needed for collagen production?
*Lysine + Proline (Vitamin C) *Copper
56
Glycosylation
Occurs in Golgi
57
Hydroxylation
Occurs in RER
58
Wound contractions happens with what? - Abnormal connective tissue healing causes:
*Myofibrils & Fibrils - Abnormal Healing: *Keloids & Desmoplasia
59
Scurvy *Cause *Sx's
*Results of Vitamin C deficiency - Leads to inability to hydroxylate proline + lysine in RER *Sx's: Gingival bleeding, petechiae, ecchymoses, perifollicular hemorrhage, poor wound healing
60
Ehler's Danlos *Cause *Sx's
*Cause: Faulty collagen synthesis - Deficiencies of lysyl hydroxylase or pro-collagen peptidases *Sx's: Highly stretchable skin, hypermobile joints, easy bruising
61
Osteogenesis Imperfecta
*Abnormal collagen type 1 production - leads to brittle bones *Sx's - Skin gets SO thin you can see through it - See choroidal veins
62
Keratin
*Proteinaceous structure rich in cysteine - provides tensile strength to tissue *Found in hair, nails, outer skin, cornea *Epithelial cells: - Tumors that stain (+) Keratin: - Carcinomas, mesotheliomas, thymomas, sarcomas, trophoblastic tumors, desmoplastic small round cell tumors
63
Elastin
*Needed for stretching and recoiling properties *Contains Hydroxyproline *Contains smallest amino acid glycine
64
Anabolic Pathways take place in?
Cytoplasm/Cytosol
65
Catabolic Pathways take place in? *What pathway is the exception?
*Break down pathways *Mitochondria - Controlled by epinephrine & glucagon *Glycolysis: cytosol
66
What 3 pathways occur in cytoplasm & mitochondria?
(1) Heme Synthesis (2) Gluconeogenesis (3) Urea cycle
67
Types of energy used by different structures?
*Brain: Glucose (normal conditions), glucose (stress conditions), ketones (extreme stress) *Heart: Lipids *Muscle: Glucose, Fatty Acids, FA's *RBC: Glucose
68
Glucokinase - Where does it work? - Km
- Where does it work?: Works in the liver + beta islet cells in the pancreas - Km: High Km, Low affinity
69
Hexokinase - Where does it work? - Km
- Where does it work?: Other tissues - Km: LOW Km, High affinity for glucose
70
Rate limiting step of glycolysis
PFK-1 *Converts F-6-P ---PFK-1---> F-1,6-BP
71
2,3 BPG
Causes a conformational change in hemoglobin molecule and forces it to release oxygen
72
Glycolysis produces how many net ATP's? net NADH's?
2 ATP's ; 2 NADH's/glucose
73
Last step in glycolysis
Phosphenylpyruvate ---pyruvate kinase--> Pyruvate
74
2 methods for getting NADH into mitochondria
(1) Malate aspartate shuttle - Alpha-KG-->OAA----NADH-NAD+ & Malate DH---> Malate *crosses mitochondria* Malate --> OAA ---> Alpha KG (2) 3-phosphoglycerate shuttle (req. 2 ATP's)
75
Gluconeogenesis *4 Uni-directional enzymes
(1) Pyruvate Carboxykinase (Pyruvate --> OAA) (2) PEP Carboxykinase (OAA --> PEP) (3) Fructose-1-6-Bisphophatase (Fructose-1,6-BP --> Fructose-6-P) **Rate limiting enzyme** (4) Glucose-6-P (glucose-6-P --> glucose)
76
The Cori Cycle
Shuttles lactate from muscle --> liver to make lactate --> pyruvate --> glucose
77
Galactosemia *What is the rate-limiting enzyme? *Inheritance *Sx's *Seen w/?
*Enzyme: Galactose-1-Phosphate Uridyltransferase Deficiency *Inheritance: AR *Sx's: lethargy, N/V, failure to thrive, jaundice, hepatomegaly, intellectual disability, cataracts *Seen in between bottle feedings
78
Galactokinase Deficiency
*Galactokinase = kinder *Galactose accumulates -*Sx's: see infantile cataracts
79
Essential fructosuria *Deficiency?
*Deficient enzyme: Fructokinase
80
Fructosemia *Enzyme deficiency? *Seen when? *Sx's
*Enzyme deficiency: Aldose B deficiency - Accumulation of F-1-P *Seen w/ baby started on fruits *Sx's: hypoglycemia, jaundice, cirrhosis, vomiting
81
Pyruvate --> Acetyl CoA - Requires: 5 Co-Factors
*B Vitamins 1 - 5
82
Antidote to methanol or ethylene glycol poisoning?
Fomepizole
83
Citric Acid Cycle *Mnemonic *Main goal? *Rate limiting step
*Mnemonic: Citrate is krebs starting substrate for making oxaloacetate *Main goal: Produce NADH for ETC to make ATP - NADH2 = 2.5 ATPs - FADH2 = 1.5 ATPs *Rate limiting step = isocitrate DH
84
Do saturated fats have double bonds?
No
85
Do unsaturated fats contain double bonds?
Yes
86
How does fatty acid synthesis begin? - Where does it get it's NADPH's from?
*Begins from citrate accumulation due from inhibition of PFK-1, *Acetyl-CoA --ATP (via ACoA Carboxylase)---> Malonyl CoA *NADPH's come from HMP Shunt
87
# of rounds to make certain length of chain = Number of NADPH's needed / round = Number of rounds to make certain length of chain = # of ATP's needed to make entire FA = Number of FA breakdown to release NADH, FADH2, ACoA =
# of rounds to make certain length of chain = (#C / 2) -1 Number of NADPH's needed / round = # of carbons - 2 Number of roounds to make certain length of chain = (#C / 2 ) - 1 # of ATP's needed to make entire FA = #C - 1 Number of FA breakdown to release NADH, FADH2, ACoA = (#C / 2 ) -1
88
Fatty Acid synthesis steps
Acetyl CoA -----Acetyl CoA Carboxylase------> Malolnyl CoA ---> Decarboxylation --> Addition of NADPH + Addition of NADPH
89
How does fatty acid catabolism being? - What is needed? - Fatty acids > 12 carbons need? - Steps of catabolism
Glucagon stimulates hormone sensitive lipase - 2 ATP's needed - Fatty acids > 12 carbons need CAT-1 (cytosol) and CAT-2 (mito) to be transported - Steps of catabolism: Oxidation, hydrolysis, oxidation, thiolysis
90
Deficiency of Cat-1 causes:
Adrenoleukodystrophy (X-linked Rec) - Disrupts leydig cells, CNS , adrenal cortex
91
What do you need in dealing with Odd chain fatty acids?
Propionate + Succinyl CoA --> TCA intermediate
92
Ketone Synthesis *What is the Rate Limiting Enzyme? *What is the Reaction?
*Rate Limiting Enzyme?: HMG-COA Synthase *Reaction: Acetyl CoA --Thiolase--> Acetoacetyl CoA -----**HMG-CoA Synthase**--> Hydroxy-beta-methylglutaryl CoA ---HMG-CoA Lyase--> Acetoacetate ---D-Beta-hydroxybutyrate DH---> Acetone + CO2 & D-Beta-Hydroxybutyrate
93
The phospholipid pathway
Phospholipids ---> Arachidonic Acid ---*--> COX1 & COX2 COX1 --> Homeostatic Functions COX2 --> Inflammation COX 1 & COX 2 --> Prostacyclin (PGI2), Thromboxane (TXA2), Prostaglandins (PGD2, PGE2) *Can be inhibited by NSAIDs Phospholipids ---> Arachidonic Acid ---> 5-Lipoxygenase --> 5-HPETE --> Lipoxin A4/B4 5-HPETE --> Leukkotrienes --> Vasoconstriction, ^ Vascular permeability, Bronchospasm
94
(1) What irreversibly inhibits cox1 & cox 2? (2) What reversibly inhibits cox1 & 2? (3) What inhibits the cox enzyme? (4) What reversibly inhibits Cox-2?
(1) Aspirin (2) NSAIDs: Ibuprodfen & Naproxen (3) Acetominophen (4) Celecoxib
95
What is the rate limiting enzyme of glycogen synthesis? - What elongates the chain?
*Glycogen Synthase - Chain elongates in alpha-1,4 direction & links via Alpha-1,6 linkage
96
Von Gierke Disease *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: Glucose-6-phosphatase *Clinical Findings: - Hepatomegaly - Hypoglycemia (severe) - Hyperlipidemia - Hyperuricemia - Failure to Thrive
97
Pompe's Disease *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: Alpha-glucosidase *Clinical Findings: - Cardiorespiratory Failure
98
What does ABCD stand for in terms of glycogen storage diseases?
A: Anderson B: Branching enzyme C: Cori D: Debranching Enzyme
99
Cori *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: - Debranching enzyme *Clinical Findings: - Similar to Von Gierke but less severe
100
Anderson *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: Branching Enzyme *Clinical Findings: - Cirrhosis of liver - Death by liver failure
101
McArdle *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: Myophosphorylase *Clinical Findings: - Cramping during physical activity
102
Hers *Inheritance: *Enzyme Defect: *Clinical Findings:
*Inheritance: AR *Enzyme Defect: Liver Phosphorylase - issue w/ glycogen synthesis *Clinical Findings: - Increased Amount
103
Pentose Phosphate Pathway *Generates? *Rate Limiting Enzyme? *Occurs where? *Two phases?
*Generates: NADPH & Ribose-5-Phosphate *Rate Limiting Enzyme: Glucose-6-phosphate DH *Occurs: Cytosol *Two Phases: Oxidative & Non-Oxidative
104
Glucose-6-Phosphate DH Deficiency - Inheritance
*NADPH used by RBC to maintain reduced glutathione to counteract free radicals *Inheritance: X-linked recessive
105
Cholesterol Synthesis *Rate-limiting enzyme: *What acts at this enzyme? *Pathway
*Rate-limiting enzyme: HMG-CoA Reductase *What acts at this enzyme? Statins *Pathway: Acetoacetyl CoA + Acetyl CoA --> HMG-CoA --HMG-COA reductase--> Mevalonate --> Mevalonate --> Prequalene pyrophosphates --squalene synthase--> squalene --> Cholesterol
106
Niacin *What Vitamin is it? *What does it do?
*Vitamin B3 *Decreases VLDL production in the Liver, Best HDL-raising ability, Uncomfortable skin flushing
107
Urea Cycle (p. 125) *What is it? *Where does it work *Rate limiting ezyme
*What is it?: Removes toxic ammonia that builds up during protein breakdown + makes urea *Where does it work: cytosol & mitochondria *Rate limiting enzyme: Carbamoyl phosphate synthetase 1 (CPS-1)
108
Arginase Deficiency *What is arginase used for? *Sx's of deficiency *Management:
*What is arginase used for?: makes urea *Sx's: spaticity *Management: - Lower protein intake and eleminiate arginine from diet
109
Liver Failure Tx 1. Management 2. Treatment
1. Lower protein inake 2. Lactulose: used to treat constipation + hepatic encephalopathy. Pulls in water to lumen, and traps ammonia
110
Rate Limiting Enzymes Glycolysis RLE
RLE of glycolysis: Phosphfructokinase-1 (PFK-1)
111
Rate Limiting Enzymes Gluconeogenesis RLE
RLE of gluconeogenesis: Fructose-1,6-Bisphosphatase
112
Rate Limiting Enzymes Citric Acid Cycle
RLE of Citric Acid Cycle: Isocitrate DH
113
Rate Limiting Enzymes Glycogen synthesis
RLE Glycogen Synthesis: Glycogen Synthase
114
Rate Limiting Enzymes Glycogenolysis
RLE of Glycogenolysis: Glycogen Phosphorylase
115
Rate Limiting Enzymes HMP Shunt
RLE HMP Shunt: G6PDH
116
Rate Limiting Enzymes Urea Cycle
RLE Urea Cycle: Carbamoyl Phosphate Synthetase 1 (CPS-1)
117
Rate Limiting Enzymes Fatty Acid Synthesis
Fatty Acid Synthesis RLE: Acetyl CoA Carboxylase
118
Rate Limiting Enzymes Fatty Acid oxidation
Fatty Acid Oxidation RLE: Carnitine acyltransferase 1
119
Rate Limiting Enzymes Ketogenesis
Ketogenesis RLE: HMG CoA Synthase
120
Rate Limiting Enzymes Cholesterol Synthesis
Cholesterol Synthesis RLE: HMG-CoA Reductase
121

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