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biochem 3
Anion Gap Metabolic Acidosis
Pathophysiology
Increased Anion Gap
MUDPILES
Methanol
Uremia
Diabetic Ketoacidosis (DKA)
Propylene Glycol
Isoniazid or Iron
Lactic Acid
Ethylene Glycol
Salicylates
1 min
Beriberi (Thiamine Deficiency)
Thiamine Deficiency
Dry Beriberi
Polyneuritis
Muscle Wasting
Wet Beriberi
Dilated Cardiomyopathy
Edema
51 secs
Beta Thalassemia
Mechanism
Microcytic, Hypochromic Anemia
Mediterranean Populations
Decreased Beta-Globin
Beta-Thalassemia Minor
Increased HbA2
No Intervention
Beta-thalassemia Major
Blood Transfusions
Hemochromatosis
Crew-cut on Skull X-Ray
Diagnosis
Electrophoresis
2 mins
Biotin (Vitamin B7)
Mechanism
Carboxylation Reaction
Pyruvate Carboxylation to Oxaloacetate
Propionyl-CoA Carboxylation to Methylmalonyl-CoA
Acetyl-CoA Carboxylation to Malonyl CoA
Deficiency Causes
Antibiotic Use
Ingestion of Raw Eggs
Signs & Symptoms
Alopecia
Dermatitis
Enteritis
2 mins
Coagulation Cascade Overview
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
2 mins
Ergocalciferol (Vitamin D2)
Mechanism
Vitamin D2
Indications
Hypoparathyroidism
Rickets
Hypophosphatemia
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
2 mins
Folate Deficiency
Clinical Features
Macrocytic Anemia
Megaloblastic Anemia
Etiologies
Malabsorption
Dietary
Tea and Toast
Alcoholics
Medication-induced
Methotrexate
Trimethoprim
Increased Requirement
Hemolytic Anemia
Pregnancy
2 mins
Hartnup Disease
Pathophysiology
Autosomal Recessive
Neutral amino acids
Defective Transporter
Renal and Intestinal cells
Signs and Symptoms
Causes tryptophan excretion in urine
Leads to Pellagra
Diarrhea
Dermatitis
Dementia
2 mins
Hemochromatosis Pathophysiology
Pathophysiology
Hemosiderin Deposition
Autosomal Recessive
HLA-A3
Secondary to Transfusion Therapy
Increase Iron
Increase Ferritin
Increased Transferrin Saturation
2 mins
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
2 mins
Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
1 min
Lead Antidotes
Antidotes
Dimercaprol
CaEDTA
Succimer
39 secs
Maple Syrup Urine Disease
Pathophysiology
Defect in alpha ketoacid dehydrogenase
Blocked degradation of branched chain amino acids
Leucine
Isoleucine
Valine
Signs and Symptoms
Seizures
Intellectual Disability
1 min
Metabolic Alkalosis
Diuretic use
Vomiting
Antacid
Hyperaldosteronism
26 secs
Vitamin B3 (Niacin)
Derived from Tryptophan
Synthesis Requires Vitamin B6
Constituent of NAD+
Deficiency Causes
Hartnup Disease
Carcinoid Syndrome
Deficiency Symptoms
Pellagra
Diarrhea
Dermatitis
Dementia
Glossitis
Excess Symptoms
Flushing
2 mins
Niacin Therapy (Vitamin B3)
Mechanism
Inhibits Lipolysis in Adipose Tissue
Reduces Hepatic VLDL Secretion
Indications
Decrease Triglycerides
Decrease LDL
Increase HDL
Side Effects
Flushing
Decreased by Aspirin
Hyperglycemia
Hyperuricemia
2 mins
Normal Gap Metabolic Acidosis
HARD-ASS
Hyperalimentation
Addison's Disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline Infusion
2 mins
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
Airway Obstruction
Respiratory Muscle Weakness/Paralysis
3 mins
Respiratory Alkalosis
Hyperventilation
High Altitude
Aspirin
Restrictive Lung Disease
Pulmonary Embolism
Pregnancy
Progesterone
Rib Fracture
Anxiety
2 mins
Riboflavin (Vitamin B2)
Classification
Vitamin B2
Biochemistry
FAD
FAD Makes 1.5 ATP
Succinate to Fumarate
DEFICIENCY
Glossitis
Cheilosis
Corneal Vascularization
2 mins
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