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she is also volume overloaded. more fluid leads to a decrease in Hematocrit.
I thought PTH increases 1-alpha-hydroxylase which increases levels of 1 ,25?
it's supposed to in the setting of proper kidney fxn
The decrease in GFR leads to decreased delivery of 25 dihydro vit D to the PCT and the decrease in functional renal mass limits production of 1a-hydroxylase. The increase in PO4 also stimulates FGF-23 from bone, which inhibits PO4 reabsorption and 1a-hydroxylase.
you're definitely not alone lol
And its not in FA, so fuck it IMO
I guessed it because the names sounded similar :D
I also guessed because both words start with "glu")))
same as person above me. also bc arginine carbamoyl phosphate and nag are all related through urea cycle.
Not a clue. This was so random.
this made me feel a lot better.
also, no fucking clue
My immediate thought after reading this was "why would i know this and how does this make me a better doctor?"
Generally speaking Glutamine is often used to aminate things. Think brain nitrogen metabolism. You know that F-6-P isn't an amine, and that Glucosamine is, so Glutamine isn't an unrealistic guess.
yea, I mature 30k anki cards to see this bs
I literally shouted wtf in quiet library at this question.
Lol def didn't know it. Looks like I'm not going to be a competent doctor because I don't know the hexosamine pathway lol
Is it biochemistry? Then I do not know it.
I Ctrl+F'd glucosamine in FA and it's not even there lol
i definitely guessed, for some reason got it down to arginine and glutamine
I did not
Narrowed it down to Arginine and Glutamine figuring the Nitrogen would have to come from one of these two but of course I picked the wrong one. Classic.
+1 no idea!
Ahhh yes the classic Glucosamine from fructose 6-phosphate question....Missed this question harder than the Misoprostol missed swing
no idea. i could only safely eliminate carbamoyl phosphate because that's urea cycle
just adding in to say, nope.
Lol I didn't either. I think this is just critical thinking though. The amine has to come from somewhere. Glutamine/glutamate is known to transfer amines at the least
Why does Calcitriol not increase with the increased PTH? Wouldn't the increased PTH stimulate the kidneys to make more activated vitamin D.
vitamin d malabsorption --> dec calcitriol
@kuhnboom Yes, while PTH stimulates the kidneys to make more active vitamin D (calcitriol), you need vitamin D precursors to begin with in order to do that. If you have vitamin D malabsorption, then the activated form won't be high even with high levels of PTH. Therefore, calcitriol is decreased.
Also, Vitamin D causes Ca and Phosphate absorption in the intestines. A lack of activated vitamin D would cause more Ca/Phosp wasting