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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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ppdsetieDi adn eispptitder rae rudocpde yb the ctaytvii of rstynpi dan rimhpyoytncs hwitni teh uenlm of hte dd.umunoe eFer aionm sacdi rea opudrecd onpu htrfreu eoinditgs of eehst laslm tpieepds tnhwii eht urhsb odrber of het tilnisaent oacu.ms

hTe uelmn fo the oduunmed si nogrw auceesb that si eehrw arlreg cmpoxel tsloyepeppdi are onkreb wdon to -id nad iettprsidpe tub het oantci of takign di- nad tseetiirppd donw ot aiuviniddl mnaoi dasci appesnh in teh sletntnaii msuao.c

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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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