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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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tsieidppDe dna teidpstirpe rae ocurdepd yb eth iycittav fo rysnipt nad isypnmhtycor iiwtnh hte leunm of hte eddo.nmuu reeF iamon iasdc rae repddocu ounp ruerfth negtosdii of ehset lmsal sidptpee iihntw eht srhbu dorebr of hte taiitlnnes c.souma

The luemn of het dueondum is gowrn cbsaeeu taht si ewerh grlaer mlocxpe epplyisoptde ear eobnkr wnod to di- dan pestpietidr tub hte toaicn fo gniatk di- adn deteiptrsip wnod ot lindiuvdai oimna acisd pnpeash in eth tiietnalns acso.mu

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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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