AEC peer review 9/2

Which of the following are essential amino acids?

• Lys, Gly, Ala, Val

• Glu, Met, Tyr, Ser

• His, Val, Thr, Lys

• Cys, His, Val, Lys

After eating a Costco chicken, Anna begins studying how the body processes amino acids. She learns the alanine cycle is dependent on aspartate alanine aminotransferase (ALT) in the muscle and the liver. What vitamin deficiency would cause a disruption of this cycle?

• B1

• B9

• B2

• B6

Al presents to the ED with vomiting, confusion, slurred speech, and flapping tremors. He is found to have high levels of ammonia. Which compound is depleted in Al’s brain?

• Glutamate

• Ala

• Gly

• Gln

A 48-year-old homeless male presents with confusion and slurred speech. Physical examination reveals spider angiomas on the chest and flapping tremors on wrist extension. Labs reveal elevated AST and ALT levels. Where does the first step of this patient’s metabolic defect normally occur?

• Hepatocyte cytosol

• Hepatocyte mito

• Myocyte cytosol

• Neuronal mito

Calvin is wondering why amino acids must travel through a cell in order to get into the blood. What structure(s) in adjacent enterocytes prohibit passage of materials in the extracellular space?

• desmosomes and tight junctions

• tight junctions and cadherins

• gap junctions

• desmosomes and cadherins

A 32-year-old man presents with chronic diarrhea and weight loss. Laboratory studies reveal hypoalbuminemia and evidence of protein-energy malnutrition. Upper endoscopy with small bowel biopsy shows blunted villi and increased intraepithelial lymphocytes. Which of the following best describes the primary mechanism by which dietary protein is absorbed in the small intestine?

• Direct transcytosis of intact proteins across enterocytes

• Hydrolysis of proteins to amino acids and small peptides, followed by passive diffusion of amino acids across the epithelial barrier

• Hydrolysis of proteins to amino acids and small peptides, followed by absorption via specific transporters in the brush border membrane

• Endocytosis of large protein aggregates by M cells

A professional basketball player collapsed to the ground during a game and was found to have an enlarging aortic dissection. History revealed that his father died very young with similar symptoms. His genetic and clinical testing is consistent with Marfan syndrome. Which of the following findings would be least likely in this patient?

• intellectual disability

• tall stature

• long fingers

• dislocated lens

Which of the following is seen in patients with Marfan’s syndrome but not Ehlers-Danlos syndrome?

• Flexible joints

• Stretchy skin

• Vascular abnormalities

• Dislocated lens

Which of the following combinations is the correct gene mutation and inheritance pattern seen in Marfan’s syndrome?

• FBN1, AR

• COL5A1, AD

• FBN1, AD

• COL3A1, AR

What is represented by the first sound you hear when taking a manual blood pressure?

• Systolic BP

• aortic valve opening

• Diastolic BP

• aortic valve closing