Disorders of glucose metabolism/Questions and case studies

Questions

 * 1) During fasting, which enzyme is responsible for the production of free glucose in the liver
 * 2) * A – Glucagon
 * 3) * B – Glucose-6-phosphate dehydrogenase
 * 4) * C – Glucokinase
 * 5) * D – Hexokinase
 * 6) * E – Glucose-6-phosphatase
 * 7) Which of the following metabolites cannot provide carbon atoms for gluconeogenesis?
 * 8) * A – Alanine
 * 9) * B – Pyruvate
 * 10) * C – Lactate
 * 11) * D – Palmitate
 * 12) * E – Oxaloacetate
 * 13) Insulin accelerates
 * 14) * A – glucose production by the liver
 * 15) * B – uptake of glucose in the muscles
 * 16) * C – excretion of fatty acids from adipose tissue
 * 17) * D – conversion of glycogen into glucose in the liver
 * 18) * E – conversion of amino acids to glucose in muscles
 * 19) Which of the following enzymes has a role in the Cori cycle?
 * 20) * A – Lactate dehydrogenase
 * 21) * B – Glucose-6-phosphate dehydrogenase
 * 22) * C – Pyruvate dehydrogenase
 * 23) * D – Glucokinase
 * 24) * E – Hydroxymethylglutaryl–CoA reductase
 * 25) After taking food (mixed food), insulin is secreted. This rise in insulin causes a normal person to: (fill in correctly if something rises, falls or does not change)
 * 26) * A – release of glucose from the liver...
 * 27) * B – uptake of glucose by muscle and fat tissue...
 * 28) * C – gluconeogenesis in the liver...
 * 29) * D – synthesis of fatty acids...
 * 30) * E – glucagon secretion...
 * 31) Glucagon controls the function of target cells by first binding to a specific membrane receptor and thus increases inside the cell:
 * 32) * A – neurotransmitter
 * 33) * B – a specific peptide that activates certain enzymes
 * 34) * C – cAMP (cyclic adenosine monophosphate)
 * 35) * D – nucleic acids
 * 36) * E – synthesis of enzymes
 * 37) What are the metabolic causes of hyperglycemia in diabetes mellitus?
 * 38) * A – Reduction of glucose utilization in tissues
 * 39) * B – Gluconeogenesis in muscles
 * 40) * C – Gluconeogenesis in the liver
 * 41) * D – Glucose transfer across the hepatocyte membrane conditioned by insulin deficiency
 * 42) * E – Increased renal threshold for glucose
 * 43) * F – Increasing the effect of glucagon over the effect of insulin
 * 44) * G – Inhibition lipolysis (breakdown of fatty acids)
 * 45) What are the metabolic causes diabetic ketoacidosis? (more options)
 * 46) * A – Reduced degradation ketone body in the liver
 * 47) * B – Combination of insulin deficiency with glucagon excess
 * 48) * C – Conversion of acetoacetate to acetone
 * 49) * D – Catabolism of fatty acids (lipolysis)
 * 50) * E – Increased production of acetyl CoA in the liver
 * 51) * F – Increased formation of hydroxymethylglutaryl-CoA in mitochondria
 * 52) What are the main causes of hyperosmolar coma in diabetes mellitus?
 * 53) * A – Osmotic diuresis for hyperglycemia with insufficient water intake
 * 54) * B – Complete lack of insulin combined with an excess of glucagon
 * 55) * C – A lack of insulin will reduce the utilization of glucose in the brain, causing a malfunction in the brain's centers controlling water and electrolyte metabolism
 * 56) * D – Glycation of collagen in the glomerular basement membrane, which leads to increased permeability

Female patient with overweight and abdominal pain
49-year-old woman, long history of obesity without dieting and weight reduction. She has pelvic pain. Gynecologist. find: chron. pelvic inflammation. At the last visit, elevated blood pressure, fasting blood glucose 15.8 mmol/l.

Questions:
 * 1) What type of diabetes does the patient probably suffer from?
 * 2) What does elevated glucagon do?
 * 3) What is the cause of increased excretion of urea in the urine in diabetes mellitus?

Female, 21 years old with type 1 diabetes
Admitted to hospital in a delirious state with tachypnea. A fruity smell on the breath. History of acute respiratory infection. Laboratory findings:
 * blood: glucose 22 mmol/l, bicarbonate 9.5 mmol/l
 * serum: urea 11.8 mmol/l, Na+ 136 mmol/l, K+ 5.7 mmol/l

Questions:
 * 1) What diagnosis is involved
 * 2) How can a low bicarbonate level be explained (pathobiochemical basis)
 * 3) Why is the level of urea and K+ elevated.

Nurse, 24 years old
She had repeated episodes of hypoglycemia. Laboratory examination showed the following results: B-glucose repeatedly 0.9 - 1.1 mmol/l, C-peptide: 0.01 pmol/l to undetectable (repeatedly)

Questions:
 * 1) What is the most likely cause of hypoglycemia?

Patient on parenteral nutrition
A 32-year-old man with an advanced stage of Crohn's disease (ileitis terminalis) and severe malnutrition was on parenteral nutrition. Laboratory examination:
 * B-glucose (not fasting): 9.8 mmol/l
 * S-phosphate: 0.3 mmol/l
 * S-albumin: 27 g/l
 * S-Ca: 1.96 mmol/l

Questions:
 * 1) What is the explanation of the laboratory values

Related Articles

 * Inherited metabolic glycogen storage diseases
 * Energy metabolism and its disorders