Question 1

The susceptibility to type 1 diabetes is affected by genes.Genes that are especially important for susceptibility to type 1 diabetes are those coding for:

Accepted Answer

A)  GLUT-4 transporters, which bring glucose into muscle and adipose tissue.
B)  Human leukocyte antigens (HL
A)  , which regulate immune responses.
C)  The insulin receptor.
D)  Glucokinase.
E)  The nuclear receptor peroxisome proliferators-activated receptor (PPAR)  , which is the target of glitazone drugs. B

Question 2

Mrs.Keller weighs 50 kg and is 1.5 m tall.This means she is considered:

Accepted Answer

A)  Obese.
B)  Overweight.
C)  Normal.
D)  Underweight. C

Question 3

A 200-meter run is powered by the production of adenosine triphosphate (ATP) mainly from:

Accepted Answer

A)  b-Oxidation.
B)  Creatine phosphate.
C)  Anaerobic metabolism of glycogen.
D)  Lactate obtained from the Cori cycle.
E)  Glucose oxidation. C

Question 4

You are treating a diabetic/hypertensive patient.When evaluating the effectiveness of the medical and dietary regimen, which of these results should give you reason for concern?

Accepted Answer

A)  Fasting blood glucose: 100 mg/dL.
B)  Glycosylated hemoglobin: 9%.
C)  Blood pressure: 120/80.
D)  Body mass index: 24.
E)  Sodium intake: 3000 mg/day.

Question 5

You have been on a strict Atkins diet for the past 2 weeks.Of your calories, 80% come from fat, 15% from protein, and 5% from carbohydrate.What is the major source of blood glucose under these conditions?

Accepted Answer

A)  Gluconeogenesis from amino acids.
B)  Muscle glycogenolysis.
C)  Gluconeogenesis from lactate.
D)  Hepatic glycogenolysis.
E)  Gluconeogenesis from acetyl-CoA.

Question 6

Excess alcohol can impair fatty acid oxidation in the liver, thereby diverting fatty acids into triglyceride synthesis.The triglycerides are then exported as VLDL, or they stay in the liver, contributing to the development of fatty liver.This alcohol effect is mediated by:

Accepted Answer

A)  Impaired gluconeogenesis.
B)  Inhibition of lactate dehydrogenase by alcohol.
C)  Depletion of NAD+.
D)  Excessive formation of ketone bodies from alcohol.
E)  Inhibition of the carnitine shuttle.

Question 7

When you wake up in the morning, 12 hours after supper, the main source of blood glucose is:

Accepted Answer

A)  Dietary glucose from the intestine.
B)  Muscle glycogen.
C)  Gluconeogenesis from amino acids.
D)  Liver glycogen.
E)  Gluconeogenesis from glycerol.

Question 8

In Type I diabetes, high levels of ketone bodies are liable to result in acidosis because:

Accepted Answer

A)  The brain consumes very large amounts of acetoacetate.
B)  The kidneys excrete large amounts of protonated ketone bodies.
C)  The ketone bodies are acids, but the triglycerides from which they are formed are not.
D)  Ketone bodies combine with circulating plasma bicarbonate.
E)  Ketone bodies increase the urinary excretion of protons.

Question 9

The insulin level is reduced in many (although not all) diabetic patients.Adipocyte metabolism in these hypoinsulinemic patients is altered in the following ways, in comparison with normal subjects:

Accepted Answer

A)  Glycerolphosphate-acyl transferase activity is lower, and triglyceride synthesis slows down.
B)  Hormone-sensitive adipose tissue lipase activity is reduced, and more triglyceride is stored.
C)  More glucose transporter 4 (GLUT-4)  transporters are deployed in the plasma membrane.
D)  Enhanced lipoprotein lipase (LPL)  activity leads to hypotriglyceridemia.
E)  The synthesis of ketone bodies by adipocytes is increased.

Question 10

Hemoglobin A₁C measurement can be used to monitor diabetic patients.The unique advantage of this test is that:

Accepted Answer

A)  It determines glucose tolerance rather than glucose concentration.
B)  It is more selective for glucose than any other commonly used laboratory test.
C)  It monitors the long-term control of blood glucose.
D)  It is especially accurate in determining the blood glucose concentration.
E)  It assesses not the effects of glucose but those of ketone bodies.

Question 11

Infectious illnesses can precipitate ketoacidosis in patients with insulin-dependent diabetes.The reason for this is:

Accepted Answer

A)  Excessive formation of ketone bodies by cells of the immune system.
B)  Reduced food intake by the ill patient.
C)  Stimulation of lipolysis in adipose tissue by cortisol and epinephrine.
D)  Impaired function of the insulin-secreting β cells during fever.
E)  Excessive glycogen synthesis in response to cytokines.

Question 12

Acute ethanol intake raises the NADH/NAD⁺ ratio in the liver.This can inhibit gluconeogenesis by influencing the reaction catalyzed by:

Accepted Answer

A)  Fructose-1-6-biphosphatase.
B)  Glyceraldehyde-3-phosphate dehydrogenase.
C)  Lactate dehydrogenase.
D)  Phosphoenolpyruvate (PEP)  carboxykinase.
E)  Pyruvate carboxylase.

Question 13

One of the reasons for hyperglycemia in patients with diabetes mellitus is the effect of insulin on GLUT-4 transporters in:

Accepted Answer

A)  All tissues.
B)  Brain and erythrocytes.
C)  Liver and adipose tissue.
D)  Muscle and adipose tissue.
E)  Liver and brain.

Question 14

A 52-year-old man with chronic alcoholism has a plasma lipid profile with increased very-low-density lipoprotein (VLDL).The mechanism that best explains the increase of VLDL in the blood of patients with chronic alcoholism is:

Accepted Answer

A)  Impaired β-oxidation of fatty acids in the liver.
B)  Reduced synthesis of apolipoprotein B-100.
C)  Inactivation of capillary lipoprotein lipase.
D)  Increased synthesis of glycerol-3-phosphate in adipose tissue.
E)  Increased levels of apolipoprotein E receptors in the liver.

Question 15

After their absorption in the intestine, most nutrients go to the liver first, before they reach the systemic circulation.Of the following nutrients, which one does not go to the liver before being distributed to the rest of the body?

Accepted Answer

A)  Vitamin E.
B)  Inorganic ions such as sodium and potassium.
C)  Fructose.
D)  Amino acids.
E)  Glucose.

Exam 30: Integration of Metabolism