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Physician Assistant (PA)
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PANCE Prep Pearls: 3rd Ed. (2019)
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Metabolic Disorders

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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid

Metabolic Disorders
16 Picmonics to Learn | 39 mins
G6PD Deficiency
X-linked Recessive
Hemolytic Anemia
Inflammatory Response
Fava Beans
Sulfonamides
Primaquine
Anti TB Drugs
Heinz Bodies
Bite Cells
Prevalent Among African Americans due to Increased Malarial Resistance
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2 mins
G6PD Mechanism
Turns NADP+ to NADPH
NADPH Used by Glutathione Reductase
Detoxifies Free Radicals and Peroxides
X-linked Recessive
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2 mins
Paget's Disease of Bone
Pathophysiology
Men > Age 40
Increased Osteoblast and Osteoclast activity
Mosaic Pattern
Signs and Symptoms
Increased Skull Diameter
Hearing Loss
Fractures
Bone Ache and Joint Pain
High Output Heart Failure
Diagnosis
Bone Scan
Normal Parathyroid hormone (PTH) and Calcium
Elevated ALP
Treatment
Bisphosphonate
Calcitonin
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2 mins
Phenylketonuria (PKU)
Pathophysiology
Decreased Phenylalanine Hydroxylase
Decreased Tetrahydrobiopterin Cofactor
Autosomal Recessive
Tyrosine Becomes Essential
Phenylalanine Found in Nutrasweet
Symptoms
Musty or Mousy Body Odor
Growth Retardation
Seizures
Intellectual Disability
Hypopigmentation
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2 mins
Vitamin C Mechanism and Deficiency
Mechanism
Ascorbic acid
Antioxidant
Protects Against Free Radicals
Keeps Iron in Reduced State
Hydroxylation of Proline and Lysine
Necessary for Dopamine B Hydroxylase
Deficiency Signs and Symptoms
Scurvy
Swollen Gums
Bruising
Poor Wound Healing
Hemarthrosis
Perifollicular Hemorrhages
Anemia
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4 mins
Vitamin D Deficiency
Signs & Symptoms
Rickets in children
Bending bones
Rachitic rosary
Breast milk has decreased vitamin D
Osteomalacia in adults
Tetany from Hypocalcemia
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2 mins
Vitamin A (Retinol)
Mechanism
Maintains Mucous Membranes
Eyes and Skin
Indications
Dietary Deficiency
Skin Disorders
Side Effects
Hepatosplenomegaly
Jaundice
Increased ICP
Vomiting
Considerations
Teratogen
Animal Food Products
Dark Green and Orange Fruits/Vegetables
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2 mins
Vitamin A (Retinol) Toxicity
Signs and Symptoms
Alopecia
Vision Changes
Headache
Skin Changes
Hyperlipidemia
Hepatotoxicity
Arthralgias
Teratogen
Cleft palate
Cardiac Abnormalities
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3 mins
Vitamin A (Retinol) Function and Deficiency
Mechanism
Retinol
Constituent of Visual Pigments
Differentiation of Epithelial Cells into Specialized Tissue
Signs and Symptoms
Night Blindness
Dry Skin
Considerations
Used to Treat Measles
Antioxidant
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2 mins
Vitamin B12 (Cobalamin) Mechanism and Deficiency
Mechanism
Cobalamin
Large reserve pool in the liver
Homocysteine to methionine
Methylmalonyl CoA to succinyl CoA
Deficiency Signs and Symptoms
Macrocytic Megaloblastic Anemia
Hypersegmented Neutrophils
Neurologic defects
Posterior column
Lateral corticospinal tract
Spinocerebellar tract
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5 mins
Vitamin B12 (Cobalamin) Deficiency Causes
Causes
Vegans
Pernicious Anemia
Gastric Bypass Surgery
Malabsorption
Sprue
Enteritis
Crohn's Disease
Diphyllobothrium latum
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4 mins
Vitamin B1 (Thiamine)
Mechanism
Carbohydrate Metabolism
Indications
Dietary Deficiency
Beriberi
Wernicke-Korsakoff
Considerations
Alcoholics Highest Risk
Give Before Glucose
Give IM or IV
Enriched Whole Grains
Pork
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2 mins
Beriberi (Thiamine Deficiency)
Thiamine Deficiency
Dry Beriberi
Polyneuritis
Muscle Wasting
Wet Beriberi
Dilated Cardiomyopathy
Edema
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51 secs
Vitamin B3 (Niacin)
Derived from Tryptophan
Synthesis Requires Vitamin B6
Constituent of NAD+
Deficiency Causes
Hartnup Disease
Carcinoid Syndrome
Deficiency Symptoms
Pellagra
Diarrhea
Dermatitis
Dementia
Glossitis
Excess Symptoms
Flushing
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2 mins
Vitamin B6 (Pyridoxine)
Mechanism
Amino Acid and Protein Metabolism
Heme Synthesis
Neurotransmitters
Indications
Adjunct to Isoniazid
Dietary Deficiency
Premenstrual Syndrome (PMS)
Side Effects
Ataxia
Peripheral Neuropathy
Contraindications
Levodopa
Considerations
Cereals and Meats
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3 mins
Vitamin B6 (Pyridoxine) Deficiency
Deficiency From Isoniazid
Deficiency From Oral Contraceptives
Seizures
Hyperirritability
Peripheral Neuropathy
Sideroblastic Anemia
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3 mins

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