10. The patients with a genetically determined medium-chain acyl-CoA dehydrogenase (MCAD) deficiency suffer from episodes of profound fatigue associated with vomiting, which is happening if they fasted for more than 8 hours. They have hypoglycemia, clevated level of free fatty acids in the blood but ketone bodies were below normal. Explain the development of these symptoms. For that answer the question and do the following tasks: a) why hypoglycemia occurs in the patients fasting for more than 8 hours? b) why the level of free fatty acids is elevated in blood? Write the scheme explaining this symptom; c) draw the scheme of fatty acid metabolism, which is blocked in case of this genetic disorder.
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- 8. Ketone bodies were found in the urine of the patient with diabetes mellitus. Explain the sequence of metabolic changes resulting in ketonuria. For that answer the question and do the following tasks: a) what are the ranges of ketone bodics in blood of the healthy pcople and the patients with diabetes mellitus? b) explain the main changes in hormonal regulation of patient with diabetes mellitus; c) explain why the level of free fatty acids in the blood is clevated; d) name the pathways of lipid metabolism which becomes more active in patients with diabetes mellitus; e) draw the scheme of ketone body synthesis and oxidation.Discuss the 3 mechanisms of abnormal carbohydrates metabolism that result in the development of ketone bodies in the urine and give examples of the condition to each.1. State if true or false a. Microbial enzymes can digest carbohydrates containing β–1,4 bonds b.Glycerol 3-phosphate shuttle, which is active in skeletal muscles and in the brain, bypasses Complex I and II of ETC resulting to less energy produced compared to malate-aspartate shuttle. c.Insoluble NSP has high water holding capacity and will increase the intestinal transit time of digesta.
- 8. The adipose tissue is not only store triacylglycerols but also is active endocrine organ. Explain this function of the adipose tissuc. For that: a) explain the «clinical obesity» and possible consequences of the discase; b) name the biologically active molecules secreted by the adipose tissue; c) explain how secretion of these molecules changes with development of obesity. 9. A daily dict ofa 55-ycar-old woman, consisted ofa 500 g of carbohydrates, 100g of animal fats and 150 g of proteins, at the background of low physical activity.Briefly describe how the increased use of amino acids as a carbon source in the muscle can lead to α-ketoglutarate depletion in the liver.All of the following are true with respect to alpha-glucosidase inhibitor, except:A. It inhibits intestinal alpha-glucosidase B. It decreases enzymatic conversion of oligo- to monosaccharidesC. It lowers postprandial glucoseD. It causes gastrointestinal disturbances.E. It may cause development of hypertension.
- 1. Briefly explain why an individual with Aldolase B deficiency will suffer from hypoglycemia upon ingestion of fructose. Make sure to mention the affected pathways and explain why these are affected. 2. Briefly explain the mechanism involved when an individual with glucose 6-phosphate dehydrogenase deficiency develops an episode of hemolytic crisis after eating fava beans. Make sure to mention pathways and enzymes involved.3. A patient has got excess carbohydrate meal for the years and gain the weight. To explain this: a) draw the schemes of TAG synthesis in the liver; b) describe the transport of TAG from the liver to adipose tissue; c) describe the functions of insulin in the conversion of glucose to TAG in the liver and adipose tissue. Glucose containing Catoms was added to isolated hepatocytes inanexperiment. Ifthe glucose was added in excess, the rate of triacylglyccrol synthesis increased.5. There is an expression: diabetes mellitus is «hunger among abundance. What metabolic changes in diabetes confirm the validity of this statement? For answer: 9.8. Metabolic Changes in Diabetes Mellitus 535 a) list the main causes of metabolic changes in IDDM; b) enumerate the tissues with the main energy sources metabolism procceding according to this type of starvation; c) name the metabolic pathways that are activated and inhibited in these tissues, and explain why; d) list the symptoms of diabetes mellitus, that reflect such metabolic changes; c) draw a diagram of one of the mctabolic pathways that is activated in the liver under these conditions and explain the consequences of such activation.
- 5. In peripheral insulin resistance (a characteristic metabolic abnormality is pre-diabetes, metabolic syndrome, and type 2 diabetes), peripheral tissue cells, including liver, muscles and adipose, become resistant to insulin (cells respond less to insulin, and insulin action is decreased). A. Explain how the metabolism of glucose, amino acids and fatty acids will be altered in liver, muscles and adipose tissues after ingesting a typical meal consisting of carbohydrates, fats and protein (during the absorptive or fed state) in patients with insulin resistance (explain how the major metabolic pathways of glucose, amino acids and fatty acids during the absorptive state will be impaired in liver, muscles, and adipose in insulin resistance disorder). B. How will the plasma glucose levels change during the absorptive (fed) state in insulin resistance?1a. Type II Diabetes involves the development of insulin resistance (i.e. a dampening of the metabolic response to insulin). Describe the metabolic effects of such resistance. 1b. What would the likely metabolic effects be of a person being hypersensitive to insulin?1. Describe the clinical significance associated with abnormal levels of cholesterol 2. How does liver disease affect the cholesterol levels in the blood 3. Describe completely the lipoprotein metabolism.