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28 Cards in this Set

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list the essential aa's
Private Tim Hall

PVT TIM _H(A)LL
phe val trp thr iso met his arg leu lys
what is special about his and arg
his=does not fulfill all criteria for being indispensible

arg = essential only under extreme circumstances
livr failure, want to increase or decrease aa consumption
decrease to avoid hepatic trauma
fractures, want to increase or decrease aa
increase
eating disorders, increase or decrease aa consimption
increase
uremia increase or decrease aa consumption
decrease, aa will be metabolized for energy or gluconeogenesis and nitrogen will be stripped off and incorporated into urea
how do you measure protein metabolism
BUN blood urea nitrogen
poor or high quality protein generates a higher BUN
poor, because wrong mix of aa's, excess aa's will be metabolized increasing blood urea nitrogen
where are proteins absorbed
abs as aa and di/tri peptides along entire small intestine, but more at proximal end
draw out dietary protein going from stomach to small intestine, and where enzymes come in
stomach - polypeptides unwound and partially degraded by pepsin and low pH

small intestine: enteropeptidase on brush border
pancrease secretes trypsin, chymotripsen, elastase, and carboxypeptidase in the zymogen form

peptides are cleaved to 40% free aa and 60% oligopeptides
how does absorption of free aa and oligopep's work
free aa - symport with Na

di and tri peptides = symport with H+
Uptake of aa from blood
mainly by liver, which catabolizes 57% converts 20% to protein and releases 23%

most released aa are BCAA

insulin decreases plasma BCAA by stimulating uptake in muscles
what are the primary energy sources of enterocytes?
what aa do enterocytes generate?
E = glutamine

generate = alanine
enterocytes synthesize
4
1) export proteins (apolipoprotein for lipoprotein formation)
2) glutathione - GSH
3) non essential aa's
4) intermediates of urea cycle
in a healthy adult if 100 g protein ingested, to be in balance, 100 g have to be excreted in stool(about 10) or catabolized(about 90)
aa are catabolized to CO2 and nitrogen, nitrogen=urea
1 gram of nitrogen comes from how many grams protein?
6.25
Nitrogen balance equation
Intake - (urine + Feces + skin)

Nitrogen balance =
protein N intake(g/24h) - (urinary urea N + 4g)
protein balance equation
protein intake(g) - [(urinary urea N + 4)X 6.25
a positive nitrogen balance means more intake or more loss
more intake

during periods of growth or pregnancy

negative during starvation sickness etc
PEM
Protein energy malnutrition: spectrum of states of malnutrition

Kwashiorker mildest in anthropomorphic changes
Marasmus more severe anthro changes
Kwashiorker
adapted or nonadapted starvation
adequate caloric intake?

major symptoms
non-adaptive starvation

caloric intake may actually be adequate or nearly adequate, protein intake is not

symptoms: EDEMA (intra and extracellular)
hair changes,
skin disorders,
hepatomegaly,
hypoalbumin
Kwashiorker
what happens to liver?
b/cms fatty because of increased FA synthesis

cant produce apolipoproteins for lipid transport cause no aa's
severe weight loss associated with chronic diseases like cancer is called?
cachexia
back to kwashiorker

muscle protein broken down or not?
non adaptive PEM

dietary carbohydrate insulin levels are maintained and muscle protein is not broken down to generate glucogenic amino acids

but DO have significant negative nitrogen balance
explain edema in kwashiorker, why do you get it
liver is unable to maintain blood levels of albumin, and osmotic balance is disturbed, causing fluid to accumulate in extracellular spaces
explain hepatomegaly in kwashiorker
Can't make aoplipoproteins(LDL etc), Triglyceride made in the liver cannot become packaged with protein for export, and accumulates in the liver.
how much protein is in human plasma
how much of this is albumin
7.5 g of protein per 100 ml

about 1/2 to 2/3 is albumin
how would you assess PEM
mild: 2.8-3.5 albumin g/Dl
moderate: 2.1-2.7
severe: less than 2.1