study_ing
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hmm great q pallav
B and d ruled out coz skeletal muscle duznt have to do with blood glucose levels, the liver duz.
if alanine infusion raises bld glucose, gluconeogenesis distal to Pyruvate carboxylase and PEPCK is intact.
im thinking..
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| pallav
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buddy
ill just suggest that ur going out of direction.......
keep trying
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| plastic_girl
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A. Hepatic gluconeogenesis?.....
Not sure.......hate metabolisms.....
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| muzammil
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well i hate biochem from the days of my medical school
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| muzammil
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y a atudy_ng
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| study_ing
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i had a brainwave, then it disappeared.....or else, trust me, i wud had written it
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| study_ing
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| study_ing
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aspartate and citrulline form argininosuccinate which is broken down to fumarate and arginine..
pt has hypoglycemia and something wrong with the urea cycle coz urea is low
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| study_ing
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sorry i lost it again 
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| study_ing
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i have it half figured out i think
MY last attempt before i vanish to sleep
alanine infusion corrects hypoglycemia
so A is RULED OUT.
prblem with inadequate alanine cud point to a def in protein catabolism in muscle
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| pallav
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so studying
a is ruled out and this
fucking questions explanation says that the answer is d
if you guys want i can explain
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| study_ing
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please
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| raves
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 whewh n i thought i could do metabs.please explain pallav,even m lost.
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| pallav
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first of all guys its not my q
its a borrowed question
i couldnt understand myself
they say
"the patient is hypoglycemic bacause of deficient release of gluconeogenic amino acid
precursors from muscle
the results plus normal lactate and hyperketonemia eliminate the deficiencies in glycogenolysis. gluconeogenesis and lipolysis as possibilities. defective muscle glycogenolysis would not produce hypoglycemia.
IF U CAN MAKE SOMETHING OUT OF THE EXPLANATION. KINDLY EXPLAIN TO ME TOOOOOOOOOO
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| muzammil
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my explanationis as the question looks awkward the answer shud be more awkward and thus the correct answer is d
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| pallav
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cmon yaar
we are taking the exam of our life
and ure making fun of the questions
you know such questions have increased my cigarette consumtion to twice
does anybody have any clues??????
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| plastic_girl
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Ok I am probably wrong but given the answer heres my explanation for it :
Liver maintians blood glucose by two processes:
-glycogenolysis and
-gluconeogenesis
We are told that the boy is underweight and semi-comatose. So he doesnt have much glycogen reserves to begin with, and the little that he does is used up, as we know for the first 24 hours. He is SEMI comatose, so not completely in a coma, meaning glycogenolysis kept him ok as far as this.
Now the next part is that he was given alanine or glucagon infusion. Alanine is a gluconeogeneic AA (protein from muscle) and glucagon promotes gluconeogenesis. He was infused either and so his gluconeogenesis was promoted.
So that cuts out adipose from the equation, as gluconeogenesis does not take place in adipose, but were left with skeletal muscle proteolysis and hepatic gluconeogenesis. As they say lactate is normal, so hepatic gluconeogenesis is out (?). And glycogenolysis only goes on for 24 hours and then gluconeogenesis takes over. And the only way to have that happen is proteolysis......
MAN I HATE METABOLISMS......how the hell are we supposed to think up all this in 1 minute????!!!!!
I think the clue to the answer for this is that the child is better when he is infused alanine and that should guide us into thinking that that is what is deficient....
Edited by plastic_girl on 07/14/06 - 12:53 AM
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| muzammil
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pallav i was not making fun of question but trying to ease tension
may be i was using the most mature defenses
HUMOR
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| muzammil
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palstic girl that was a very nice explanation
ur biochem must be very gud
hats off to u
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| pallav
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ok muzz and plastic
but questions like this are really making me
jittery
and ive started doubting myself........
and yesterday did some nbme q...............
need i say what happened
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| pallav
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but plastic dear thats really a wonderful explanation
and ull for sure make a wonderful med professor...
guys keep going
help me with biochem
pallav
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| new_n_lost
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get some more questions like this one n it would be great to solve them in a minute  practice makes man perfect
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