chat transcript - biochemistry (metabolism and vits)

[Anonymous]

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

[doc_heart]

pls guide me guys...am newbie

[efemena]

my name is efe,am a student of biochemistry in Nigeria. can i be your chart partner?

[efemena]

hello; pls can u help explain the difference in unsaturated and oxidation in fatty acid? thanks.efe