Crystal Arthropathies Flashcards

(48 cards)

1
Q

which base is N-containing single ring structure

A

pyrimindine

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2
Q

which base is N-containing double ring structure

A

purine

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3
Q

which nucleotides are purines

A

A and G

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4
Q

which nucleotides are pyrimidines

A

C, T, and U

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5
Q

difference in DNA and RNA for nucleotides

A

DNA has T and RNA has U

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6
Q

what are the two pathways to synthesize purines?

A

de novo synthesis pathway and salvage pathway

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7
Q

explain the de novo pathway to synthesize purines

A

Glutamine is used to transfer an N to PRPP, then a base is built on the N, the nucleotide product is inosine monophosphate (IMP)

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8
Q

what is used in the de novo synthesis pathway?

A

glutamine

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9
Q

what is the nucleotide product of the de novo synthesis pathway

A

inosine monophosphate (IMP)

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10
Q

IMP can then be used to make what?

A

AMP or GMP
ATP to make GMP
GTP to make AMP

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11
Q

why is reciprocal control in the de novo synthesis useful?

A

Helps ensure you are not making all of one type of purine and not enough of the other

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12
Q

what purine base is made from the de novo synthesis pathway?

A

hypoxanthine

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13
Q

what does the salvage pathway use?

A

Uses hypoxanthine, guanine, and adenine bases that already exist

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14
Q

what are the two enzymes used in the salvage pathway?

A
  • hypoxanthine-guanine phosphoribosyl transferase
  • adenine phosphoribosyltransferase
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15
Q

what does hypoxanthine-guanine phosphoribosyl transferase do?

A

catalyzes the addition of phosphoribose (sugar +P) from PRPP to:
- Hypoxanthine to make IMP
- guanine to make GMP

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16
Q

what does adenine phosphoribosyltransferase do?

A

catalyzes the addition of phosphoribose (sugar + P) from PRPP to:
adenine to make AMP

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17
Q

what is the pathway for pyrimidine nucleotide synthesis

A

de novo pathway

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18
Q

how is the de novo pathway different in pyrimidine than purine synthesis

A

in purimidine, it involves making an intermediate pyrimidine ring first, then attaching a ribose-5-P (via PRPP)

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19
Q

what are the substrates for the pyrimidine ring in pyrimidine synthesis

A
  • carbamoyl phosphate (made from glutamine, ATP, CO2)
  • aspartate
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20
Q

during the de novo pathway for pyrimidine, what is the nucleotide intermediate when the pyrimidine ring is attached to PRPP?

21
Q

how is CTP made from UMP

A

UMP is phosphorylated via kinases to make UTP, UTP is aminated to make CTP (glutamine provides the N)

22
Q

how to make dTMP from UMP

A

UMP is phosphorylated (kinase) to make UDP, then converted to dUMP, dUMP is methylated to dTMP using folate coenzyme

23
Q

what removes P’s from nucleotides to relase nucleosides

A

nucleotidases

24
Q

what happens when pyrimidine bases are degraded

A

cytosine to uracil and ultimately alanine

25
what happens when purine bases are degraded
first to xanthine, then uric acid, and then excreted in urine
26
what is the enzyme that converts hypoxanthine to xanthine, and xanthine to uric acid?
xanthine oxidase
27
what leads to gout?
hyperuricemia
28
what is hyperuricemia
underexcretion (most common) or overproduction (less common) of uric acid
29
what is chronic tophaceous gout
Nodular masses of monosodium urate crystals (tophi) may be deposited in soft tissues
30
what is the enzyme that is responsible for the degradation of uric acid?
uricase
31
what is gout?
joint inflammation due to deposition of urate crystals
32
what results in acute gouty arthritis?
monosodium urate crystal precipitation
33
in a patient with acute gout, how does the joint become inflamed
Urate crystals are phagocytosed by macrophages, activating them, they then release chemokines that attract neutrophils into the joint, found within the synovial fluid, Neutrophils mediate joint inflammation
34
people with acute gout tends to have pain in which joints
1st metatarsal-phalangeal joint, insteps, ankles, heels, knees, wrists, elbows, finger, Lower limbs are more often affected than upper
35
Chronic gout leads to ?
chronic arthritis with joint erosion, chronic inflammation, development of pannus, and development of tophi
36
what is the pathognomonic hallmark of gout
tophi
37
what are tophi
uric acid crystals that accumulate in and around the affected joint
38
how does Lesch-Nyhan Syndrome happen?
deficiency of HGPRT
39
Lesch-Nyhan Syndrome can lead to?
hyperuricemia because increase in uric acid
40
what is calcium pyrophosphate crystal deposition disease (CPPD) also known as ?
pseudogout
41
most cases of pseudo gout are?
sporadic
42
what causes pseudogout?
caused by the buildup of calcium pyrophosphate crystals in the joints, macrophages phagocytose the crystals, recruiting neutrophils and causing inflammation
43
what is used to distinguish what type of arthritis a person has?
synovial fluid analysis
44
what are the 3 C's when doing the synovial fluid analysis
Crystals Cells Culture
45
when the cells (seen in synovial fluid analysis) are super high, it's usually what
septic arthritis
46
what are some anti-gout agents
- target the inflammation (corticosteriods and colchicine) - analgesics (NSAIDs) - decrease uric acid production - increase uric acid excretion
47
how does colchine effect inflammation
Blocks the migration of leukocytes (most importantly neutrophils), thereby decreasing the inflammatory response
48
what is the most serious adverse effect of colchine
bone marrow depression