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Medicine (MD/DO)
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USMLE Step 1
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Biochemistry
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Metabolic Pathways

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Biochemistry | Medicine (MD/DO) School Study Aid

Metabolic Pathways
16 Picmonics to Learn | 49 mins
Glycolysis
Characteristics
Glucose
Hexokinase or Glucokinase
Glucose-6-phosphate
Fructose-6-phosphate
Phosphofructokinase-1 (PFK-1)
Fructose-1,6-bisphosphate
Aldolase
Glyceraldehyde-3-Phosphate
1,3-bisphosphoglycerate
3-phosphoglycerate
2-phosphoglycerate
Phosphoenolpyruvate (PEP)
Pyruvate Kinase
Pyruvate
Pyruvate Dehydrogenase
Acetyl-CoA
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4 mins
Gluconeogenesis
OVERVIEW
Produces Glucose from Non-Carbohydrate Substrates
Upregulated by Glucagon and Cortisol
PATHWAY
Pyruvate
Pyruvate Carboxylase
Oxaloacetate
Phosphoenolpyruvate (PEP) Carboxykinase
Phosphoenolpyruvate (PEP)
Fructose-1,6-bisphosphate
Fructose-1,6-bisphosphatase
Fructose-6-phosphate
Glucose-6-phosphate
Glucose 6-phosphatase
Glucose
Clinical Relevance
Von Gierke Disease
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4 mins
Fructose Metabolism
Liver Fructose Metabolism
Fructose
Fructokinase
Fructose-1-Phosphate
Aldolase B
DHAP
Glyceraldehyde
Glyceraldehyde-3-Phosphate
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2 mins
Ethanol Metabolism
Characteristics
Zero Order Elimination
Pathway
Ethanol
Alcohol Dehydrogenase
Produces NADH
Acetaldehyde
Acetaldehyde Dehydrogenase
Produces NADH
Acetate
Thiokinase
Acetyl-CoA
Drugs
Fomepizole
Disulfiram
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3 mins
Lipid Metabolism and Ketogenesis
Lipid Metabolism
Acetyl-CoA
Biotin Cofactor
Malonyl-CoA
Fatty Acids
Triglycerides
Glycerol
DHAP
Acetoacetyl-CoA
HMG-CoA
HMG-CoA Reductase
Mevalonate
Cholesterol
Ketogenesis
Acetoacetate
Beta-Hydroxybutyrate
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4 mins
Citric Acid Cycle (Krebs Cycle)
Characteristics
Acetyl-CoA + Oxaloacetate
Citric Acid
Isocitric Acid
Produces NADH
Alpha-Ketoglutaric Acid
Produces NADH
Succinyl CoA
Produces GTP
Succinate
Produces FADH2
Fumarate
Uses Water
Malate
Produces NADH
Oxaloacetate
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4 mins
Urea Cycle
Mitochondria
N-Acetylglutamate
Carbamoyl Phosphate Synthetase I
NH3 + CO2
Carbamoyl Phosphate
Ornithine Transcarbamylase
Citrulline
Cytosol
Aspartate
Argininosuccinate
Fumarate
Arginine
H2O to Urea
Ornithine
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3 mins
G6PD Mechanism
Turns NADP+ to NADPH
NADPH Used by Glutathione Reductase
Detoxifies Free Radicals and Peroxides
X-linked Recessive
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2 mins
Hexose Monophosphate Shunt (Pentose Phosphate Pathway)
Oxidative Phase (Irreversible)
Glucose-6-Phosphate Dehydrogenase
Converts Glucose-6-Phosphate to Ribulose-5-Phosphate
Generates NADPH
Reduces Glutathione
Prevents Oxidative Damage
Non-Oxidative Phase (Reversible)
Ribulose-5-Phosphate to Ribose-5-Phosphate
Nucleotide Synthesis
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2 mins
Galactose Metabolism
Galactose Breakdown
Lactase
Converts Lactose to Galactose
Galactokinase
Converts Galactose to Galactose-1-Phosphate
Galactose-1-Phosphate Uridyltransferase (GALT)
Converts Galactose-1-Phosphate to Glucose-1-Phosphate + UDP-Galactose
Glucose-1-Phosphate Enters Glycolysis
Galactose Synthesis
Produced from Glycerol in Lactating Breast Tissue
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3 mins
Glycogen Metabolism
Glycogenesis
Glucose to UDP-Glucose
Chain Elongation
UDP-Glucose to Glycogen
Glycogenin
Glycogen Synthase
Branching Enzyme
Glycogenolysis
Glycogen to Glucose
Glycogen Phosphorylase + Vitamin B6 Cofactor
Limit Dextrin
Debranching Enzyme
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4 mins
Cholesterol Synthesis
Pathway
Acetyl-CoA
Acetoacetyl-CoA
Cytosolic HMG-CoA Synthase
HMG-CoA
HMG-CoA Reductase
Mevalonate
Cholesterol
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2 mins
Lipogenesis
Fatty Acid Synthesis
Acetyl-CoA
Citrate Shuttle to Cytoplasm
Acetyl-CoA Carboxylase
Biotin Cofactor
Malonyl-CoA
Fatty Acid Synthase
Triglyceride Synthesis
Glycerol
Glycerol-3-Phosphate Acyltransferase
Triglycerides
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2 mins
Lipolysis
Triglyceride Breakdown
Triglycerides
Hormone Sensitive Lipase
Glycerol
Fatty Acids
Fatty Acid Transport
Long-chain Fatty Acids
Carnitine Shuttle
Medium-chain and Short-chain Fatty Acids Diffuse Freely
Fatty Acid Breakdown
Beta Oxidation
Acetyl-CoA if Even Number of Carbon Atoms
Propionyl-CoA if Odd Number of Carbon Atoms
Propionyl-CoA Carboxylase
Biotin Cofactor
Methylmalonyl-CoA
Methylmalonyl-CoA Mutase
Vitamin B12 Cofactor
Succinyl-CoA
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5 mins
Ketogenesis and Ketogenolysis
Ketogenesis
2 Acetyl-CoA
Thiolase
Acetoacetyl-CoA
Mitochondrial HMG-CoA Synthase
HMG-CoA
HMG-CoA Lyase
Ketone Bodies
Acetoacetate
Beta Hydroxybutyrate
Acetone
Ketogenolysis
Succinyl-CoA and Acetoacetate
Acetoacetyl-CoA
Thiolase
2 Acetyl-CoA
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4 mins
Fed State Metabolism
Increased Insulin
Decreased cAMP
Decreased Protein Kinase A
Decreased Fructose Bisphosphatase-2
Increased Phosphofructokinase-2
Increased Glycolysis
Decreased Gluconeogenesis
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1 min

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