First Aid - Biochem 2

Front 1

Night blindness, Xeropthalmia (pathologic dryness of conjunctiva and cornea), Keratomalacia (wrinkling, clouding of cornea), Bitot's spots (dry silver gray plaques on bulbar conjunctiva)

Back 1

Vitamin A Deficiency

Front 2

Pseudotumor cerebri, dry and pruritic skin

Back 2

Vitamin A toxicity

Front 3

Vitamin A contraindicated in

Back 3

Pregnancy and Smokers (inc risk of lung cancer)

Front 4

Vitamin A Tx

Back 4

Measles and AML (M3 subtype)

Front 5

How to Dx Vitamin B1 deficiency?

Back 5

Inc in erythrocyte transketolase activity upon addition of thiamine

Front 6

Asian, nonspecific peripheral neuropathy, toe drop, wrist drop, MM weakness

Back 6

Dry Beriberi

o Beriberi – where polished rice is the major component of the diet
 Dry Beriberi
• Nonspecific peripheral neuropathy w/ myelin degeneration
• Toe-drop, wrist drop, and foot drop
• MM weakness, hyporeflexia, areflexia

Front 7

Asian, cardiomegaly, peripheral edema, deficiency

Back 7

Wet Beriberi

o Beriberi – where polished rice is the major component of the diet

Wet Beriberi
• Peripheral vasodilation  high output heart failure peripheral edema
• Cardiomegaly

Front 8

Alcoholic, nystagmus, ataxia, confusion, disorientation, memory loss

Back 8

Vitamin B1 - Thiamine Deficiency

o Wernicke-Korsakoff – Chronic alcoholism
 Ocular disturbances and nystagmus
 Gait ataxia
 Mental dysfunction (confusion, apathy, listlessness, and disorientation)
 Korsakoff psychosis: retrograde recall, inability to acquire new info, and confabulations ( the invention of fictitious detail about supposed past events [often to disguise an inability to remember past events])

Front 9

Old woman with dentures, dermatitis, cheilosis, glossitis, and anguular stomatitis

Back 9

Vitamin B2 - Riboflavin Deficiency

o Dermatitis
o Cheilosis – fissuring of the corners of the mouth
o Angular Stomatitis – inflammation fo the corners fo the mouth
o Glossitis (smooth, purple tongue)
o Note: Deficiency is especially common in denture wearers

Front 10

Excess Vitamin B3

Back 10

Niacin
- Facial flushing
- Tx hyperlipidemia

Front 11

Corn farmer, with diarrhea, memory loss, and skin rash

Back 11

Vitamin B3 - Niacin Deficiency

o Pellagra: Dermatitis, Diarrhea, Dementia (possible death)

Front 12

Dermatitis, enteritis, alopecia, adrenal insufficiency

Back 12

Vitamin B5 - pentothenate deficiency

Front 13

Isoniazid (INH) can lead to a deficiency in what to vitamins?

Back 13

B3 (niacin) and B6 (pyridoxine)

Front 14

Convulsions, peripheral neuropathy, Chelitis, Dermatitis

Back 14

Vitamin B6 - Pyridoxine deficiency

• Signs of B6 deficiency are the same as B2 (riboflavin) deficiency + convulsions, hyperirritability, and peripheral neuropathy
• Riboflavin Deficiency (Vitamin B2)
o Dermatitis
o Cheilosis – fissuring of the corners of the mouth
o Angular Stomatitis – inflammation fo the corners fo the mouth
o Glossitis (smooth, purple tongue)
o Note: Deficiency is especially common in denture wearers

Front 15

Body builder who eats egg whites for breakfast, lunch and dinner starts loosing his hair and develops a skin rash and diarrhea.

Back 15

Vitamin B7 - Biotin deficiency

Front 16

How much folate supplements if
- sexually active
- high-risk pregnancy for neural tube defects

Back 16

.4mg/day - sexually active
4g/day - high-risk pregnancy for neural tube defects

Front 17

Test to determine VItamin B12 deficiency etiology

Back 17

Schilling Test

Front 18

Which vitamin facilitates iron absorption

Back 18

Vitamin C (ascorbic acid)

Front 19

Swollen gums, bruising, hemarthrosis, anemia, poor wound healing

Back 19

Vitamin C deficiency

Front 20

N, V, Diarrhea, fatigue, sleep problesm

Back 20

Vitamin C excess

Front 21

Sarcoidosis causes excess of what vitamin

Back 21

Vitamin D

Front 22

proximal M weakness, peripheral neuroapthy, and ataxia

Back 22

Vitamin E deficiency

Front 23

Bone disorders with normal Ca, phosphate, ALP, and PTH

Back 23

Ostseoporosis and Osteopetrosis

Front 24

Dec Ca and PO4; Inc ALP and PTH

Back 24

Osteomalacia/Ickets

Front 25

Dec Ca, Inc PO4, Inc PTH

Back 25

Renal insufficiency

Front 26

Inc Ca and PO4, Dec PTH

Back 26

Vitamin D intoxication

Front 27

Inc Ca, Dec PO4, Inc ALP and PTh

Back 27

Primary hyperparathryoidism or Osteitis Fibrosa Cystica

Front 28

Nl Ca, PO4, and PTH; Inc ALP

Back 28

Paget Dx

Front 29

Neonate w/ jaundice, inc PT and inc PTT

Back 29

Vitamin K deficiency

Front 30

Infertility, depressed mental fxn, rash around eyes, mouth, nose, anus, dec healing time

Back 30

Zinc Deficiency

• Deficiency
o Delayed wound healing
o Decrease immune response
o Rash around the eyes, mouth, nose, anus – Acrodermatitis enteropathica
o Anorexia, Diarrhea
o Impaired night vision
o Growth retardation in children
o Depressed mental fxn
o Infertility

Front 31

Fomepizole (Use, MOA)

Back 31

- Inhibits alcohol dehydrogenase
- Antidote for methanol or ethylene glycol poisoning

Front 32

Disulfiram (MOA)

Back 32

Inhibits acetalaldehyde dehydrogenase
--> Hangover Sxs

Front 33

Methanol causes

Back 33

Metabolic acidosis & Retinal damage/blindness

Toxic substance b/c it is metabolized to formaldehyde

Front 34

Ethylene glycol causes

Back 34

Metabolic acidosis, kidney damage, heart and lung toxicity, and CNS problems

It is metabolized to oxaloacetate --> oxalate crystals prcipitate --> kidney damage

Front 35

Small child, swollen belly, Skin lesions, edema, liver malfunction (fatty change due to dec apo B-100)

Back 35

Kwashiorkor - protein deficiency

Front 36

2yo w/ inc ab girth, failure to thrive, and skin/hair depigmentation

Back 36

Kwashiorkor

Front 37

MM wasting, loss of subcutaneous fat and variable edema

Back 37

Marasmus - misssing everything; malnutrition

Front 38

Refeeding Sx

Back 38

Giving back nutrients and electorlytes to fast --> arrhythmias and neuro problems
- Go slow
- milk is good

Front 39

Fisherman develops peeling of fingertiips, ab pain, neuro problems

Back 39

Mercury poisoning

Front 40

Arsenic poisoning
- Aucte
- Chronic

Back 40

Acute - multisystem organ failure b/c ATP production is disrupted

Chronic - cancer in every tissue

Front 41

Cadmium poisoning

Back 41

Obstructive lung disease
inc risk of lung cancer
osteoporosis
Osteomalacia

Front 42

Rate Limiting Step - Glycolysis

Back 42

Phosphofructokinase-1

Front 43

Rate Limiting Step - GLuconeogenesis

Back 43

Fructose 1-6-bisphosphatase

Front 44

Rate Limiting Step - TCA cycle

Back 44

Isocitrate dehydrogenase

Front 45

Rate Limiting Step - GLycogen synthesis

Back 45

GLycogen synthase

Front 46

Rate Limiting Step - GLycogenolysis

Back 46

Glycogen phosphorylase

Front 47

Rate Limiting Step - HMP shunt

Back 47

GLucose 6 phosphate dehydrogenase

Front 48

Rate Limiting Step - De novo pyrimidine syntehsis

Back 48

Carbamoyl phosphate synthetase II

Front 49

Rate Limiting Step - De novo purine syntehsis

Back 49

Gluatmine PRPP amidotransferase

Front 50

Rate Limiting Step - Urea cycle

Back 50

Carbamoyl phosphate syntehtase I

Front 51

Rate Limiting Step - Fatty acid syntehsis

Back 51

Acetyl Coa Carboxylase

Front 52

Rate Limiting Step - Fatty acid oxidation

Back 52

Carnitine Acyltransferase I

Front 53

Rate Limiting Step - Ketogenesis

Back 53

HMG-CoA Synthase

Front 54

Rate Limiting Step - CHolesterol syntehsis

Back 54

HMG0CoA reductase

Front 55

Regulators - Glycolysis

Back 55

Stimulate
- AMP
- Fructose 26 Bp

Inhibit
- ATP
- Citrate

Front 56

Regulators - Gluconeogenesis

Back 56

Stimulate
- ATP

Inhibit
- AMP
- Fructose 2,6 BP