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Old 05-06-2011
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Cool Deficient metabolic pathway

An underweight 14 year old boy was admitted in E/R in semicomatose condition. Plasma glucose, urea and glutamine are abnormally low.
Acetoacetate is elevated and lactate is normal
He is admitted to ICU where an increased blood glucose level was achieved by controlled infusion of glucagon or alanine.
WHICH METABOLIC PATHWAY IS DEFECTIVE?

1) hepatic gluconeogenesis
2) adipose tissue lipolysis
3) skeletal muscle proteolysis
4) hepatic glycogenolysis
5) skeletal muscle glycogenolysis
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  #2  
Old 05-06-2011
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I guess its hepatic gluconeogenesis
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eesfee (05-07-2011)
  #3  
Old 05-06-2011
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Quote:
Originally Posted by asfand View Post
I guess its hepatic gluconeogenesis
I AM SORRY BUT YOU ARE WRONG DUDE...

here is explanation

1) hepatic gluconeogenesis ----> wrong Y?----> by injecting glucagon pt recovers..(it means gluconeogenesis pathway is working but glucagon is missing)

2)skeletal muscle glycogenolysis----> nothing to do with glucose

3)adipose tissue lipolysis---->then acetoacetate should be low but it is elevated in this case

4)skeletal muscle proteinolysis--->which is source of ALANINE is defective so by giving ALANINE which is comes from proteinolysis PT recovers


5)hepatic glycogenolysis---> nothing to do with urea and glutamine..

SO CORERCT ANSWER IS OPTION 4

IT IS VERY HARD QUESTION FOR ME AND I GOT -ve HERE
BUT NOW I GOT IT
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  #4  
Old 05-06-2011
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Oh okay, now i got it..Thanks
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  #5  
Old 05-07-2011
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Thanks for such a question. It made me revise all the glucagon world pathways
though I arrived at option 4 by eliminating other options it took me a long time
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