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Showing posts from June, 2019

A 3 year old child had a severe viral illness, a few days later there were repeated vomiting, loss of consciousness and convulsions. Laboratory blood tests revealed hyperammonemia.

what is it hyperammonemia? when there is hyperammonemia? Inc^ NH3 in blood Metabolic fate of ammonia. Formation of urea, amination of ketoacid, Glutamate to glutamine, ketogluterate to glutamate Transport of ammonia. NH3+Glutamate -> glutamine  -> glutamate +NH3--->urea cycle (tissue blood liver) Reactions of urea cycle. Significance of urea cycle. Dec^ NH3 and make it safe for excretion Regulation of urea cycle . Carbonyl phosphate syanthesis-> rate controling enzyme Metabolic inborn errors of urea cycle 6 enzymes of the cycle CPS1, NAGS, OTC, AS, ASL, AG
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A 42-year-old man suffers from rheumatoid arthritis. Aspirin, as inhibitor of prostaglandin synthesis, is included in the complex of drugs prescribed to him.

Aspirin. Properties, Mechanism of action, also acetyl salicylic acid, it is NSAID (non-steroidal)C9H8O4 .....Action blocks prostaglandins synthesis What are eicosanoids? signaling molecule made by oxidation of Aracidunic Acid Types of eicosanoids. Prostaglandins, Prostacyclins, Thromboxyn, Leukotriene Function of prostaglandins. Conriction and dilation of smooth muscles(pain singniling) inc^ CAMP in Endocrine gland......Dec^ CAMP in adipose tissue, gastric secretion , insulin secretion, Synthesis of prostaglandins. Substrates . DiAcylGlycerol, phosphoglycerol
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how many chiral centers are in the molecule of promedol

2
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Alanine is an amino acid with a non polar radical, is essential

1 L-isomeres 2-aminopropanoic acid
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glucose is an optically active substance, formed during the hydrolysis of starch

4 16 polarimetry
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Myocardial infarction, injuries and surgical interventions may be accompanied by thrombosis.

Blood coagulation system in book Mechanism of fibrinolysis. - plasmine urokinase Blood coagulation disorders von Willebrand disease ,hemophilia a-8, b-9,c-11 The role of the vascular wall in the coagulation system? synthesis of thromboxane and endothileum . What kind vitamins are necessary for normal functioning of the coagulation system? vit k Anticoagulants. Representatives. Characteristics. direct ans indirect..heparin an warfarin
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A young girl turned to a dermatologist about redness, swelling and itching that appeared on open skin areas after a country walk on a sunny day. The patient took sulfonamides due to the exacerbation of chronic bronchitis. 5-aminolevulinate and porphobilinogen were detected in the patient's blood, urine was colored red.

What is the preliminary diagnosis  porphyrias(hepatic) Metabolic disturbance of which substance is observed in this case  heme Why urine has red color in this case  due to porphyrins Heme synthesis. Reactions. Regulation  ALAS What heme synthesis enzyme is induced by sulfonamides  aminoleulanate synthase
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The concentration of total cholesterol and HDL cholesterol were determined in 60-year-old man: total cholesterol - 7.2 mmol/l, HDL cholesterol - 1.55 mmol/l.

Estimate the results of lipids profile presented in this case? increase lipid,increase hdl What is the normal level of total cholesterol, LDL and HDL in blood? total-5.17mmol/l..ldl-2.59mmol/l hdl-1.03-1.55mmol/l LDL. Structure. Synthesis. Functions. Apolipoprotien HDL. Structure. Synthesis. Functions.  What lipoproteins are atherogenic? Why? LDL,contain apolipoproteinB, What lipoproteins are antiatherogenic? Why? HDL(imhibit,atherosclerosis)
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In female patient in the study of the composition of bile, not only primary, but also secondary bile acids were found.

What bile acids do you know? glycocholic acid, tyrocholic,glycol-chenodeoxycholic,tyro- chenodeoxycholic Which bile acids are primary? glycocholic acid. glycol-chenodeoxycholic Which bile acids are secondary? tyrocholic, tyro- chenodeoxycholic The role of bile acids in lipid digestion? emulsification of lipid In component of which structures bile acids will be reabsorbed in the intestine? mixed miccelle Which bile acids is excreted with feces? secondary:deoxycholic and lithocholic
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Doctor prescribed to the patient suffering from overweight drug Xenical, which is an inhibitor of pancreatic lipase. The drug must be taken with meals.

What type of reaction does catalyze by pancreatic lipase? HYDROLYSIS OF TAG What is the substrate for pancreatic lipase? TRIGLYCERIDES What are the products of TAG digestion? MONOGLYCERIDES+ 2 FATTY ACID What is steatorrhea? PRESENCE OF FAT IN FECE
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58 years-old female patient came to the clinic with complaints of general weakness, aching abdominal pain, poor appetite. The examination revealed gallstones that periodically blocked the bile duct and disrupted the flow of bile into the intestine. An increase in conjugated bilirubin was detected in the serum.

What is the preliminary diagnosis? BILE STONE DISEASE What bile acids do you know? GLUCOCHOLIC ACID, THYROCHOLIC ACID, GLYCOCHENODEOXYCHOLIC, THYROCHENODEOXYCHOLIC , DEOXYCHOLIC , LITHOCHOLIC What is the substrate for bile acids synthesis? CHOLESTEROL The role of bile acids in lipid digestion? EMLSIFICATION OF LIPID Deficiency of what substances observe in this patients? FAT SOLUBLE VITAMIN DECREASE
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24 years-old young man was admitted to the hospital with symptoms of coronary heart disease as a result of atherosclerosis. The survey found that the patient's lipoproteins contain a low-level enzyme lecithin-cholesterol acyltransferase (LCAT).

What lipoprotein fractions are rich in LCAT? HDL Why the deficiency of LCAT can lead to the development of atherosclerosis? ESTERIFICATION OF CHOLESTEROL STOPS HDL. Structure. Synthesis. Functions. HDL IN LIVER REVERSE CHOLESTEROL TRANSPORT APOPROTEIN A1,2     C1,2,3   E AND D
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25-year-old patient in the morning on an empty stomach took blood serum for analysis, after storing it in the refrigerator for 16 - 24 hours white fatty flakes appear above the transparent serum. The blood levels of triglycerides are sharply elevated, the concentration of cholesterol is slightly elevated. There are no clinical signs of atherosclerosis. Marked by the presence of xanthomas

What is the preliminary diagnosis? HYPERLIPIDEMIA TYPE 1ST What enzyme deficiency is observed in this case? LIPPOPROTEIN LYPES What types of lipoproteins do you know? HDL, LDL, IDL, VLDL, CHYLOMICRONES Chylomicrons. Structure. Synthesis. Functions. B48 APPOPROTEIN , SYNTHESIS  IN INTESTINE, FUNCTION IS TRANSPRTATION OF LIPID TO PERIPHERAL TISSUE VLDL, IDL, LDL. Structure. Synthesis. Functions. VLDL - KIVER, ENDOGENOUS  TRIGLYCEROL FROM LIVER TO PERIPHERAL TISSUE IDL- LIVER, ALSO IN TRANSPORTATION LDL- PLASMA TRANSPORT LIVER TO PERIPHERAL TISSUSE(cholesterol)
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Make a preliminary diagnosis according to the following data of the patient’s biochemical blood analysis: total bilirubin - 120 mmol/l (increase in both free and bound bilirubin); total protein is reduced; proteinogram: albumins are reduced; alpha and gamma globulins are elevated; ALT activity is increased.

What is the preliminary diagnosis? HEPETITIS What type of jaundice is observed in this patient? HEPATOCELLULAR Write 4 types of jaundice PREHEPATIC, HEPATOCELLULAR, POST HEPATIC, NEONATAL What is the substrate for the synthesis of bilirubin? HEME Where and in what reaction is unconjugated bilirubin synthesized? SPLEEN Where and in what reaction is conjugated bilirubin synthesized? LIVER
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The results of biochemical analysis of blood: total protein 48 g/l; albumin 25 g/l; total bilirubin - increased; prothrombin time is reduced; ammonia is elevated.

What is the preliminary diagnosis? LIVER CIRROSIS What blood parameters are decreased in this case? LOW PROTEIN LEVEL BELOW THE 60-80/L What is hypoproteinemia? DECREASE LEVEL OF PROTEIN IN BLOOD What are albumin functions? REGULATE THE ONCOTIC PRESSUR OF BLOOD AND TRANSPORTATION What does prothrombin time show? DECREASE CLOTTING TIME
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The patient was admitted to the clinic with complaints of pain behind the sternum and over the left shoulder blade, which lasts about an hour. The examination revealed the increase of creatine kinase MB activity in 2.5 times. AST activity is at the upper limit of the norm, ALT activity is not changed

What is the preliminary diagnosis? MYOCARDIAL INFARCTION What does the high enzyme activity in the blood in this case show? LYSIS OF CARDIOMYOCYTES What types of creatine kinase do you know? CKMM, CKMB, CKBB In which tissues are different types of creatine kinase localized? CARDIAC MUSLE, SKELETON MUSCLE AND BRAIN Which enzymes and proteins do you need to check in blood of patient to prove your diagnosis? TROPONIN T, TROPONIN I
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The patient is exhausted due to severe diseases of the gastrointestinal tract and disorders of digestion and absorption processes.

How will change the concentration of total protein in the blood of this patient? PROTEIN LOW ( HYPOPROTENEMIA) IN BLOOD AND HIGH PROTEIN IN FECES AND URINE What will you use for treatment of patients with violation of proteins digestion in the stomach? DIGESTIVE ENZYMES How does called an increase in total protein in the blood? HYPERPROTENEMIA How does called a decrease in total protein in the blood? HYPOPROTENEMIA Write the normal concentration of total protein in the blood. 65-85 GRAM/L
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The parents of a 3.5 year-old boy turned to the medical genetic consultation. They complained of short stature, deformity of the joints, curvature of the spine in the thoracic region. As a result of the examination, the boy was diagnosed with Ehlers–Danlos syndrome type VIII. The cause of this disease is a defect in the procollagen peptidase enzymes.

At what stage of collagen synthesis do procollagen peptidase enzymes work? 6 STAGE What is the sequence of amino acids in collagen? GLY-X-Y What type of collagen is located in bones? 1 ST How many types of collagen exist? 19 What is the strength of collagen fiber? TENSILE STRENGTH CARTILAGE LIGAMENT TENDON
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The parents of a one-year-old boy appealed to the pediatrician with complaints about the restless state of the child, poor appetite, swelling of interdental papillae, contact bleeding of gums, bleeding from the nose, swelling of the extremities, hemorrhagic skin rash, chest deformity, curvature of the long tubular bones of the legs. The baby is exclusively bottle-fed. During the examination in the urine were found red blood cells. A pediatrician diagnosed with Möller-Barlow syndrome (vitamin C deficiency in children or "children's scurvy").

Violation of the synthesis of which protein is observed in this case C OLLEGAN Name every third amino acid of collagen LYSINE What type of collagen is located in the basement membranes of the renal capillaries LEMININES What are the reactions of collagen synthesis depend from vitamin C HYDROSYLATION OF LYSINE OF PROLINE What are the reactions of collagen synthesis depend from iron? PROLYLHYDROXYLASE , LYSYLHYDROXYLASE
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The child has iron deficiency anemia and hypoalbuminemia. Further examination revealed the presence of Ancylostoma hookworms - are parasites that violate the integrity of the intestinal vascular bed and feed directly on the blood. The consequence of this is a chronic loss of blood in the intestines. When Ancylostomiasis revealed violations of the integrity of the mucous membrane of the mouth, tongue, cracking of the skin of the lips, gingivitis, periodontitis.

What is the main fibrillar protein of connective tissue collgen Name 2 enzymes of collagen synthesis that depend on vitamin C and iron hydroxylase,lusyl hydroxylase What is collagen primary structure formula glycine-x-y What cells synthesize collagen fibroblast How many types of collagen exist 19(X-proline,Y-hydroxyproline )
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Emphysema of the lungs is disease that gradually develops in people whose professional activity is associated with a systematic increase in intrapulmonary pressure (musicians playing wind instruments, glass blowers). A typical clinical picture of emphysema is given by the following signs: the lungs are enlarged, swollen, soft, with surgical intervention they are cut with a crunch. Microscopic examination is characterized by the expansion and flattening of the alveoli, the thinning of the alveolar septa.

What enzyme deficiency can cause emphysema alpha -anti trypsin What is the main stretchable protein of the walls of blood vessels, ligaments and lungs? elastin,prolein What are the features of the amino acid composition of this protein? high strechibility and and subsequently to recoil What are the vitamins and metals which are necessary for elastin synthesis? vitamin b6,b3 ans copper
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A 45-year-old man addressed a surgeon with complaints of pain and a feeling of heaviness in the lower limbs, the frequent appearance of edema in the ankle joints, dilation of the subcutaneous veins of the lower limbs. The doctor diagnosed "varicose veins of the lower extremities." The cause of this disease is considered a violation of the structure of the venous wall or insufficiency of the valvular apparatus. These tissues are characterized by high stretchability under load and rapid restoration of the original shape and size after load’s removal.

What is the main stretchable protein of the walls of blood vessels, ligaments and lungs elastin What are the features of the amino acid composition of this protein? alanine,valine,levsine,isoloosine What pathological condition does deficiency of α1-antitrypsin in the lungs cause -emphysema What type of collagen is present in the walls of blood vessels? type 3 How many stages of collagen synthesis are there 8(extracellular-3,intracellular-5)
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Hunter syndrome is mucopolysaccharidosis type II. It is manifested by bone deformations, hearing loss, oligophrenia, changes in the ocular fundus. In addition, there is an increased urinary output of dermatan- and heparan sulfates.

What are the reasons for mucopolysaccharidosis development disorder of GAG catabolism in lysosome What types of GAG do you know chondroetin -4-sulphate-, chondroetin -6-sulphate-,heparin,keratan-sulphate,hyulonoronic acid,dermatan-sulphate. What is the structure of heparan sulfate Consist of glucuronic acid linked to n-acetylglucosamide What are the functions of heparan sulfate in structure of basemembrane (kidney ) What are proteoglycans Compound consist of pprotein bounded to mucopolysacchride What is the structure of proteoglycans core protein bind with gag What are the functions of proteoglycans? included in binding cation, Thery form large compound
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A young woman addressed a dermatologist with complaints of the appearance of several small nodules on the anterolateral surface of the neck. The doctor diagnosed the presence of papillomas and offered to remove them. After electrocautery papillomas, a dermatologist prescribed zinc hyaluronate (curiosin*) to rub into damaged skin. Such recommendations are due to the fact that this drug contains hyaluronic acid (HA).

What are the properties of hyaluronic acid high molecular weight,low surface tension,anti imflammatery What are the disaccharides units of hyaluronic acid? D-Glucornic acid and N-acrtyl Glucosive Name the enzymes which are zinc containing?carbonic anhydrase,thormolysin,bacteriophage What are the causes of papillomas human papilloma virus
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32 years-old woman came to the dentist with complaints of pain, swelling and bleeding gums, her teeth began to loosen. A further survey revealed: symptoms of chronic fatigue, bruising, bruises on the skin, hair loss.

What is the preliminary diagnosis scurvy What vitamin deficiency observed in? What is name vitamin vitamin c(ascorbic acid) What kind of biochemical synthesis collagen is deficiency of this vitamin 3 intracellular stage What enzymes do catalyze the reaction of collagen posttranslational modification glucotranferatio What could be the cause of this vitamin deficiency due to low intake of citrus fruits .
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Hemorrhages under the skin and mucous membranes associated with a decrease in the strength of the vascular wall is one of the clinical manifestations of scurvy. The main structural protein of the vascular wall is type III collagen. Synthesis and maturation of this protein is a complex multi-step process, for the success of which requires various substances.

What vitamin deficiency is observed in this patient vitamin c What 2 enzymes of collagen synthesis do depend on this vitamin lyse hydroxylase,prolyne hydroxylase What 2 metal is needed for collagen synthesis iron,copper How many intracellular stages of collagen synthesis are there 5 How many extracellular stages of collagen synthesis are there 3
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63 years-old male entered the emergency room with a suspected hip fracture. According to the patient: slipped and fell. Complaints of insomnia, numbness and tingling in the arms and legs, sometimes cramps, cardiopalmus, gum pain, in the last 2 months lost 4 teeth. Preliminary diagnosis: osteoporosis.

What is the reason of osteoporosis in this case low calcium level low vit D What substance deficiency can cause osteoporosis vitamin D What hormones increase Ca level in blood PTH What hormones decrease Ca level in blood calcitonin Place of parathyroid hormone syn.Chemical structure. parathyroid gland. protein Place of calcitonin synthesis. Chemical structure thyroid gland.protein Places of calcitriol synthesis. Chemical structure. liver,kidney.steroid
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The parents of a two-year-old son turned to the pediatrician with complaints that their child had become moody, irritable, and did not eat well. There was sweating, an unstable feces. On examination the compliance of the bones of the skull and the deformation of the chest were observed. In the biochemical analysis of blood the level of total calcium is 1.57 mmol/l (the norm of 2.3-2.8 mmol/l). The child received good nutrition and was often in the sun.

Preliminary diagnosis Rickets What hormone does regulate Ca reabsorption calcitriol and PTH Calcitriol.Synthesis,chemicalstructure,functions. 3stepskin,liver,kidney.steroid.calcium resabsorptin from intsetine What is the role of 1 - alpha - hydroxylase in calcitriol synthesis it convert vitamin D2 into D3 or active form of vitamin D.
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A 40-year-old female patient who had been eating monotonously for a long time, excluding products such as liver, rye, milk, yeast from her diet, went to the clinic with complaints of inflammation of the oral mucosa, muscle fatigue, conjunctivitis. The doctor diagnosed vitamin В2 hypovitaminosis.

What is the name of vitamin B2 riboflavin What is the coenzyme form of vitamin B2 FAD,FMN What type of reaction do catalase enzymes with vitamin B2 reduction/oxidative/dehydroxygenase Vitamin B2 deficiency. Causes. Symptoms. dermatitis,cheilosis,glossitis,vascularization of cornea
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The patient complains of increased daily diuresis, which is 10-15 liters. Urine analysis showed hypostenuria, glucosuria is absent.

What is the preliminary diagnosis diabetes insipidus What is hypostenuria decrease relative sensitivity of urine What are the causes of hypostenuria deficency of adh What is glucosuria glucose of urine What is the normal daily diuresis in an adult 1.5-2l
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The patient was approached by a doctor complaining of frequent urination and a constant feeling of thirst. During the examination, an increase in the daily volume of urine was noted with a sharp decrease in urine density. The analysis showed that the insulin level is within the normal range, but a decrease in the content of the hormone responsible for the reabsorption of water in the distal nephron was found.

What is the preliminary diagnosis diabetes insipidus What changes in homeostasis cause ADH secretion increased blood osmolality or decreased ecf volume Where vasopressin is synthesized Hypothalamus(supraoptic nucleus ) Where is V1 vasopressin receptors located in arteries(blood vessel ) Where is V2 vasopressin receptors located in Last part Of dct and collection tubule or duct
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50 years old patient complained of thirst, polyuria, polyphagia. In the analysis of blood and urine were revealed: blood glucose level - 10 mmol/l, glucosuria. The content of C-peptide is below normal.

Justify the preliminary diagnosis DIABETES MALITES TYPE 1 Types of this disease TYPE-1 DIABETES MELLITUS OR INSULIN DEPENDENT what is polyuria EXECESSIVE URINE(ABOVE 3.5L/DAY) what is polyphagia EXESSIVE EATING OR HUNGER OR APPETITE what level of glucose is normal 70MG/DL      ,    3.3-5.5 MMOL/L clinical significance of C – peptide INDICATION OF NORMAL SECRETION OF INSULIN
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Assess the condition of 60 years old patient based on the results of urine analysis: daily volume is 3 liters, density is 1050, glucose is positive, and ketone bodies are present.

Justify the preliminary diagnosis Diabetes MALITES diuresis. norm and pathology NORM 1,5 Liter less than 800ml OLIGOURIA , more than3000 POLYURIA , absent anuria what physical properties urine you know volume color smell ph relative density transparency sediment pathological components of urine Glucose and ketone in urine that are normally not present what ketone bodies do you know Acetone, acetoactate, beta- hydroxybutarat e the function of ketone bodies in the body give energy to brain at staravation which biochemical indicators it is necessary to check the patient HBA1c
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A 7-year-old child was taken to the hospital in the state of anaphylactic shock, which developed after a wasp sting. There is increased concentration of biogenic amine - histamine in the blood.

Biogenic amines A biogenic amine is a biogenic substance with one or more amine group Formation of histamine. BY Histidine Laboratory diagnosis of allergic conditions. Allergen specific IGE blood test, complete blood count, Histanine and tryptase blood test
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A 33-year-old man came to the doctor with complaints of joint pain. Pigmentation of the sclera and auricles was revealed during patient examination. In the urine analysis it was found that in an alkaline medium and in air urine turns black.

What is the preliminary diagnosis? Justify the symptoms. Alkaptonuria , ASYMPTOMIC in children above 30 year above person being to develop pain in joint have turn urine black The cause of this pathology Defect in HGD gene What amino acids Metabolism is broken PHENYLALANINE and tyrosine
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A 48-year-old patient went to the doctor with complaints of severe pain, swelling, reddening of the joints, fever (up to 38 °C). High content of urates was revealed in the blood.

Justify the preliminary diagnosis. What is the cause of the disease GOUT, due to high uric acid in blood metabolism some substances are broken Breakdown of purines , salvage pathway of purine metabolism Why in the blood has a high content of urate due to high uric acid Laboratory diagnosis of this condition Uric acid in blood
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The patient complains of acute pain in the upper third of the abdomen, uncontrollable vomiting with presence of bile, fever, weakness and dizziness. Your preliminary diagnosis is acute pancreatitis.

Pancreatic enzymes Lipase, amylase, tripsin, chymotrypsin, GALACTASE  ,CARBPXYPEPTIDASE The role of the pancreas in digestion Breakdown glucose, TRIGLYCERINE , protein and carbohydrate Laboratory diagnosis of acute pancreatitis BLOOD Amylase
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Patient X is brought to the hospital by an ambulance. The condition is grave, consciousness is absent, adynamia. There are dry skin, sunken eyes, cyanosis of the face, tachycardia and the smell of acetone from the mouth. Results of analysis: blood glucose is 20.1 mmol / l (normal: 3.3-5.5 mmol / l), in urine - 3.5% (normal: absence).

Explain the preliminary diagnosis Diabetic ketoacidosis disease(Hypoglycemia) Evaluate the results of laboratory  Glucose HbA1e ph of blood ketone bodies blood and urine What pathological components of urine Glucose, ketone bodies What is the symptom increased or decreased Hyperglycemia , hypoglycemia
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