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6703531600Amino acids necessary for purine synthesisGlycine Aspartate Glutamine0
6703551407glutamine + CO2 --?--> Carbamoyl phosphateCarbamoyl phosphate synthetase I (+): N-acetylglutamine1
6703558888Carbamoyl phosphate + aspartate --?--> orotic aciddihydroorotate dehydrogenase blocked by leflunomide2
6703569000orotic acid + PRPP --?--> UMPUMP synthase impaired in orotic aciduria3
6703580944Ribose 5-P --?--> PRPPPRPP synthetase4
6703582822PRPP --X?--> IMPblocked by 6-MP and its prodrug azathioprine5
6703592511IMP --?--> GMPinosine monophosphate dehydrogenase blocked by mycophenolate and ribavirin6
6703596551UDP --?--> dUDPribonucleotide reductase blocked by hydroxyurea7
6703601925dUMP --?--> dTMPthymidylate synthase blocked by 5-FU8
6703607000DHF --?--> THFdihydrofolate reductase blocked by methotrexate (humans), trimethoprim (bacteria), and pyrimethamine (protozoa)9
6703618144Adenosine deaminase deficiencyrequired to degrade adenosine and deoxyadenosine more dATP in lymphocytes = toxic AR SCID10
6703623438Lesch-Nyhanabsent HGPRT in purine salvage (hypoxanthine --> IMP; guanine --> GMP) X-linked recessive Hyperurecemia Gout Pissed off (aggression, self-mutilation) Retardation Dystonia11
6703645306Frameshift mutation diseasesDuchenne MD Tay-Sachs12
6703653198Nonhomologous end joining diseasesataxia telangiectasia BRCA1 mutation ovarian/breast cancers Fanconi anemia13
6703661941Amanita phalloides mushroom toxicityinhibits RNA polymerase II (makes mRNA), causing severe hepatotoxicity14
6703676899Antibodies to spliceosomal snRNPsanti-Smith highly specific for SLE15
6703692816Defect in N-acetlyglucosaminyl-1-phosphotranferaseI cell disease failure of Golgi to phosphorylate mannose residues (decreased mannose-6-P) coarse facial features, clouded corneas, restricted joints, high plasma levels of lysosomal enzymes, fatal in childhood16
6703704036peroxisome diseasesZellweger syndrome: hypotonia, seizures, hepatomegaly, early death Refsum disease: scaly skin, ataxis, cataracts/night blindness, shortening of 4th toe, epiphyseal dysplasia17
6703720825stain for vimentinmesenchymal tumors (sarcoma), but also others like endometrial, renal cell, meningioma18
6703726834stain for desminrhabdomyosarcoma19
6703729156stain for cytokeratinepithelial tumors (squamous cell)20
6703734555Drugs that act on microtubulesMebendazole Griseofulvin Colchicine Vincristine/Vinblastine Paclitaxel21
6703741864examples of microfilamentsactin, microvilli (muscle contraction; cytokinesis)22
6703744567examples of microtubulescilia, flagella, mitotic spindle, centrioles (movement; cell division)23
6703746709examples of intermediate filamentsvimentin, desmin, cytokeratin, lamins, GFAP (maintain cell structure)24
6703759458Oubaininhibits Na/K ATPase by binding to the K+ site25
6703766896gene defects in COL1A1 and COL1A2Osteogenesis imperfecta AD decreased production of type I collagen (problem during glycosalation phase where triple helix is formed) bone fractures, blue sclera, dental imperfections, hearing loss (BITE)26
6703792282faulty collagen synthesis in proteolytic processing (cleavage) and cross-linkingEhlers-Danlos syndrome AD or AR hyperentensible skin, tendency to bleed, hyper mobile joints; berry and aortic aneurisms, organ rupture Can be due to problems in type V or III (vascular type) collagen27
6703810537Defective ATP7A causing decreased lysol oxidaseMenkes disease brittle, kinky hair28
6703820282Cre-lox systemcan inducibly manipulate genes at specific development points (gene expression modification) i.e. to study a gene whose deletion causes embryonic death29
6703826014McCune Albright syndromemutation affecting G-protein signaling 1- unilateral cafe-au-lait spots 2- polyostotic fibrous dysplasia 3- endocrinopathy Lethal if mutation is before fertilization survivable in patients with mosacism30
6703841378X-linked dominant diseaseshypophosphatemic rickets: increased phosphate wasting at PCT fragile X syndrome Alport syndrome31
6703853110CTG expansion of DMPK geneMyotonic type I MD myotonia, muscle wasting, cataracts, testicular atrophy, frontal balding, arrhythmia CTG = cataracts, toupee, gonadal atrophy32
6703864443CGG repeats on FMR1 geneFragile X, X-linked dominant hypermethylation causing decreased expression of FMR1 gene post-pubertal big testes, long face, large ears, autism, MVP33
6703878706Microdeletion of short arm of chromosome 5Cri-du-chat microcephaly, high pitched cries, epicanthic folds, VSD34
6703886039Microdeletion of long arm of chromosome 7William syndrome deletion includes elastin gene elf face, intellectual dis., hypercalcemia, overly friendly, cardiovascular issues35
6703896758Velocardiofacial syndromepalate, facial, and cardiac defects 22q11 deletion distinct from DiGeorge aberrant development of 3rd and 4th branchial pouches36
6703911277Causes of vitamin B3 deficiencyHartnup disease (AR, deficiency of neutral amino acid transporters at PCT and gut, like tryptophan, treat with high protein diet + niacin) carcinoid syndrome (increased tryptophan metabolism) symptoms include pellagra: diarrhea, dementia, dermatitis37
6703939714Ethanol --?--> acetaldehydealcohol dehydrogenase blocked by fomepizole (antidote for methanol or ethylene glycol)38
6703949085acetaldehyde --?--> acetateacetaldehyde dehydrogenase blocked by disulfiram (discourages drinking)39
6703956420RLE of *glycolysis*Phosphofructokinase-1 (+): AMP, F-2,6-BP (-): ATP, citrate40
6703960657RLE of *gluconeogenesis*Fructose-1,6-bisphosphatase (+): citrate (-): AMP, fructose-2,6-BP41
6703963245RLE of *TCA cycle*Isocitrate dehydrogenase (+): ADP (-): ATP, NADH42
6703963246RLE of *glycogenesis*Glycogen synthase (+): G-6-P, insulin, cortisol (-): epinephrine, glucagon43
6703968532RLE of *glycogenolysis*Glycogen phosphorylase (+): epinephrine, glucagon, AMP (-): G-6-P, insulin, ATP44
6703968533RLE of *HMP shunt*Glucose-6-phosphate dehydrogenase (+): NADP+ (-): NADPH when deficient: (X-linked recessive) less NADPH is around to protect RBCs from oxidizing agents, causing hemolytic anemia --> heinz bodies (denatured hemoglobin), then bite cells Due to exposure to oxidizing agents: fava beans, sulfonamides, primaquine, TB drugs, infection45
6703973024RLE of *de novo pyrimidine synthesis*Carbamoyl phosphate synthetase II (+): ATP, PRPP (-): UTP46
6703973025RLE of *de novo purine synthesis*PRPP amidotransferase (+): none (-): AMP, IMP, GMP47
6703975896RLE of *urea cycle*Carbamoyl phosphate synthetase I (+): N-acetylglutamate (-): none48
6703978001RLE of *fatty acid synthesis*Acetyl-CoA carboxylase (+): insulin, citrate (-): glucagon, palmitoyl-CoA49
6703978002RLE of *fatty acid oxidation*Carnitine acyltransferase I (+): none (-): malonyl-CoA50
6703980550RLE of *ketogenesis*HMG-CoA synthase51
6703980551RLE of *cholesterol synthesis*HMG-CoA reductase (+): insulin, thyroxine (-): glucagon, cholesterol52
6705011451galactose --?--> galactose-1-phosphategalactokinase defective in mild galactosemia (AR, galactose builds up in blood and urine, infantile cataracts, may present as failure to track objects or develop a social smile)53
6705016754galactose-1-phosphate --?--> glucose-1-phosphategalactose-1-phosphate uridyltransferase defective in severe galactosemia (AR, toxic substances build up including galactitiol in the lens, symptoms start with breast feeding, jaundice, hepatomegaly, infantile cataracts, predispose to E. coli sepsis, exclude galactose and lactose from diet)54
6705053837ribulose-5-phosphate --?--> fructose-6-phosphatetransketolase (thiamine cofactor) non-oxidative, reversible can also make ribose-5-P for nucleotide synthesis in HMP shunt55
6705085134fructose-6-phosphate --?--> fructose-1,6-bisphosphonatephosphofructokinase-156
6705088417fructose-1,6-bisphosphonate --?--> fructose-6-phosphatefructose-1,6-bisphosphonate57
6705103790PEP --?--> pyruvatepyruvate kinase (+): fructose-1,6-P (-): ATP, alanine58
6705106347pyruvate --?--> acetyl-CoApyruvate dehydrogenase puts acetyl-CoA into TCA cycle actually 3 enzymes that use 5 cofactors (thiamine pyrophosphate (B1), lipid acid, CoA (B5), FAD (B2), NAD (B3)) (+): NAD+/NADH ratio, ADP, Ca2+ deficiency: pyruvate builds up, gets shunted to lactate and alanine = neurological defects treatment: lysine and leucine in diet (ketogenic nutrients, high fat)59
6705112324pyruvate --?--> oxaloacetatepyruvate carboxylase (biotin cofactor) uses ATP ox. can be used in gluconeogenesis or regenerate TCA cycle60
6705267845pyruvate --?--> lactatelactic acid dehydrogenase NADH --> NAD+ (B3) end of anaerobic glycolysis (done in RBC, WBC, kidney medulla, lens, testes, cornea)61
6705287444pyruvate --?--> alaninealanine aminotransferase B6 cofactor part of cahill cycle, carrying amino groups from muscle to liver62
6705117115oxaloacetate --?--> PEPPEP carboxykinase63
6705120676isocitrate --?--> a-ketoglutarateisocitrate dehydrogenase64
6705126752a-ketoglutarate --?--> succinyl-CoAa-ketoglutarate dehydrogenase (thiamine cofactor)65
6705144188propionyl-CoA --?--> methylmalonyl-CoApropionyl-CoA carboxylase (biotin cofactor) propionyl-CoA comes from odd-chain fatty acids, branched-chain amino acids, methionine, and threonine methylmalonyl-CoA can go on to make succinyl-CoA in TCA cycle with B1266
6705165568ornithine + carbamoyl phosphate --?--> citrullineornithine transcarbamylase deficiency: X-linked recessive, body cannot eliminate ammonia, excess carbamoyl phosphate is made into orotic acid elevated orotic acid in blood/urine, decreased BUN, symptoms of hyperammonemia NO MEGALOBLASTIC ANEMIA (compared to orotic aciduria)67
6705169061fructose --?--> fructose-1-phosphatefructokinase defective in essential fructosuria (AR) benign, fructose in blood/urine68
6705176284arsenic's effect on glycolysiscauses it to produce net zero ATP69
6705295820TCA cycle end products3 NADH 1 FADH2 1 GTP (2 CO2) = 10 ATP per acetyl-CoA70
6705308971blocks complex Irotenone71
6705309020blocks complex IIIamtimycin A72
6705311373blocks complex IVCO and cyanide73
6705315021blocks complex V (ATP synthase)oligomycin74
6705315022uncoupling agentsproduces heat by blocking promo gradient. ATP synthesis stops, but electron transport continues 2,4-dimitrophenol aspirin thermogenin75
6705334143glucose-6-phosphate --?--> ribulose-5-phosphateglucose-6-phophate dehydrogenase makes 2 NADPH from NADP+ oxidative, irreversible part of HMG shunt76
6705386567fructose-1-P --?--> DAP + glyceraldehydeAldolase B defective in frutose intolerance (AR) build up of F-1-P depletes phosphate available, inhibiting glycogenolysis and gluconeogenesis Sx: hypoglycemia, jaundice, cirrhosis, vomiting treatment: stop eating fructose and sucrose77
6705422892essential amino acidsPVT TIM HALL phenylalanine, valine, threonine, tryptophan, isoleucine, methionine, histidine, arginine, lysine, leucine78
6705448610citrulline + aspartate --?--> (urea cycle)arginosuccinate synthetase (uses ATP) makes arginosuccinate in urea cycle79
6705453822arginosuccinate --?--> (urea cycle)arginosuccinase makes arginine and fumarate in urea cycle80
6705460735arginine --?--> (urea cycle)arginase makes urea and ornithine in urea cycle81
6705467935Cahill cyclealanine (NH3) in muscle to the liver converted to pyruvate, then glucose (via cori cycle) which is sent back to muscle alanine to pyruvate also used a-ketoglutarate to make glutamate which becomes urea82
6705488724Cori cyclelactate made in muscle from glucose --> pyruvate --> lactate is moved to liver where it is converted back to glucose (then back to muscle) with help from the cahill cycle83
6705527519(amino acid) --?--> porphyrin --> hemeglycine, uses B684
6705535679phenylalanine --?--> tyrosinephenylalanine hydroxylase (+ BH4) defective in PKU (AR, either enzyme or tertahydrobiopterin are low, tyrosine becomes essential, excess phenyl ketones in urine (phenyl acetate, phenyl lactate, phenyl pyruvate), growth retardation, fair skin, eczema, musty odor treat: increase tyrosine in diet, restrict phenylalanine (including aspartame sweetener), BH4 supplementation)85
6705553049tyrosine --?--> DOPAtyrosine hydroxylase (+ BH4)86
6705556767DOPA --?--> melanintyrosinase defective in albinism87
6705561503DOPA --?--> dopamineDOPA decarboxylase (+ B6) blocked by carbidopa (for Parkinson's)88
6705568520dopamine --?--> norepinephrinedopamine ß-hydroxylase (+ vitamin C)89
6705574087norepinephrine --?--> epinephrinePhenylethanolamine-N-methyltransferase (+ SAM) increased by cortisol90
6705586978(tyrosine ->) homogentisic acid --?--> maleylacetoacetic acid (-> fumarate)homogentisate oxidase defective in alkaptinuria (AR, pigment forming homogentisic acid builds up in tissue, ochronosis (benign bluing of connective tissue, sclera), urine turns black with air, may have arthralgias91
6705676271homocysteine --?--> cystathione (-> cysteine)Cystathione synthase (+ serine and B6) deficiency in (one type of) homocysteinuria (osteoporosis, marfinoid habitus, ocular changes, cardiovascular effects, kyphosis) treat: B6, cysteine, avoid methionine92
6705702253homocysteine --?--> methioninemethionine synthase (with B12) deficiency in (one type of) homocyteinuria (osteoporosis, marfinoid habitus, ocular changes, cardiovascular effects, kyphosis) treat: more methionine in diet93
6705724896CystinuriaAR defect in renal PCT and intestinal amino acid transporters that prevent reabsorption of cysteine, ornithine, lysine, arginine (COLA) hexagonal cystine stones precipitate in urine diagnose with urine cyanide-nitroprusside test treat: urinary alkalization, chelating agents (penicillamine) increase cystine solubility; hydrate well94
6705774997glucose-6-phosphate --?--> glucoseglucose-6-phosphatase deficient in Von Gierke disease (I) severe fasting hypoglycemia, increase in liver glycogen, increase blood lactate, increased triglycerides, increased uric acid (gout), hepatomegaly treat: frequent oral glucose; avoid fructose and galactose95
6705801389fully branched glycogen --?--> glucose residuesa-1,4-glucosidase when lysosomal form of enzyme (acid maltase) is deficient: Pompe disease (II) cardiomegaly, hypotonia, exercise intolerance96
6705821346glycogen with 1 residue limit dextrin --?--> straight chain glycogena-1,6-glucosidase (debranching enzyme) deficient in Cori disease (III) mild form of Von Gierke, normal blood lactate levels. Gluconeogensis is in tact97
6705839432branched glycogen --?--> limit dextrins of 4 glucose residuesglycogen phosphorylase when skeletal muscle version of enzyme is defective (myophosphorylase): McArdle disease (V) glycogen in muscle, but cannot be broken down: painful muscle cramps, myoglobinuria with tough exercise, arrhythmia from electrolyte abnormalities second wind phenomenon with stop-start exercise because of increased muscular blood flow. blood glucose levels normal98
6705894161decreased branched-chain a-ketoacid dehydrogenase (B1)Maple syrup urine disease (AR) blocked degradation of branched amino acids (isoleucine, leucine, valine) vomiting, CNS defects treat: restrict these in the diet, give thiamine99
6705933228deficient: Hexosaminidase ATay-Sachs disease (AR) lysosomal storage disease (sphingolipidosis) accum.: GM2 ganglioside progressive neurodegeneration, "cherry red spot" on macula, lysosomes wth onion skin, *no* hepatosplenomegaly100
6705935141deficient: a-galactosidase AFabry disease (*XR*) lysosomal storage disease (sphingolipidosis) accum.: ceramide trihexoside triad: 1- episodic peripheral neuropathy, 2- angiokeratomas, 3- hypohidrosis late: renal failure, CVD101
6705935142deficient: arylsulfatase AMetacromatic leukodystrophy (AR) lysosomal storage disease (sphingolipidosis) accum.: cerebroside sulfate central and peripheral demyelination: ataxia and dementia102
6705938796deficient: galactocerebrosidaseKrabbe disease (AR) lysosomal storage disease (sphingolipidosis) accum.: galactocerebroside, psychosine peripheral neuropathy, destruction of oligodendrocytes, developmental delay, optic atrophy, globoid cells103
6705942144deficient: glucocerebrosidase (ß-glucosidase)Gaucher disease (AR) most common lysosomal storage disease (sphingolipidosis) accum.: glucocerebroside hepatosplenomegaly, pancytopenia, osteoporosis, avascular necrosis of femoral head, Gaucher cells (lipid laden macrophages that look like tissue paper)104
6705946516deficient: sphingomyelinaseNiemann-Pick disease (AR) lysosomal storage disease (sphingolipidosis) accum.: sphingomyelin progressive neurodegeneration, hepatoplenomegaly, foam cells (lipid laden macrophages), "cherry red" spot on macula105
6705948331deficient: a-L-iduronidaseHurler syndrome (AR) mucopolysaccaridosis accum.: heparan sulfate, dermatan sulfate developmental delay, gargoylism, airway obstruction, corneal clouding, hepatosplenomegaly106
6705950716deficient: iduronate sulfataseHunter syndrome (*XR*) mucopolysaccaridosis accum.: heparan sulfate, dermatan sulfate mild Hurler syndrome without corneal clouding, + aggressive behavior107
6705992400ketone bodiesacetone acetoacetate (can be detected in urine) ß-hydrohybutarate (can't be detected in urine)108
6706022303fatty acid synthesiscitrate shuttled from mitochondria into cytoplasm converted to acetyl-CoA via ATP citrate lyase acetyl CoA --biotin--> malonyl CoA --> fatty acids109
6706033853fatty acid degradationfatty acid + CoA --fatty acyl-CoA synthetase--> fatty acyl-CoA (in cytoplasm) fatty acyl-CoA shuttled into mitochondria via carnitine shuttles (blocked by malonyl CoA) fatty acyl-CoA undergoes ß-oxidation (acyl-CoA dehydrogenase) into acetyl-CoA, which can be used for TCA cycle or ketone bodies110
6706056212systemic 1˚ carnitine deficiencydefect in transport of long chain fatty acids into the mitochondria causes weakness, hypotonia, hypoketotic hypoglycemia111
6706064481medium-chain acyl-CoA dehydrogenase deficiencydecreased ability to break down fatty acids into acteyl-CoA accumulation fo fatty acyl carnitines in the blood vomiting, lethargy, seizures, coma, death treat: avoid fasting112
6708641359pancreatic lipasedegradation of dietary triglycerides in the small intestine113
6708643586lipoprotein lipasedegradation triglycerides in chylomicrons and VLDLs found on vascular endothelial cell surface defective in hypercylomicronemia (AR)114
6708654972hepatic triglyceride lipasedegradation of triglycerides remaining in IDL115
6708656690hormone-sensitive lipasedegradation of triglycerides stored in adipocytes116
6708658385LCATcatalyzes esterification of 2/3 of plasma cholesterol activated by apolipoprotein A-I117
6708662843cholesterol ester transfer protein (CETP)mediates transfer of cholesterol esters to other lipoprotein particles118
6708666680Apolipoprotein EMediates reuptake of everything except LDL including chylomicron, chylomicron remnant, VLDL, IDL, HDL defective in dysbetalipoproteinemia (AR)119
6708671832Apolipoprotein C-IIlipoprotein lipase cofactor that catalyzes cleavage defective in hypercylomicronemia (AR)120
6708685069Apolipoprotein B-48mediates chylomicron secretion into lymphatics121
6708685070Apolipoprotein B-100Bind LDL receptor122
6708692217AbetalipoproteinemiaAR absent chylomicrons, VLDL, LDL deficiency in ApoB48, B100 infants have fat malabsorption, steatorrhea later may include retinitis pigments, spinocerebellar degeneration due to vitamin E deficiency, ataxia, acanthocytosis treat: restrict long-chain fatty acids; give large doses of vitamin E123
6708757438Role of chylomicronsdeliver dietary triglycerides to peripheral tissue deliver cholesterol to liver in the form of chylomicron remnants (depleted of TGs) secreted by intestinal epithelial cells124
6708767533Role of VLDLsdelivers hepatic TGs to peripheral tissue secreted by liver125
6708767534Role of IDLsformed in the degradation of VLDL delivers TGs and cholesterol to the liver126
6708767535Role of LDLsdelivers hepatic cholesterol to peripheral tissue formed by hepatic lipase modification of IDL in liver and peripheral tissue taken up by target cells via receptor-mediated endocytosis127
6708770302Role of HDLsmediates reverse cholesterol transport from periphery to liver acts as a repository for apolipoproteins C and E (needed for chylomicron and VLDL metabolism) secreted from both liver and intestine alcohol increases synthesis128
6708774099lipoprotein lipase or apolipoprotein C-II deficiencyHyperchylomicronemia (AR) blood levels: increased chylomicrons, TG, cholesterol Sx: pancreatitis, hepatosplenomegaly, pruritic xanthomas *no* increased risk for atherosclerosis129
6708774100absent or defective LDL receptorsFamilial hypercholesterolemia (AD) blood levels: increased LDL, cholesterol (and VLDL in type IIa) Sx: accelerated atherosclerosis, tendon (achilles) xanthomas, corneal arcus Worse in homozygotes130
6708775718defective ApoEDysbetalipoproteinemia (AR) blood levels: increased chylomicrons, VLDL Sx: premature atherosclerosis, tuberoeruptive xanthomas, xanthoma striatum palmare131
6708778859hepatic overproduction of VLDLHypertriglyceridemia (AD) blood levels: increased VLDL, TG Sx: can cause acute pancreatitis132

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