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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(23)
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ipeeitDdsp and trdpisetepi rae cudrdope by hte iticvayt of rspinyt dna romctyyishnp wnhtii eht enuml of het nde.mdouu Free iomna idcsa are dcrpdoue onup hrtufre tdeoiings of heets almls piespdte hiwnit het srubh rerdbo fo the nasteiitnl u.cmaso

ehT elmun of eht ouudemnd is wrogn cbsueae ahtt si rheew aegrrl eclpomx ldiepsyppeot rae nboker wdno ot -di dan tdieietpprs tbu eth tancio of atnkig i-d nad rptetiisdpe wdon to invulaidid oanmi disac aphepsn in teh atiitesnln acoum.s

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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(23)

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