One-page handwritten-style medical study notes on metabolism of carbohydrates, proteins, and lipids. The page has a white background with a slightly textured paper feel. Written in blue and black ink in a neat handwritten font, divided into three clearly labeled sections with colored underlines: SECTION 1 - CARBOHYDRATE METABOLISM (blue heading): - Glycolysis: Glucose → Pyruvate (cytoplasm), net 2 ATP, key enzymes: Hexokinase, PFK-1, Pyruvate kinase - Aerobic: Pyruvate → Acetyl-CoA (PDH complex) → TCA cycle → 30-32 ATP - Anaerobic: Pyruvate → Lactate (Cori cycle) - Gluconeogenesis: Lactate/AA/Glycerol → Glucose (liver, fasting) - Glycogenesis/Glycogenolysis: storage and release (liver & muscle) - Pentose Phosphate Pathway: NADPH + Ribose-5-P (RBCs, biosynthesis) SECTION 2 - PROTEIN METABOLISM (red/orange heading): - Digestion: Proteins → AA (pepsin, trypsin, chymotrypsin) - Transamination: AA + α-ketoglutarate → Keto acid + Glutamate (ALT, AST) - Deamination: Glutamate → NH3 + α-ketoglutarate - Urea Cycle: NH3 → Urea (liver) → excreted by kidneys; key enzymes: CPS-1, ASS, arginase - AA → Glucogenic or Ketogenic - Essential AA mnemonic: PVT TIM HaLL SECTION 3 - LIPID METABOLISM (green heading): - Lipolysis: TG → Glycerol + FFA (hormone-sensitive lipase) - Beta-oxidation: FFA → Acetyl-CoA (mitochondria); FADH2 + NADH per cycle - Ketogenesis: Excess Acetyl-CoA → Ketone bodies (fasting/DKA) - Lipogenesis: Acetyl-CoA → FFA (cytoplasm, insulin stimulated) - Cholesterol synthesis: Acetyl-CoA → HMG-CoA → Cholesterol (HMG-CoA reductase - rate limiting) - Lipoproteins: Chylomicrons > VLDL > IDL > LDL > HDL Central box labeled: TCA CYCLE / Krebs Cycle (common hub) with arrows from all three sections pointing to it. Small arrow diagram showing: Glucose → Acetyl-CoA ← FFA; Amino Acids → Acetyl-CoA Bottom note: "All pathways converge at Acetyl-CoA & TCA Cycle → ATP via oxidative phosphorylation" Layout: clean, organized, uses boxes, arrows, and underlines. Looks like neat student handwritten notes on lined paper.