20:57:23 >[Step_1] Welcome to our chat. Please obey the net etiquette while chatting: try to be pleasant and polite.
20:58:00 hutals enters this room
20:58:53 Lorena enters this room
20:59:37 [Step_1] hi loena. hi hutals
20:59:52 [hutals] hello
20:59:58 [Lorena] hi guys!
21:00:15 [Lorena] how are you?
21:00:32 [Step_1] very good, how about you?
21:00:45 [Lorena] same here thanks
21:01:36 [Step_1] my two worst subjects back to back with biochem and physio....cant wait until these two weeks are up
21:01:38 [Lorena] roxanita sent me a pm , shw wont be able to be here today
21:02:27 nne enters this room
21:02:35 [Step_1] thanks for letting us know. she always has great input
21:02:42 [Step_1] hi nne
21:02:54 [nne] hi eveyone
21:02:55 [Lorena] yes, she does
21:03:02 [Lorena] hi nne
21:03:28 [nne] i got your message step 1. will look thru it
21:03:33 [Step_1] nne, did you get my pm?
21:03:34 [nne] thanks
21:03:54 [Step_1] no prob.
21:04:16 [nne] physio is bette for me than biochem
21:05:01 [Step_1] i was just telling lorena that aside from biochem, physio is my next worst subject....cant wait until they're over
21:05:36 [Lorena] i have to study the subjects again after we are done with the schedule, there are many chapters i didnt finish
21:05:36 [nne] we have to crack it step 1.
21:05:54 vladi enters this room
21:05:54 [nne] i will still read it next week
21:06:09 [Lorena] hi vladi
21:06:14 [Step_1] hi valadi
21:06:41 [vladi] hi everybody
21:06:52 [Step_1] should we get started or wait a few more mins?
21:07:15 [nne] step 1 you do a good job of answering the questions in the posts. what's up with that
21:07:28 [Lorena] the questions you just post and explanations are great step 1, thank you very much for the time you put in them! they are great
21:07:45 [vladi] step 1- thank you so much for wonderful overview of some important Qs from mol.biol with excellent images
21:08:07 [nne] yes, i agree with them
21:08:08 [Step_1] hopefully people are trying to guess the answers before looking. it helps me study....i'm glad they're helping you too
21:08:29 [Lorena] yes, excellent way to present the information
21:08:52 [Lorena] we should start now if you want
21:08:58 [nne] where do you get these answers from
21:09:06 [vladi] let's get started
21:09:07 [Step_1] now if I can only make it stick in my head during the exam
21:09:38 [Step_1] ok, i think today we're mostly talking about metabolism....right?
21:10:18 [Lorena] yes
21:10:21 mash enters this room
21:10:34 [Step_1] lets start general. how many ATP produced in anaerobic glycolysis?
21:10:49 [vladi] it's most difficult point- to keep everything, but in real exam it has multi-choice and you can pick up right one
21:12:07 [Step_1] the answer is 2 atp per glucose molecule....not very efficient so only as last resort
21:12:21 [mash] 2
21:12:35 [nne] 2
21:12:49 [Lorena]
21:13:06 [Step_1] which is the only cell type to always use anaerobic glycolysis for atp? why?
21:13:21 [mash] rbcs
21:13:25 [Lorena] RBC because they lack mitocondria
21:13:32 [mash] dont ve mito
21:14:09 [Step_1] thats right... very good
21:14:14 [vladi] agree with lorrena
21:14:35 [Step_1] how about 2nd messengers....which use Gq?
21:14:47 [vladi] actually in WBC also (Princeton review)
21:14:55 [Step_1] sorry which receptors use?
21:15:26 [Step_1] i didnt know that vladi.
21:15:39 [Lorena] i didnt know that either
21:15:59 [vladi] alpha 1, musc 1 and 3
21:16:07 [mash] M1,3, alpha1
21:16:16 [Lorena] receptors that use Gq are alpha 1, M1, M3, H1 and V1
21:16:48 [Step_1] Gq -> alpha 1, M1, M3. and V1 and H1 for detailed info....great!
21:16:56 [mash] which receptors use Gi/Gs?
21:17:03 [Lorena] do you guys have the neumonic for that one? second messengers?
21:17:33 [Step_1] Gs are Beta 1 and 2
21:17:35 [Lorena] Gi : alpha 2, M2, D2
21:17:53 kokushubila enters this room
21:17:57 [mash] right!
21:18:07 [Step_1] hi kokush
21:18:09 [vladi] take a look at Tommy notes- he gave a lot of pneumonic
21:18:27 [kokushubila] Hello Everybody!
21:18:41 [Lorena] i have it , i was wondering if you do or i post it , but it is in neumonics.com
21:18:58 [Lorena] hi koku!
21:18:59 [vladi] Gs- beta 1,2 : Gi- alpha 2 , musc.2
21:19:06 [Step_1] i dont have it, please post
21:20:09 [Lorena] "KISS and KICK till you are SICK of SEX" (QISS and QIQ till you're SIQ od SQS
21:20:14 [kokushubila] Please post it Lorena
21:20:27 [Step_1] hexokinase vs glucokinase...which is feedback inhibited by G6P?
21:21:00 [Step_1] good one lorena
21:21:00 [mash] hexokinase
21:21:25 [Lorena] agree with mash
21:21:41 [Step_1] thats right hexokinase
21:22:13 [mash] feed forward activation in glycolysis?
21:22:23 dsa503 enters this room
21:23:18 [dsa503] hello everyone
21:23:19 [Step_1] AMP, fructose 2,6 BP, fructose 1,6 BP, NAD, ADP, pyruvate, CoA
21:23:43 [Step_1] actually last ones were pyrvate dehydrogenase activators
21:23:48 [vladi] which step is only reversible in priming stage of glycolysis
21:23:51 [Lorena] hi dsa
21:24:04 [Step_1] hi dsa
21:24:10 [dsa503] hi lorena
21:24:25 [dsa503] hi step_1
21:24:27 [Lorena] glucose 6p to fructose 6p and viceversa
21:24:39 [nne] hi dsa
21:24:40 [vladi] hi dsa
21:24:54 zeda enters this room
21:24:56 [mash] glucose6p<----->fructose6p
21:25:01 [kokushubila] Hi dsa
21:25:07 [dsa503] hi vladi, nne
21:25:11 [vladi] great lorena
21:25:19 [Step_1] G6P to F6P
21:25:29 [Lorena] thanks vladi
21:25:36 [vladi] mush also great
21:25:52 [Lorena] what are the 3 irreversible steps in lgycolisys?
21:26:05 [Lorena] i mean glycolisis
21:26:34 [kokushubila] Which enzyme is found in raised amount in pt with cocaine toxicity -esp Cardiomyopathy
21:26:56 [mash] glucokinase, PFK1,pyruvate kinase
21:27:04 [Lorena] great mash!
21:27:12 [Step_1] Gluc to G6P, F6P to F1,6BP, PEP to Pyr
21:27:36 [Lorena] yes step 1!!!
21:27:43 adam enters this room
21:28:00 [Step_1] hi adam
21:28:05 [adam] hello guys!
21:28:11 [adam] hey step 1
21:28:11 [dsa503] hi adam
21:28:17 [adam] hey dsa
21:28:26 [Lorena] hi adam and zeda!
21:28:34 [vladi] hi adam
21:28:37 [mash] dont know kokushubila
21:28:38 [adam] cool. Lorena! Hi!
21:28:38 [zeda] hi lorena
21:28:50 [adam] hey vladi
21:28:55 [Lorena]
21:29:11 [dsa503] koku what is the answer to your q
21:29:34 [mash] wat is d glucose donor in glycogen synthesis
21:29:39 [vladi] what catalyses rate-linited step of glycolysis
21:30:07 [adam] fructose 2,6 biaphosphate
21:30:17 [mash] PFK1
21:30:22 [Step_1] phosphofructokinase
21:30:31 [kokushubila] Cocaine causes an increase in Epinephrine which increases Glycolysis in the muscle(not in the liver) so there will be increase in Phosphofructokinase enzyme
21:30:38 [dsa503] phosphofructokinase
21:30:49 [adam] oh sorry,,the question was about the enzyme. u guys are right
21:30:59 [Lorena] thanks koku
21:31:03 [vladi] right-PFK
21:31:24 [kokushubila] U are welcome!
21:31:25 [dsa503] good one koku
21:31:32 [Step_1] it also looks like that was the ans to kokush's question....2 for 1
21:32:51 [Step_1] G6P? is that right mash?
21:32:59 [vladi] what 2 substrate-level phosporylations in glycolysis
21:33:47 [Lorena] gluceraldehyde 3p to 1,3 biphosphate and PEP to pyruvate
21:34:06 [Step_1] pyr kinase and phosphoglycerate kinase
21:34:11 [mash] phosphoglycerate kinase and pyruvate kinase
21:34:29 [adam] PG Kinase and pyruvate kinase
21:34:44 [mash] nope,step1
21:35:10 [vladi] right
21:35:24 [adam] UDP-glucose mash
21:35:41 [mash] right
21:35:51 [adam] cool
21:36:00 [vladi] lorena-sorry, you are not right, others-great
21:36:16 [Lorena] oopps
21:36:27 [vladi] agree with Adam-UDP-glucose
21:36:40 [adam] cool vladi
21:36:48 [adam] keep goin guys
21:36:59 [Step_1] well i agree with him now too
21:37:01 [Lorena] what are the enzimes in the brebs cycle that DONT produce NADH?
21:37:12 [Lorena] i mean krebs cycle
21:37:45 [mash] succinyl DH
21:38:00 [Step_1] succinate dh
21:38:18 [Step_1] and succinate thiokinase
21:38:23 [mash] i mean succinate DH, it produces FADH2
21:38:24 [nne] succinate dh
21:38:45 [Lorena] yes
21:38:53 [Lorena] and the other one? there are 2
21:38:58 DrMG enters this room
21:39:10 [DrMG] hello everyone
21:39:11 [adam] fumerase Lorena
21:39:20 [adam] hello DrMG
21:39:37 [mash] fumerase, succinyl coa synthase
21:39:42 [vladi] only 3 steps produce NADH- iso>alpha-keto, alpha-keto>syccinyl and malate>oxalacetate
21:40:00 [Step_1] isnt the other succinate thiokinase which produces GTP
21:40:13 [Lorena] succinil coA and succinate dh ....yes , very good guys
21:40:21 [vladi] hi DrMG
21:40:23 [Step_1] hi drmg
21:40:36 [DrMG] hi
21:40:39 neurodoctor_75 enters this room
21:40:40 [Lorena] hi Dr MG
21:40:55 [neurodoctor_75] hello,room
21:41:01 [Step_1] NAD+ and NADH....which one activates and which inhibits krebs cycle?
21:41:13 [Step_1] hi neuro
21:41:16 [Lorena] succinil coA produces GTP and succinate dh FADH2
21:41:25 [neurodoctor_75] hello
21:41:35 [mash] nadh inhibits and NAD activates
21:41:35 [kokushubila] Which Vitamins are necessary as the cofactors in the pyruvate dehydrogenase complex
21:41:40 [adam] NAD+ activates and NADH inHibits
21:41:45 [Lorena] NAD activates
21:41:45 [dsa503] nad avtivates nadh inactivates
21:41:58 [Step_1] NADH inhibits and NAD+ activates krebs cycle via isocitrate dh......good job
21:42:11 [vladi] NAD+-stimul, NADH- inhibit
21:42:27 [mash] thiamine(TTP), riboflavin(FAD), niacin(NAD),
21:42:39 [Step_1] the first 4 B vits and lipoic acid
21:42:49 [adam] yes step 1
21:42:49 [dsa503] thimine CoA fad niacin
21:43:04 [Lorena] thiamine, lipouc acid, coA from pantothenate, FAD(H2) from riboflavin and NAD(H) from niacin
21:43:16 [dsa503] the pneumonic is tender loving care for nancy
21:43:17 [kokushubila] Good job !
21:43:39 [Step_1] thanks dsa
21:43:49 [Lorena] "Tender Loving Care For Nancy"
21:43:59 [dsa503] your welcome
21:44:21 [Step_1] where is thiamine impt (what diz)....clinical correlation?
21:44:39 [DrMG] alcohol, beri beri
21:44:46 [adam] beriberi, dry and wet
21:44:50 [Lorena] agree with dr MG
21:44:52 [mash] beri beri
21:44:57 [Step_1] def in chronic alcohol....beri beri, wernikes. good
21:45:08 [adam] and Wornikei Kowraskoff
21:45:09 [dsa503] beri beri
21:45:10 [mash] wernickes and korsakoffs
21:45:43 [Step_1] that is why you NEVER give IV glucose if you suspect alcolholism because used in this pathway and will induce wernicke
21:46:09 [Step_1] give with IV thiamine first....recall question
21:46:13 [adam] yes step 1
21:46:14 [mash] 1st thiamine and then glucose
21:46:20 [dsa503] good step1
21:46:41 [Lorena] thanks step
21:47:06 [vladi] what's 2 types of beri=beri
21:47:08 [Step_1] why does alsohol have hypoglycemia ....hint...has to do with NAD and NADH
21:48:07 [DrMG] wet and dry
21:48:07 [dsa503] because alcohol when degraded by alcohol dehydrogenase & acetaldehyde dehydrogenase uses nad therefore deficiency of nadh
21:48:09 [kokushubila] Ethanol Increase NADH/NAD+ ratio in the liver
21:48:26 [nne] wet and dry
21:48:34 [adam] alcohol increases NADH and this in turn inhibits gluconeogenesis
21:48:57 [adam] dry and WET
21:49:03 [Step_1] ethanol pushes NADh->Nadh and pyr ->NADH->NAD+ -> lactate, so decrease glucose produced
21:49:11 [Step_1] very good
21:49:50 [Lorena] role of aldolase reductase in the genesis of cataracts in galactosemia and diabetics?
21:49:55 [adam] what type of heart failur the WET beri is associated with?
21:50:08 [vladi] which one- is cardian beri-beri
21:50:20 [mash] high output
21:50:20 [Lorena] congestive heart failure
21:50:22 [dsa503] congestive heart failure
21:50:22 [adam] increase the production of galactitol
21:50:37 [Step_1] high output failure
21:50:47 [adam] it is high out put HF guys
21:50:52 [adam] good step 1
21:50:52 [dsa503] increased galactitol which cause osmotic damage to lens
21:51:00 [vladi] adam- we think synhronously
21:51:18 [Step_1] thanks dsa, good correlation
21:51:22 [Lorena] good adam and dsa
21:51:22 [adam] Sorry vladi, I didn't get ya?
21:51:26 [dsa503] thanks adam
21:51:28 [kokushubila] Dilated Cardiomyopathy
21:52:00 [Lorena] thats in galactosemia...and in diabetes ?
21:52:23 [adam] increased production of sorbitol Lore!
21:52:41 DrMG exits from this room
21:52:42 [adam] what did ya want to say vladi?
21:52:42 [vladi] cardiac- wet- involves dilated heart with fatty changes and can produce pulmonary edema. Can be symptoms of wet and dry present together
21:52:48 [Lorena] excellent!!!
21:52:54 DrMG enters this room
21:53:42 [Step_1] what is the rate limiting step for heme sysnthesis?
21:53:47 [vladi] adam - i mean abput cardiac beri-beri- we arised this Q at the same time
21:54:05 [mash] delata levulinic acid synthase
21:55:04 [vladi] aminolevulinic acid
21:55:11 [adam] heme synthesis- ALA-synthetase
21:55:22 [Step_1] aminolevulinate (ALA) synthase ....spelling that correctly should be bonus
21:55:41 [adam] which enzymes are inhibited by lead poisoining?
21:55:48 [mash] wat r d cofactors reqd fr this?
21:56:02 [adam] Pyridoxine, Mash
21:56:17 [mash] and?
21:56:35 [adam] hummmmm, is it NADPH?
21:56:44 [dsa503] ferrochelatase
21:56:53 [adam] what else dsa?
21:57:09 [mash] PB poisoning inhibits ferrochelatase
21:57:15 [dsa503] the second step hehehe
21:57:27 [mash] and glycine
21:57:38 [dsa503] don't remember the enzyme though
21:57:47 [adam] okay, cool
21:58:11 [adam] it is ALA-dehydratase
21:58:32 [dsa503] ala dehydratase I just looked it up
21:58:54 [adam] cool
21:58:55 [Step_1] d-Aminolevulinic Acid Dehydratase (ALAD)
21:59:09 [Step_1] i had to look it up too
21:59:33 [dsa503] we are learning that is what's imp
21:59:33 [adam] good step 1, hope you will be step 2 soon
21:59:50 [dsa503] lol
21:59:55 [Lorena] if this is your worse subject step 1, you will do great in your step 1!!!
22:00:10 [Lorena] you are very good at every subject!
22:00:14 [vladi] marvellous-step1- i'll never remind this
22:00:18 [adam] it's okay, remember that they are 2: ferrochelatase is easy and the other one has LEAD in its name: ALA-DE
22:00:19 [Step_1] i hope i can change my name to step 2 soon
22:00:39 [adam] you will soon, don't worry
22:00:56 [adam] and I will be Adam who knows step 2
22:01:01 [Lorena] i hope we can have the same chat in the step 2 forum!
22:01:14 [vladi] yes-you can
22:01:30 [Step_1] we'll all be there together soon enug
22:01:37 [adam] we will Lorena and you wil be Lorean who knows step 2 and Adam who knows step 2 and Lorena , lol
22:01:51 [vladi] i'll stay by myself hopefully either
22:01:56 [adam] keep going guys
22:02:03 [Lorena] lol
22:02:15 [Step_1] i'll be the artist formerly known as step 1
22:02:24 [adam] no, you will be with us Vladi
22:02:40 [adam] okay, guys. go!
22:02:51 [dsa503] ok guys what is the pblm in methheamoglobinemia
22:02:52 [Step_1] we're all going together vladi!
22:03:32 [dsa503] yeah vladi you are coming with us just keep going & don 't ever give up
22:04:02 [Step_1] formed when the iron (Fe) atom in a given hemoglobin (Hb) subunit is oxidized from the normal Fe2+ state to the Fe3+ state. In this oxidized state
22:04:17 [adam] MetHb
22:04:26 [vladi] i meant that i will keep my name- i'm pretty optimistic
22:04:26 [DrMG] does anyone remember what vit deficiency u have with carcinoid tumour
22:04:32 [dsa503] excellent step 1
22:04:53 [dsa503] exposure to what causes it & WHAT IS THE TREATMENT
22:05:10 [vladi] anyway- thanks a lot for your great support-i'll certainly pass also
22:05:14 [adam] I think in carcinoid syndrome there should be 2 defecienceies: Niacin and Pyridoxine
22:05:15 [kokushubila] DMG -Niacin
22:05:25 [dsa503] deficiency of niacin ?
22:05:31 [DrMG] ya....i agree
22:05:47 [dsa503] because serotonin uses it up right.....
22:05:57 [DrMG] yes
22:06:00 [DrMG] now i remember
22:06:04 [DrMG] u r right
22:06:14 [adam] nope, serotonin uses pyridoxine up
22:06:17 [dsa503] pyridoxine too???
22:06:19 [vladi] adam- can you explain
22:06:30 [DrMG] tryptophan makes serotin and niacin
22:06:31 [adam] yes sure
22:06:34 [Step_1] caused by (1) oxidant drugs and chemicals, (2) abnormalities of red blood cell enzymes, and (3) Hb M disorders.
22:06:40 [DrMG] so if too much serotinin made
22:06:54 [adam] Tryptophan makes serotonin and Niacin
22:07:25 [adam] but in the pathway of serotonin production the reaction needs pyridoxine
22:07:31 [Step_1] Methylene blue is tx for meth
22:07:43 [dsa503] oh ok thanks adam & drmg
22:07:48 [Step_1] is that right dsa?
22:07:57 [dsa503] yes iv meth blue & vit c
22:08:00 [DrMG] thnx adam
22:08:15 [adam] u welcome
22:08:24 [dsa503] yes you're doing good step 1
22:08:35 [vladi] thanks adam-it's pretty tricky
22:08:43 [Step_1] thanks dsa, just trying to keep up
22:09:07 [DrMG] so adam.can i say if u take INH u can have serotinin def too
22:09:08 [adam] yep and I had a debate with others about it because they thought it only causes Niacin def
22:09:37 [Step_1] isnt there a correlation with B6 and TB? I thought I heard that somewhere
22:09:55 [DrMG] INH is a TB drug
22:10:01 [adam] hummmmmmmmm, Dr. MG, this is a good question , I don't know
22:10:06 [dsa503] yes inh treatment will cause b6 def
22:10:10 [DrMG] that will cause b6 def
22:10:23 [adam] INH causes B6 def
22:10:36 [DrMG] cuz u said u need b6 to make serotinin
22:10:42 [DrMG] so if INH cause b6 def
22:10:50 [DrMG] then no serotinin prodiuction
22:10:54 [kokushubila] Isoniazid Tx for TB induces B6 deficiency
22:10:59 [Step_1] yes....that was it.....so you need to give B6 with INH in TB pts or they will develop B6 def symptoms....thanks
22:11:16 [adam] yeah, I got what ya are sayin Dr. MG but I have never thought of it or heard of that so I acn't say yes or no
22:11:32 [DrMG] ok
22:12:19 [dsa503] what are the symptoms of vit a toxicity
22:12:34 [DrMG] dry skin
22:12:39 [DrMG] blindness
22:12:40 [DrMG] night
22:12:53 nne enters this room
22:12:55 [adam] Dry skin, dry mucus membranes and night blindness
22:13:12 [dsa503] those are deficiency symptoms
22:13:13 [DrMG] i get screwed up do u get niacin in corn or eating too much corn causes niacin def?
22:13:23 [dsa503] what are the symptoms of excess
22:13:24 [Step_1] papilledema
22:13:49 [kokushubila] Toxixity-Athralgia, fatigue, headache,skin changes ,sore throat,alopecia
22:13:50 [vladi] anorexia, vomiting, increase ICP and hepatomegaly
22:14:05 [Step_1] hypercalcemia, liver toxicity, convulsions.....over caused by eating bear liver
22:14:20 [kokushubila] Can you give Vit A to pregnant women?
22:14:37 [Lorena] no, contraidicated
22:14:40 [Step_1] look for pt who is a hunter and presents with papilledma
22:14:42 [DrMG] no
22:14:44 [mash] no, its teratogenic
22:14:50 [DrMG] it is teratogenic
22:14:56 [vladi] what is main sourse of vit A toxicity - i mean consumption of what
22:15:17 [mash] carrots
22:15:17 [adam] what is the earliest sign of vitamin a def?
22:15:41 [vladi] you went ahead me step 1- polar bear liver
22:15:45 [Lorena] night blindness
22:15:53 [Step_1] eating bear liver is the main source for vit a tox
22:15:57 [adam] correct Lorena, You are doin great!
22:16:14 [Step_1] night blindness
22:16:29 [DrMG] adam do u know about the corn thing
22:16:29 [adam] how do u diagnose Thiamin def?
22:16:42 [adam] honestly , no i don't
22:17:04 [vladi] what's Bilot spots in Vit A def
22:17:05 [DrMG] i think it was in goljan notes
22:17:11 [DrMG] if i find out i will tell u guys
22:17:20 [Step_1] if anyone has goljans notes, excellent section on vits
22:17:22 [adam] thanks
22:17:38 [adam] i thought it is Bitot spot
22:17:39 [Lorena] thanks
22:17:59 [adam] small gray plaque on conjungtiva
22:18:21 [dsa503] I think bitots spots are seen in vit a def
22:18:36 [vladi] sorry-it's Bitot- my mistake
22:18:56 [adam] what are the therapeutic uses of Retinoids?
22:18:56 [Step_1] Bitot's spots are superficial, irregularly-shaped, foamy gray or white patches that appear on the conjunctiva, the membrane that covers most of the eyeball.
22:19:13 [dsa503] acne
22:19:20 [vladi] actually it's corneal keratin plaques (Princeton review, p.91)
22:19:44 [Lorena] acne
22:19:51 [adam] good one, before you prescribe an acne medication for a 17 year old girl what should ya do dsa?
22:20:15 [adam] what else other than acne Lorena?
22:20:19 [dsa503] pregnancy test
22:20:30 [adam] good dsa
22:20:47 [dsa503] thanks adam
22:20:49 [vladi] right now- in oncology also for differentiation therapy
22:20:58 [Step_1] the vit a recall question had to do with acne teenage girl who was pregnant. asked which vit is contraindicated? ans, i think, was vit a because teratogenic effect
22:21:08 [adam] yes, for which malignancies vladi?
22:21:08 [Lorena] i dont know adam, what else?
22:21:32 [dsa503] skin
22:22:17 [Lorena] anti wrinkle treatment ??
22:22:27 [vladi] it's a big deal of controversy whether we can use of local retinois for preganacy- i did not get this point definitely
22:22:50 [adam] Retinoids: antioxidants: beta caroten, cancer therapy: All Trans Retininoic acid for treating APML, Acne: Retinoic acid, psoriasis: All trans Retinoic acid
22:23:03 [DrMG] in goljan it says diet high in corn causes niacin def
22:23:12 [DrMG] pg 106 general path
22:23:13 [vladi] i know about prostate cancer- cis-retionoid acid
22:23:23 [Lorena] thank you adam!
22:23:30 [adam] how DrMG?
22:23:44 [DrMG] doesn't say how
22:23:46 [Step_1] signs and symptoms of niacin def?
22:23:56 [adam] how do u treat Folic acid defeciency?
22:23:58 [DrMG] just states it and it is a sumle question
22:24:03 [DrMG] he put usmle next to it
22:24:17 [dsa503] diarrhoea dermatitis & dementia
22:24:22 [adam] 3Ds: dementia diarrhea and dermatitis and you can add to that death if not treated
22:24:34 [vladi] adam- what stands for APML
22:24:41 [Step_1] DDD - diarrhea, dementia, dermatitis and sometimes death....good job
22:24:43 [Lorena] diarrhea, dermatitis, dementia, death
22:25:03 [adam] Acute promyelocytic leukemia
22:25:09 [dsa503] folic acid & b12
22:25:14 [adam] got it Vladi?
22:25:18 [adam] good dsa
22:25:32 [Step_1] folate to tx folic acid def
22:25:40 [adam] what are the cause of folic acid def?
22:25:44 [vladi] thanks
22:25:45 [dsa503] adam which canmcers?
22:25:56 [dsa503] I meant cancers?
22:25:57 [DrMG] phentyoin
22:25:57 [adam] nope step 1, never treat folate def alone. always add b12
22:26:04 [DrMG] alcohol and birht control pills
22:26:10 [Lorena] alcoholics, pregnancy (higher requirement)
22:26:15 [dsa503] only apml?
22:26:17 [adam] i said APML, check it out up
22:26:20 [Step_1] ok, thanks
22:26:37 [adam] vladi added prostate cancer but never read that any where
22:26:43 [dsa503] ok trhanks
22:27:10 [adam] what else for folate def?
22:27:27 [Step_1] folate def caused by alcoholism (except beer), poor diet, preg/lactation, disseminated cancer, phytoin bcp
22:27:29 [adam] don't ever forget the drugs, which ones?
22:27:31 [kokushubila] What is the main cause of <a href=http://www.amazon.com/exec/obidos/ASIN/0071429484/qid%3D1085033910/sr%3D2-1/valuetheplace-20>FA</a> def,Is it Overcooked meals or lack of eating green leaves
22:28:04 [kokushubila] I mean Folic acid deficient
22:28:07 [Lorena] TMP SMX?
22:28:18 [adam] good, what else lore?
22:28:36 [Step_1] methotrexate,
22:28:40 [vladi] it's came from from differents urologic meetings that i visited- i am not sure whether FDA apporved it
22:28:52 [adam] TMP, SMX, Dapsone, MTX, Pyremethamine
22:29:31 [Lorena]
22:29:47 [Step_1] which one, folate or B12, causes neurological symptoms? what are the signs?
22:29:51 [adam] which vitamin defeciency cause seizure in childrens particularly?
22:29:57 [adam] B12
22:30:09 [Lorena] piridoxine
22:30:13 [dsa503] b 12
22:30:31 [DrMG] romberg and barbinksi
22:30:32 [adam] it is called subacute Combined degenration of the spinal cord
22:30:36 [dsa503] dorsal column signs
22:30:41 [adam] upper and lower motor neurone signs
22:30:53 [Step_1] B12 def causes subacute combined degeneration with post column degeneration, lack proprioception, lack vibratory sense, [os rhombergs....good
22:31:00 [Lorena] pyridoxine cause seizure i meant
22:31:04 [vladi] piridoxine
22:31:07 [adam] dorsal column signs and ataxia
22:31:15 [Lorena] sorry step 1 i didnt see you r questions first
22:31:17 [Step_1] dementia also
22:31:29 [adam] good, why? which enzyme needs this vitamin?
22:31:30 [Step_1] no prob
22:31:30 ttngo2 enters this room
22:31:44 [Step_1] hi ttngo
22:31:54 ttngo2 exits from this room
22:32:33 [vladi] adam- what;s your answer about kids- b12
22:32:43 [Step_1] thymidylate synthetase?
22:33:00 [adam] a patient is taking a lot of animal proteins in his diet? which vitamin would be needed excessivly in this patient and which vitamin would be produced excessively?
22:33:16 [adam] nope, my question was about pyridoxine def
22:33:33 [Lorena] aminotransferases adam
22:33:50 [Lorena] but i dont know why convulsions, can you explain?
22:34:09 [adam] Glutamate decarboxylase needed to produce Gaba and when pyridoxal is defecient, there is decreased GABA synthesis....seizure
22:34:14 [vladi] we were right with lorena
22:34:59 [Step_1] 23 yo pure vegan is breast feeding. baby is anemic from what? folate def, iron def, B12 def, pyrox def, blood loss?
22:35:19 [Lorena] thank you!!
22:35:22 [adam] i would assume folate
22:35:23 [DrMG] b12
22:35:31 [adam] increase needs, step 1
22:35:36 [adam] you welco,me lore
22:35:42 [Lorena] B12
22:35:44 [dsa503] b12
22:35:55 [adam] sorry guys, you are right, B12
22:35:55 [vladi] folate
22:35:58 [adam] I am wrong
22:36:11 [Step_1] yes the ans is B12 def
22:36:31 [dsa503] adam what is the ans to your other q
22:36:42 [adam] which vitamin is used to treat hypercholestrolemia?
22:36:50 [dsa503] niacin
22:36:55 [Lorena] vit e
22:37:08 [dsa503] the one abt animal proteins
22:37:14 [Step_1] niacin
22:37:33 [adam] increase need for pyridoxine and increase production of Niacin
22:37:43 [vladi] niacin-agree with dsa
22:37:53 [adam] Niacin in 100X RDA dose
22:37:58 [DrMG] do u know which vit def is in celiac sprue
22:38:03 [dsa503] could you explain why adam
22:38:43 [adam] animal protein contains a lot of tryptophan........increase Niacin production
22:38:59 [adam] pyridoxine is a vitamin essential for protein metabolism
22:39:06 [adam] that was for u dsa
22:39:11 [Lorena] B12 is deff in celiac sprue
22:39:25 [dsa503] thanks adam!!
22:39:39 [adam] where is Iron, folate and B12 in the intestine absorbed?
22:39:57 [hutals] b12 is terminal ileum
22:40:16 [hutals] iron is duodenom i think
22:40:22 [vladi] very tricky Q- what's vit def causes "tea and toast" diet and "strict vegetarian"
22:40:24 [adam] cool hutals, where have ya been hiding?
22:40:29 [DrMG] no lorena...celiac effect in duodenum so iron
22:40:43 [dsa503] iron in duodenum foalte in jejunum & B12 in terminal illeum
22:40:44 [DrMG] this is what i read in goljan
22:40:48 [vladi] distal ileum
22:41:08 [Lorena] oh ..ok, thanx
22:41:09 [adam] good job dsa
22:41:22 [hutals] i'm an observer, i'm kinda shy since i dont know much
22:41:35 [dsa503] B12 tea & toast diet
22:41:45 [dsa503] thnks adam
22:41:49 [Lorena] adam , what was thje answer to vit to treat hypercholeterolemia?
22:42:01 [adam] what else is absorbed in the terminal ilium that is necessary for absorption of fat soluble vitamins?
22:42:19 [dsa503] bile salts
22:42:20 [Step_1] intrinsic factor
22:42:22 [adam] Niacin Lorena but you give it in 100X the RDA dose
22:42:35 [Lorena] hutals, it is great you are here! one learn a lot listening to these guys share what they know
22:42:41 [adam] intrinsic factor is not absorbed by the way step 1
22:42:48 [Lorena] ok, thanks adam
22:42:58 [adam] welcome lore
22:43:09 [Step_1] good point adam
22:43:35 [DrMG] which vit is stored for many years
22:43:41 [adam] also step 1, intrinsic factor is not needed for fat soluble vitamins abs
22:43:47 [hutals] thanks. i'm glad you dont mind me listening in
22:43:49 [adam] b12, Dr MG
22:44:02 [adam] its okay hutals, you are most welcomed
22:44:05 [DrMG] correct adam
22:44:10 [adam] I am gonna get you talk in here in a minute
22:45:03 [dsa503] hutals you should try you will l;earn from your mistakes & ours
22:45:17 [hutals] not me, i'm only on my first reading and haven't even been through the stuff once yet. but i'm learning alot from you all
22:45:18 [Lorena] what about vit E ? i read it prevents peroxidation of fatty acids in membranes?
22:45:19 [adam] The bufferenig capacity of Hb is because it contains which amino acid?
22:45:27 [DrMG] which bug causes b12 def
22:45:48 [Lorena] D. latum
22:45:54 [dsa503] histidine
22:45:57 [DrMG] correct
22:45:59 [Step_1] fish tapeworm
22:46:12 [adam] it does Lorena and it is receomended sometimes as an antioxidants for patients with Atherosclerosis or increased risk of malignancy
22:46:18 [adam] correct dsa
22:46:18 [vladi] tean and toast diet- folate def, strict vegetarian- b12
22:46:44 [Lorena] i see
22:47:01 [dsa503] thanks vladi
22:47:11 [adam] Dr.MG, also in general bacterial overgrowth in the intestine causes Vit B12 def. so dont forget
22:47:31 [DrMG] which vit is needed for heme synthesis
22:47:41 [DrMG] thnx adam
22:47:48 [adam] pyridoxine
22:48:16 [Step_1] B6
22:48:43 [adam] vitamin C increases the absorption of iron, how?
22:48:47 [DrMG] B12 needed to make succinyl coA which with glycine heme
22:49:16 [DrMG] succinly CoA + glycine = heme
22:49:34 [adam] but more importantly DrMG, you need pyridoxine for the ALA synthetase which is the RLS for heme synthesis
22:50:08 [DrMG] ok thnx
22:50:20 [adam] how do u diagnose Thiamin defeciency?
22:50:30 [Step_1] reduction of iron from ferric to ferrous state
22:50:41 [adam] what is Vitamin A embriopathy?
22:50:45 [adam] excellent step 1
22:50:56 [adam] embryopathy sorry?
22:51:02 [Step_1] thanks
22:51:09 [DrMG] it is an antioxidant ( vit c)
22:51:29 [DrMG] so keeps iron in Fe2 state
22:51:53 [Step_1] vit a derivative is teratogenic...is that what you're asking adam?
22:51:55 [DrMG] only Fe2 ges absorbed
22:51:55 [dsa503] thiamin def polyneuritis?
22:52:02 [Lorena] what is the answer to dx of thiamine def adam?
22:52:23 [Lorena] transketolase?
22:53:08 [vladi] vit e- antioxidant, not c
22:53:16 [adam] This is a very important diagnostic test and it is used clinically; u need to give the patient Thiamine and measure RBC transketolase activity which increase upon administering Thiamin. got it Lorean?
22:53:21 [DrMG] e and c
22:53:46 MDK enters this room
22:53:47 [adam] vladi: Antioxidants include: Vitamin C, Vitami E, and Beta carotene ( vitamin A)
22:53:53 [DrMG] ut only vitamin is a antioxidant that prevents oxidation of LDL
22:54:08 [DrMG] but A,C,E are antioxidant
22:54:11 [Lorena] yes
22:54:31 [DrMG] *e was the vit for ldl
22:54:53 [Lorena] trasnektolase is cytoplasmic so easy to mesure
22:54:55 [adam] why most men OTC multivitamin preperations do not contain iron?
22:55:20 [vladi] adam- Boards most frequently tests as antioxidant vit E and selenium- this is HY
22:55:25 [dsa503] because they don't need as much iron as women since no iron loss
22:55:45 [Step_1] constipation?
22:55:50 [adam] nope dsa, that is not the answer. there is a more seriuos risk
22:55:54 [adam] more serious
22:56:16 [dsa503] hmmmm
22:56:26 [dsa503] iron overload disease??
22:56:32 [DrMG] adam interesting..plz tell
22:56:42 [adam] true Vladi if you have all these options in the question then go for E, okay?
22:57:05 [adam] iron increases the oxidation of LDL which increases the risk of atherosclerosis
22:57:21 [Step_1] pt with cystic fibrosis most likely to be def in which vit and why?
22:57:27 [dsa503] adam what was the vit A embryopathy?
22:57:39 [dsa503] Thanks \adam that was a good one
22:57:42 [adam] all the fat soluble vitamens: DEAK
22:57:46 [dsa503] fat solubl;e vit
22:58:04 [DrMG] the importance of vit E being an antioxidant is that unlike the the others this one is the only one that can preven oxidation of LDL ...oxidized LDL is the one taken up by macro and form foam cells
22:58:21 [DrMG] vit c and A don't have this ability
22:58:23 [adam] It is facial defects that results in babies of mothers who consume excess vitamin A, okay dsa?
22:58:38 [Step_1] CF patients have fat malabsorption because they lack pancreatic enzymes. so all fat soluble vits (A,D,E,K)....good job
22:58:47 [dsa503] ok thanks adam
22:59:06 [adam] step 1, also Vitamin B12 will be defecient
22:59:32 [vladi] exactly DrMG- that's what i meant, but Board won't dig so deep
22:59:44 [Step_1] adam, didnt know that one. why B12?
22:59:58 [DrMG] ok
23:00:03 [adam] which drugs are contraindicated in patients with porphyria?
23:00:20 [Step_1] just found it....pancreatic enz cleave off RR factor. this allows B12 to bind to IF
23:00:32 [adam] cool step one, do you know what is the role of R factor in the carriage of vitamin B12?
23:00:41 [adam] cool step 1
23:01:05 [vladi] iron
23:01:14 [Step_1] prevents gastric acid destruction of B12
23:01:20 [Step_1] good question adam
23:01:33 [adam] excellent step 1
23:01:40 [adam] you will go to step 2 soon
23:01:43 [MDK] barbiturates-porphyria
23:01:43 [dsa503] How does folic acid def cause MI?
23:01:50 [adam]
23:02:04 [Step_1] i hope we all will
23:02:18 [dsa503] yesa good adam
23:02:18 [adam] which causes increased thrombosis every where you can think of
23:03:23 [adam] got it right dsa?
23:03:36 [dsa503] which metal is needed for wound healing?
23:03:46 [dsa503] yes adam you are correct
23:03:57 [adam] what precursor is increased in lead poisoning?
23:04:19 [vladi] zinc
23:04:22 [adam] is it Zinc, dsa? not sure!
23:04:27 [dsa503] aminilevulinic acid
23:04:30 [MDK] zinc
23:04:35 [dsa503] yes good vladi
23:04:38 [adam] good dsa
23:06:03 [vladi] adam- how about Q of porphyria
23:06:15 [dsa503] biotin def cause by what?
23:06:24 [adam] yes vladi, that was agood one
23:06:29 [MDK] eggs
23:06:52 [dsa503] yes raw eggs
23:07:04 [adam] yes, avidin in egges avidly binds biotin
23:07:06 [Step_1] raw eggs
23:07:09 crusher enters this room
23:07:21 [Lorena] hi crusher!!
23:07:28 [dsa503] hello crusher
23:07:32 [crusher] hi everyone,sory i,m late today
23:08:02 [dsa503] no pblm
23:08:07 [Step_1] hi crusher
23:08:16 [DrMG] about vitamins
23:08:33 [vladi] hi crusher
23:08:36 [DrMG] oops i meant hi crusher we are talking about vit
23:09:07 [crusher] ok.can i know whats the Q?
23:09:49 [dsa503] adam how ab t the porphyria q
23:09:50 [Step_1] what are causes of vit K def?
23:10:29 [adam] vladi: cyt p450 in the liver contains porphyrin and drugs that induce cytp450 increase the synthesis of this protein and increase ALA synthetase activity and increase ALA production, okay?
23:10:33 [DrMG] prolong antibiotic use
23:10:45 [MDK] liver disease,broad spectrum a'biotics
23:10:54 [Lorena] malabsorption, antibiotics, new born with liittle flora, anticonvulsants during pregnancy
23:10:59 [vladi] we missed urea cycle- HY-let'sw do it
23:11:06 [adam] and don't ever forget the poor newborns who have no normal flora
23:11:16 [adam] all new borns are administered IM Vitamin K
23:11:22 [Step_1] antibiotics, newborn (give IM vit k at birth), warfarin (recall about child eating rat poison which has warfarin), malabsorption.....good job
23:11:34 [DrMG] u r right adam
23:11:46 [vladi] thanks adam- i got your point
23:12:02 [dsa503] wow thanks adam
23:12:21 [adam] welcome dsa
23:12:51 [Step_1] good stuff adam, thansk
23:13:20 [Step_1] whats the most common cause of vit d deficiency?
23:13:24 [adam] guys, don't ever forget that hyperuricemia increases the risk of thrombosis
23:13:31 [dsa503] so basically drugs that induce ct p450 are contraindicated in porphyria
23:13:42 [adam] that is why they go crazy on hyperuricemia and gout
23:13:51 [adam] excellent dsa
23:14:05 [adam] Kidney disease , is it step 1?
23:14:13 [dsa503] thanks adam, I am learning a lot today
23:14:20 [vladi] the only urea cycle the def of which produces the clinical manifestation
23:14:23 [adam] good dsa
23:14:30 [Step_1] chronic renal failure tops the list because of lack of 1 alpha hydroxlase causing dec vit d. good job adam
23:14:50 [adam] good step 1
23:16:01 [DrMG] thnx guys i learned alot today....goodnight
23:16:21 [Step_1] thanks drmg...see you on wed
23:16:45 [dsa503] thanks drmg gd night
23:16:57 [adam] megaloblastic anemia and vitamin B12 def. hummmmmmmm: is there any other cells that are megaloblastic in this def?
23:16:57 [Lorena] thnk you Dr MG , learnt a lot from you today
23:17:04 crusher enters this room
23:17:10 [adam] take care DrMI
23:17:20 [adam] DrMG sorry
23:17:28 [MDK] megakaryocytes
23:17:40 [adam] where else?
23:18:34 [dsa503] neutrophils
23:19:00 [adam] neutrophils are hypersegmented, where eles?
23:19:36 [adam] how do u avoid Vitamin D defeciency in infants?
23:19:37 [dsa503] all cells will be large right ..?
23:19:48 [crusher] in b12 def and folate def
23:19:49 [dsa503] sunli\ght
23:20:13 [adam] right dsa, especially cells that shed frequently. you can even see megaloblastic changes oin pap smear
23:20:18 [Step_1] sun
23:20:37 [dsa503] yes thats right
23:20:50 [adam] sun is correct but you guys no that most of the kids nowadays are not exposed to adequate sun, what do u do?
23:21:25 [crusher] i guess give phototherapy
23:21:27 [Step_1] take away their video games
23:21:38 [dsa503] lol
23:22:08 [adam] lol, infants don't have video games yet. did u have one when you were an infant?
23:22:10 [dsa503] in what dis do you get vit D excess?
23:22:15 [crusher] ohhh kids i misunderstood infants ..
23:22:20 [MDK] adeq breast milk& vitD &ca supplementation
23:22:35 [Step_1] fortified milk
23:22:36 [adam] crusher, phototherapy for hyperbilirubinemia
23:22:48 [kokushubila] Sarcoidosis
23:22:53 [adam] what is the rule of phototherapy in the treatment of hyperbilirubinemia?
23:23:02 [adam] excellent step 1
23:23:21 [adam] all children formulas in USA contain fortified milk
23:23:29 [MDK] isomerisation to stable forms which get increasingly shed
23:23:41 [adam] shed where?
23:23:43 [dsa503] good koku!!
23:24:07 [adam] what about sarcoidosis Kuku?
23:24:12 [kokushubila] Sarcoidosi a dses where the epithelioid macrophages convert Vit D into active form
23:24:21 [adam] Lorena, Vladi, where are ya?
23:24:21 [Step_1] vit D, belive it or not, is not natural component of milk, so neaks to be added. vit d is absent in colostrum of breast milk
23:24:40 [Lorena] i am right here reading you guys
23:25:05 [adam] Okay guys, I will have to go soon!
23:25:34 [Step_1] same here. any other hy that you want to go over before we go?
23:25:41 [Lorena] lets move on on lipids.... we have not talked about that yet
23:25:56 [Step_1] ok, lipids it is
23:25:58 [vladi] i'm here- i offered urea cycle but nobody supported my idea- we stick around vits already more than 1 hour
23:26:03 [dsa503] adam what is the rule of phototherapy in the treatment of hyperbilirubinemia?
23:26:11 [adam] patients who are starved or malnurished are particularly at increased risk of hypoglycemia, why?
23:26:15 [kokushubila] Can anyone explain what is "Milk-Alkali" syndrome , do no it
23:26:19 [MDK] otc
23:26:45 [Step_1] ok, so lipids and urea cycle
23:26:48 [MDK] i.e ornithine transcarbamoylase
23:27:20 [adam] ismoerization is correct but it converts bilirubin to a more soluble form that can be excreted in urine
23:27:37 [adam] okay guys, what is the question?
23:27:41 [dsa503] thanks adam
23:27:52 [adam] welcome dsa
23:28:08 [Step_1] rate limiting step for cholesterol synthesis
23:28:45 [dsa503] hmg co a synthetase
23:28:52 [adam] HMG CoA reductase
23:28:54 [Lorena] HMG coA red
23:29:10 [Step_1] HMG-CoA reductase is right. which converts what to what? what drug inhibits this?
23:29:12 [crusher] hmgcoa reductase
23:29:25 [adam] nope dsa, HMG CoA synthetase is for Ketone bodies sunthesis
23:29:43 [Lorena] statin inhibits it, it converts HMG coA into mevalonate
23:29:43 [dsa503] oh ok
23:30:05 [vladi] if an individual has a genetic defect in the enzyme that produces N-acetylglutamate, the clinical finding would be hyperammonemia with...
23:30:09 [dsa503] thanks for pointing that out
23:30:19 [Step_1] converts HMG CoA to mevalonate. statins (i.e. Lovostatin) inhibits
23:30:24 [adam] HMG CoA reductase inhibitors: statins
23:30:32 [Step_1] good job
23:30:37 [crusher] hmgcoa to malvonate,,,,statinins
23:31:13 [adam] with encephalopathy vladi?
23:31:55 [vladi] what's SE of statins- HY Q
23:32:16 [crusher] muscle pain
23:32:36 [adam] very important: You have to keep an eye on LFT and also they cause myopathies
23:32:54 [vladi] good Q adam- yes
23:33:03 [adam] always take arefernce point of their LFTs before u start them on statins
23:33:07 julieog1 enters this room
23:33:23 merjo13 enters this room
23:33:39 [Step_1] hi julie and merjo
23:33:59 [merjo13] Hi I'm really late
23:34:01 [adam] move on guys, what was your question Lorena?
23:34:10 [vladi] actually they loves to ask about rabdomyolysis, because it significantly diminished the consumption of statins in US
23:34:14 [adam] its okay, welcome merjo
23:34:30 [dsa503] vladi can you explain the ans to your previous q
23:34:48 [Lorena] no question adam
23:35:05 [Step_1] so the answer is rhabdo
23:35:14 [Lorena] just before we go, what are we going to discuss next chat?
23:35:19 [adam] I know, I just wnated ya to share, ask
23:35:49 [Lorena]
23:36:09 [Step_1] lorena, do you mean which part of physio?
23:36:14 [adam] step one, can you repeat your question please?
23:36:21 [Lorena] yes
23:36:57 [Step_1] i was asking if the answer to the question about statin side effect....was it rhabdomyolitis?
23:37:44 [adam] juliog1: I like your sign, its pretty. yellow hair with blue shirt, can you guys see that?
23:38:09 [Lorena] yes i see that....how do you do that julie?
23:38:18 [adam] julieog
23:38:22 [crusher] no i cannot see
23:38:31 [dsa503] no I can't see
23:38:35 [Lorena] the rest of us look like with uniforms
23:38:37 [adam] now Lorena come on, you became jealous
23:38:43 [crusher] oh ya i just se..
23:38:52 [dsa503] oh yeah hehehe
23:38:54 [kokushubila] Ha ha ha ha I like it too !!!
23:39:03 [Lorena] hey i want to look cute too !
23:39:22 [adam] You are babe, by your mind
23:39:26 [dsa503] hey come on julie tell us how you do it
23:39:48 [Step_1] thats hilarious...i've never seen that....seems like a bunch of guys and only one girl here
23:39:55 [adam] julie is hiding. she is plushed
23:39:55 [Lorena] how sweet thanks adam
23:40:06 [adam] you welcome
23:40:08 [vladi] ammonia reacts with carbone dioxide and ATP to form carbo-phosph-synthetase. Thus enzyme requires N-acetylglutamate.W/o this reaction urea would not be produced. The next step is reaction of carmoyl phosphate with ornitine to form citrulline, i.e. no citrulline
23:40:10 [dsa503] lol
23:40:24 [adam] Julie: you got the attention of every body
23:40:52 [adam] was that a question Vladi?
23:41:24 MDK exits from this room
23:41:50 [adam] guys, I am trying to pm Julieog1 and I can't
23:41:52 MDK enters this room
23:42:04 [adam] what was the last question?
23:42:25 [vladi] see above adam- i try to clarify with urea cycle
23:42:28 [adam] Hello! any body still here or was I kiked out?
23:42:37 [Lorena] ok guys i have to go ... thank you for your knowledge...you are great! see you next chat
23:42:38 MDK exits from this room
23:42:49 [Step_1] ah, ok, i thought it was a question
23:42:57 [dsa503] hey julie I did it
23:43:04 MDK enters this room
23:43:10 [Step_1] thanks for the chat lorena. see you on wed
23:43:18 [adam] you did what? that fast , lol
23:43:22 [Step_1] before you go lorena...which subjects
23:43:30 [adam] thanks lorena
23:43:38 [vladi] mainly - read carefully legend- if there is a high levels of ammonia and low levels of BUN- it's urea cycle disorder
23:43:40 [adam] was nice having ya with us today
23:43:46 [dsa503] thanks lorena
23:43:58 [kokushubila] Bye Lor , Thanx
23:44:40 [adam] hey dsa: you got my attention too pretty!
23:44:46 [Step_1] i guess we can do endocrine, cardio and muscle on wed and then the remainder on sat?
23:44:50 [dsa503] lol
23:45:07 [adam] is that the only top tank they have, I like the blue color
23:45:11 [Step_1]
23:45:24 [adam] okay fine with me
23:45:38 [dsa503] yeah it is just the sign for female
23:45:57 [dsa503] gals change your profile to female & you're all gonna be looking cute!!!
23:46:02 [adam] Lorena is not around, she must be busy tryng to figure out how to die here hair and change her top tank
23:46:03 [kokushubila] Good Step 1
23:46:16 [adam] dye i meant sorry
23:46:22 [Step_1] lol....i think you're right
23:46:40 [vladi] then follow 2 main enzyme: lack of citrulline goes trhru carbomoyl phosphate synthetase I, high urine level of orotic acid goes thru ornitine transcarbomoylase
23:46:54 [adam] and she is going crazy trynig to find out where the hell are the tops , lol
23:46:57 [Lorena] sorry, i got disconnected
23:47:16 [kokushubila] Guys , THANX A LOT , have a nice sleep. I have to go now
23:47:34 [dsa503] ok bye koku
23:47:36 [Lorena] hey adam i read that!!! lol
23:47:53 [crusher] i have to check chat transcript.....
23:47:56 [adam] oh, its okay lore , look at dsa , she changed dyed her hair and changed her top too, can u see that?
23:47:57 [Lorena] so the topics , i must leave now
23:48:03 [Step_1] bye kokshub
23:48:14 [Step_1] i guess we can do endocrine, cardio and muscle on wed and then the remainder on sat?
23:48:17 [crusher] me girl too...i need to dye my hairs
23:48:17 [dsa503] I thi nk I'll call it a night too, vladi is really scaring me
23:48:22 [vladi] thanks, good night
23:48:29 [Lorena] i wish they had a brunette
23:48:42 [adam] The Top-ics Endocrinology
23:49:03 [adam] why is she scaring you?
23:49:22 [Lorena] ok, see you next chat then, good night !
23:49:24 [adam] vladi, why ya are scaring dsa?
23:49:26 [dsa503] thanks guys adam, lorena vladi step1 & everyone else for a great discussion!!!!
23:49:42 [adam] good night every body
23:49:50 [adam] all the best for every body
23:49:55 [dsa503] never really liked urae cycle... I'm a litt;le lost right now
23:50:03 [Step_1] physiology is the main topic, so we have a bunch of subtopics to choose from. does endocrine, cardio and muscle physio for wed sound good?
23:50:10 [adam] guys if any body needs any question or just want to say hi, please drop me a message any time
23:50:44 [Step_1] i'll try to post some more questions in the forum for you guys in between the chats
23:50:56 [dsa503] yeah me too ... my email is
dsa503@yahoo.com
23:51:01 [dsa503] thanks guys
23:51:06 [adam] all the best to every body and good night and a very special good night to Julieo who is still hiding.
23:51:09 [dsa503] g'night
23:51:29 [adam] mine is freedom_rhythm2003@yahoo and you can also pm me on this forum
23:51:45 [Step_1] good night everyone.
23:51:49 [adam] Thank you step 1, you are doing great
23:52:21 [Lorena] thank you step , adam, everybody, you are great!
23:52:50 [Step_1] thanks adam, but not as good as you. thanks to everyone...i learned alot in my most difficult subject