metabolic cases.txt

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metabolic cases.txt
2010-10-21 21:24:53
metabolic cases

metabolic cases
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  1. What are three causes of hydrogen peroxide (Free radicals)?
    • 1) infection
    • 2) oxidant drugs
    • 3) fava beans
    • *Ultimately caused by G6PD deficiency so no NADPH is produced and hydrogen peroxide cannot be reduced utilizing glutathione
  2. How does high hydrogen peroxide due to G6PD deficiency help malaria patients?
    Malaria can't survive in RBC that are high in H2O2.
  3. What are the two sources of NADPH in cells w/mito and w/o mito?
    • w/ = Malic Enzyme
    • w/o = HMP shunt
  4. What two major organs does malic enzyme function?
    Liver and muscle (so it can compensate it's RBC with enough NADPH since there are mito to produce NADPH)
  5. What do RBC use to compensate for a lack of Hb in the blood?
    2,3 BPG to keep Hb in T-state to release more O2 to the blood
  6. At what percentage will Mb cause tissue hypoxia and cyanosis?
    Mb =/> 10% of Hb (this happens b/c Mb cannot release O2)
  7. What is deficient to cause increased Mb?
    Cytochrome-b-5 reductase
  8. Does methylene blue use NADH or NADPH to convert Mb to Hb?
    • NADPH (NADH has its own reductase cycle)
    • ***If you have a G6PD deficiency you cannot change Mb to Hb through methylene blue due to the lack of NADPH
  9. What is the main energy source of the liver during short and long term fasting?
    S/L = Beta oxidation
  10. Energy for muscle in S/L fast?
    • S = Beta oxidation/ FA
    • L = Ketogenesis, Beta oxidation, BCAA
  11. Main source of glucose in S/L fast?
    • S = glycogenolysis/gluconeogenesis
    • L = gluconeogenesis
  12. What is Type I glycogen storage disease?
    • Inability to produce G6Pase to produce glucose
    • leads to hyperuricemia, hyperalanemia, hypoglycemia
  13. What enzyme brings carbamoyl-P into the urea cycle?
  14. What happens with extra ammonia after Urea uptake or lack of OTC?
    Ammonia gets taken up by glutamin synthetase to become glutamine