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Retired NBME 25 Answers

nbme25/Block 2/Question#8 (reveal difficulty score)
The breakdown of dipeptides and tripeptides ...
Intestinal mucosa ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(19)
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piepsditDe nda dtietsrpipe rea pcdeudro by eht tvyatiic fo tirypns and ychpysirntom inwthi eth mnlue of eht dunoudme. eerF ionam daics rea erpcuddo nuop tuefhrr dtonsiegi fo etseh llmsa eptpieds itniwh het ushrb edrbro of teh ielnistatn suocam.

The nlmue of hte omdenduu si rwogn bseauec htta si ewrhe graler olxcepm yeppldopseit rae oernbk nodw ot di- dan editptirpse btu teh oincta of ingtka i-d dna idsrpeipett owdn ot viiadiulnd aomin sdcai phesnpa in the eitnisltan .amucso

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Maybe a way to remember this would be to think about Hartnup disease, an AR deficiency of neutral amino acid (primarily tryptophan is implicated) transporters in the proximal renal tubular cells and on ENTEROCYTES. This leads to neutral aminoaciduria and decreased absorption from the gut and little breakdown of dipeptides and tripeptides to amino acids in the intestinal mucosa. Decreased absorption from the gut causes decreased tryptophan for conversion to niacin and pellagra-like symptoms (diarrhea, dementia and hallucinations, and dermatitis in the C3-4 circumferential "broad collar" or "Casal necklace" dermatome, hyperpigmentation of sun-exposed limbs).

So if you can't convert dipeptides and tripeptides to amino acids in the ENTEROCYTES in the INTESTINAL MUCOSA, then you can get Hartnup disease.

+1/- shak360(19)


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