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BMS 150 2.0 > Rheumatology 3 - Crystal Arthropathies > Flashcards

Rheumatology 3 - Crystal Arthropathies Flashcards

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1
Q

what does a nucleoside contain?

A

sugar + base

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2
Q

what is the sugar in a nucleoside?

A

5-C ribose (RNA) or deoxyribose (DNA)

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3
Q

what is a nitrogenous base?

A

N-containing single or double ring structure

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4
Q

what is a single ring nitrogenous base?

A

pyrimidine

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5
Q

what is a double ring nitrogenous base?

A

purine

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6
Q

what are the purines?

A

A & G

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7
Q

what are the pyrimidines?

A

C, T, U

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8
Q

Which pyrimidine is only found in RNA?

A

uracil

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9
Q

which pyrimidine is only found in DNA?

A

thymine

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10
Q

What does a nucleotide contain?

A

nucleoside + 1-3 phosphates

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11
Q

what is the pathway where you make the nucleotides and purine bases from scratch?

A

De Novo Pathway

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12
Q

What is the role of glutamine in purine nucleotide biosynthesis involving PRPP?

A

Glutamine donates a nitrogen (N) to PRPP, resulting in a phosphoribose (sugar + phosphate) structure with an added nitrogen.

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13
Q

the base is built on what? in the de novo synthesis

A

N of the phosphoribose

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14
Q

what supplies the C, H, O, and N in the De novo synthesis?

A

Amino acids: Glutamine, glycine, aspartate.

CO₂: Adds a carbon.

Folate (tetrahydrofolate): Provides extra carbon atoms.

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15
Q

what is the nucleotide product after the base has been added

A

inosine monophosphate (IMP)

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16
Q

IMP contains the purine base ?

A

hypoxanthine

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17
Q

IMP can then be used to make ?

A

AMP or GMP

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18
Q

what is used to make AMP

A

GTP (requires aspartate)

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19
Q

what is used to make GMP

A

ATP (requires glutamine)

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20
Q

what type of control is this called when GTP make AMP and ATP make GMP

A

Reciprocal control

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21
Q

why is reciprocal control useful in making AMP and GMP

A
  • Balances AMP and GMP levels
  • Saves energy
  • Supports cell function – ATP powers most cell activities, GTP is critical for protein synthesis and signaling
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22
Q

what is the pathway that recycles existing purine bases and create nucleotides?

A

salvage pathway

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23
Q

what does the salvage pathway use to make nucleotides?

A

uses hypoxanthine, guanine, and adenine bases that already exist

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24
Q

where does the already existing bases coming from for the salvage pathway?

A

diet or breakdown of DNA and RNA from dead cells

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25
what are the key enzymes in the salvage pathway?
- hypoxanthine-guanine phosphoribosyl transferase (HGPRT) - Adenine phosphoribosyltransferase (APRT)
26
what does the hypoxanthine-guanine phosphoribosyl transferase
catalyzes the addition of phosphoribose from PRPP to: - Hypoxanthine to make IMP - Guanine to make GMP
27
in the salvage pathway, what enzyme takes hypoxanthine and make IMP
Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
28
in the salvage pathway, what enzyme takes Guanine and make GMP
Hypoxanthine-guanine phosphoribosyl transferase (HGPRT)
29
what does the adenine phosphoribosyltransferase do?
catalyzes the addition of phosphoribose from PRPP to adenine to make AMP
30
in the salvage pathway, what enzyme takes adenine and make AMP
adenine phosphoribosyltransferase
31
IMP converts to what?
inosine and then hypoxanthine
32
hypoxanthine is further broken down to ? and then ?
xanthine uric acid
33
what is the enzyme that converts xanthine to uric acid?
xanthine oxidase
34
GMP is broken down into ?, which follows the same pathway as ?
guanine hypoxanthine
35
AMP is broken down into ? and ?
inosine and enters the catabolic pathway via hypoxanthine.
36
what is the end product of purine catabolism in humans?
uric acid
37
excess uric acid can lead to ?
hyperuricemia, gout, or urate kidney stones
38
HGPRT deficiency causes ?
Lesch-Nyhan syndrome
39
In pyrimidine nucleotide synthesis, what is built first—the ring or the ribose sugar?
The pyrimidine ring is synthesized first, then attached to ribose-5-phosphate via PRPP.
40
How does pyrimidine synthesis differ from purine synthesis?
Pyrimidines are synthesized as a ring first and then attached to ribose-5-P, whereas purines are built directly on the ribose-5-P.
41
What are the main substrates used to form the pyrimidine ring in de novo synthesis?
Carbamoyl phosphate and aspartate.
42
What molecules are needed to form carbamoyl phosphate for pyrimidine synthesis?
Glutamine, ATP, and CO₂.
43
What is another biological use of carbamoyl phosphate besides pyrimidine synthesis?
It is used in the urea cycle to help eliminate ammonia by forming citrulline in the liver.
44
what is a crucial building block for RNA and also plays a role in lipid biosynthesis?
CTP
45
How is CTP produced?
- UMP is phosphorylated via to make UTP by specific enzymes called kinases. - UTP is aminated to make CTP
46
when making CTP, UTP is aminated to make CTP, what supplies the N
Glutamine
47
what is the enzyme that adds the N to UTP to make CTP?
CTP synthetase
48
how to make dTMP?
- UMP is first phosphorylated (kinase) to make UDP, then converted to dUMP - dUMP is methylated to dTMP using a folate coenzyme called thymidylate synthase
49
dTMP is a precursor for ?, one of the 4 nucleotides required for DNA synthesis
thymidine triphosphate (dTTP)
50
what remove P's from nucleotides to release nucleosides?
nucleotidases
51
Pyrimidine base degraded: Cytosine is broken down into ?, which is eventually converted into ?
uracil alanine
52
Pyrimidine base degraded: Thymine is broken down into ?
aminoisobutyrate
53
Purine bases degraded: Purines are first converted to ? and then to ?.
xanthine uric acid
54
Conversion of hypoxanthine to xanthine, and xanthine to uric acid, uses the enzyme ?
xanthine oxidase
55
what can lead to gout?
hyperuricemia
56
what is GOUT?
Deposition of monosodium urate crystals in the joints -> immune cells mount an inflammatory response to crystals
57
in gout, Nodular masses of monosodium urate crystals (tophi) may be deposited in soft tissues known as ?
chronic tophaceous gout
58
what is Uric acid stones can form in the kidneys
urolithiasis
59
what is the enzyme responsible for the degradation of uric acid
uricase
60
simple term gout =
joint inflammation due to deposition of urate crystals
61
gout is either caused by which two causes
- increased uric acid production - decreased uric acid excretion
62
what is the pathognomonic hallmark of gout?
tophi
63
what are tophi
Large, inflammatory bodies that surround areas of crystal deposition
64
tophi consists of what?
macrophages and lymphocytes
65
what is the most common place to have gout?
1st metatarsal-phalangeal joint
66
what is a deficiency of HGPRT called?
Lesch-Nyhan syndrome
67
lesh-nyhan syndrome leads to what?
hyperuricemia
68
deficiency of HGPRT leads to accumulation of hypoxanthine and guanine, which break down into ?
uric acid
69
deficiency of HGPRT leads to PRPP also accumulates and stimulates production of purine nucleotides, which ultimately break down into ?
uric acid
70
calcium pyrophosphate crystal deposition disease is also known as ?
pseudogout
71
why is synovial fluid analysis done?
It is not always easy to distinguish between septic arthritis, gout, pseudogout, hemarthroses and rheumatic joint diseases
72
when is synovial fluid analysis done?
Suspicion of an infectious arthritis, flare of crystal arthritis, or hemarthrosis
73
for synovial fluid analysis, you analyze the 3 C's which are?
Crystals Cells Culture
74
what is a good drug to target the inflammation?
corticosteriod
75
what is a good drug specific for gout?
colchicine
76
what is something that can decrease uric acid production?
allopurinol
77
what is something that can increase uric acid excretion?
Uricosurics
78
what is the mechanism of action of colchine?
Binds tubulin and prevents microtubule polymerization
79
what is the most serious adverse effects of colchine?
bone marrow depression
80
what is allopurinol
It is a competitive inhibitor of xanthine oxidase, preventing the formation of uric acid.
81
Typically give ? at beginning of allopurinol therapy to reduce pain
aspirin
82
what is the mechanism of action of uricosurics?
Block tubular reabsorption of uric acid, increasing excretion

BMS 150 2.0 (17 decks)

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