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A 9 month old girl is brought to ER 30 mins after she had generalized tonic-clonic seizures. She has had failure to thrive & developmental delay since birth. She is at the 3rd percentile for length & weight. Physical exam shows microcephaly, tachypnea, & hypotonia. Lab studies show hypoglycemia, hyperalaninemia, & lactic acidosis. After I/V glucose is administered, her serum glucose concentration returns to within the reference range. This patient most likely has a deficiency of which of the following enzyme activities?

a) glucokinase
b) glyceraldehydes-3-phosphate dehydrogenase
c) hexokinase
d) pyruvate carboxylase
e) triose-phosphate isomerase

Please try....
 

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Im thinking D also, liver starts 2 break down glycogen, which since it cant do this...the body must use lactic acid as an energy source... makes sense... final answer.. D
 
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