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A man presented with a clinical picture of recurrent headaches, lethargy, and blurred vision particularly after exercise or fasting. His blood glucose during one of the attacks measured 35 mg/dl. Concomitant insulin and C peptide levels were reportedly higher than normal values.
Which of the following enzyme activity is expected to be high in this patient?

A- Hexokinase
B- Glycogen phosphorylase
C- Acetyl Co A carboxylase
D- Protein Kinase A
E- Glycogen phosphorylase kinase
 

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For me its acetyl CoA carboxylase because insulin increases fatty acid synthesis by its positive effect on acetylCoA carboxylase in fatty acid synthesis pathway ... so high blood insulin causes increase acetylCoA carboxylase and increase fatty acid synthesis .... example in type 2 DM , there is increase insulin but they cant work to decrease glucose due to resistant , but this increase insulin stimulate fatty acid synthesis , as a result patient with type 2 DM are obese .....
 

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acetyl coa carboxylase

insulin activates phosphodiesterase hence lowers cAMP levels..hence the activity of glycogen phosphorylase wud be low

second insulin increases glucokinase activity but NOT hexokinase..hexokinase is specific to liver and glucose entry into liver doesnt require insulin anyway... and hexokinase is not affected by insulin..it is only affected by glucose 6 phosphate

insulin favours lipogenesis by providing more glycerol 3 phosphate <frm glycolysis> and NADPH <frm HMP shunt or pentose phosphate shunt> and also increases acetyl coA carboxylase

this persons hypoglycemia cud be either due to a tumour of pancreas, that causes increased levels of insulin and c peptide
 
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