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83 Cards in this Set

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Free radicals

Infections


Neutrophils

Cause

MOST rapidly dividing cells

Growth (pregnancy, childhood, puberty)

Periods

B12 def

Methylmalonic ac in urine


Neuropathy


Ch state (yrs to be depleted)

Syphilis

Anterior bowing of legs

Vit K inhibition

Cefamandole


Cefotetan


Cefoperazone


Moxalactam

Cephalosporins

Smallest aa

Glycine

Proline

ONLY Imino acid

Sickle cell anemia

Val for glu

HbC Dz

Lys for glu

Statins SE

Myositis


Hepatitis


Increase liver enz's

X-linked enz's def's

G6PD: glu-6-Pase


CGD: NADPH


Pyruvate DHSE


Fabry's: @-galactosidase


Hunter's


Lesch-Nyhan: HPRT

Newborn screening

PKU


Congenital adrenal hyperplasia


Biotidinase


Galactosemia


Hypothyroidism

Steroids

Inhibit macrophage migration


Kill T-cells & eosinophils


Inhibit phospholipase A


Inhibit mast cell degranulation


Stabilizes endothelium


Stimulate protein synthesis

Low volume state

Decrease K+, Na+, Cl-


Increase pH & BP

B12

Methyl malonyl CoA mutase


Homocysteine methyl transferase

B vit's

B1 = thiamine (Beriberi, Wernicke's, Korsakoff)


B2 = riboflavin (angular stomatitis)


B3 = niacin (pellagra - 4 D's)


B4 = lipoic ac


B5 = pantothenic ac


B6 = pyridoxine (seizures)


B9 = folic ac


B12 = cobalamine (pernicious anemia, neuropathy)

Mast cells

Histamine


SRS-A


ECF of anaphylaxis

Eosinophil

Histaminase


Aryl-sulfatase


Heparin

Increase cholesterol

Xanthomas on extensor surfaces


Increased risk for CAD

Increase TGCs

Xanthelasmas on eyelids & face


Increase risk of pancreatitis

Trinucleotide repeats

Huntington's


Fragile X


Myotonic Dystrophy


Spinal/bulbar muscular atrophy


Friederick's ataxia


Prader Willi

Gluconeogenesis ONLY

Pyruvate DHSE


PEP carboxykinase


Fru-1,6-Pase


Glu-6-Pase

Enz's

ONLY in glycolysis

Hexokinase


PhosphoFructoKinase (PFK) 1


Pyruvate kinase

Enz's

Elastase

S. aureus


Pseudomonas

Electron Transport Chain (ETC)

I = Amytal, rotenone


II = malonate


III = antimycin


IV = CN, CO, chloramphenicol


V = oligomycin

ETC uncouplers

Chemical = DNP, free Fa's


Physical = aspirin

aa's in/out of Krebs

Pyruvate = gly, ala, ser


Acetyl CoA = phe, ile, thr, tyr, lys, leu


@KG = glu, gln


Succinyl CoA = phe, trp, tyr


Fumerate = pro


OAA = asp, asn

aa def's

PKU = phenylalanine hydroxylase


Maple Syrup Dz = branched aa's (leu, lys, val)


Cystinuria = cystathione synthase

aa

alanine = ala


arginine = arg


asparagine = asn


aspartate = asp


cysteine = cys


glycine = gly


glutamine = gln


glutamate = glu


histidine = his


isoleucine = ile


leucine = leu


lysine = lys


methionine = met


phenylalanine = phe


proline = pro


serine = ser


tryptophan = trp


threonine = thr


tyrosine = tyr


valine = val

aa

acidic = asp, glu


basic = arg, lys


sulfur bonds = cys, met


O-bonds = ser, thr, trp


N- bonds = asp, gln


branched = leu, ile, val


aromatic (bulky) = phe, thr, trp


smallest = gly


bends = pro


ketogenic = lys, leu


gluco- & keto- genic = phe, ile, thr, trp


ONLY glucogenic = his, arg, glu, asp, gln, asn, tyr, cys, pro, met, val, ala, gly

Essential aa's

Phe Trp His


Val Ile Arg


Thr Met Leu


Lys



phe def = tyr essential


met def = cys essential

Restriction enz's

Cut to the Rt


trypsin = arg, lys


chymotrypsin = phe, tyr, trp


elastase = gly, ser, ala


mercaptoethanol = met, cys


aminopeptidase = amino terminal


cyanobromide = met



Cut to the Lt


carboxypeptidase = carboxy terminal

Cofactors for pyruvate DHSE, @KG DHSE & branched chain DHSE

B1 = TPP


B2 = FAD


B3 = NAD


B4 = lipoic ac


B5 = CoA

XLR

CGD = NADPH oxidase def


G6PD


Lesch-Nyhan


Pyruvate DHSE def


Fabry's


Hunter's


Burton's agammaglobulinemia


Duchenne's muscular dystrophy


Color blindness


Hemophilia

XLD

Huntington's


Vit D resistant rickets

Glycogen synthesis

Glycogen synthase


Branching:


Glycogen @-1,4-glycosyltransferase


Glycogen @-1,6-glycosyltransferase

Enz's

Glycogenolysis

Phosphorylase


Debranching enz


@-1,6-glucosidase


Phosphatase

Enz's

HAD

Male = female


Heterozygous have manifestation


Transmitted by either parent


Delayed onset (adult)


Vertical transmission


Decrease penetrance & variable expressivity


Structural defects

HAR

Parents NOT affected


Seen in siblings & uncles


Early onset (child)


Manifests when BOTH alleles mutated


Horizontal transmission


Enz defect

Mitochondrial

Mother pass Dz ONLY


ALL offspring affected


CNS, <3 & sk. m. affected

Hypercholesterolemia

Provastatin


Atorvastatin


Lovastatin


Simvastatin

HMG CoA reductase inhibitors

ASA

COX irreversible inhibitor

Metronidazole

Increase free radicals prod

Valproic ac

Inhibit Na+ & Ca2+

Amyloidosis

AL = Ig light chain


1ry amyloidosis


MM



AA = unique N-terminal


Ch active Dz


Hodgkin's



Pre-albumin/transthyretin = single aa substitution


Hereditary neuropathy, nephropathy & cardiopathy



AB = B2-microglobin


Cerebral art amyloid


Alzheimer's


Down



AE = endocrine


Aging



AP = assoc w/ ALL

Coumadin & Heparin

Coumadin Heparin


Extrinsic Intrinsic


Tissue Blood


PT PTT


2, 7, 9, 10 3


PO IV


8-10 hr Immediate


Teratogenic Pregnants OK


Inhibit vit K de- DOC for DVT


pendent factor

HLA

IDDM-1 = DR3, DR4


Pernicious anemia = DR5


Hemochromatosis = A3


21-@-hydroxylase def (vit D) = BW47

Niacin (B3)

Decrease VLDL prod in liver

Sulfonylureas

1st gen = inhibit K+ channels in islet cells



2nd gen = inhibit gluconeogenesis in liver

Miglitol/ascarbose

Inhibit glucose absorption in GIT

Metformin

STOP gluconeogenesis in liver

Troglitazone

Increase insulin receptors sensitivity

Inhibit Na+ & Ca2+

Valproic ac


Carbamazepine

When vit A is used?

Measles


CA


Infections


Burn

Vit B3 = Niacin

Increase metabolism


Increase HDL


SEs: flushing


Itching (PGs - histamine release by mast cells) - Give ASA prophylactically


Insulin resistance (DM-2)


Gout (competes w/ uric ac)



Carcinoid synd

Mets to liver


5-HT in urine - overuse of trp


Decrease vit B3


2ry pellagra

Increase HDL

Exercise


Niacin


Estrogen


Moderate R-OH


Genetics

Antioxidants

Vit E = blood


Vit C = GIT


Vit A = mild

Factor V (Leiden) mutation

MCC spontaneous venous clot


Give warfarin for LIFE!

Autosomal Dominant

Structural Dz


1 parent w/ Dz = 1/2 chance


Both parents w/ Dz = 3/4 chance


NO carrier = ONLY 1 gene needed to express


Incomplete penetrance = has gene BUT NO Dz


Variable expression = same gene in family members BUT look different

Autosomal Recessive

MOST enzymes


Family Hx


Skip generation


Dz = 1/4


Carrier = 2/3

Barbiturates

Increase Cl- channel opening duration = GABA effects enhanced

Amitriptyline

DOC for ch neuropathy

Tetanus toxin

Blocks release of gly from sp cord = stronger muscle contractions = diaphragm locks up = Pt CAN'T breath

Lots of Disulfide bonds

Prolactin


Insulin


GH


Inhibin

PIGI hormones

Catecholamines

Dopamine


Epi


NE

trp in urine

Hartnup's

Kwashiorkor

Protein-calorie malnutrition

Enzymes that use Biotin

Carboxylases

MC CA in America

Skin

Has a lot of twists and turns

Hair


GIT


Vessel

Lots of Beta pleated sheets

Flat = skin, flat bones

Give Alzheimer Pts to prevent oxidation

Vit E

MEN-2 tumors

Medullary CA of thyroid


Pheochromocytoma

Lowest Km for ANY substrate

Brain

Where?

Effects of acidosis

GABA increase


Proteins denature


HypERkalemia


Kussmaul breathing

Myoglobin

ONLY in muscle


Weak acid

MC IBD in 1/2 age

Crohn's

Drug-induced lupus

Hydralazine


Isoniazid


Procainamide


Penicillamine


Phenytoin


Ethosuximide

MC COD while toxic

Resp failure

b/c of CNS depression

MC COD during w/drawal

Arrhythmias

Spleen fx's

Removes:


old RBCs


oddly-shaped RBCs


nuclear remnants (Howell-Jolly)


encapsulated org's (S. pneumoniae, HiB, meningococcus)

#1 reason for transfusion

Sxic anemia