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A patient with type 1 diabetes mellitus takes an insulin injection before eating dinner, but then gets distracted and does not eat. Approximately 3 hours later, the patient becomes shaky, sweaty, and confused. These symptoms have occurred because of which one of the following?
A patient with type 1 diabetes mellitus takes an insulin injection before eating dinner, but then gets distracted and does not eat. Approximately 3 hours later, the patient becomes shaky, sweaty, and confused. These symptoms have occurred because of which one of the following?
Concerning our patient in question 19.1, if the patient had fallen asleep before recognizing the symptoms, the patient could lose consciousness while sleeping. If that were to occur and paramedics were called to help the patient, the administration of which one of the following would help to reverse this effect?
Concerning our patient in question 19.1, if the patient had fallen asleep before recognizing the symptoms, the patient could lose consciousness while sleeping. If that were to occur and paramedics were called to help the patient, the administration of which one of the following would help to reverse this effect?
Caffeine is a potent inhibitor of the enzyme cAMP phosphodiesterase. Which one of the following consequences would you expect to occur in the liver after drinking two cups of strong espresso coffee?
Caffeine is a potent inhibitor of the enzyme cAMP phosphodiesterase. Which one of the following consequences would you expect to occur in the liver after drinking two cups of strong espresso coffee?
Assume that an increase in blood glucose concentration from 5 to 10 mM would result in insulin release by the pancreas. A mutation in pancreatic glucokinase can lead to MODY because of which one of the following within the pancreatic ß-cell?
Assume that an increase in blood glucose concentration from 5 to 10 mM would result in insulin release by the pancreas. A mutation in pancreatic glucokinase can lead to MODY because of which one of the following within the pancreatic ß-cell?
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Which one of the following organs has the highest demand for glucose as a fuel?
Which one of the following organs has the highest demand for glucose as a fuel?
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Glucagon release does not alter muscle metabolism because of which one of the following?
Glucagon release does not alter muscle metabolism because of which one of the following?
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A male patient with fasting hypoglycemia experiences tremors, sweating, and a rapid heartbeat. These symptoms have been caused by the release of which one of the following hormones?
A male patient with fasting hypoglycemia experiences tremors, sweating, and a rapid heartbeat. These symptoms have been caused by the release of which one of the following hormones?
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A patient has tried many different “fad” diets to lose weight. Which one of the following meals would lead to the lowest level of circulating glucagon shortly after the meal?
A patient has tried many different “fad” diets to lose weight. Which one of the following meals would lead to the lowest level of circulating glucagon shortly after the meal?
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A 45-year-old patient was admitted to the hospital in a coma caused by severe hyperglycemia and was treated with insulin and fluids. He has been placed on long- and short-acting insulin injected daily to control his blood glucose levels. What test could be ordered at this point to determine if the patient has type 1 versus type 2 diabetes?
A 45-year-old patient was admitted to the hospital in a coma caused by severe hyperglycemia and was treated with insulin and fluids. He has been placed on long- and short-acting insulin injected daily to control his blood glucose levels. What test could be ordered at this point to determine if the patient has type 1 versus type 2 diabetes?
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The patient in the previous question had very high blood glucose levels, and his urine also contained high blood glucose levels. The high blood glucose levels can lead to cerebral dysfunction owing to which one of the following?
The patient in the previous question had very high blood glucose levels, and his urine also contained high blood glucose levels. The high blood glucose levels can lead to cerebral dysfunction owing to which one of the following?
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The facilitative transporter that is most responsible for transporting fructose from the blood into cells is which one of the following?
The facilitative transporter that is most responsible for transporting fructose from the blood into cells is which one of the following?
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A patient with alcoholism developed pancreatitis that affected his exocrine pancreatic function. He exhibited discomfort after eating a high-carbohydrate meal. The patient most likely had a reduced ability to digest which one of the following?
A patient with alcoholism developed pancreatitis that affected his exocrine pancreatic function. He exhibited discomfort after eating a high-carbohydrate meal. The patient most likely had a reduced ability to digest which one of the following?
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A man with type 1 diabetes neglects to take his insulin injections while on a weekend vacation. Cells found within which tissue will be most greatly affected by this mistake?
A man with type 1 diabetes neglects to take his insulin injections while on a weekend vacation. Cells found within which tissue will be most greatly affected by this mistake?
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After digestion of a piece of cake that contains flour, milk, and sucrose as its primary ingredients, the major carbohydrate products that enter the blood are which of the following?
After digestion of a piece of cake that contains flour, milk, and sucrose as its primary ingredients, the major carbohydrate products that enter the blood are which of the following?
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A patient has a genetic defect that causes intestinal epithelial cells to produce disaccharidases of much lower activity than normal. Compared with a normal person, after eating a bowl of oatmeal and milk sweetened with table sugar, this patient will exhibit higher levels of which of the following?
A patient has a genetic defect that causes intestinal epithelial cells to produce disaccharidases of much lower activity than normal. Compared with a normal person, after eating a bowl of oatmeal and milk sweetened with table sugar, this patient will exhibit higher levels of which of the following?
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The majority of calories in the US diet are derived from carbohydrates, which can contain a variety of glycosidic bonds. Which one of the following carbohydrates contains glucosyl units linked through α-1,6 glycosidic bonds?
The majority of calories in the US diet are derived from carbohydrates, which can contain a variety of glycosidic bonds. Which one of the following carbohydrates contains glucosyl units linked through α-1,6 glycosidic bonds?
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A patient has increased her dietary fiber intake in an effort to decrease constipation. She has recently noticed abdominal cramping and bloating as well as increased flatulence. Which one of the following best explains why this is happening?
A patient has increased her dietary fiber intake in an effort to decrease constipation. She has recently noticed abdominal cramping and bloating as well as increased flatulence. Which one of the following best explains why this is happening?
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A newly diagnosed patient with diabetes avoided table sugar because he knew he had “sugar diabetes,” but he continued to consume fruits, fruit drinks, milk, honey, and vegetables, with the result being poor diabetic control. The diet the patient was following contained carbohydrate primarily in which form? Choose the one best answer.
A newly diagnosed patient with diabetes avoided table sugar because he knew he had “sugar diabetes,” but he continued to consume fruits, fruit drinks, milk, honey, and vegetables, with the result being poor diabetic control. The diet the patient was following contained carbohydrate primarily in which form? Choose the one best answer.
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A 10-year-old patient had 3 days of severe diarrhea after developing a viral gastroenteritis. Now, whenever she drinks milk, she experiences nausea, abdominal pain, and flatulence. She never had this happen before after drinking milk. Which one of the following would be the best advice for this patient?
A 10-year-old patient had 3 days of severe diarrhea after developing a viral gastroenteritis. Now, whenever she drinks milk, she experiences nausea, abdominal pain, and flatulence. She never had this happen before after drinking milk. Which one of the following would be the best advice for this patient?
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A runner wanted to “carb load” just before a race, and she wanted to pick something to eat that has a high glycemic index. Which one of the following foods should the runner pick?
A runner wanted to “carb load” just before a race, and she wanted to pick something to eat that has a high glycemic index. Which one of the following foods should the runner pick?
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Glucose is the body's universal fuel, which can be used by virtually all tissues. A major role of glycolysis is which one of the following?
Glucose is the body's universal fuel, which can be used by virtually all tissues. A major role of glycolysis is which one of the following?
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Glycolysis generates energy such that cells have a source of energy to survive. Starting with glyceraldehyde 3-P and synthesizing one molecule of pyruvate, the net yield of ATP and NADH would be which one of the following?
Glycolysis generates energy such that cells have a source of energy to survive. Starting with glyceraldehyde 3-P and synthesizing one molecule of pyruvate, the net yield of ATP and NADH would be which one of the following?
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Glycogen is the body's storage form of glucose. When glycogen is degraded, glucose 1-P is formed. Glucose 1-P can then be isomerized to glucose 6-P. Starting with glucose 1-P and ending with two molecules of pyruvate, what is the net yield of glycolysis in terms of ATP and NADH formed?
Glycogen is the body's storage form of glucose. When glycogen is degraded, glucose 1-P is formed. Glucose 1-P can then be isomerized to glucose 6-P. Starting with glucose 1-P and ending with two molecules of pyruvate, what is the net yield of glycolysis in terms of ATP and NADH formed?
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Every human cell has the capacity to use glycolysis for energy production. Which one of the following statements correctly describes an aspect of glycolysis?
Every human cell has the capacity to use glycolysis for energy production. Which one of the following statements correctly describes an aspect of glycolysis?
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Fructose is the second most common sugar in the human adult diet and its metabolism parallels glycolysis. Which one of the following substances is found in both the fructose metabolic pathway and the glycolytic pathway?
Fructose is the second most common sugar in the human adult diet and its metabolism parallels glycolysis. Which one of the following substances is found in both the fructose metabolic pathway and the glycolytic pathway?
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A 4-week-old baby is being seen by the pediatrician because of frequent vomiting after meals and tenderness in the abdomen. Upon examination, the physician noted an enlarged liver and a hint of cataract formation in both of the child's eyes. A urine dipstick test for a reducing sugar gave a positive result. Blood glucose levels were slightly below normal. The compound that reacted with the urine dipstick test was most likely which one of the following?
A 4-week-old baby is being seen by the pediatrician because of frequent vomiting after meals and tenderness in the abdomen. Upon examination, the physician noted an enlarged liver and a hint of cataract formation in both of the child's eyes. A urine dipstick test for a reducing sugar gave a positive result. Blood glucose levels were slightly below normal. The compound that reacted with the urine dipstick test was most likely which one of the following?
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Considering the child discussed in the previous question, measurement of which single intracellular metabolite would allow a determination of the enzyme deficiency?
Considering the child discussed in the previous question, measurement of which single intracellular metabolite would allow a determination of the enzyme deficiency?
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Metformin is a medication used in treating diabetes mellitus type 2. One of its actions is to decrease hepatic gluconeogenesis. A theoretical concern with this medication was lactic acidosis, which in practice does not occur in patients taking metformin. Which one of the following explains why lactic acidosis does not occur with the use of this medication?
Metformin is a medication used in treating diabetes mellitus type 2. One of its actions is to decrease hepatic gluconeogenesis. A theoretical concern with this medication was lactic acidosis, which in practice does not occur in patients taking metformin. Which one of the following explains why lactic acidosis does not occur with the use of this medication?
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Because glucose has several metabolic routes it might take once it arrives in the cytoplasm, which one of the following reactions would commit the glucose to following the glycolytic pathway?
Because glucose has several metabolic routes it might take once it arrives in the cytoplasm, which one of the following reactions would commit the glucose to following the glycolytic pathway?
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The red blood cells require ATP in order to maintain ion gradients across their membrane. In the absence of these ion gradients, the red blood cells will swell and burst, bringing about a hemolytic anemia. Red cells generate their energy via which one of the following?
The red blood cells require ATP in order to maintain ion gradients across their membrane. In the absence of these ion gradients, the red blood cells will swell and burst, bringing about a hemolytic anemia. Red cells generate their energy via which one of the following?
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An individual displays lactic acidemia as well as a reduced activity of α-ketoglutarate dehydrogenase activity. The most likely single enzymatic mutation that leads to these changes would be in which one of the following proteins?
An individual displays lactic acidemia as well as a reduced activity of α-ketoglutarate dehydrogenase activity. The most likely single enzymatic mutation that leads to these changes would be in which one of the following proteins?
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A patient diagnosed with thiamin deficiency exhibited fatigue and muscle cramps. The muscle cramps have been related to an accumulation of metabolic acids. Which one of the following metabolic acids is most likely to accumulate in a thiamin deficiency?
A patient diagnosed with thiamin deficiency exhibited fatigue and muscle cramps. The muscle cramps have been related to an accumulation of metabolic acids. Which one of the following metabolic acids is most likely to accumulate in a thiamin deficiency?
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Succinate dehydrogenase differs from all other enzymes in the TCA cycle in that it is the only enzyme that displays which one of the following characteristics?
Succinate dehydrogenase differs from all other enzymes in the TCA cycle in that it is the only enzyme that displays which one of the following characteristics?
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During exercise, stimulation of the TCA cycle results principally from which one of the following?
During exercise, stimulation of the TCA cycle results principally from which one of the following?
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A deficiency of which one of the following compounds would lead to an inability to produce coenzyme A?
A deficiency of which one of the following compounds would lead to an inability to produce coenzyme A?
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One of the major roles of the TCA cycle is to generate reduced cofactors for ATP production from oxidative phosphorylation. The compound donating the net eight electrons to the cofactors is which one of the following?
One of the major roles of the TCA cycle is to generate reduced cofactors for ATP production from oxidative phosphorylation. The compound donating the net eight electrons to the cofactors is which one of the following?
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Atherosclerosis can narrow the coronary arteries, leading to decreased blood flow and hypoxia of cardiac cells (cardiomyocytes). This causes the patient to experience angina. Which one of the following is likely to occur in the cardiomyocytes during the hypoxic event?
Atherosclerosis can narrow the coronary arteries, leading to decreased blood flow and hypoxia of cardiac cells (cardiomyocytes). This causes the patient to experience angina. Which one of the following is likely to occur in the cardiomyocytes during the hypoxic event?
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A distance runner is training for her half marathon and as part of the training is allowing her muscles to use fatty acids as a fuel source. Fatty acids are converted to acetyl-CoA in the mitochondria, at which point the acetyl-CoA can be oxidized in the TCA cycle to generate reduced cofactors. Which one of the following correctly describes how the acetyl-CoA is metabolized in the mitochondria?
A distance runner is training for her half marathon and as part of the training is allowing her muscles to use fatty acids as a fuel source. Fatty acids are converted to acetyl-CoA in the mitochondria, at which point the acetyl-CoA can be oxidized in the TCA cycle to generate reduced cofactors. Which one of the following correctly describes how the acetyl-CoA is metabolized in the mitochondria?
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Study Notes
Diabetes Mellitus
- Type 1 Diabetes: Insulin injections are needed before eating, but if a person is distracted and forgets to eat, symptoms including shakiness, sweating, and confusion may arise 3 hours later. These symptoms are caused by a drop in blood glucose levels (low blood glucose).
- Treatment for Low Blood Sugar: Administration of insulin can reverse low blood glucose levels, if the patient loses consciousness before these symptoms are recognized.
Consequences of Caffeine
- Liver Response: Drinking two cups of strong coffee can lead to a prolonged response to glucagon which is the opposite of insulin.
Highest Glucose Demand Organ
- Brain: The brain has the highest demand for glucose as a fuel source.
Glucagon and Muscle
- Glucagon Effect on Muscles: Glucagon does not affect muscle metabolism because muscle cells lack the receptors for the hormone.
Symptoms of Hypoglycemia
- Hormone Release: Tremors, sweating, and rapid heartbeat in a male patient with hypoglycemia are caused by the release of epinephrine (adrenaline).
Optimizing Blood Sugar Levels Post Meal
- Meal Choice: A high-carbohydrate meal will have the lowest level of circulating glucagon shortly after the meal, compared to a high-fat meal.
Diagnosing Diabetes Type
- C-Peptide Levels: Measuring C-peptide levels can help determine if a patient with hyperglycemia has type 1 or type 2 diabetes.
Cerebral Dysfunction and High Blood Sugar
- High Blood Sugar & Cerebral Effects: High blood glucose levels can cause cerebral dysfunction due to dehydration. Increased or decreased lipid concentrations in the blood are not a factor in this situation.
Fructose Transport
- Facilitative Transporter for Fructose: GLUT 5 is the facilitative transporter primarily responsible for fructose transport from blood into cells.
Pancreatic Function and Carbohydrates
- Impaired Carbohydrate Digestion: Reduced ability to digest starch is a likely cause of discomfort after a high-carbohydrate meal in a patient with pancreatitis that affects exocrine function.
Important Blood Sugars After Eating a Meal
- Breakdown Products: Glucose, galactose, and fructose are the main breakdown products of common foods like flour, milk, and sucrose after digestion.
Defective Disaccharidase Deficiency
- Malabsorbed Sugars Post Meal: A patient with disaccharidase deficiency will experience higher levels of maltose, sucrose, and lactose in their stools relative to a healthy individual who has eaten a similar meal.
Carbohydrate with a-1,6 Glycosidic Bonds
- Amylopectin: This carbohydrate contains glucosyl units linked through a-1,6 glycosidic bonds.
Enzymes and Fiber Digestion
- Gas Production after High Fiber Diet: High fiber intake can lead to increased gas production because human enzymes can't break down or digest fiber. Bacteria in the colon break down the fiber, which creates gas such as hydrogen, carbon dioxide, and methane.
Important Carbohydrate For The Body
- Glucose Used as fuel by all organs in the body.
Type 1 Diabetes Issues
- Insulin Deficiency and Tissue Affected: The tissue most affected by a neglect of insulin injections in a type 1 diabetic is muscle.
High Glycemic Index Food
- Ice cream is a food that can be consumed to increase blood sugar, which is good for carb loading for endurance athletes.
Glycolysis and Energy
- Glycolysis and energy production: Glycolysis generates energy for cells, with the net yield of 2 ATP and 2 NADH when starting with a molecule of glyceraldehyde 3-P and synthesizing a molecule of pyruvate.
Glycogen and ATP Formation
- Glycolysis ATP and NADH yield: Glycolysis has a net yield of 2 ATP and 2 NADH when starting with glucose 1-P and ending with two molecules of pyruvate,
Glycolysis Enzymes
- Rate-limiting Glycolysis enzyme: Pyruvate kinase is the rate-limiting enzyme in glycolysis (the process of breaking down glucose into energy).
Key Mitochondria Components
- Component required for electron transfer: Cytochrome C is needed for electron transfer in the mitochondria.
- Mitochondrial Membrane Permeability: The mitochondrial membrane is permeable to ROS (reactive oxygen species), which is partly why the level of oxidative damage to mitochondrial DNA is higher than for nuclear DNA.
Lactic Acidosis & Metformin
- Metformin and Lactic Acidosis: Metformin tends not to cause lactic acidosis. One possible theoretical explanation of its effect on reducing lactic acidosis relates to the Cori Cycle, which overcomes buildup of lactate in the liver. Lactic acid is not typically used as a fuel source in the heart or the brain.
Metabolic Acid and Thiamine
- Acumulated Metabolic Acid: The metabolic acid that is most likely to accumulate in a thiamine deficiency is pyruvic acid.
Vitamin Deficiencies and Free Radicals
- Vitamin Protection Against Radicals: Vitamin E forms a covalent bond with free radicals thereby stabilizing the radical state, which protects against free radical damage.
Oxidative Stress and Free Radicals
- Oxygen Radical Reactions: Superoxide Dismutase enzyme reacts with oxygen radicals to create hydrogen peroxide.
Oxidative Stress and Free Radicals (cont)
- Metal Involved in Oxidative Damage: Iron is a critical metal involved in the conversion of hydrogen peroxide to reactive radical forms.
Chronic Granulomatous Disease (CGD)
- Defect Involved: CGD involves the inability to generate superoxide, which is critical for immune function..
Amyotrophic Lateral Sclerosis (ALS) and Genetic Mutation
- Genetic Mutation and Detoxification: ALS is thought to be linked to a genetic mutation that leads to a deficiency in the detoxification of oxidized glutathione.
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Description
Test your knowledge on diabetes mellitus, its types, and the impact of caffeine on blood glucose levels. This quiz covers essential hormonal responses and symptoms related to low blood sugar. Gain insights into how the body manages glucose, especially in the brain and muscle tissues.
