Disorders of uric acid metabolism/Questions and case studies

Questions

 * 1) In humans, carbamoyl phosphate is a precursor for the biosynthesis of:
 * 2) * A – uridine monophosphate
 * 3) * B – Inosine monophosphate
 * 4) * C – urea
 * 5) * D – glutamine
 * 6) The metabolites of vitamin B12 play a role in:
 * 7) * A – Catabolism of fatty acids with an odd number of carbon atoms
 * 8) * B – In the formation of acetyl-CoA from pyruvate
 * 9) * C – During the transfer of the CH3- group from tetrahydrofolate coenzyme to homocysteine
 * 10) * D – In the synthesis of palmitate
 * 11) All of the statements below regarding purine biosynthesis nucleotides are correct except:
 * 12) * A – PRPP is a substrate in this metabolic pathway
 * 13) * B – 2 nitrogen atoms of the purine cycle are formed from glutamine
 * 14) * C – Formation of N-glycosidic bond only after completion of base structure
 * 15) * D – Folate cofactors are involved in the carbons of the purine cycle
 * 16) * E – Inosine monophosphate is a precursor to both AMP and GMP.
 * 17) Gout is caused by an excessive increase in the concentration of uric acid in the blood. The cause can be both overproduction and insufficient excretion. To recognize this situation, 15N-labeled amino acid can be administered. Which one is best for this purpose?

Female patient treated for acute leukemia
A 3-year-old girl was admitted with a diagnosis of acute lymphocytic leukemia. She received IVs, allopurinol, 2nd day of vincristine therapy, prednisone, methotrexate, etc. Discharged home in 5 days. She continued therapy at home (prednisone, allopurinol). Added chemotherapy again in a month. Then she gotthrush in her mouth, she couldn't eat.

Questions:
 * 1) How do you explain the high uric acid level (1st examination performed after 5 days of hospitalization, after discharge)
 * 2) Why was the uric acid already normal during the next examinations?
 * 3) Why was there a urea level of 0.7 mmol/l?
 * 4) What other tests will confirm this finding?

Related articles

 * Ureagenesis disorders
 * Antiuratics
 * Arthritis uratica