Biochemistry - Glycolysis and NADH Production
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Questions and Answers

What type of enzyme is responsible for the production of NADH in glycolysis?

  • Dehydrogenase (correct)
  • Hexokinase
  • Kinase
  • Phosphatase

    • Which enzyme specifically catalyzes the conversion of glyceraldehyde-3-phosphate to 1,3-bisphosphoglycerate, resulting in the production of NADH?

  • Aldolase
  • Lactate dehydrogenase
  • Phosphoglycerate kinase
  • Glyceraldehyde-3-phosphate dehydrogenase (correct)

    • In aerobic conditions, where does NADH go next after being produced in glycolysis?

  • It is converted back to NAD+ in the cytoplasm
  • It is transported into the mitochondria (correct)
  • It is used to produce ATP directly in the cytoplasm
  • It is stored in the nucleus for energy

    • Once inside the mitochondria, to which complex of the electron transport chain does NADH donate its electrons?

    <p>Complex I</p> Signup and view all the answers

    What drives ATP synthesis during the process of oxidative phosphorylation in mitochondria?

    <p>A proton gradient across the inner mitochondrial membrane</p> Signup and view all the answers

    What is a primary characteristic of water-soluble vitamins?

    <p>Absorbed directly into the blood</p> Signup and view all the answers

    Which vitamin is associated with the coenzyme FAD?

    <p>Vitamin B2</p> Signup and view all the answers

    What is the role of FMN in the electron transport chain?

    <p>It facilitates electron transfer.</p> Signup and view all the answers

    Where is FMN reduced to FMNH2 in the electron transport chain?

    <p>Complex I.</p> Signup and view all the answers

    What is the main reaction catalyzed by the coenzyme FAD in the citric acid cycle?

    <p>Oxidation of succinate to fumarate</p> Signup and view all the answers

    How are lipid-soluble vitamins primarily excreted from the body?

    <p>Feces</p> Signup and view all the answers

    What occurs after FMNH2 passes electrons through the electron transport chain?

    <p>A proton gradient is generated.</p> Signup and view all the answers

    Why is there a less chance of toxicity with water-soluble vitamins?

    <p>Excess amounts are easily excreted</p> Signup and view all the answers

    Which vitamin is associated with the regeneration of the antioxidant glutathione?

    <p>Vitamin B2.</p> Signup and view all the answers

    Which of the following neurotransmitters is metabolized using FAD by monoamine oxidase?

    <p>Dopamine.</p> Signup and view all the answers

    What benefit would a patient seek from vitamin supplementation if they are experiencing fatigue?

    <p>Improve energy production</p> Signup and view all the answers

    Which feature contrasts water-soluble vitamins and lipid-soluble vitamins?

    <p>Storage capabilities</p> Signup and view all the answers

    What is the metabolic type of the electrons supplied from FADH2 in the electron transport chain?

    <p>They support ATP production indirectly.</p> Signup and view all the answers

    What is the primary function of electron carriers like FMN in the electron transport chain?

    <p>To facilitate electron transfer.</p> Signup and view all the answers

    What is the general classification of biotin?

    <p>Water-soluble vitamin</p> Signup and view all the answers

    Which complex in the electron transport chain directly receives electrons from FMNH2?

    <p>Complex I.</p> Signup and view all the answers

    Which of the following is a coenzyme form of Vitamin B2?

    <p>FMN</p> Signup and view all the answers

    What is primarily responsible for the bright yellow color of urine after riboflavin intake?

    <p>Excess riboflavin</p> Signup and view all the answers

    Which pathway is primarily responsible for the production of FADH2?

    <p>Beta oxidation</p> Signup and view all the answers

    What role do FMN and FAD play in the body?

    <p>They act as coenzymes for various flavoproteins.</p> Signup and view all the answers

    Which enzyme assists in the dephosphorylation of FAD and FMN for riboflavin absorption?

    <p>FMN phosphatase</p> Signup and view all the answers

    Excess riboflavin is primarily excreted through which bodily fluid?

    <p>Urine</p> Signup and view all the answers

    In which type of tissues is FMN and FAD distributed most abundantly?

    <p>Metabolically active tissues</p> Signup and view all the answers

    What is a primary function of NADPH in the body?

    <p>Regeneration of antioxidants</p> Signup and view all the answers

    What biochemical functions are associated with Vitamin B2?

    <p>Energy production and antioxidant defense</p> Signup and view all the answers

    What physiological effect is primarily caused by nicotinic acid?

    <p>Vasodilatory prostaglandin release</p> Signup and view all the answers

    Which enzyme is responsible for blocking the production of vasodilatory prostaglandins?

    <p>Cyclooxygenase</p> Signup and view all the answers

    What common medication can help prevent the 'niacin flush' effect?

    <p>Aspirin</p> Signup and view all the answers

    What role does NADPH play in fatty acid metabolism?

    <p>Facilitates the synthesis of fatty acids</p> Signup and view all the answers

    Ethanol is converted into which of the following substances during alcohol metabolism?

    <p>Acetaldehyde</p> Signup and view all the answers

    What is the likely physiological effect of consuming high doses of nicotinic acid?

    <p>Increased blood flow and flushing</p> Signup and view all the answers

    Which of the following statements is false regarding NAD and NADH in alcohol metabolism?

    <p>NADH facilitates the oxidation of acetaldehyde</p> Signup and view all the answers

    Which statement accurately describes internal hemorrhoids?

    <p>Internal hemorrhoids are covered by a mucous membrane that lacks pain receptors.</p> Signup and view all the answers

    What is the primary arterial supply of the spleen?

    <p>Splenic artery</p> Signup and view all the answers

    Which artery is NOT part of the arterial supply to the midgut?

    <p>Left Colic artery</p> Signup and view all the answers

    What is the function of amniotic fluid related to the gut tube?

    <p>It is essential for lung development.</p> Signup and view all the answers

    Which of the following accurately describes the innervation of the hindgut?

    <p>It is innervated by the Pelvic Splanchnic Nerves (S2 – S4).</p> Signup and view all the answers

    Which condition is characterized by an excess of amniotic fluid?

    <p>Polyhydramnios</p> Signup and view all the answers

    Which of the following best describes a symptom of bowel obstruction?

    <p>Absent bowel movements</p> Signup and view all the answers

    What provides somatic innervation to the lower anal canal?

    <p>Pudendal Nerve</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Embryology Study Notes

    •  Gastrointestinal embryology is the study of how the digestive system develops during fetal development.
    • A 14-year-old boy presented with severe lower left quadrant abdominal pain, abdominal distension, nausea, vomiting, and absent bowel movements (signs of bowel obstruction).
    •  This suggests that the patient could have symptomatic Meckel's Diverticulum.
    • Learning outcomes include describing the contribution of lateral, caudal, and cephalic folding to the foregut, midgut, and hindgut development.
    • The ventral mesentery and diaphragm form during the development of the septum transversum.
    • The intraembryonic coelom, splanchnopleure, and somatopleure grow into abdominal walls, the peritoneal cavity and the alimentary canal and accessory organs.
    •  Embryological development and associated congenital disorders of the GI tract that are derived from the foregut, midgut, and hindgut and their arterial vascular supply are covered in the learning outcomes.
    •  Congenital disorders like trachea-esophageal fistula, esophageal atresia, pyloric stenosis, duodenal stenosis, extrahepatic biliary atresia, Meckel diverticulum, congenital omphalocele, gastroschisis, congenital diaphragmatic hernia, annular pancreas, congenital epigastric hernia, and umbilical fistula are also part of the study material.
    • The intraembryonic coelom and its contributions to different abdominal structures are detailed.
    •  The development of the hindgut and allantois, forming the cloaca, cloacal membrane, urorectal septum, urogenital sinus, proctodeum, and pectinate line, are part of the study material. 

    Learning Outcomes

    • Describing the development's contribution of lateral, caudal, and cephalic folding to the development of the foregut, midgut, and hindgut.
    • Describing the development of the septum transversum that forms the ventral mesentery and diaphragm.
    • Describing the development of the intraembryonic coelom, splanchnopleure, and somatopleure into the following abdominal structures: the abdominal wall, peritoneal cavity, dorsal mesentery, visceral and parietal peritoneum and the alimentary canal and accessory organs.
    • Briefly describing the components of the alimentary tract (derived from the foregut, midgut, and hindgut) and their arterial vascular supply.
    • Briefly describing how the respiratory tract and accessory structures develop.

    Learning Outcomes Continued

    • Describing the development of the hindgut and allantois as it forms the structures of the cloaca, cloacal membrane, urorectal septum, urogenital sinus, proctodeum, and pectinate line.
    • Relating the embryologic development of the GI tract to the pathogenesis and basic clinical features of specific congenital disorders.
    • The detailed study of trachea-esophageal fistula, esophageal atresia, pyloric stenosis, duodenal stenosis, extrahepatic biliary atresia (2) Meckel diverticulum, congenital omphalocele, gastroschisis, congenital diaphragmatic hernia, annular pancreas, congenital epigastric hernia, umbilical fistula.
    • This includes relations between embryological structures of the hindgut to selected congenital disorders.

    Pre-Assessment Quiz

    • The pericardial cavity, pleural cavity, and peritoneal cavity are derived from the intraembryonic coelom.
    • The splanchnopleure gives rise to the wall of the gut.
    • The intathecal cavity is not derived from the intraembryonic coelom.

    What has happened so far?

    • Dorsally: Neural Tube
    • Ventrally: Gut Tube
    • Tube on top of vault
    • Diagrams of the development with different stages are included.

    Formation of the Body Cavity

    • At the end of the 3rd week, intraembryonic mesoderm transforms into paraxial mesoderm (somitomeres & somites), intermediate mesoderm (urogenital system), and lateral plate mesoderm (body cavity).
    • The lateral plate mesoderm splits into somatic (somatopleure) and visceral (splanchnopleure) layers.
    • The space between these layers forms the body cavity.
    • Diagram showing the formation of the body cavity at 19 and 20 days is included.

    Formation of the Body Wall

    • During the 4th week, the embryo forms two lateral body wall folds.
    • The folds consist of the parietal layer of lateral plate mesoderm, overlying ectoderm and cells from adjacent somites.
    • These folds progress, causing the endoderm layer to fold ventrally and close to form the gut tube.
    • The lateral body wall folds meet in the midline and fuse to close the ventral body wall by the end of the fourth week.
    • Diagrams illustrate the progressive closure.

    Formation of the Body Wall

    • Diagrams illustrating the stages of body wall formation are included.

    Serous Membranes

    • The parietal layer of the lateral plate mesoderm forms the parietal layer of the serous membranes that line the outside of the peritoneal, pleural, and pericardial cavities.
    • The visceral layer of the lateral plate mesoderm lines the outside of the abdominal organs, lungs, and heart.
    • Visceral and parietal layers are continuous as the dorsal mesentery.
    • Ventral mesentery exists from the caudal foregut to the upper portion of the duodenum from the thinning of septum transversum mesoderm.
    • Diagrams illustrating serous membranes and their formation are included.

    Septum Transversum

    • Diagrams of the septum transversum and its role in the formation of the diaphragm.

    Diaphragm & Thoracic Cavity

    • Lung buds expand within the pericardioperitoneal canals.
    • Lung expansion leads to a reduction in the size of the canals.
    • Ventral and lateral expansions are behind the pleuropericardial folds.
    • With lung expansion, mesoderm separates into definitive wall of the thorax and the pleuro-pericardial membranes (containing common cardinal veins and phrenic nerves)
    • Common cardinal veins move towards the midline, and membranes extend outwards like a mesentery.
    • These fuse with each other and the lung roots, dividing the thoracic cavity into a definitive pericardial cavity and two pleural cavities.
    • Diagrams showing the stages of diaphragm development and thoracic cavity formation are included.

    Formation of the Diaphragm

    • Diagrams of the pleuroperitoneal fold, pericardioperitoneal canal, aorta, esophagus, pleuroperitoneal membrane, esophagus, inferior vena cava.
    • Muscular Ingrowths from the body wall and Central tendon of the diaphragm, contributing to diaphragm development, are included.

    Formation of the Diaphragm

    • Overall, the diaphragm is derived from two pleuroperitoneal membranes and muscular components from somites at C3-5 and the mesentery of the esophagus (the crura of the diaphragm).

    GI System Overview

    • The GI system is divided into four sections (foregut, midgut, hindgut, and upper anal canal)
    • Endoderm forms the epithelial lining, and visceral mesoderm forms the parenchyma and stroma.

    Quiz

    • Correct answers to quiz questions regarding the embryonic layer that contributes to the serous membranes and the structures contributing to the development of the diaphragm are included.

    Esophagus

    • Develops caudal to the primordial pharynx.
    • It's partitioned by the tracheoesophageal septum.
    • Elongates with heart and lung growth.
    • Upper 2/3 is striated and innervated by vagus nerve.
    • Lower 1/3 is smooth and innervated by splanchnic plexus

    Esophageal Atresia & Tracheoesophageal Fistula

    • Diagrams and descriptions of esophageal atresia and tracheoesophageal fistula are included.

    Stomach

    • A fusiform enlargement of the caudal part of the foregut with different growth rates of their borders (dorsal is faster than ventral).
    • The stomach rotates 90 degrees clockwise around the long axis, causing the ventral (anterior) border to move to the right (lesser curvature) and the dorsal (posterior) border to move to the left (greater curvature).
    • Innervation, mesenteries, and relationships of the stomach with associated structures are detailed. Diagrams showing the rotation are included.

    Stomach & Mesenteries

    • Diagrams of the relationship between the stomach and surrounding structures (such as the bare area of the liver, diaphragms, falciform ligament, vitelline duct, allantois, cloaca, umbilical artery) are included.

    Stomach & Spleen

    • The spleen and its relationship to the stomach and surrounding peritoneal structures (such as omental bursa, lesser omentum, falciform ligament, and parietal peritoneum) are discussed. Diagrams of the relationships of the stomach and the spleen are included.

    Stomach & Mesenteries

    • Diagrams of dorsal mesogastrium, mesoduodenum, mesocolon, and relationship of the stomach to the mesenteries are included.

    Pyloric Stenosis

    • Pylorus hypertrophies and thickens, leading to a narrowing of the pyloric lumen and obstruction of food passage. 
    • Symptoms include projectile vomiting

    Duodenum

    • Development from the caudal part of the foregut and proximal part of the midgut.
    • Junction of two parts is directly distal to the origin of the bile duct (major duodenal papilla).
    • The duodenum grows rapidly and forms a C-shaped loop.
    • Rotation of the stomach and duodenum together causes the growth into a retroperitoneal organ.
    • The duodenum receives blood supply from both the celiac and superior mesenteric arteries.
    • Diagram showing various stages of development and retroperitoneal position are included.
    • Duodenum recanalization (cell death and re-opening of the lumen) is associated with proliferation of epithelial cells.

    Duodenal Stenosis & Atresia

    • Diagrams and descriptions of duodenal stenosis, duodenal atresia, and associated conditions are included.

    Liver & Gallbladder

    • Outgrowth of endodermal epithelium (liver bud) infiltrates the septum transversum.
    • The ventral outgrowth forms the gallbladder and cystic duct.
    • Hepatic epithelial cords merge with vitelline and umbilical veins (hepatic sinusoids).
    • Diagrams show the liver and gallbladder's relationship to surrounding structures, such as the diaphragm, falciform ligament, esophagus, stomach, pancreas, and hindgut, are included.

    Liver & Haematopoiesis

    • Large islands of proliferating cells, producing red and white blood cells, are located between hepatic cells and vascular walls.
    • The activity subsides during the last two months of intrauterine life, leaving small hematopoietic islands at birth.

    Extrahepatic Biliary Atresia

    • The obliteration of the bile duct causes distention of the gallbladder and hepatic ducts distal to the obliteration.
    • Diagrams of obstructive conditions, such as duplicated gallbladder and obliterated bile ducts, are included.

    Pancreas

    • The pancreas develops from ventral and dorsal buds. The ventral bud is incorporated into the duodenum, and the dorsal bud remains separate as the dorsal pancreas, along with its mesentery.
    • The ventral and dorsal buds fuse to produce the pancreas to form its head.
    • Diagrams illustrating the development and relationship to surrounding structures are included.

    Annular Pancreas

    • The ventral pancreas splits and forms a ring around the duodenum, occasionally causing duodenal stenosis.
    • Diagram illustrating the annular pancreas's development is included.

    Midgut Structures

    • The midgut, suspended from the dorsal abdominal wall by an elongated mesentery (supplied by the SMA), forms a ventral U-shaped loop with cranial and caudal limbs due to elongation.
    • The midgut is projected into the proximal part of the umbilical cord.
    • The midgut loop rotates during protrusion and returning to the abdomen, creating a 90° and 180° counterclockwise rotation around the axis of the SMA which the intestines return back to the abdomen during the 10th week of development, or the physiological midgut hernia is reduced.
    • The small intestine is the first part that returns to the abdomen, followed later by the large intestine.

    Midgut Loop (Rotation & Retraction)

    Midgut Loop

    • Diagrams illustrating the stages of midgut loop rotation and retraction are included.

    Volvulus

    Meckel's Diverticulum

    • An outpouching of the intestinal wall formed from remnants of the embryonic tissue.
    • Diagrams showing the locations, development, possible clinical manifestations, and attachments of Meckel's diverticulum are included.

    Umbilical Fistula

    • The persistence of the vitelline duct creates a direct communication between the umbilicus and the intestine.

    Omphalocele

    • Failure of the midgut loop to return to the body cavity.
    • The herniated loop is covered by amnion.

    Gastroschisis

    • The ventral abdominal wall fails to close, exposing the abdominal contents.
    • The herniated loop isn't covered by amnion.

    Quiz

    • Correct answers and explanations to quiz questions related to the rotation of the stomach during embryonic development are provided.
    • Descriptions of the esophagus's innervation are provided.

    Part III: Congenital Herniation into the Thoracic Cavity

    • Describes esophageal and congenital diaphragmatic hernias. This includes the anatomical pathways, the consequences of incomplete closure, and the herniation of abdominal organs into the thorax.
    • Diagrams showing different stages of development or potential consequences are included. 

    Hindgut Development

    • The hindgut gives rise to the distal third of the transverse colon, descending colon and sigmoid colon and the upper part of the anal canal
    • Stages and embryological structures involved in the development are illustrated with diagrams.

    Hirschsprung's Disease

    • This congenital anomaly involves the absence of ganglion cells in a section of the colon, leading to a functional obstruction.
    • Ganglion cells coordinate rhythmic contractions along the gut to move intestinal contents forward.
    • The inability of this section of colon to relax and propel stool forward is the result of a failure of the ganglion cells to migrate.

    Internal and External Hemorrhoids

    • Internal hemorrhoids are located within the upper two-thirds of the anal canal and lack pain receptors, whereas external hemorrhoids are in the lower one-third and have pain receptors, which explains why each may cause different symptoms (or no pain).

    Arterial Supply of Foregut, Midgut, and Hindgut

    • Descriptions of the various arteries and their specific parts of the GI tract, such as the celiac trunk (common hepatic, left gastric, and gastroduodenal arteries), the superior mesenteric artery (inferior pancreaticoduodenal, intestinal, ileocolic, right colic, and middle colic arteries), and the inferior mesenteric artery (left colic, sigmoid, and superior rectal arteries) are included. Diagrams of these supplies are included.

    Innervation Overview

    • Table summarizing the sympathetic and parasympathetic innervation of the foregut, midgut, hindgut, and anal canal.

    Amniotic Fluid Volume & Function of Gut Tube

    • The amniotic fluid acts as a protective shield for the gut tube against direct injury and pressure, and supports fetal lung development along with metabolic function.
    • Amniotic fluid also supports nutrient delivery, waste removal, and gut mobility, and important for fetal development.
    • Problems of polyhydramnios (too much fluid) and oligohydramnios (too little fluid) are included.

    Case Study

    • The presented case study is about the possible complications of symptomatic Meckel's Diverticulum involving a 14-year-old boy.

    References

    • Refresher information about Langman’s Medical Embryology

    Reflections

    • Discussion on the importance of studying GI embryology in the context of understanding and diagnosing various conditions.

    B-vitamins (Intro, B1, B2, B3, B5)

    • Introduction.

    Overall Outcome

    • Discussion of objectives for the vitamin lessons to describe how our bodies absorb, convert, and utilize vitamins at a biochemical level to promote health, and to apply those biochemical mechanisms in select conditions.

    Intro Objectives

    • The objectives of defining classifications for water soluble and lipid soluble vitamins along with their properties (absorption, transport and storage, excretion and toxicity and their respective dosings.

    Specific Case Scenarios and Additional Information

    • More detailed descriptions of possible complications associated with the GI tract.

    Thiamin: Vitamin B1

    • Food sources and objectives relating B1 to absorption, metabolism, excretion, and carbohydrate metabolism (energy production).

    What do you already know?

    • Quiz questions related to metabolic pathways that utilize B1.

    Pathways that Use B1

    • Description of the roles of B1 (thiamine) or the thiamine diphosphate (TDP) in different metabolic pathways (glycolysis, pentose phosphate pathway, Citric acid cycle and beta-oxidation)

    Structure and function

    • Structural diagram of the coenzyme form of thiamin.

    Absorption and Metabolism

    • Description of enzymes that convert TDP to thiamine for absorption.

    Enzyme that Converts Absorbed Thiamin Into TDP Coenzyme

    • Description of the enzyme, thiamin pyrophosphokinase (TPK), and its role.

    Specific functions

    • The detailed explanation of functions of B1 in different metabolic processes such as the citric acid cycle, pyruvate dehydrogenase complex, Alpha-Ketoglutarate and energy production.

    Specific Functions

    • B1's role in energy-related processes like succinyl CoA (a substrate for heme synthesis) is discussed using diagrams.

    Specific functions

    • Explanation of B1's functions in pentose phosphate shunt and the rationale behind the role of B1.

    Deficiencies

    • Explanation of conditions, such as Sulphur dioxide preservatives, polyphenols, and others, that inhibit B1 absorption and their possible effect on bodily functions.

    Deficiencies

    • Explanation of conditions like 5-fluorouracil and diuretics and their role in causing B1 deficiency.

    Deficiencies

    B1 Deficiency - Symptoms and Testing

    Riboflavin: Vitamin B2

    • Food sources.
    • Objectives relating B2 to absorption, metabolism, and energy production, catabolism of purines and GSH reduction, and its application in migraines and cataracts.

    What do you already know?

    • Quiz questions related to coenzyme forms of B2.

    Absorption and Metabolism

    • Enzyme identification used in B2 absorption versus metabolism.

    FAD and FMN

    • Absorption and metabolism of FAD (flavin adenine dinucleotide) and FMN (flavin mononucleotide)

    B2 and energy

    • Detailed explanation of the metabolic pathways (Glycolysis, Beta Oxidation, and CAC, Cori cycle ) and their role in producing FADH2 using B2.

    Beta oxidation

    B2 and Energy

    • Description of B2's role in energy production within fatty acid beta-oxidation using diagrams.

    Other

    • The roles of B2 in relation to other pathways (antioxidant glutathione regeneration, neurotransmitter metabolism) and their importance are discussed.

    Therapeutic uses and deficiency

    • The therapeutic values (such as migraines and cataracts) and deficiency symptoms associated with B vitamins are discussed.

    Testing

    • The rationale for testing B2 deficiency using blood tests and glutathione reductase activity is described. 

    Niacin: Vitamin B3

    • Food sources.
    • Objectives relating B3 to absorption, metabolism, excretion, testing, various pathways, and therapeutic use in Raynaud's, elevated TG and cholesterol, diabetes and peptic ulcer disease along with the possible mechanistic role of high dose B3 on ulcer conditions and the relationship between corn-based diets, carcinoid syndrome, and B3 deficiency-pellagra.

    What do you already know?

    • Quiz questions related to coenzyme forms of B3.

    Naming

    • Information on niacin as nicotinic acid and/or nicotinamide and its use in coenzyme production.

    Why nicotinamide rather than nicotinic acid?

    • Rationale for using nicotinamide over nicotinic acid in supplements due to its side effect profile and metabolic pathways.

    Absorption and Metabolism

    • The impact of corn on niacin availability is explained, including the composition of niacytin, and niacinogen in terms of biochemical factors influencing bioavailability.

    FYI Visual

    • Visual aid reinforcing the structure of NADH and its components: nicotinamide adenine dinucleotide.

    B3 and energy

    • Description of the metabolic pathways (glycolysis, beta oxidation, citric acid cycle, and anaerobic respiration) where NADH is generated, along with the enzyme types.

    Energy

    • Discussion of the role of NADH in energy production within different metabolic pathways from glucose, fatty acids, and anaerobic respiration.

    Specific Functions

    • The details of B3's function and role in different metabolic processes are detailed using diagrams (such as glycolysis and the Cori cycle)

    Specific Functions

    • Detailed explanations of B3's role in energy-related processes, such as the CAC and beta-oxidation.

    Specific Functions

    • The detailed explanation of reactions catalyzed by B3's cofactors, such as NAD+ and NADP+, including their roles in different metabolic pathways.

    Pantothenic Acid: Vitamin B5

    • Food sources.
    • Objectives to relate B5 absorption, metabolism, excretion, testing, its role in energy production, fatty acid, lipid, cholesterol, ketone synthesis, and symptoms of B5 deficiency (such as "burning foot syndrome").

    What do you already know?

    • Quiz questions related to coenzyme forms of B5.

    Structure and function, B5 → CoA

    • Diagram illustrating the structure of coenzyme A (CoA) and its connection to pantothenic acid (B5).

    B5 → CoA

    • Detailed explanations of the functions of B5 and its coenzyme forms within different metabolic processes (CAC, fatty acid oxidation, ketolysis, and heme production)

    B5 and Synthesis

    • Explanation of B5’s role and importance in fatty acid production, phospholipid and triglyceride synthesis, and cholesterol/ketone metabolism.

    Specific Functions - FYI Review

    • Review of the two roles of B5 in fatty acid synthesis.

    Specific Functions - FYI Review

    • Review of B5's role and importance in lipid synthesis.

    Deficiency symptoms

    • Description of B5 (pantothenic acid) deficiency symptoms, such as burning foot syndrome.
    • Further discussion of the rationale behind the occurrence of such symptoms.

    B-vitamins (B6, B7, B9, B12) - Summary

    • Summary of B vitamins B6, B7, B9, and B12, including their objectives, functions, and possible implications. The information also includes relevant conditions and symptoms to be considered in the diagnosis of clinical cases.

    Overall Outcome Reminder

    • A reminder of the important learning outcomes related to B vitamins.

    Pyridoxine (Vitamin B6) Objectives

    • Objectives related to the understanding of B6, including its absorption,metabolism, and function, and its connection to neurotransmitters, lipids, and carbohydrate metabolism.

    What do you already know?

    • Quiz questions related to biochemical reactions catalyzed by B6 for interconverting amino acids.

    Review

    • Overview of different amino acids (Alanine, Aspartate, Glutamate, Pyruvate, Oxaloacetate, a-ketoglutarate) to be considered and their biochemical roles.

    What do you already know?

    • Additional quiz questions about other reactions facilitated by vitamin B6, including trans and de-sulfhydration, and decarboxylation.

    Structure and function, Vitamin B6

    • Visual aid of the different forms of vitamin B6 (pyridoxine, pyridoxal, pyridoxamine, and their phosphorylated forms).

    Absorption and metabolism, Vitamin B6

    • Description of the processes involved in absorbing the phosphorylated B6 forms and then converting them to PLP, the active coenzyme form.
    • The role of specific enzymes, such as phosphatases (for converting the phosphorylated forms to free vitamins) and enzymes in converting pyridoxal to PLP, are explained.

    Specific functions, B6 and energy

    • Overview of B6’s role in NAD+ production from amino acids and the different metabolic pathways (glycolysis, beta-oxidation, and the citric acid cycle) involved in energy production.
    • The role of B6 in glycogenolysis, the release of glucose from glycogen, is explained.
    • Discussion of B6's role in heme synthesis by condensing succinyl CoA with glycine.

    Specific functions, B6 and synthesis

    • Description of B6's role in producing neurotransmitters from amino acids.
    • Discussion of the associated biochemical reactions, the derived amino acids, and the general functions of neurotransmitters.

    Specific functions, B6 and synthesis

    • Detailed explanation of B6's involvement in specific metabolic reactions related to gluconeogenesis, the conversion of pyruvate to oxaloacetate.
    • Descriptions of desaturated fatty acid synthesis (with gamma-linolenic acid and its relation to homocysteine and serine production) are presented, with discussion on how B6 facilitates these functions.

    Deficiencies, Infantile Seizures, and other Symptoms

    • Discussion of possible causes of infant seizure spikes (formula) with B6 deficiency; the role of neurotransmitters and the significance of microcytic anemia; and the importance of understanding other deficiency symptoms, including neurological depression and dermatitis.

    Testing, Tryptophan Load, and Xanthurenic acid

    • Discussion of testing methods (tryptophan load test) used to assess B6 status, with emphasis on the significance of xanthurenic acid in urine samples.

    Biotin: Vitamin B7

    • Food sources.
    • Objectives to relate B7 absorption, metabolism, role in energy production and carbohydrate metabolism, fatty acid synthesis, heme synthesis, ketone synthesis, cholesterol synthesis, and blood sugar regulation (as seen in diabetes).

    What do you already know?

    • Quiz questions related to the functional reactions of biotin.

    Structure and function, Biotin

    • Detailed structure and function of the coenzyme form, biotin (containing CO2 attached and linked with lysine residues).

    Absorption, Vitamin B7

    • Discussion of the need to remove the carboxylase enzyme prior to biotin absorption along with the role of biotinidases.
    • Description of the binding of biotin with avidin found in egg whites and ways this binding affects bioavailability.

    Specific functions, B7 and gluconeogenesis

    • Description related to B7’s role in converting pyruvate to oxaloacetate. 

    Specific functions, B7 and fatty acid synthesis

    • Discussion of B7 involvement as an intermediate in fatty acid synthesis using biotin-dependent enzymes and the synthesis of two substrates - acetyl CoA and malonyl CoA.

    Specific functions, B7 and energy, B7 Synthesis

    • Discussion of B7's role in synthesizing succinyl CoA from propionyl CoA and its use in the CAC and heme production.
    • Overview of the biochemical pathways and possible energy production mechanisms associated with the process.

    Specific Functions

    • Discussion of fatty acid and lipid synthesis using acyl-CoA and its relation to B7.

    Deficiency symptoms, biotin

    • Overview of biotin deficiency.
    • Description of symptoms, such as burning foot syndrome, fatigue, and listlessness, and possible connections between these symptoms and their biochemical rationale.
    • Review of possible connections between energy production pathways, heme synthesis, and blood glucose maintenance and B7.

    Folate (Vitamin B9)

    • Food sources.
    • Objectives related to folate’s absorption, metabolism, excretion, roles in different pathways, and genetic polymorphisms influencing optimal folate supplementation.

    What do you already know?

    • Overview of the primary function of folate's biochemical role in methylation and 1-C transfer reactions including possible examples of this role in different pathways.

    Structure and function, Folate

    • Detailed structure of the coenzyme form of folate (THF) and its components, and added 1-C group, and the significance of the multiple glutamate attachments.

    Absorption and Metabolism, Folate

    • Description related to folate's absorption processes including the role of hydrolases and conjugation.

    To Know: Points 1–4, Folate

    • Discussion of NADPH use to help reduce DHF to THF and role in purine/pyrimidine synthesis.

    Absorption and Metabolism, Folate

    • The liver’s role in folate storage and enterohepatic circulation is discussed here, including how folate is converted into a coenzyme form by the liver or sent to the rest of the tissue or recycled.
    • Diagrams supporting enterohepatic circulation are included.

    Specific functions, B9 and synthesis

    • Summary of the importance of B9.
    • Detailed explanation of B9's role in support of purine and pyrimidine synthesis.
    • Discussion for how deficiency can impact cell division and related possible illnesses.

    Folate Deficiency symptoms

    • Discussion on possible causes of folate deficiency and relating them to possible illnesses/complications.
    • Summary of the dangers associated with using folate to treat a B12 deficiency.

    Specific functions, B9 and various aspects

    • Discussion for how folate deficiency affects synthesis of various amino acids (including methionine).
    • Detailed steps associated with conversion from homocysteine to methionine, and the role of methyl folate in this process.
    • B9's role in synthesizing/converting certain aminos, such as SAM as methyl donor, is described.
    • The process of methylation relating to B12 and B9 and their interactions and deficiencies/implications are covered.

    Specific functions, B9, Neurotransmitter Synthesis

    • Explanation of the correlation between folate and neurotransmitter synthesis (including serotonin and dopamine) and a potential link to depression.
    • Diagrams relating folate to the synthesis/conversion of neurotransmitters are included.
    • Possible review/follow-up of the presentation, including a review of the four possible conditions caused by folate deficiency are included.

    Cobalamin: Vitamin B12

    • Food sources and objectives: Cobalamin’s role in absorption, metabolism, and energy production, SAM, and folate activity, along with B12 excretion, and testing.

    Structure and function, Vitamin B12

    • Structure and function of cobalamin, along with various forms (cyano and hydroxo) and their roles as coenzymes.

    Structure and function, Methylcobalamin coenzyme

    • Description of the enzyme's function and the significance of methyl folate trap, and the generation of succinyl CoA from propionyl CoA.
    • Diagrams related to the function of each coenzyme are included.

    Absorption and metabolism, Vitamin B12

    • Absorption processes required for B12, including the role of R-proteins along with pepsin and hydrochloric acid.
    • Role of intrinsic factor(IF) in transporting B12 across the intestinal membrane.
    • Uptake of B12-IF and the role of enterocytes in endocytosis.
    • Diagram illustrating the absorption process and the role of various enzymes.

    Absorption and metabolism

    • Explanation of how B12 is absorbed and its enterohepatic circulation including how B12 is mostly stored as Adenosylcobalamin and its site of storage.
    • Description of the importance of the storage site and how it relates to possible deficiency timeframes .

    Deficiency Symptoms, Vitamin B12

    • Summary of the conditions and possible outcomes caused by B12 deficiency, including the similarities between B12 and B9 deficiencies.

    Clinical Scenarios, B12 Deficiency

    • A clinical scenario where a patient with megaloblastic anemia initially receives B9 supplementation that incorrectly corrects the anemia.

    Methyl Folate Trap and B12 Deficiency

    • In detail the effects of B9 supplementation in case of B12 deficiency, and potential problems associated with it including the implication associated with methyl folate trap.
    • Description of the process where B9 supplementation may "incorrectly" correct or bypass certain effects of B12 deficiency.
    • Diagrams related to the mechanisms involved in the "methyl folate trap" as the consequence of B12 deficiency are included.

    Excretion and testing, Vitamin B12

    • Testing methods (such as blood tests for B12-related compounds like homocysteine and methylmalonic acid) and the rationale behind observing elevated or decreased levels in cases of B12 deficiency are discussed.
    • Diagrams may be included.

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