Tagged: Gluconeogenesis

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Lactate to glucose conversion

Lactate is oxidized to pyruvate in a reaction catalyzed by Lactate dehydrogenase. The patients with genetic deficiency of lactate dehydrogenase present with muscle cramping and myoglobinuria after intense exercise. The sources of lactate include muscle and red blood cells. Lactate is a waste product in such cells; it is transported to liver and can be converted to glucose through pathway of gluconeogenesis. The energy requirements for conversion of lactate to glucose are: A. 2 ATP B. 4 ATP C. 6 ATP D. 8 ATP E. 38 ATP. The correct answer is C- 6 ATP. Lactate produced by active skeletal muscle...

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Alcohol induced hypoglycemia

Case details A known alcoholic is found lying semiconscious at the bottom of a stairwell with a broken arm by his landlady, who called an ambulance to take him to the emergency room. Initial laboratory studies showed are relatively large anion gap of 34 (normal = 9 to 15). His blood alcohol was elevated at 245 mg/dL (intoxication level = 150 to 300 mg/dL), and his blood glucose was 38 mg/dL (low normal). The patient/s large anion gap and hypoglycemia can best be explained by which of the following? A. Decreased secretion of glucagon B. Increased secretion of insulin C....

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Implications of maternal hyperglycemia

Case details A pregnant mother with a history of long-standing uncontrolled diabetes mellitus has come for a routine check up. The examination reveals a normal pregnancy. Blood chemistry reveals random blood glucose – 165 mg/dl and Glycated hemoglobin (HbA1c) of 10.5 %. What are the possible complications in a fetus under such conditions of maternal hyperglycemia? A. Fetal hyperglycemia B. Large fetal size C. Hypoglycemia after birth D. Fetal hyperinsulinemia E. All of the above. See the image below and try to find out the answer Figure- Showing the implications of maternal hyperglycemia. The correct answer – E- all of the...

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Prolonged fasting and gluconeogenesis…

A 14-year-old high school girl who is extremely conscious about her appearance has gone a full day fasting to fit in to a dress she intentionally brought a size smaller than her actual size for a dance party. Which of the following organs/tissues contribute to the glucose that is being synthesized through gluconeogenesis during periods of prolonged fasting? A. Spleen B. Red blood cells C. Skeletal muscle D. Liver E. Brain D-Liver is the correct answer. Gluconeogenesis is the process of converting noncarbohydrate precursors to glucose or glycogen. The major substrates are the glucogenic amino acids, lactate, glycerol, and propionate....

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Role of Insulin in Diabetic ketoacidosis

Case details An 8-year old boy, a known diabetic (type 1 DM), has been brought to emergency room in a state of coma. His breathing is rapid and deep, and his breath has a fruity odor. His blood glucose is 480 mg/dL. The attending physician has administered IV fluids, insulin, and potassium chloride. A rapid effect of insulin in this situation is to stimulate A. Gluconeogenesis in liver B. Fatty acid release from adipose C. Glucose transport in muscle D. Ketone utilization in the brain E. Glycogenolysis in the liver Answer- The right answer is- c) Glucose transport in muscle....

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Case study- Starvation

Case details A 25 –year-old woman living alone became severely depressed after the termination of her engagement. Two months later, she was brought to the emergency room by a friend because of weakness and lethargy. She appeared thin and pale. Questioning revealed that she had not eaten for several weeks. Analysis of a plasma sample indicated elevated levels of acetoacetate, β hydroxybutyrate, and blood urea nitrogen (BUN). However her plasma glucose concentration was within normal limits. She was hospitalized, given intravenous feeding and antidepressant medications and subsequently shifted to an 1800 Cal (7500 kJ) diet. Her recovery was uneventful. During...

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Answer to the question- Amino acids in the post absorptive state ..

During a medical rotation, a medical student volunteered for a respiratory physiology exam that determines basal metabolic rate and the respiratory quotient. She followed the protocol for a resting individual in the post absorptive state. Which of the following amino acids would be found in the highest concentration in serum? A. Alanine and Glutamine B. Arginine and Ornithine C. Glutamate and Aspartate D. Branched chain amino acids E. Hydrophobic amino acids Answer- A- Alanine and Glutamine. Post absorptive state is the state of the body 3-5 hours after meals. It is that period of time in the body during which...

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