Chapter 6: Anabolic Pathways Flashcards
(149 cards)
1
Q
Do anabolic pathways happen in fed state or starvation state?
A
fed state (anabolic is building)
2
Q
lipids, proteins, glucose, ketones, glycogen, glucose: in what order are these broken down and in what order are they built back up
A
broken down: glucose, glycogen, protein, lipids, ketones
built up: same order as above
3
Q
What hormone allows us to take in glucose?
A
insulin
4
Q
What are the second messengers for insulin?
A
tyrosine kinase, parasympathetic cGMP
5
Q
What anabolic pathway does glucose activate and which catabolic pathway does glucose inhibit?
A
glucose activates glycogen synthesis and inhibits gluconeogenesis
6
Q
5 areas of glycogenesis
A
liver, skeletal muscle, adrenal cortex, intestinal wall and heart
7
Q
What are the only 2 organs that can use glycogen for glucose and put it into bloodstream?
A
liver and adrenal cortex
8
Q
What drug inhibits gluconeogenesis?
A
metformin
9
Q
Which diabetes drug blocks the voltage sensitve potassium channels and promotes insulin release?
A
sulfonylureas
10
Q
SE of sulfonylureas
A
hypoglycemia, sulfa drug reactions, SIADH (Chlorpropamide)
11
Q
Which DM2 drug blocks postprandial absorption of glucose?
A
alpha glucosidae inhibitors: acarbose, miglitol
12
Q
SE of alpha glucosidase inhibitors
A
abdominal pain, gas, bloating, nausea
13
Q
If a person is taking metformin, what must you do if he/she needs a contrast CT?
A
Stop metformin for a few days, then perform CT; if acute, stop metformin, give IV fluids and add NAC to protect kidneys.
14
Q
Name a few thiazolidinediones for DM2
A
pioglitazone, rosiglitazone
15
Q
Name a few incretin mimetics. What do they do?
A
exenatide, semaglutide: mimic incretins that are secreted by intestinal wall in response to food; potentiates insulin release, inhibits glucagon release, inhibit appetite and food intake (Ozempic)
16
Q
DPPP4 inhibitors
A
inhibits degradatoin of GLP-1; more insulin release, inhibit glucagon release
17
Q
two short acting insulin
A
regular and lispro
18
Q
two medium length insulins
A
NPH and lente
19
Q
two long acting insulin analogs
A
ultralente; glargine
20
Q
What kind of bonds are involved in glycogen chain?
A
alpha 1,4 bonds
21
Q
After 8 to 10 bonds on glycogen chain, what kind of bond is needed to branch the chain?
A
alpha 1,6 bond
22
Q
Which glycogen storage disease has only straight chains and no branching enzyme?
A
Anderson’s Disease
23
Q
What pathway makes ribose 5 phosphate used in DNA and RNA synthesis and NADPH as a byproduct?
A
pentose pathway (HMP shunt)
24
Q
What are the uses of NADPH?
A
DNA synthesis, fatty acid synthesis, RBC repair (glutathione)
25
What happens in G6PD deficiency?
cannot repair RBC; cannot protect against sulfur reactions
26
List the X-linked recessive enzyme deficiencies
GOLF PAATCHS
G6PD
OTC
Lesch-Nyhan (HGPRT)
Fabry's (alpha-galactosidase)
PRPP Synthetase
Adenosine Deaminase
Adrenoleukodystrophy (CAT-1)
Tyrosine Kinase
CGD (NADPH-oxidase)
Hunter's (iduronidase)
27
In alcoholics, what do you add to IV before administering glucose?
Thiamine! otherwise brain cells will swell and burst causing Wernicke's encephalopathy and Wernicke's aphasia
28
With GGT what is the product of this: carbon+ glutamic acid yields _______________
AA + alpha ketoglutarate
29
With AST what is the product of this: oxaloacetate + AA yields ___________
aspartate + carbons
30
With ALT what is the product of this: pyruvate + AA yields __________
alanine + carbons
31
What destroys all membranes?
alcohol
32
Why in alcoholics AST: ALT is 2:1
because the mitochondrial membrane is destroyed, both AST and GGT will leak out as well as one AST and one ALT from cell membrane, making AST:ALT 2:1 and GGT goes up
33
What does the COX pathway synthesize?
prostaglandins
34
What does the LOX pathway synthesize?
leukotreines
35
If you block the COX pathway which way will the pathway go?
to LOX and vice versa
36
5 things steroids do
IKISS
Inhibit Phospholipase A
Kills T cells and eosinophils
Inhibits macrophage migration
Stabilize mast cells
Stabilize endothelium
37
What does prostaglandin A2 do?
promotes platelet aggregation
38
What does prostaglandin E1 do?
vasodilator, keeps PDA open; Misoprostol: treatment of aspirin induced ulcers and abortifacient
Alprostadil; keeps PDA open
39
What does Prostaglandin E2 do?
Dinoprostone: labor induction, dilates cervix
40
What does Prostaglandin I2 do?
dilates pulmonary vessels; inhibits platelet aggregation
41
What does Prostaglandin F2 do?
responsible for dysmenorrhea (period cramps); separates placenta after fetal delivery, abundant in semen Specific PGF-2s Carboprost -abortifacient Latanoprost; --glaucoma med
42
Where is COX 1 found?
GI tract
43
Where is COX 1 and 2 found?
joints
44
Where is COX 2 found?
vascular endothelium
45
What are SRS-A (slow reacting substance of anaphylaxis)
leukotreines
46
Which cells make leukotreines?
mast
47
Which leukotreines are involved in anaphylaxis (SRS-A)?
LTC4, LTD4, LTE4
48
What breaks down slow reacting substance of anaphylaxis SRS-A?
aryl sulfatase
49
What is aryl sulfatase deficiency?
metachromatic dystrophy: ataxia, visual disturbance (bumping into furniture), learning impaired
50
What leukotriene along with IL-8 is a strong chemoattractant for neutrophils?
LTB-4
51
What is a clue for aspirin-sensitive asthma?
bronchoconstriction upon taking aspirin and nasal polyps
52
What is cinchonism?
thrombocytopenia, hearing loss (CN8); tinnitus
53
What medicine is classic for cinchonism?
aspirin
54
At the beginning of aspirin toxicity (within 20 min) what is the RR, pCO2, HCO3- and pH?
RR up; pCO2 down, HCO3-normal; pH high=respiratory alkalosis
55
between 30 - 60 minutes of aspirin toxicity?
RR up; pCO2 low, HCO3- Low, pH normal; respiratory alkalosis and metabolic acidosis
56
after 60 minutes GABA increases what is the RR, pCO2, HCO3-, pH
RR down; pCO2 up; HCO3-down; pH low mixed acidosis (anion gap acidosis)
57
Which medicine can close PDA?
IndomethiCin (C for close)
58
Which NSAID is topical?
Diclofenac, Ketoprofen
59
What is the main oral steroid?
prednisone
60
What is the main IV steroid?
methylprednisone
61
What is the DOC steroid to produce surfactant in premature delivery?
Dexamethasone
62
Best drug to take place of cortisol
hydrocortisol
63
best drug to take place of aldosterone
fludrocortisone
64
Which steroid is used to treat endometriosis?
Danazol (androgenic) SE: hirsutism, weight gain, insulin resistance
65
What is a 16 carbon fatty acid attached to C3 of G3P?
triglyceride
66
What is cellular marker for apoptosis?
phosphatidylserine
67
If an OH group is attached to C3 instead of phospate, what is it?
DAG used in IP3-DAG second messenger system
68
Which hypothalamic hormone does not use IP3-DAG system?
CRH
69
What are lacteals?
lymphatic channels for lipid absorption
70
Short, medium, long chain fattly acids, which first go into lacteals?
short and long
71
How can medium chain FA be absorbed?
attached to albumin, and can be absorbed even by IBD pts.
72
Which medicine blocks lateals and doesn't allow fat absorption?
Ezetimibe
73
What needs CII from HDL to transport long chain fatty acids to adipose?
VLDL
74
Which apolipoprotein is missing in apolipoproteinemia?
Apo B48
75
What is the deficiency in Type 1 dyslipidemia?
lipoprotein lipase deficiency
76
What is the deficiency in Type 5 dyslipidemia?
lipoprotein and CII deficiency
77
What is the deficiency in Gaucher Disease?
Glucocerbrosidase; macrophages look like crinkled paper
78
What is the deficiency in Fabry's disease?
alpha-galactosidase (X-linked recessive); cataracts; early renal failure
79
What is the deficiency in Krabbe's?
beta-galactocerbrosidase causing globoid bodies (macrophages swollen with sugar)
80
What is the deficiency in Tay Sach's?
Hexosaminidase A; cherry red macula, fine for first few years then regressive development
81
What is the deficiency in Sandhoff's?
Hexosaminidase A and B; cherry red macula, more severe than Tay-Sach's
82
What is the deficiency in Niemann-Pick?
shingomyelinase, cherry red macula, hepatosplenomegaly sets it apart from Tay Sach's or Sandhoff's
83
What is the deficiency in Matachromatic Leukodystrophy?
arylsulfatase deficiency; "childhood MS"; demyelinated plaques on LP; MRI shows demyelination
84
What is the deficiency in Hurler's?
alpha L iduronidase; Gargolye features; cataracts
85
What is the deficiency in Hunter's?
Iduronidase sulfatase; XL recessive, no cataracts
86
What is the deficiency in Metachromatic Leukodystrophy?
arylsulfatase deficiency; "childhood MS"; demyelinated plaques on LP
87
What enzyme do statins work on?
HMG-COA reductase
88
What is the remnant of VLDL and IDL?
LDL
89
What lipoprotein does LDL use to deposit cholesterol into tissues?
B-100
90
3 signs of common bile duct gallstone
pancreatitis, ALP up, WBC up and fever
91
What is the rate limiting enzyme for Urea cycle?
carbamoyl phosphate sythetase 1 (CPS-1)
92
If there is an enzyme deficiency early in the Urea cycle, what will you see in urine or plasma?
High ammonia
93
If there is an enzyme deficiency late in the pathway, what will you see?
serum pH is high (alkalotic); pyrimidines in the urine
94
MCC of liver failure?
NAFLD (alcohol #2)
95
Tx for liver failure
low protein diet (less than 2g/day); lactulose to flush out GI, NO fat-soluble drugs, P450 dependent drugs, benzos, barbs, GABA enhancers, alcohol
96
Glutamate cannot enter urea cycle, add another amine to it and turn it into glutamine to excrete in kidney, but kidney can only excrete 10%, eventually GABA rises, this is called ______
Hepatorenal Syndrome
97
If you want to add 1 sugar to anything what do you use?
UDP
98
If you want to add phospholipids what do you use?
CDP
99
What is the methyl donator in whole body except for nucleotides?
SAM
100
What is the methyl donor in nucleotides?
THF
101
3 ways to distinguish B12 from B9 deficiency:
B12 takes a longer time to deplete (years); B12 deficiency is associated with neuropathy; up methylmalonic acid in urine
102
If you want to silence DNA what enzyme can you use?
methylation (tightens DNA--methylation down with aging, more Gs and Cs)
103
If you want to loosen up DNA?
acetylation of histone (add A+T)
104
What happens to DNA upon UVB light?
form Thymidine dimers
105
What enzyme can snip out thymidine dimers?
UV endonuclease
106
What disease is associated with partial deficiency of UV light endonucleases?
Ecthyma or Ichthyosis
107
What disease is associated with complete deficiency of UV light endonucleases?
Xeroderma Pigmentosa
108
What disease is associated with too many DNA breaks from free radicals?
Ataxia Telangiectasia (spider veins, IgA def. ; malabsorption of GI
109
What is another name for Hereditary Non-polyposis colon cancer?
Lynch
110
If PRPP is high which path will it take?
De Novo, higher Km (needs more energy)
111
If PRPP is low which path will it take?
salvage, lower Km (needs less energy)
112
What is the rate limiting enzyme of Purine Pathway?
PRPP synthetase+
113
What three things are needed for membrane movement?
ATP,Ca, microtubules
114
Tx for acute gout?
indomethacin
115
best Tx for gout? and MOA
colchicine, blocks microtubules and interferes with cellular division and inflammatory cell mobility
116
best tx for gout if pt has renal failure
steroids (injected into affected joints) because indomethacin and colchicine are water soluble and toxic to kidney
117
best tx for chronic/recurring gout
allopurinol or Febuxostat (MOA: blocks xanthine oxidase)/ Probenicid (promotes uric acid excretion)
118
tx for chemotherapy pts with hyperuricemia?
fluids and allopurinol
119
What is the enzyme deficiency of Lesch-Nyhan Syndrome?
HGPRT deficiency; severe gout with self-mutilation
120
What's the difference between uracil and thymidine?
thymidine contains a methyl group (from THF)
121
What does 5 Flourouracil do?
inhibits thymidylate synthetase (break down pyrimidine synthesis--CA drug)
122
What disease is caused by adenosine deaminase deficiency?
SCID (2/3 XL; 1/3 AR IL2, !L7 defect)
123
Tx for SCID
bone marrow transplant
124
explanation of SCID
adenosine deaminase deficiency causes dATP levels to increase--ribonucleotide reductase activity decreases--DNA syntehsis decreases--rapidly dividing cells affected most (deplete bone marrow)
125
Any cancer ages 0-20 are usually caused by repressor genes or enhancer genes?
repressor; K-ALLA (ALL), Rb
126
What enhancer mutation can cause follicular lymphoma or Burkitt's lymphoma?
BCL2
127
What enhancer mutation can cause GI or Bone marrow cancers?
KRAS
128
What enhancer mutation can cause melanoma?
BRAF
129
Which ribosomes will make the proteins that stay in the cytoplasm?
free floating ribosomes
130
Which ribosomes make the proteins that will be secreted out of the cell?
fixed ribosomes (fixed to RER)
131
What is messenger RNA job?
transcribe DNA to mRNA, 3' end poly A tail, 5' end guanosine cap with methyl group
132
Which proteins are responsible for splicing out introns and bringing exons together posttranscriptionally?
SNRPs
133
Which RNA is used in translation?
transfer RNA
134
Which disease has anti-RNP?
mixed connective tissue (antibody against SNRPs)
135
Which enzyme replicates rRNA?
RNA polymerase I
136
Which enzyme helps replicate mRNA
RNA polymerase II
137
Which enzyme helps replicate tRNA and SNRPs?
RNA polymerase III
138
What is the start codon for tRNA?
AUG
139
What are the stop codons for tRNA?
UAA, UAG, UGA (u are away, u are gone, u go away)
140
Where does mRNA bind initiation factors IF-1, IF-2, IF-3 in prokaryotes? AGGAGG
Shine-Dalgarno sequence
141
Which antibiotic blocks initiation factors in prokaryotes?
aminoglycosides
142
Which two diseases are associated with EF-2 elongation?
diptheria, pseudomonas
143
Which antibiotics block translocase?
macrolides
144
Which kind of mutations often happen in diseases from birth/ early childhood?
frameshift
145
Which mutations are a change in one base at one point and occurs with a DNA base from same family (purine-purine) (pyrimadine-pyrimadine)?
transition mutation
146
Which mutations are a change in one base at one point but occurs from different DNA family? (purine --pyrimadine)
transversion mutation
147
Which mutation there is a change in one base but still codes for same amino acid and is asymptomatic?
silent mutation (HbC sub lysine for glutamic acid at position 6 of beta chain, asymptomatic)
148
What mutation changes in one base and now codes for different amino acid, i.e. in sickle cell)?
missense mutation (sickle cell, valine for glutamate)
149
Which mutation there is a change in one base and it becomes a stop codon?
nonsense mutation (occurs early in life)
