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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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sdptpieDei dna peirdettisp are oredupdc by the tviatiyc fo yntsrpi and omnirstcpyyh iinwth eth umeln of teh d.mouednu Feer oaimn casdi era odpuderc nopu feuhtrr tiiongdse of ehste lmals seppetid winhit eht hrbus errbdo of het tiiltsenna sucam.o

eTh nmlue fo eth udonmeud si ogrwn scuabee htat si eehrw grrael poxlmce pytsppeiledo ear enobkr nwod ot di- dan pesdirepitt tub eht oaitcn fo inagtk d-i and ederttipisp wdno ot ndidviulia nmoia csdia ehanspp in the tlsnieatin so.aucm

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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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