Term
| What is unique for Vitamin A? |
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Definition
| Night vision and cofactor for parathyroid hormone. Also a mild antioxidant. |
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Term
| When PTH has a problem then Calcium and Phosphate levels will be opposite, but when will it be in the same direction? |
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Definition
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Term
| Is calcium always in the direction of parathyroid hormone? |
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Definition
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Term
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Definition
| An increase in CSF from taking in too much Vit. A (NB that a lack of vitamin A will give u less CSF but that is asymptomatic) |
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Term
| If you want cells to mature faster what do you give ur pts? |
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Definition
| Vit. A as it helps with cell maturation |
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Term
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Definition
| Moans, Growns, Bones & Stones |
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Term
| Vitamin B1/ Thiamine is need for 4 important enzymes, which are? |
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Definition
| Pyruvate Dehydrogenase, Alpha ketogluterate Dehydrogenase, Branched Chain A.A Dehydrogenase, Transketolase |
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Term
| Thiamine deficiencies are seen mostly in which kind of pts? |
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Definition
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Term
| Thiamine Deficiency cause what 3 things? |
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Definition
| Beriberi (biventricle dilation of the heart - as it needs the 3 enzymes to function); Wernicke's Encephalopathy; Wernicke-Korsakoff syndrome |
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Term
| What is the difference btw dry and wet beriberi? |
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Definition
| Its dry until there is heart failure and thus fluid backup and enter the lungs. |
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Term
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Definition
| The inability to understand wirtten or spoken language because the posterior tomporal lobe (the wernicke's area) is affect as it is in Wernicke's encephalopathy. |
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Term
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Definition
| Is in the posterior frontal lobe and its responsible for Expressive! |
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Term
| What are the mammillary bodies responsible for? |
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Definition
| Converting short-term memory into long-term memory (eg remembering what u did yesterday) thus leading to confabulation (making shit up) |
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Term
| Vitamin B2/ Riboflavin is? |
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Definition
| Used to make the cofactors (FAD), best source is in milk but the sun breaks it down thus now milk is in cartons and not in bottles where the sun can get to it. |
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Term
| Riboflavin deficiency gives you? |
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Definition
| Fissures in the corners of ur mouth (Angular Cheilosis) |
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Term
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Definition
| Needed for alot of cofactors (NAD, NADH, NADP, NADPH) and for all 3 of the dehydrogenase |
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Term
| Niacin deficiency gives you? |
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Definition
| Pallegra (the 4 D's: Diarrhea, Dermatitis, Dimentia, Death) and Hatnup's Dz (like pellegra but is a defect in renal transport of tryptophan which normally converts to Niacin) |
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Term
| Vitamin B4/ Lipoic acid & Vitamin B5/ Panthotenic acid (used in anything that has CoA)? |
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Definition
| Is needed for the dehydrogenases but there is no deficiency state. NB that these 2 vitamins are found in anything, even kissing ur gf!!! |
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Term
| Vitamin B6/ Pyridoxine is? |
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Definition
| Needed to make heme thus giving you NEUROPATHY!!! Also needed by all enzymes that end in transaminases |
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Term
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Definition
The first vitamin to run out when u have rapidly dividing cells. Is also used to make tetrahydrofolate (THF) via Dihydrofolate reductase from which you make purines/ A.A's/ Thymidine
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Term
| Dihydrofolate reductase inhibitor is? |
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Definition
| A drug used for cancer pts to block folate. Same concept with sulfur drugs |
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Term
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Definition
| Megaloblastic anemia with hypersegmented neutrophils. Pregent women would also give their fetuses Neural Tube Defects. NB the most common cause is overcooked vegetables. |
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Term
| Vitamin B12/ Cyanocobalamin is? |
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Definition
| Need for 2 enzymes: Homocysteine methyltransferase (also need to make THF - Tetrahydrofolate) & Methylmalonyl-CoA mutase |
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Term
| Both folate and Vit. B12 help make THF independently thus how can an anemia of Vit. B12 be treated? |
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Definition
| By giving extra folate BUT if the B12 is not fixed then they come back with irreverible dementia (cause recall that methylmalonyl-CoA mutase is used to recycle odd-numbered carbon FA's, that includes myelin) |
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Term
| Folate and Vit. B12 Pathways |
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Definition
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Term
| Corticospinal tract and dorsal column are the two longest pathways and thus need the most amount of mylin and thus are affected most by the lack of Vit. B 12, True of False? |
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Definition
| True, However these are ONLY classical examples BUT NOTE that it can be any neuropathy!!! |
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Term
| What is the most common cause of Vit. B12 deficiency? |
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Definition
| Pernicious anemia (type A gastritis) |
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Term
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Definition
| Is used for hydroxylation of proline and lysine in collagen and elastin. Also is a main antioxidant in the GI. |
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Term
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Definition
| Stimulates Osteoblastic activity (as opposed to PTH that stimulates Osteoclastic activity) and also stimulates calcium AND phosphorous absorption and reabsorption, AND it also mineralizes bones and teeth! |
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Term
| One of two X-link dominant (dad gives it to all of his girls) diseases is? |
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Definition
| Vitamin D resistant (other is pyruvate dehydrogenase deficiency) |
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Term
| Vitamin D resistant Rickets is? |
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Definition
| A renal prob where phosphorous is not being reabsorbed and is also dragging calcium with it. |
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Term
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Definition
| The main antioxidant in the bloodstream. |
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Term
| Diseases involving oxidation, are? |
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Definition
| Cancer, Alzheimer's DZ, Coronary artery DZ, Hemolytic anemia (esp. G6PD) |
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Term
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Definition
| Necessary for carboxylation (non-specific as its found in every organ) |
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Term
| Vit. K is needed for what? |
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Definition
| Gamma- Carboxylation of the vit. K dependent clotting factors (1972 & protein C & S). Also NB that Shortest T1/2 is for protein C followed by factor 7 |
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Term
| Protein C (T1/2 6hrs)is the first thrombolytic. Factor 7 has a T1/2 is 2 days |
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Definition
| That is why haprin is always given before the warfin (a blood thinner) |
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Term
| NB that if you give someone warfin before the haprin then u have one last warning that is a piece of necroses skin. But this sign is paradoxical in the sense that you might think they need more warfin cause it looks like a large clot. What other way might this pts have come to the same outcome given that u Tx correctly? |
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Definition
| They might have a genetic predispositon to a low Protein C level |
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Term
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Definition
| A competitive inhibitor of vit. K. Its dangerous for the fetus as it crosses the placenta (it can bleed to death) and its a teratogen to it too. NB that you follow the PT time as factor 7 (extrinsic pathway) is involved |
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Term
| Fresh frozen plasma and Vit. K IM is used when? |
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Definition
| When u give someone too much warfarin and they are bleeding on ur floor like mad or when its not that bad |
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Term
| Recall now that the only reason you give haprin before warfarin is cause? |
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Definition
| Warfarin knocks out the vit. K dependent clotting factors & the protein C & S. The prob is that protein C is something that can help warfarin cause its a thrombolytic but cause warfarin knocks it out we give harprin first. Haprin is an antithrombolytic and thus u can think of it as a substitute for Protein C but u give it in advance cause u know what ur doing. |
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Term
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Definition
| Is a cofactor for antithrombin III. Thus is blocks thrombin & clotting factors (all have X). Thus followed by PTT as this is intrinsic pathway. |
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Term
| So why is haparin used in pregnant women? |
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Definition
| Cause its charged and wont cross the placent |
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Term
| A reason for forming clots spontaneously is cause of Factor V Leiden deficiency |
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Definition
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Term
| What are the 3 complications of haparin? |
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Definition
| Bleeding; Both GLucagon and Haparin activate hormone sensitive lipase; Haparin can sit on the platelet and make it look foregin giving "haparin induced thrombocytopenia" (haparin acting as a hapten) |
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Term
| Where do you get 90% of ur Vit. K? |
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Definition
| Gut flora (also made are: biotin, folate, panthotenic acid). And they help u absorb Vit. B12 |
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Term
| One pt is a newborn in a poor country that was born at home and the second pt who was put on preoperative antibiotics both bled heavily after 2 days, why? |
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Definition
| Cause by 2 days 50% of factor 7 is broken down and since no Vit. K, its not replenished. (NB that gut flora makes 90% of it) |
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Term
| What are the main minerals the body needs? |
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Definition
| Calcium, magnesium, phosphorous, iron and zinc |
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Term
| Two new facts abt Calcium are? |
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Definition
| Atrium is the only membrane that uses calcium to depolarise. Cardiac ventricles requires extracellular calcium to trigger intracellular calcium release. |
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Term
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Definition
| A cofactor for all KINASES (without which u cannot make 90% of ATP - thus why anesthesiologiest must check levels before putting u under as u might not wake up). Its also a cofactor for PTH (along with Vit. A) thus if calcium is low so will Magnesium and visa-versa. Lastly it also helps reabsorb potassium in the DCT. |
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Term
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Definition
| Hair, skin, sperm, and taste buds (Most important - dysguisia) |
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Term
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Definition
| lysine hydroxylase (looks like it needs 1 Vit (C) and 1 mineral) in forming collagen and is also needed by complex IV in the electon transport chain. |
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Term
| What hormone and what enzyme do u know so far that uses both a Vit and a mineral as a cofactor? |
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Definition
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Term
| Copper excess is know as Wilson's Dz, its? |
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Definition
| Auto. recessive (thus is there is a family Hx then u use Aa X Aa but if not then use the hardy whine burg equation where P2 X 2pq X Q2 then for frequency u'd find q and then to find the carrier rate u'd find 2q). NB that enzymes and proteins will be recessive where as receptors will be dominant. In this case the protein ceruloplasmin is deficient. Thus it deposits in 3 places: Lenticular nucleus (basal ganglia), iris (kayser-Fleischer rings), and liver (cirrhosis) |
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Term
| Penetrance, variable expression, anticipation are? |
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Definition
| If u have the genes but it didnt penetrate through; if everyone in ur family has it but its all at different levels, and lastly if with each generation it hits the person earlier and earlier |
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Term
| What are the two many causes of movement disorders in middle aged persons? |
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Definition
| Huntingtons (90%) and Wilson's DZ (10%) |
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Term
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Definition
| Auto Dom. triplet repeat that involves the caudate nucleus and is Sx is Tx with antipsychotics (DA blockers as they have too much movement). Mcc is suicide |
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Term
| Trinucleotide repeat DZs are? |
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Definition
| Huntingtons, Fragile X , Fredrieck's ataxia, Prader willi syndrome (not all of the time, they have something called uniparental disomy - where one parent has both mutations on chromosome 15) NB that Proud PaPa like to she his son eat alot whereas Mama's Angel is always laughing, Myotonic dystrophy |
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Term
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Definition
| Need to make heme but NB that its the ferrous that binds the oxygen and not the ferric (oxidized form - prevented by giving with Vit. C in GI and Vit. E in blood). Is also need in complex III and IV of electron transport. |
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Term
| Lack of which trace element can make u look like u have diabetes and why? |
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Definition
| Chromium as it normally enchances action of insulin (thus in both diabetes) |
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Term
| Which trace element is needed by the heart and without which can give u dilated cardiomyopathy? |
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Definition
| Selenium, and NB that excess smells like garlic breath but arsenic can have the same give the same smell too. |
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Term
| Xanthine oxidase is involved with breaking down uric acid and gout. What 2 trace elements must it have? |
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Definition
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Term
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Definition
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Term
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Definition
| Needed for teeth and bone growth but excess blocks enolase in glycolysis pathway and this leads them to a low energy state |
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