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Biochemistry SJSM > Block 4 Quiz > Flashcards

Block 4 Quiz Flashcards

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1
Q

Hemoglobin electrophoresis categories:

Fetus
6 month old
Adult

A

Fetus: wide HbF (80%) + HbA (20%)
6 months: transition to HbA
Adult: HbA (96%) + HbA2 (2.5) + HbF (<1)

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2
Q

Hemoglobin electrophoresis categories:

B-thalassemia minor
B-thalassemia major

A

Minor: narrow HbA + wide HbA2
Major: wide HbA2 + Wide HbF

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3
Q

Hemoglobin electrophoresis categories:

Sickle Cell Disease
Sickle Cell Trait
HbC Disease
HbC Trait
HbSC Disease

A

SS: HbS

AS: HbA + HbS

CC: wide HbC

AC: HbA + HbC

SC: HbS + HbC

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4
Q

Left shift in the Hemoglobin O2 dissociation curve:
“HigH Mile Flyer Prices & Low Bus Prices”

A

High:
Hb affinity (poor tissue oxygenation)
Methemoglobin
HbF
Ph

Low:
2,3 BPG
POC

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5
Q

Right shift in the hemoglobin-O2 dissociation curve:
“low Health Prices & high Bus/TrAin ExPenses”

A

Low:
- Hb affinity (lots of tissue oxygenation)
- pH

High:
- 2,3-BPG
- Temperature
- Altitude
- Exercise
- PCO2

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6
Q

Anemia:

Iron deficiency
“Having Persistent Fatigue May HurT Playful Kids with a Low Feeling”

A

Hypochromic
Parllor
Fatigue
Microcytic
High TIBC
PICA
Koilomychia (spooning nails)
Low Ferritin

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7
Q

Anemia:

ACD (Chronic inflammation)
“CaN Cause InflaMmatioN, low TItre, & High Ferritin”

A
  • Cancer
  • Normocytic
  • Inflammation
  • Microcytic
  • Non-hemolytic
  • Low TIBC & Iron
  • High Ferritin
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8
Q

Anemia:

Sideroblastic anemia
“captaIn MarVeL’s high FlIghT & low Tough BlowS”

A

Isoniazid (TB Rx.)
Microcytic
Vit B6 deficiency (biotin)
Lead poisoning
High Ferritin, Iron, & Transferrin
Low TIBC
Basophilic Stippling

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9
Q

Alpha-Thalassemia:
“ARMy NEws”

& subtypes:

Silent
A-thalassemia trait
HbH disease
Hydrops fetalis

A

Alpha-Thalassemia:
- Reticulocytosis
- Microcytic anemia
- Normal Hemoglobin Electrophoresis

Subtypes:
Silent (-a/aa) Asymptomatic

Trait: (–/aa Asian or -a/-a African) Asymptomatic/mild anemia

HbH: (–/-a) intermittent-severe chronic anemia

Hydrops: (–/–) fatal

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10
Q

A-Thalassemia:

HbH Disease
“HbH Causes Jaundice, HigHeR Problems & lower HeMe adHesion”

A

HbH on the heme electrophoresis
Chronic hemolysis
Jaundice
High HbH (hypoxia), Reticulocytosis, & Hepatosplenomegaly
Poikilocytosis
Low Hb, MCV, Hct

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11
Q

Differentials for Alpha vs Beta thalassemias

Alpha minor/trait
Alpha HbH disease
Beta minor/major

A

Alpha minor/trait:
MCV (Normal/low)
HbA2 (Normal/low)
HbF (Normal)
HbH (Maybe present)

Alpha HbH disease:
MCV (Low)
HbA2 (Normal/low)
HbF (Normal/low)
HbH (Present)

Beta minor/major:
MCV (Low)
HbA2 (High)
HbF (High)
HbH (Absent)

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12
Q

Alpha-Thalassemia:

Hydrops Fetalis
“HuSHPuppiEs”

A

Hepatosplenomegaly
Heart failure
Edema
Prenatal death
Severe hypoxia

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13
Q

B-Thalassemia: ~6MONTHS

Minor
“Minor Melon RINds Have lower Healthy Minerals”

vs

Major
“My Terrible STD Penis gets BITCHeD & NoT CHuCked”

A

Minor: 1 allele deletion
Microcytic
Mild Anemia
Normal Reticulocytosis + Iron
Low Hb, Hct, MCV

Major: 2 allele deletion
Microcytic
Target cells
Severe Transfusion-Dependent anemia
Poikilocytosis
Transfused patients (Bronze pigmentation, Iron overload, Cardiomegaly, Hypogonadism, Diabetes)
Not Transfused (Crew-cut skull, Hepatosplenomegaly, Cardiac failure)

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14
Q

Sickle cell disease
“I CHANCeD An Proper Actual Home with BJs

A

Triggers: Infection dehydration, Hypoxia

Hemolytic anemia
Cholecystitis
Microvascular ischemia
Acute chest syndromes (bone pain)
Autosplenectomy
Poikilocytosis
Crew-Cut skull
Normocytic
Howell-Jowell bodies

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15
Q

Hemophilia A, B, C

A

A: VIII
B: IX
C: XI

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16
Q

Inactive II, VII, IX, X, C, S are turned into active carboxylated clotting factors & anticoagulants (C,S) via which enzyme:

A

Y-glutamyl carboxylase (Vit K dependent)

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17
Q

Extrinsic pathway (Tissue injury)

Factors:
Test:

A

Factors: VII goes to –> VIIa —>X
Prothrombin time test

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18
Q

Intrinsic pathway (Collagen, basement membrane, & activated platelets)

Factors:
Test:

A

Factors:
XII (XIIa) –> XI (XIa) –> IX (IXa) –> VIIIa
Activated Partial Thromboplastin Time (aPTT/PTT)

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19
Q

Common hemostasis pathway:
Factors:

A

X (Xa) –> II (Prothrombin) –> IIa (Thrombin)
–> I (Fibrinogen) —> Ia (Fibrin monomers) –> aggregation + Ca2+ & IIa (thrombin) activates XIIIa (XIIIa fibrinogen stabilizing factor)
–> Fibrin mesh for platelet plug

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20
Q

XIIa activates the kininogen system (aka Kinin cascade) & Plasminogen.

A

Kinin cascade:
HMWK –> (via Kallikrein) Bradykinin (more vasodilation, perm, pain)

Plasminogen:
Plasminogen –> (via tPA) Plasmin
Plasmin helps degrade fibrin mesh into D-dimers

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21
Q

Von Willebrand Disease (VIII)
“Poor PaTienTs BuTts get NePTunes PeaChy kiss,r wiPes with lower the PApeR towel”

A
  • Def factor VIII (No platelet adhesion)

Prolonged:
PTT, BT

Normal:
PT, Platelet count

Low:
Platelet aggregation + Ristocetin

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22
Q

Vitamin K deficiency can be due to
“Dunk My WIenER In HaBanaro & PuT NoRi & PeanuTTs”

A

Diet (dark greens)
Malabsorption (pancreatic insufficiency)
Warfarin (inhibits Epoxide Reductase)
Bleeds (Hemarthosis, bleeding joints)
Prolonged PT/NR (Extrinsic coagulation pathway)
Prolonged PTT (Intrinsic coagulation pathway

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23
Q

Adrenal cortex

“GAMeR gAl FuCks GAy Cock & RiDes All Cock”
salty–> sweet –> sex

A

Glomerulosa
- Aldosterone
Mineralocorticoids
- reg via Angiotensin II

Fasciculata
- Cortisol
Glucocorticoids
- Reg via ACTH & CRH

Reticularis
- DHEA
Adrogen
- Reg via ACTH & CRH

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24
Q

common steps in Steroid hormone synthesis

Cholesterol (3)
Cholesterol hydroxylation
Pregnenolone

A

Cholesterol:
- Stored as CE’s
- De novo synthesis
- Uptake LDL via LDL receptors

Cholesterol hydroxylation:
Pregnenolone via desmolase (CYP11A + NADPH) RLS induced by ATCH & Angiotensin II

Pregnenolone:
Progesterone via 3-Beta-Hydroxysteroid Dehydrogenase (3BHSD)

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25
Zona Glomerulosa Steroid hormone synthesis: "Cold, PooPs Dunk, Crash, Chunk Alot"
Cholesterol ester (CEH) Cholesterol (CYP11A1 & stAR) Pregnenolone (3BHSD) Progesterone (CYP21) 11-OH-Deoxycorticosterone (CYP11B2) Corticosterone 18-OH-Corticosterone (Aldosterone synthase, Angiotensin II+) Aldosterone (21ketosteroid)
26
Zona Fasiculata Steroid hormone synthesis: "Cold PooPs 2 Hype Dudes Cool Cocks"
Cholesterol (Desmolase, ACTH +) Pregnenolone (3BHSD)--->17 Hydroxypregnenolone Progesterone (CYT17A) --> 17-Hydroxyprogesterone (CYP21) 11 deoxycortisol CYP11B2) Cortisol (Steroid 11B hydroxylase) (CYT17A) Cortisone
27
Zona Reticularis Steroid hormone synthesis: "Cold PooPs Produce Pungent Aromas & Damage"
Cholesterol (Desmolase +ACTH) Pregnenolone (CYT17A) --> 17-OH Pregnenolone (17,21 lyase) --> DHEA (3B) --> Androstenedione (3B) --> progesterone (CYT17A) --> 17-OH Progesterone (17,20 lyase) --> Androstenedione (17 ketosteroid)
28
Complete steroid hormone synthesis pathway
29
RAAS Pathway & Effects
Effects: Hypertension (more aldosterone) Hypernatremia Hypokalemia Metabolic alkalosis
30
Conn's Syndrome (Primary Hyperaldosteronism) VS Secondary Hyperaldosteronism
Conns: High Aldosterone Low Renin & Angiotensin II Secondary: Renin-secreting tumor High aldosterone, Renin, & Angiotensin II
31
Cortisol regulation pathway (pituitary) & effects
Metabolism: Bone reabsorption Anti-inflammatory Immunosuppresion Less glucose uptake & insulin release Cardiovascular system: More synthesis of PNMT
32
Cortisol regulation conditions: ACTH-Independent (primary adrenal disease)
Adrenocortical tumours (adenoma/carcinoma) - high cortisol - Low ACTH, adrenal androgens, DOC, & SMALLER ADRENAL GLANDS Dexamethasone test diff pituitary adenoma vs ectopic ACTH-secreting tumor
33
Cortisol regulation conditions: ACTH-Dependent (Cushing's disease)
Pituitary adenomas - High ACTH, Cortisol, Adrenal androgens - Bigger adrenals Moon face Buffalo hump Hyperglycemia Purple striae Rx. Suppress ACTH/Cortisol via a high dose of dexamethasone
34
Cortisol regulation conditions: Ectopic (paraneoplastic) secretion
Small-cell lung carcinoma - High ACTH, Cortisol, adrenal androgens - Bigger adrenals Dexamethasone doesn't work.
35
Primary adrenal insufficiency ADDISIONS DISEASE
high ACTH low Aldosterone, Na, Cl, K. hypotension, cortisol, adrenal androgens **BRONZE SKIN Weight loss Hypoglycemia Postural hypotension Adrenal crisis: low Na & high K!!!
36
21a-OH Def
21: Low cortisol/aldosterone High ACTH, Renin/ATII androgens, & urine 17-OH-progesterone Females 46XX (virilized) Males Precocious puberty Salt wasting crisis (hypotension, hyponatremia, hyperkalemia, dehydration, & met acidosis)
37
11B-OH Def
11: Low cortisol/aldosterone High ACTH, Renin/ATII, Androgens, urine 11-DOC Females 46XX Males Precocious puberty 11DOC Mineralocorticoid effects: Hypertension, hypernatremia, hypokalemia/ hydration, met alkalosis
38
17a-OH Def
High Aldosterone & 11DOC, ACTH Low Renin, ATII, Cortisol, & Androgens Female delayed puberty, no 2nd sex characteristics, primary amenorrhea Male 46XY (Psuedohermaphroditism) High mineralocorticoid effects: Hypertension, Hypernatremia, Hydration, hypokalemia, met alkalosis
39
Treating 21a-OH Def 11B-OH Def 17a-OH Def
21: Glucocorticoid therapy (reduce ACTH) + Mineralocorticoid replacement 11: Glucocorticoid therapy 17: Glucocorticoid & Sex hormone replacement
40
Ca2+ Homeostasis regulates 3 regulated by 3 regulated at 3 sites
reg: Calcium, phosphorus, Bone reg by: PTH, Calcitonin, VitD Reg at: Kidney, Bone, Intestines
41
Calcium homeostasis & vitamin D pathway
Low Ca2+ --> ups PTH activate 1a-hydroxylase Low Phosphorus activates 1a-hydroxylase
42
Vit D def Causes & 2 diseases
Causes: Night-shifts Kidney disease Lipid malabsorption High PTH Low Ca, phosphorus, or calcitriol Diseases Rickets Osteomalacia
43
Calcium homeostasis via PTH & Clinical corr Primary hyperparathyroidism
Clinical: Primary hyperparathyroidism - Hypercalcemia - Parathyroid adenoma - high PTH & Vit D - Low phosphorus Signs Kidney stones Osteoporosis Gi issues Muscle weakness Mental changes Polyuria
44
Calcium homeostasis via PTH & Clinical Corr Primary Hypoparathryoidsim Pseudohypoparathyroidism vit D deficiency/chronic renal failure
Primary Hypoparathryoidsim -Hypocalcemia -Low PTH, Vit D -High Phosphorus Genetic (DiGeorge) or Surgery PARA/THYROID Pseudohypoparathyroidism - Def PTH in bone/kidney -Low Ca2+ - High PTH, phosphorus vit D deficiency/chronic renal failure - Low Ca2+ & Vit D - High PTH - high/low phosphorus - renal failure signs
45
Link the disease to the letter Primary hyperparathyroidism Primary Hypoparathryoidsim Pseudohypoparathyroidism vit D deficiency/chronic renal failure
46
Kwashiokor DILUTED MILK FORMULA (NO BOOBIES) "MEAL"
Neg nitrogen balance via protein def Malnutrition Edema (no albumin moon face) Anemia (less globins) Liver (fatty no apolipoproteins) Dermatitis, gray hair (vit/mineral def) Weightloss/fatigue
47
Marasmus (DILUTED MILK FORMULA) NO BOOBIES!
Neg nitrogen balance via protein/cal def Tissue wasting Oldman face, sparse hair
48
BMR calculation
BMR = 24 X Weight
49
Vit B1(Thiamine TTP Cofactor (4) Def causes Beri-Beri
TTP: PDH aKG DH (TCA def means more Pyruvate, lactate, alanine (met acidosis) BC a-Keto acid DH (Val, leu Ile) Transketolate (HMP-path) Causes: Diet (polished rice/malnutrition) BOOZE Thiaminase (Raw seafood) Beri-Beri Wet BB= Edema, tachycardia, cardiomegaly, congestive heart failure Dry BB= Neuromuscular, peripheral neuropathy Wernicke-Korsakoff synd= Confusion, Ophthalmoplegia, ataxia Reversible "CAN": Confusion, Ataxia, Nystagmus - Foci of hemorrhage & necrosis in mamillary bodies Korsakoff psychosis "CAP" Confabulation Anterograde amnesia Psychosis
50
Vit B2 Riboflavin FAD/FMN cofactor Def causes Ariboflavinosis
FAD/FMN: FMN-Dependent complexes (COMPLEX 1 OF ETC moves electrons to CoQ) FAD0dependent enzymes Succinate Dehydrogenase (Comple 2 ETC) Fatty acyl CoA dehydrogenases G3PDH Glutathione reductase Def causes: Booze Malnutrition Beriberi, pellagra, Kwashiorkor No UV light Ariboflavinosis: Angular stomatitis CHEILOSIS CORNEAL VASCULARIZATION (bloodshot eyes) OXIDATIVE STRESS/NORMOCYTIC ANEMIA Glossitis Suborrhei dermatitis Peripheral Neuropathy
51
Vit B3 Niacin NAD/NADP Cofactor DEF CAUSES PELLAGRA
COfactor: Glycolysis; Ox. decarboxylation; TCA cycle; Ox. Deamination; β-oxidation of fatty acids Def causes Corn diet (low tryptophan) Hartnup disease Carcinoid syndrome (high serotonin/ HIAA Malnutrition BOOZE DEF PELLAGRA DIARRHEA DERMATITIS DEMENTIA
52
Vit B6 Biotin Cofactor Causes Def
Cofactor: Acetyl CoA cARBOXYLASE (FA SYNTHESIS) Pyruvate Carboxylase (GLUCONEOGENESIS) Propionyl CoA Carboxylase (VOMIT PATHWAY) CAUSES: Eating 5-20 egg whites (WTF) AVIDIN BINDS BIOTIN & BLOCKS ABSORPTION Parental nutrition Def: Seborrheic dermatitis Anorexia Alopecia Mild lactic acidosis
53
Vit A retinol Function (NOT COFACTOR) DEF CAUSES DEF
Function: 11-cis retinal (rhodopsin vision) Retinoic acid (growth/cell diff) Retinol (Repro) Def causes: Malnutrition Fat malabsorption/fat free diet Abetalipoproteinemia (impaired delivery to liver Def Night blindness Xerophthalmia (dry eyes) Corneal scarring Imp diff of immune cells Follicular hyperkeratosis (goose skin) Dont use on preggos!!!!
54
Vit E Tocopherol Function (not cofactor) Def CAUSES DEF
Function: Antioxidant Immune resp Protects RBC's from hemolysis Structural comp of cells Myelination in neurons DEF CAUSES Malnutrition Fat malabsorption/;fatfree diet Abetalipoproteinemia (imp delivery to liver) Def: Oxidative stress Hemolytic anemia Acanthocystosis RBCS (FRAGILE MEMBRANES) Neuro deficits & muscle weakness Peripheral neuropathy without megaloblastic anemia
55
Heme synthesis pathway “GLASs PHotos of Ugly Corgis, Poodles, & Hounds”
Mito: —> Glycine + Succinyl-CoA combine to make Aminolevulinic acid (via ALA synthase+ B6 (biotin)) Cyto: —> Aminolevulinic acid leaves the mito & forms Porphobilinogen (via ALA Dehydrase) —> Porphobilinogen forms Hydroxymethylbilane (via Porphobilinogen Deaminase/Hydroxymethylbilane synthase) —> Hydroxymethylbilane forms Uroporphyrinogen III (via Uropophrynogen synthase) —> Uroporphyrinogen forms Coporhyrinogen III (via Uroporphyrinogen Decarboxylase) Mito: —> Corporphyrinogen forms Protoporphyrin IX —> Protoporphyrin forms Heme (via Ferrochetalase + Fe2+)
56
Inhibition of Heme synthesis Lead (affects which 2 enzymes) & Heme & high glucose Low iron
Lead: inhibits ALA Dehydrase & Ferrochetalase Heme/hematin/hemenin & high glucose: ALA synthase I (Liver) Low iron: ALA synthase II (Bone marrow)
57
Heme synthesis disorders: Acute intermittent porphyria “Ads No ACcePtABLe Pain”
Deficient Porphobilinogen Deaminase/Hydroxymethylbilane synthase: Auto Dom + Late onset Causes build-up of PBG (Porphobilinogen) & ALA (Cause neurological dysfunction) Symptoms: - Anxiety, confusion, Paranoia - Acute Abdominal pain - Port-wine urine (sometimes) DON’T GIVE BARBITUATES or fast 5 P’s: - Painful abdomen - Port-wine urine - Polyneuropathy - Psych issues - Precipitated by barbituates Treat: - Hematin/hemin - high CHO diet
58
Heme synthesis disorders: Porphyria cutanea tarda “Ads Heat, PAin, & BuRns”
Deficient Uroporphyrinogen Decarboxylase Auto DOM + Late onset Causes build-up of cyclic tetrapyrroles (cause sunlight-induced lesions) Symptoms: - Photosensitivity - Blistering/inflammation of the skin - Red/Brown urine (build-up of uroporphyrinogen & abnormal liver enzymes) - Hyperpigmentation WORSE WITH ALCOHOL
59
Port-wine urine is due to build-up of which substrate & is associated with what conditions?
Build-up: Uroporphyrinogen Ass.: - Hepatitis - HIV - Alcoholism - Oral contraceptives - Acute int porphyria - Porphyria cutanea tarda
60
Anemia types: Microcytic (less than 80) “MIcro AnTS”
Iron deficiency ACD Thalassemias Sideroblastic anemia
61
Anemia types: MCV (80-100) Normocytic-Hemolytic & Intrinsic anemia “Normal HIGHSchool Pressure”
G6PD, PK Spherocytosis (hereditary Paroxysmal nocturnal hemoglobinuria Sickle cell Hbc
62
Anemia types: MCV (80-100) Normocytic-Hemolytic & Extrinsic anemia “A NormAl HEMIsphere”
MAHA MIHA Auto immune Infection
63
Anemia types: MVC (80-100) Normocytic-Nonhemolytic anemia “NAKed Ass”
ACD Kidney disease Aplastic anemia
64
Anemia types: Macrocytic-Megaloblastic anemia “Massive Mega-Bull Frogs”
Megaloblastic B12 Def Folate def
65
Anemia types: Macrocytic-Megaloblastic: B12 def absorbed in the ileum “VitAMin B12 in Breakfast Cereal, HeMP, Trout, HeARTy AniMal Meats, & PeAs”
Risks (Vegans, Atrophic gastritis, Bypass surgery, Tapeworms, ***Percarnious anemia, Crohn’s, AIDS) 2-3 yrs Onset High methylmalonic acid Megaloblastosis Peripheral Neuropathy Affected MM-CoA & Homocysteine methyltransferase
66
Anemia types: Macrocytic-Megaloblastic: Folate def “FolATe Affects How PregnanT woMen Deliver”
risks (Preggos, ***Alcoholics, & Drug users (phenytoin & spruce) THF (active form via DHFR) Affects Thymidylate synthase, Homocysteine methyltransferase, & purine synthesis Megaloblastosis (ONLY)
67
Microlytic anemia: MCV < 80 Iron Deficiency “IroN BinDs 2-3x Less THen TItanium Without PacKinG”
Iron def: - Normal ALA -Bleeding (colon cancer, GI ulcer, Menorrhagia etc.) Diet def (Protein def, ascorbic acid, vit C, or copper) Low Ferritin (Fe3+) & Iron (Fe2+) in serum Tachycardia, Weakness/parllor, Glossitis, Pica, Koilonychia (spooning nails) High TIBC (body wants more iron)
68
Microcytic anemia: Sideroblastic anemia - B6 deficiency “IOns LAST & RADiatE Colour in Space” & Lead toxicity “LABS PrOvIde bLADes For iNcisions”
B6 Def: - Isoniazid (TB patients) - Low ALA synthase (Low ALA levels mean no Heme to bind iron) Iron overload (high ferritin & iron) Low TIBC (the body doesn’t need more iron) Reduced AA decarboxylase activity (def GABA, DA, NE/E = Epileptic convulsions) Reduced CBS activity (Homocystinemia & risk DVT/Stroke) Lead poisoning: - Lead exposure (paint chips) - Abdominal pain (unexplained) - Basophilic Stippling - Peripheral neuropathy - Iron Overload (high ferritin & iron) - Low ALA Dehydrase (High ALA levels) - Low ferrochelatase (sideroblastosis) - Low TIBC (the body doesn’t want more iron) - Neuro-toxic/psychic issues
69
Microcytic anemia: Thalassemia “thAlAssemiA Has Bad CHanges”
Alpha thalassemia: - 1 deletion = asymptomatic - 2 deletions = Mild anemia - 3 deletions = Severe anemia - 4 deletions = Hydropis fetalis (dead) Beta thalassemia: - 1 deletion = Minor B-T - 2 deletions = Major B-T (Hgb A2) reduces hematopoiesis in normal bone marrow in long bones, so it happens more in the skull (Chimpmunk Facies)
70
Microcytic/Normocytic anemia: ACD (Anemia of Chronic Diseases) “CD’s in the KAR”
The body can’t tell the difference between chronic inflammation and infection, so it hides its iron from siderophoric bacteria. It releases Hepcidin (lowers iron reabsorption & increases storage) Low iron & ferritin High TIBC Kidney disease Autoimmune disease Rheumatological disease
71
Normocytic anemia (80-100): Paroxysmal Nocturnal Hemoglobinuria “PNH Can DRoP PIGA”
Pancytopenia, Negative Coombes test, & Hibernation (during sleep) Complement system isn’t inhibited by CD55/59 Defective PIGA gene Decreased CD55/59 Premature RBC lyses
72
Normocytic Intrinsic anemia: “NO FRee SHots of Gin or FireBall Pay your Dollars”
No NADPH Glutathione isn’t reduced Oxidative stress on RBCs Free radicals aren’t destroyed Sulfa, Dapsone, primaquine, & favabeans Heinz bodies + Bite cells
73
Normocytic Intrinsic anemia: Hereditary Spherocytosis “DABS are Cool as SHIt”
Dsyfunctional RBC membrane protein (Ankyrin, Bands & Spectrin) Coombs negative test Splenomegaly Howell-Jolly bodies Indirect Jaundice
74
Anti Cancer Drugs: “MethotRexAte CLoSes & ALMost DRIPS”
Rheumatoid arthritis Abortion/ectopic preggos Choriocarcinoma Lymphoma Sarcoma Acute Lymphocytic Myelogenous Leukemia Inhibited Dihydrofolate Reductase S Phase
75
Anti Cancer Drugs: 5’ Fluorouracil “SiP IPA BITCheS”
S Phase Inhibits Pyrimidine Analog Basal cell carcinoma Inhibits Thymidylate synthase (reduce dTMP & DNA synthesis) Colon cancer Solid tumors
76
Anti-Cancer drugs: Hydroxyurea “SPIRR MCS”
S Phase Inhibits Ribonucleotide Reductase Melanoma CML Sickle Cell
77
Carcinoid Tumors: “cArcinoiDS Produce Gross HIAtAl”
Amine Precursors Uptake Decarboxylase Cells Diarrhea High Serotonin & Sweating Pellagra Niacin def (B3) (Diarrhea, Dementia, Dermatitis) Gi Tumors 5-HIAA (5-Hydroyindoleacetic acid)
78
Li-Fraumeni syndrome:
Rare AUTO DOM Breast, colon, brain, adrenocortical tumours Somatic mutations inactivate the TP53 gene = cancers.
79
Proto-oncogenes: BRAF BCR-ABL JAK2
BRAF: 7q34, makes Ser, Thr kinase, Melanoma, Non-Hodgkin lymphoma, Papillary thyroid carcinoma, Hairy cell leukemia BCR-ABL: zt(9;22) Philadelphia chromosome, makes non-receptor tyrosine kinase, CML JAK2: 9p24.1, non tyrosine kinase receptor, Chronic myeloproliferative disorders
80
Proto-oncogenes: HER2/neu ALK RET
HER2/neu(c-erbB2): 17q12, Receptor Tyrosine Kinase, Breast/gastric cancer ALK: 2p23.2-p23.1, Receptor tyrosine kinase, Lung adenocarcinoma RET: 10q11.21, receptor tyrosine kinase, Papillary thyroid cancer, pheochromocytoma, MEN2A & MEN2B
81
Proto-oncogenes: c-KIT L-myc-1 (MYCL1) N-myc (MYCN) c-myc
c-KIT: 4q12, Cytokine receptor, GI stromal tumors, Mastocytosis L-myc-1 (MYCL1): 1p34.2, Transcription factors, Lung cancer N-myc (MYCN): 2p24.3, Transcription factors, Neuroblastoma c-myc: 8q24.21, Transcription factors, Burkitt Lymphoma
82
Proto-Oncogenes: KRAS BCL-2 CDK4 CCND1 ERBB1
KRAS: 12p12.1, GTPase, Colorectal, lung, pancreatic cancer BCL-2: 18q21.33, Antiapoptotic molecule, Follicular lymphoma, Diff large B cell lymphoma CDK4: 12q14.1, Cyclin-dependent kinase, Liposarcoma, Melanoma, Glioblastoma multiforme CCND1: 11q13.32, cyclin D, Mantle cell lymphoma ERBB1: 7p11.2, Epidermal growth factor receptor, NSCLC (lung cancer)
83
Tumor Suppressor gene: TP53 Rb CDKN2A APC gene
TP53: 17p13.1, p53 cell apoptosis, arrests cell cycle G1 phase (most cancers & Li-Fraumeni synd) Rb: 13q14.2, Retinoblatoma protein (cell cycle arrest G1, inhibits E2F), Retinoblastoma, Osteosarcoma CDKN2A: 9p21.3, p16 (arrests cell cycle in G1 phase), Melanoma, pancreatic, lung cancer APC gene: 5q22.2, inhibits B-catenin synthesis (B-catenin/Wnt pathway), Familial adenomatous polyposis, colon cancer
84
Tumor Suppressor gene:Tumor Suppressor gene: PTEN BRCA1 BRCA2 MMR gene family DCC
PTEN: 10q23, Neg regs the Pl3k/AKT pathway, Breast cancer, prostate, endometrial, Cowden syndrome BRCA1: 17q21.31, DNA repair protein, Breast, Ovarian, Pancreatic BRCA2: 13Q13.1, DNA repair protein, Breast, Ovarian, Pancreatic MMR gene family: DNA repair protein, Lynch Syndrome DCC: 18q21.2, Transmembrane receptor in apoptosis, Colorectal cancer
85
Tumor Suppressor gene: SMAD4 MEN 1 NF1 NF2
SMAD4: 18q21.2, DNA binding protein (signal transduction TGF-B), Pancreatic cancer MEN 1: 11q13.1, Menin, MEN1 NF1: 17q11.2, Neurofibromin (Ras GTPase activating protein), Neurofibromatosis type 1 NF2: 22q12.2, Merlin (Schwannomin), Neurofibromatosis type 2
86
Tumor Suppressor gene: TSC1 TSC2 VHL WT1 WT2
TSC1: 9q34.13, Hamartin protein, Tuberous sclerosis TSC2: 16p13.3, Tuberin protein, Tuberous sclerosis VHL: 93p25.3, (Degredation of hypoxia-inducile-factor 1a), Von Hippel Lindau disease) WT1: 11P13, tRANSCRIPTION FACTOR (Urogen development), Nephroblastoma (Wilms tumor) WT2: 11p15.5, transcription factor (urogen development), Nephroblastoma
87
Radiation: Nonionizing radiation VS Ionizing radiation
Nonionizing radiation: UV-B = Skin cancers Ionizing radiation: X-rays, Gamma rays = Leukemias, Papillary thyroid cancer, Osteosarcoma, Liver angiosarcoma
88
Oncogenic infections: EBV (Epstein Barr Virus) HBV HHV HHV8 HPV16
EBV: Burkitt lymphoma Hodgkin lymphoma Nasopharyngeal carcinoma Oral hairy leukoplakia Primary CNS lymphoma in immunocompromised patients Gastric carcinoma HBV: Hepatocellular carcinoma HHV-8: Kaposi sarcoma HPV-16 & 18 E6 inhibits TP53 E7 inhibits RB1 Squamous cell carcinoma (urogenital)
89
Oncogenic infections: HTLV-1 HCV
HTLV-1: Adult T-cell Leukemia HCV: Hepatocellular carcinoma
90
Oncogenic infections: Schistosoma haematobium Clonorchis Sinensis (Chinese liver fluke) H.Pylori Streptococcus bovis
Schistosoma haematobium: Squamous cell carcinoma bladder Clonorchis Sinensis (Chinese liver fluke): Cholangiocarcinoma, MALT Lymphoma H.Pylori: Colorectal cancer Streptococcus bovis
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Tumor growth grading G1 G2 G3 G4 Gx
G1: Well-differentiated (low grade) G2: Moderately differentiated (intermediate) G3: Poorly differentiated (high grade) G4: Undifferentiated/anaplastic (high grade) Gx: Differentiation can't be assessed
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Tumor stages T N M
T: size/direct extent of primary tumor N: Involves lymph nodes M: metastasis
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Dronabinol Mirtazapine Megestrol acetate
D: For Chemotherapy induced nausea & vomiting M: For insomnia & depression-related anorexia in cancer treatment M: Progesterone analogs & corticosteroids are appetite stimulants

Biochemistry SJSM (9 decks)

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