NUTR445

FINAL EXAM
STUDY GUIDE

Digestion
What are the 4 functions of the GI tract?
What is the function of bile, how is it formed? What are the 2 common primary bile acids
important for digestion?
Understand portal circulation, and why it is important to digestion.
Define what is meant by commensal microbiota.
What is the difference between a prebiotic and probiotic?

In detail:
Compare and contrast the digestion and absorption of dietary protein, carbohydrate and lipids.
Discuss the important digestive enzymes, tissues, hormones and mediators, products of
digestion, how the products enter enterocytes, and the fate of different digestion products (get the
products to the liver).

Proteins
How do we regulate the function of enzymes? Name the three regulation mechanisms and
describe how they work.
Know the basic chemical structure of amino acids.
How are amino acids classified?
What are the essential amino acids and why are they essential?
Understand the difference between amino acid transport and peptide transport in enterocytes.
Understand amino acid metabolism in hepatocytes and renal tubule cells. In particular, what is
the importance of periportal and perivenous hepatocytes and glutamine metabolism.
Understand transamination and deamidation and their roles in amino acid catabolism.
What are the obligate amino and -keto acid pair in all transamination reactions?
Understand the importance of glutamate aspartate aminotransferase (AST) and glutamate alanine
aminotransferase.
Understand the starting components, the enzymes and the end products of the urea cycle and why
it is critical in physiology and metabolism.
What amino acid plays an important role in controlling toxicity from ammonia?
Why is ammonia toxic? (hint – what tissue is most affected by high NH3 levels)

In detail:
What is the importance of the glutamate dehydrogenase reaction, where does it occur, and how is
it regulated?
Understand the glutamine synthetase and glutaminase reaction, and the physiological
significance of these reactions.

Carbohydrates
Know the basic chemical structure of monosaccharides.
Know the difference between the simple and complex CHO.
Understand how blood glucose is regulated. What are normal blood glucose levels? What
happens if this is not maintained?
What is hypoglycemia?
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Know all of the counter regulatory hormones, what they do, what organ they are secreted from,
and how they maintain blood glucose.
Understand how insulin can increase cellular uptake of glucose (translocation of glut 4).
Understand the glycemic response to CHO – what is glycemic index? How is it calculated? What
are some examples of foods with a high vs. low glycemic index? What is glycemic load?
How much glycogen is stored in liver vs. muscle (relative amounts)?
Glycogenesis and glycogenolysis involve several important substrates and key enzymes.
Understand how glycogen is formed when the body needs to store glucose or how glycogen is
broken down to yield free glucose (liver) or glucose-6 phosphate (muscle). Be able to discuss
how these pathways are inter-related, what are the key enzymes and how do insulin and the
counter-regulatory hormones influence these pathways? (big picture here)
In what intracellular site does glycogenolysis and glycogenesis occur?
Know the difference between hexokinase and glucokinase in terms of Km, and inhibition by
glycolytic intermediates.
What happens to pyruvate under anerobic vs. aerobic cellular conditions?
What are the 3 nonequilibrium, regulated enzymes in glycolysis? How are they regulated?
In what intracellular location does glycolysis take place?
What happens to pyruvate under anerobic vs. aerobic cellular conditions?
What reaction does lactate dehydrogenase catalyze? What are the substrates and reactants of this
reaction?
What is Cori cycle and when is it in operation?
What cells use anaerobic vs. aerobic glycolysis?
What reaction does the pyruvate dehydrogenase complex catalyze? Why is this reaction called
the linking reaction? What are the substrates and reactants of this reaction?
What is the rate-limiting step in the Krebs cycle? What enzyme mediates this and how is it
regulated? In what intracellular site does the Krebs cycle occur?
What does the electron transport chain do for the cell? And where is it found? What structures
make up the ETC?
What is oxidative phophorylation?
What is the net yield of ATP formation from the Krebs cycle, and from aerobic glycolysis
(total)?
What is the efficiency in complete oxidation of glucose – how much energy is captured in the
formation of ATP and how much is released as heat?
How much energy is transferred from reduced NADH and FADH2 in the ETC (e.g. how many
ATP are produced from each)?
What is the function of the pentose phosphate pathway (PPP)? What is the starting molecule that
enters the PPP? What is the rate limiting enzyme in the PPP? how does insulin regulate this
enzyme? In what tissues does the PPP occur?
Why do we need NADPH?

In detail:
Understand the following about glycolysis: the rate limiting enzymes, how they are regulated
(what regulated them and how is this done) and what is the starting and end product of glycolysis
Understand the following about gluconeogenesis: the rate limiting enzymes, tissues where this
process occurs, what compounds could be used as gluconeogenic precursors, what tissues
convert these compounds to glucose, what tissues make the gluconeogenic precursors.

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Fiber
What is the difference between dietary fiber and functional fiber?
Know the important parameters to evaluate the functional aspects of fiber (solubility, hydration
capacity, binding ability, fermentability).
What is the relationship between soluble fiber and serum lipid levels?

Lipids
Know the basic structures of fatty acids, triacylglycerol, cholesterol and phospholipid.
Know fatty acid nomenclature (delta and omega system).
What 3 desaturases do we as humans have?
Know the major polyunsaturated fatty acids discussed in class.
Know the essential fatty acids and the fatty acids that can be derived from essential fatty acids.
What are the dietary sources of SFA, MUFA and PUFA?
Know the major apolipoproteins (A1, B100, B48, C2, E) and their functions.
Describe the role of the liver and adipose tissues in lipid metabolism?
What lipid profiles are positively or negatively correlated with CVD?
What is the function of lipoprotein lipase, hormone sensitive lipase, intracellular lipase and
pancreatic lipase?
Understand the formation and metabolism of HDL and reverse cholesterol transport.
Understand the roles of lipid and lipoproteins in atherogenesis.
Know the starting and end products of fatty acid metabolism and in what tissue this occurs.
Understand the process of beta-oxidation of fatty acids - what enzymes are involved, what
tissues this occurs in, and what mediators regulate the process.
What is the ATP yield from beta-oxidation of palmitic acid?
What are CPT1 and CPTII, where are they located and what do they do?
What is ketosis?
Understand the process of triacylglycerol storage -what enzymes are involved, where the
enzymes are located (what tissues this occurs in) and what mediators regulate the process.
Understand the process of de novo lipogenesis - what enzymes are involved, what tissues this
occurs in, and what mediators regulate the process.
What are the categories of eicosanoids? Understand the main pathways in eicosanoid metabolism
and their major physiological functions.
Know the therapeutic approaches to inhibit fat absorption
Know the feature of brown adipose tissue, and how it relates to thermogenesis

In detail
Know the four lipoproteins, and understand their function with respect to transportation of lipids.
Know where they come from (tissue of origin), what they transport, and what they do with what
they are carrying.

Alcohol
Know the biochemical and metabolic impact of alcohol.
Understand the alcohol dehydrogenase pathway.
What is MEOS and why is this important in metabolism?

In detail:

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What are the biochemical and metabolic alterations that occur with excessive consumption of
alcohol or alcoholism? Be able to discuss acetaldehyde toxicity, the metabolic consequences of
a shift in the NAD+/NADH+ ratio, substrate competition and metabolic tolerance.

Integrative Questions
How can high simple carbohydrate diet impact lipogenesis? (case study 4)
What is the final common catabolic pathway for metabolism of carbohydrate, protein and fat?
Know which Krebs cycle intermediate can move from the mitochondria into the cytoplasm to
become the initiator of fatty acid synthesis.
Which hormone has the primary responsibility for directing energy metabolism in the fed state?
And which hormones in the fasting state?
Which cells lack a metabolic mechanism to convert glucose into energy stores?
Know which amino acids are glucogenic, ketogenic or both in the post-absorptive state.
Know the substrate and hormone levels in blood of well-fed, fasting and starving humans.
Know what the energy reserves for glycogen, glucose, fat and protein are in humans.
How are the urea cycle and carbohydrate metabolism linked?
Be familiar with how long it takes to go from a post-absorptive state to a fasted state.
Muscle breakdown provide the chief substrate for which metabolic process? When would this
occur metabolically?

In detail (Hint, I would really, really know these answers)

In the following physiological states: well-fed, post-absorptive, short term fast or long-term fast
(starvation), which hormone(s) has(ve) the primary responsibility for directing energy
metabolism in each state? Discuss the metabolic processes that would be occurring in the brain,
liver, adipose tissue, muscle and RBC in each of the above states.

Know the primary fuel source of the following tissues during a fed and fasted state: brain, liver,
skeletal muscle, adipose tissue, kidney, RBC.

Know the five phases of glucose homeostasis, what is the source of glucose in each phase and
what is the timeframe of these events?

Understand the interrelationship between tissues, hormones and metabolic controllers in the
following physiological states: Type I diabetes, Type II diabetes, obesity, exercise, stress/injury.