An 11-year-old girl is brought to the emergency department by her father.
He reports she has recently been very thirsty and needing to make frequent
trips to the bathroom. At her soccer game today, she complained of
lightheadedness and that the symptoms did not resolve even after drinking
a power beverage. A rapid dipstick test revealed glucose in her urine and
further diagnostics are consistent with a diagnosis of type 1 diabetes.
Evaluation of this girl's liver would reveal an increased rate of which of the
following processes? Correct Ans - Ketogenesis
A 5-year-old female is brought to the emergency department by her
mother. She is a type 1 diabetic and has not taken her insulin while away at
a day camp. The child is unresponsive. Which of the following enzymes is
phosphorylated and active under these conditions? Correct Ans -
Hormone sensitive lipase
An individual is on a hunger strike and has not eaten in 13 days. Which of
the following best describes their metabolic state? Correct Ans -
The brain will preferentially oxidizing ketones.
An individual goes to bed around 8 pm and doesn't wake up until 9 am the
next morning. During this time, which of the following is the primary
oxidizable substrate in the skeletal muscle? Correct Ans - Free fatty
acids
Which of the following is not a product of beta-oxidation? Correct Ans
- NADPH
During the fasted state, lipolysis is facilitated by the action of hormone
sensitive lipase. This enzyme requires which of the following modifications
for activation? Correct Ans - Phosphorylation
Ketonuria, hyperglycemia and severe acidosis are prime diagnostic
indicators of the presentation of type 1 diabetic ketoacidosis. Which of the
following compounds are "ketone bodies" that would be elevated in serum
and urine of a patient in this condition? Correct Ans - D-3-
hydroxybutyrate and acetoacetate
,In the fasted state, fatty acyl-CoAs are transported across the mitochondrial
membrane. The transport of fatty acids via carnitine palmitoyl transferase I
(CPTI) can be directly inhibited by which compound? Correct Ans -
Malonyl-CoA
Under fasting conditions (ratio of insulin to glucagon <1), elevated
glucagon will activate which of the following enzymes? Correct Ans -
hormone sensitive lipase
Fatty acid synthesis is a multimeric enzyme complex. Which of the
following subunits contains pantothenic acid as a cofactor? Correct Ans
- Acyl carrier protein (ACP)
Under fasting conditions, acetyl CoA carboxylase will be inhibited by an
increase in which of the following compounds? Correct Ans - fatty
acyl-CoA
In the case of deficiency of biotin, which of the following enzymes required
for fatty acid metabolism will be impaired? Correct Ans - Acetyl-
CoA carboxylase
An individual consumes a large meal consisting of cheeseburger and fries.
Which of the following intermediates is shuffles out of the TCA cycle to be
used as a substrate for fatty acid synthesis? Correct Ans - Citrate
Under conditions when glucose oxidation is elevated, the acetyl-CoA
produced will allosterically activate which of the following enzymes
leading to an increase in the production of oxaloacetate? Correct Ans -
Pyruvate carboxylase
Which of the following is not required for the transport of newly
synthesized fatty acids to the adipose? Correct Ans - Carnitine to
shuttle the fatty acids out of the mitochondria
HDL particles interact with VLDL particles to exchange cholesterol ester for
triacyclglycerols. Which of the following enzymes is responsible for this
process? Correct Ans - Cholesterol ester transfer protein (CETP)
, Nascent chylomicrons interact with HDL particles within circulation. Which
of the following Apo proteins are obtained from HDL during this
interaction? Correct Ans - ApoCII and ApoE
Which of the following best describes the role of HDL particles?
Correct Ans - HDL particles are required for the transport of cholesterol
from peripheral tissues to the liver
A 45-year-old man is found to have an elevated serum triglycerides of >
730mg/dL. He tells you he forgot to fast before his visit and he ate a full
breakfast of bacon and eggs before the labs were drawn. Which of the
following lipoproteins would be the largest contributors to a measurement
of plasma triglycerides in this situation? Correct Ans -
chylomicrons and VLDLs
A 12-year-old male is brought to his primary care physician. His parents
are concerned with his recent decline in school work due to persistent
blurred vision. On physical exam, planar xanthomas are noted and
laboratory testing reveals extremely low plasma HDL. This presentation
would be consistent with a loss of which of the following apoproteins?
Correct Ans - ApoA
VLDL particles have which of the following combinations of apoproteins in
their mature form? Correct Ans - ApoB100, ApoCII, ApoE
Which of the following proteins is responsible for the transfer of ApoB48 to
nascent chylomicrons before secretion into circulation? Correct Ans -
Microsomal Transfer Protein (MTP)
Under fasted conditions, (glucagon is elevated), which of the following
enzymes will be phosphorylated and inactive? Correct Ans - HMG-
CoA reductase
A 45-year-old man is found to have an elevated serum cholesterol of
300mg/dL after a 12 hr. fast. Which of the following lipoproteins would be
the largest contributors to a measurement of plasma cholesterol in a
normal person following a 12 hr. fast? Correct Ans - LDLs and
adipocyte lipid droplets
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