Ppal99 Dissecting The Usmle 1,2,3 Proteolysis/gluconeolysis/ppp

Front 1

LIPOLYSIS:

Back 1

Fats:
• Synthesis in cytoplasm
• Breakdown in mitochondria

Front 2

Fatty Acid =>AcetylCoA + PropionylCoA

Back 2

Activator: Glucagon
Inhibitor: MalonylCoA
enzyme is CAT 1

Front 3

Citrate Shuttle

Back 3

FA transport out of the mitochondria

Front 4

Carnitine Shuttle

Back 4

FA transport into the mitochondria

Front 5

Citrate Shuttle:

Back 5

• Feeds Acetyl CoA into fatty acid synthesis
• Citrate moves out to the cytoplasm via the citrate shuttle

Front 6

Carnitine Shuttle: what is it used for, commited step, deficiency

Back 6

Used for long chain fatty acids
Phosphorilation is the committed step
• Carnitine Deficiency: low energy state, fat build up in the cytoplasm

Front 7

βeta-Oxidation:

Back 7

The process where fatty acids are broken down to form Acetyl-CoA as an entry into the Kreb cycle.

Front 8

what happens when you loose fat? how many atp do you produce?

Back 8

=> Oh HOT!"
1) Oxidation:7 NADH => 21ATP
2) Hydration
3) Oxidation: 7 FADH2=> 14 ATP
4) Thiolysis: 8 AcCoA => 96 ATP

Front 9

cost how many atp to get back 131

Back 9

Costs 15 ATP, get back 131 ATP

Front 10

Ratio is about 9:1 what does this mean?

Back 10

that is why there are 9 calorie per gram of fat

Front 11

how can we store fat without gaining weight?

Back 11

Fat repels water, thus able to store a lot of fat without excess water weight

Front 12

Which layer of the abdomen has the worst wound healing?

Back 12

Adipose because it is always repelling water and has least amount of blood supply

Front 13

describe how ketones are made?

Back 13

1) AcCoA + AcCoA⇨ AcetoAcetylCoA
2) AcetoAcetylCoA + AcCoA⇨ HMG-CoA
3) HMG-CoA ⇨AcCoA +AcetoAcetate
4) AcetoAcetate ⇨ Acetone
5) AcetoAcetate⇨beta-OH Butyrate

Front 14

the rate limiting enzyme for ketogenesis

Back 14

HMG-CoA synthase

Front 15

what is measure on a dipstick for ketones

Back 15

Acetone is the only one able to be measured on a dipstick

Front 16

beta-OH Butyrate

Back 16

• Uses NADH cofactor
• crosses BBB
• hydroxy group-is less polar than a ketone group

Front 17

Glycogen: Glycogenolysis vs. Glycogenesis: why is the liver big?

Back 17

1 gram of Glycogen carries 2-3 grams of water

Front 18

how does glycogen maintain blood sugar levels?

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Glycogen= branched glucose polymer, maintains blood glucose levels
•α1,4 glycosidic bonds
• α1,6 branches (every 10 residues)

Front 19

lnsulin=>effects on glycogen

Back 19

glycogen synthesis

Front 20

epinephrine = >effects on glycogen

Back 20

glycogen breakdown

Front 21

G-6P=>Glycogen (enzyme)

Back 21

Glycogen synthase

Front 22

Glycogen =>Glucose (liver) or Lactate (muscle)

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Glycogen phosphorylase

Front 23

Von Gierke

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G6Pase deficiency ''von Gierke's Guts enGorged"

Front 24

Cori's

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Debranching enzyme deficiency "Cori is a short name"
Short branches of glycogen

Front 25

Anderson's

Back 25

Branching enzyme deficiency "Anderson is a long branching name"

Front 26

McArdel's disease

Back 26

muscle phosphorylase deficiency, muscle cramps during excercise, rhabdomyolisis
"McArdels muscles got messed up"

Front 27

pentose Phosphate Pathway:
Ribose-5P's job:

Back 27

Nucleotide synthesis

Front 28

NADPH's job

Back 28

FA synthesis, RBC membrane repair, kill bacteria

Front 29

PPP: G-6P⇨A⇨Ribose-5P + NADPH⇨B⇨F-6P + G-3P

Back 29

A:G-6PD
B: transketolase

Front 30

G-6PD: Glucose 6 Phosphate Dehydrogenase: RLE, activator and inhibitor

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• Rate limiting enzyme for Pentose Pathway
• Activator: Glucose-6P Phosphate
• Inhibitor: Ribose-5 phosphate

Front 31

G-6PD Deficiency: NADPH levels, ethnicity, MCC of what crisis, Drugs that oxidize RBC's, Peripheral smear

Back 31

• ⇩NADPH: hemolytic anemia, infection,
• More common in Mediteranians (protects them from-malaria),
• MCC of hemolytic crisis is 1. infection, 2. drugs,
• Drugs that oxidize RBC's: Sulfa drugs, Anti malarials, Metronidazole, INH,
• Peripheral smear: heinz bodies

Front 32

NADPH: when is it used?

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• Fatty acid Synthesis
• DNA synthesis
• RBC repair used by Glutathion

Front 33

Sources of NADPH:

Back 33

• 90% fom pentose phosphate Pathway
• 10% from OAA-converted to Pyruvate

Front 34

Ribose-5 Phosphate: function and deficiency

Back 34

nucleotide synthesis, Forms DNA for cellular division, Deficiency leads to poor wound healing