Questions:

1. All of the following statements about gluconeogenesis are correct EXCEPT
  1. Gluconeogenesis take place in the liver and kidney but the kidney uses all the glucose it produces.  The professor told me to ignore the gluconeogenesis in the kidney.
  2. The major control enzyme is fructose-1,6-bisphosphatase that is inhibited by fructose-2,6-bisphosphate
  3. The products include glucose, NAD+ and ADP
  4. The carbon substrates include lactate, many amino acids, odd chain fatty acids, and acetyl CoA
  5. Gluconeogenesis takes place in the cytosol and mitochondria of liver. The professor told me to ignore the endoplasmic reticulum.
2. There are four enzymes of gluconeogenesis that circumvent the irreversible steps in glycolysis.  When starting with the substrate pyruvate or lactate they are
  1. Hexokinase, phosphofructokinase-1, phosphofructokinase-2 and pyruvate kinase
  2. Pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose-1,6-bisphosphatase, and glucose-6-phosphatase
  3. Glycerol kinase, glycerol-3-phosphate dehydrogenase, fructose-2,6-bisphosphatase, and glucose-6-phosphatase
  4. Amino transferase, phosphoenolpyruvate carboxykinase, fructose-2,6-bisphosphatase, and glucose-6-phosphatase
  5. Pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose-1,6-bisphosphatase, and hexokinase
3. All of following are gluconeogenic precursors are converted to pyruvate, TCA cycle intermediates, or dihydroxyacetone phosphate as follows EXCEPT
  1. Glycerol is converted using the enzymes glycerol kinase and glycerol-3-phosphate dehydrogenase
  2. Lactate is converted to pyruvate using lactate dehydrogenase
  3. Aspartate is converted to oxaloacetate using aspartate aminotransferase
  4. Glutamate is converted to alpha-ketoglutarate using either glutamate dehydrogenase or an aminotransferase
  5. Acetyl CoA is converted to succinyl CoA using propionyl CoA carboxylase and methylmalonyl CoA mutase
4. All of the following reactions convert gluconeogenic precursors to the next step in gluconeogenesis EXCEPT
  1. Glycerol is converted to dihydroxyacetone phosphate using the enzymes glycerol kinase and glycerol-3-phosphate dehydrogenase
  2. Lactate is converted to alanine using lactate reductase
  3. Alanine is converted to pyruvate using alanine aminotransferase
  4. Glutamate is converted to alpha-ketoglutarate using either glutamate dehydrogenase or an aminotransferase
  5. Propionyl CoA is converted to succinyl CoA using converted using propionyl CoA carboxylase and methylmalonyl CoA mutase
5. Large quantities of alcohol inhibit gluconeogenesis for all of the following reasons EXCEPT
  1. Because alcohol dehydrogenase produces large quantities of NADH
  2. Because high concentrations of NADH inhibit glycerol-3-phosphate dehydrogenase in the cytosol
  3. Because high concentrations of NADH inhibit glyceraldehyde-3-phosphate dehydrogenase in the cytosol
  4. Because high concentrations of NADH inhibit lactate dehydrogenase in the cytosol
  5. Because high concentrations of NADH inhibit malate dehydrogenase in the cytosol
6. We can make a little glucose from some of the fatty acids in our diet
  1. By converting even chain fatty acids to acetyl CoA and, then, using the citrate produced in the TCA cycle
  2. By converting even chain fatty acids to acetyl CoA and, then, making methylmalonyl CoA and acetoacetyl CoA
  3. By using odd chain fatty acids in an aminotransferase reaction with glutamic acid
  4. By converting odd chain fatty acids to propionyl CoA and, then, making succinyl CoA
  5. By converting odd chain fatty acids to acetoacetate and then to malate
7. All of the following statements concerning the conversion of pyruvate to phosphoenolpyruvate during gluconeogenesis are correct EXCEPT
  1. Pyruvate enters the mitochondria and is converted to oxaloacetate by pyruvate carboxylase when Acetyl CoA concentrations are high
  2. The pyruvate carboxylase adds CO2 to pyruvate using the cofactor biotin and energy from ATP
  3. Oxaloacetate is converted to malate that passes out of the mitochondria and is converted back to oxaloacetate
  4. Oxaloacetate in the cytosol is converted to phosphoenolpyruvate by phosphoenolpyruvate carboxykinase
  5. Using this pathway, NADH is produced in the mitochondria and used in the cytosol.  The NAD+ produced can be used in the glyceraldehyde-3-phosphate reaction to produce glyceraldehyde-3-phosphate
8. The enzymes that remove phosphate groups during the process of gluconeogenesis and circumvent two of the three irreversible reactions of glycolysis are
  1. Pyruvate kinase and glycerol kinase
  2. Phosphoenolpyruvate carboxykinase and glycerol kinase
  3. 3-Phosphoglycerate kinase and fructose-1,6-bisphosphatase
  4. Fructose-1,6-bisphosphatase and glucose-6-phosphatase
  5. Glucose-6-phosphatase and protein phosphatase
9. All of the following are reasonable explanations for the increased availability of substrate for gluconeogenesis EXCEPT
  1. Glycerol is released from adipose tissue during time of stress when insulin is low and glucagon, epinephrine, and cortisol are high
  2. Amino acids are released from muscle during stress or fasting when insulin is low and glucagon, epinephrine, and cortisol are high
  3. Lactate is released from muscle during exercise
  4. Lactate is continuously released from the red blood cells
  5. VLDL is released from the liver during times of stress when insulin is low and glucagon, epinephrine, and cortisol are high
10. During gluconeogenesis using pyruvate as a substrate, all of the following are occurring EXCEPT
  1. High acetyl CoA, NADH, and ATP/ADP from beta-oxidation inhibit pyruvate dehydrogenase and prevent the conversion of pyruvate to acetyl CoA
  2. Glucagon is activating the cAMP cascade and pyruvate kinase is inactivated by phosphorylation by protein kinase A
  3. Cortisol and other stress hormones repress the enzyme phosphoenolpyruvate carboxykinase so phosphoenolpyruvate cannot be converted to oxaloacetate
  4. The enzyme pyruvate carboxylase is activated by high concentrations of acetyl CoA produced by beta-oxidation
  5. Some of the energy in fatty acids is converted to the high-energy bonds of ATP and GTP necessary to drive the reaction
11. The most important control step in gluconeogenesis is fructose-1,6-bisphosphatase.  All of the following statements are true EXCEPT
  1. Fructose-1,6-bisphosphatase converts fructose-2,6-bisphosphate to fructose-6-phosphate
  2. During times when insulin is high, fructose-1,6-bisphosphatase is inhibited by fructose-2,6-bisphosphate
  3. During a fast or exercise when glucagon and/or epinephrine are high, fructose-1,6-bisphosphatase is active because of the absence of fructose-2,6-bisphosphate
  4. Glycolysis or gluconeogenesis cannot be active at the same time.  If they were is would be a futile cycle
  5. In the liver, fructose-2,6-bisphosphate is made by the enzyme phosphofructokinase-2.  This enzyme is inhibited by the cAMP cascade
12. In the liver, glucose-6-phosphate is readily converted to all of the following EXCEPT
  1. Glucose by glucose-6-phosphatase
  2. Glucose-1-phosphate by phosphoglucomutase
  3. Fructose-6-phosphate by phosphoglucose isomerase
  4. Glucose by glucokinase
13. All of the following statements about the free energy of glycolysis and gluconeogenesis are true EXCEPT
  1. When glucose is converted to two moles of pyruvate, 2 NADH and 2 ATP are produced
  2. When glucose is converted to two moles of lactate, 2 ATP are produced
  3. When two moles of pyruvate are converted to glucose, 4 ATP, 2 GTP, and 2 NADH are used
  4. When two moles of pyruvate are converted to glucose, the equivalent of 11 ATP are used
  5. Gluconeogenesis requires 6 more ATP per glucose than were derived from glucose in glycolysis
14. The energy for gluconeogenesis is obtained from
  1. The pentose phosphate pathway
  2. Anaerobic glycolysis
  3. The oxidation of amino acids in muscle
  4. Beta-oxidation of fatty acids and the oxidation of acetyl CoA in the TCA cycle in muscle
  5. Beta-oxidation of fatty acids and the oxidation of acetyl CoA in the TCA cycle in liver
15. All of the following are major factors that regulate blood glucose EXCEPT
  1. In the fed state, high glucose concentrations cause uptake and storage as glycogen in liver
  2. In the fed state, high insulin causes increased uptake, storage, and use of glucose
  3. In the exercise state, high glucagon inhibits Glut4 in muscle so that muscle has to use its own glycogen
  4. In the fasting state, high glucagon increases gluconeogenesis and glycogenolysis on liver to maintain blood glucose
  5. In the exercise state, epinephrine increases both gluconeogenesis and glycogenolysis in liver to replace blood glucose being removed by muscle
16. All of the following statements about the concentrations of insulin and glucagon soon after ingestion of a meal are true EXCEPT
  1. Following a high carbohydrate meal, insulin will rise and glucagon will decrease
  2. Following a mixed meal, the insulin to glucagon ratio will decrease
  3. Following a mixed meal, insulin increases and glucagon remains about the same
  4. Following a high protein meal, insulin will increase and glucagon will increase
  5. Following a high protein meal, the insulin to glucagon ratio will decrease
17. Following a mixed or high carbohydrate meal, all of the following occur in the liver EXCEPT
  1. The insulin to glucagon ratio increases and the cAMP cascade is inhibited
  2. Protein phosphatases will remove phosphate from glycogen synthase, phosphorylase a, pyruvate kinase, and phosphofructokinase 2
  3. Glycogenolysis and gluconeogenesis will be inhibited
  4. Glycolysis and glycogenolysis will be activated
  5. Acetyl CoA carboxylase will be dephosphorylated and activated causing fatty acid and triacylglycerol, and VLDL synthesis
18. In some tissues, an increase in blood insulin will substantially increase the glucose transporters in the cell membrane and the transport of glucose into cells. Which of these tissues react in this manner?
  1. Red blood cells and brain
  2. Brain and liver
  3. Liver and muscle
  4. Muscle and adipose
  5. Adipose and red blood cells
19. In skeletal muscle cells following a high carbohydrate or mixed meal, all of the following are true EXCEPT
  1. The uptake of glucose will increase greatly because of the increase in Glut4 transporters in the membrane
  2. Glycogen synthesis will be increased and the glycogen levels will be replenished
  3. Glycolysis will be used to supply most of the muscle cells energy as long as blood sugar remains high
  4. High blood insulin will act on the cell to activate glycogen synthase and phosphofructokinase-1
  5. Muscle gluconeogenesis activated by glucagon will be inhibited
20. In adipose tissue and following a mixed meal, increased insulin will cause all of the following EXCEPT
  1. Increase the use of glycerol from the VLDLs to synthesize triacylglycerol for storage
  2. Increase the production of dihydroxyacetone phosphate and glycerol-3-phosphate
  3. Increase the synthesis and storage of triacylglycerol
  4. Increase the hydrolysis of triacylglycerol in VLDL and the uptake of fatty acids
  5. Increase the uptake of glucose by increasing the number of glut4 transporters in the membrane and increasing glucose utilization
21. As one finishes a meal, the blood glucose decreases and the insulin to glucagon ratio drops.  This decreased influence of insulin and increased influence of glucagon result in all of the following changes in the liver EXCEPT
  1. The protein phosphatases become inhibited and the activity of the cAMP cascade increases
  2. Protein kinase A phosphorylates both glycogen synthase and phosphorylase kinase
  3. Action of phosphorylase a and debranching enzyme produces a lot of glucose-1-P and some free glucose
  4. Glucose-1-P is converted to glucose-6-P by phosphoglucose isomerase and then to glucose by glucokinase
  5. Glycogen synthase is inhibited as glycogen phosphorylase is activated, thus, preventing a futile cycle
22. As one enters the fasting state following a high carbohydrate meal, blood glucose decreases and the insulin to glucagon ratio drops.  All of the following are steps in the activation of gluconeogenesis and the inhibition of glycolysis EXCEPT
  1. Glucagon binds to its receptor and changes the conformation of the receptor and of Gs-protein
  2. Gs protein dissociates from GDP, associates with GTP and dissociates.  The beta-gamma-subunit of G protein bound to GTP binds to cAMP phosphodiesterase
  3. Increased cAMP removes the regulatory subunits and, thus, activates protein kinase A
  4. Phosphofructokinase-2/fructose-2,6-bisphosphatase is phosphorylated, activating fructose-2,6-bisphosphatase and inhibiting phosphofructokinase-2
  5. Fructose-2,6-bisphosphate is removed from the cytosol and this activates fructose-1,6-bisphosphatase
23. Blood glucose decreases and the insulin to glucagon ratio drops following a meal.  All of the following occur EXCEPT
  1. The cAMP cascade in adipose tissue is inhibited
  2. Free fatty acids are released from the stored triacylglycerol and serve as the major energy source for the body
  3. Glycerol is released from the from the stored triacylglycerol and return to the liver to be used for gluconeogenesis
  4. As more and more free fatty acids are released the synthesis of ketone bodies in the liver will increase
  5. The energy from free fatty acids is used to synthesize the ATP needed for gluconeogenesis
24. Between 3 days and 6 weeks of starvation, all of the following will occur EXCEPT
  1. The concentration of glucose will remain fairly constant at the low end of the normal range
  2. The concentration of blood ketones will increase for the next 20 to 30 days
  3. Glucose utilization will decrease during this period
  4. The total daily glucose production will increase during this period
  5. Total daily urea excretion will decrease during this period
25. Assume that your patient eats a high carbohydrate meal and fasts for the next 36 hours.  Unless otherwise noted, assume the patient is sedentary.  Concerning the source of the glucose used by the body following the beginning of the meal, all of the following would be true EXCEPT

  1. Dietary carbohydrate for the first two hours
  2. Gluconeogenesis at about 4 hours
  3. Half glycogenolysis and half gluconeogenesis at 16 hours
  4. All gluconeogenesis after 30 hours
  5. If exercising, the use of liver glycogen occurs faster
26. According to a 2005 report by the American Diabetes Society, if the patients fasting blood glucose levels are at or above _________mg/dl, the patient has diabetes.  If the patients fasting blood glucose levels are from _________ to  __________mg/dl, the patient is classified as having pre-diabetes

  1. 126;  100;  125
  2. 140;  110;  139
  3. 200;  110;  199
  4. 100;  110;  125
  5. 110;  100;  109
27. Al, a known alcoholic, was brought to the emergency room by his landlady, who stated that he had been drinking heavily for the past week.  He has not eaten in three days and his blood alcohol level is 28 mg/dl.  All of the following partially explain his low blood sugar EXCEPT
  1. Alcohol dehydrogenase produces large quantities of NADH
  2. High concentrations of NADH inhibit glycerol-3-phosphate dehydrogenase in the cytosol
  3. High concentrations of NAD+ inhibit alpha-ketoglutarate dehydrogenase in the mitochondria
  4. High concentrations of NADH inhibit lactate dehydrogenase in the cytosol
  5. High concentrations of NADH inhibit malate dehydrogenase in the cytosol
28. Your patient has taken very heavy doses of dexamethasone (an anti-inflammatory synthetic glucocorticoid) for asthma that may have led to muscle weakness and hyperglycemia (275 mg/dL).  All of the following might be used to rationalize her situation EXCEPT
  1. Glucocorticoids stimulate the net catabolism of muscle protein
  2. Glucocorticoids induce enzymes for gluconeogenesis
  3. Glucocorticoids inhibit the uptake of fatty acids by the brain
  4. Catabolism of protein increases the concentration of free amino acids in the blood
  5. The more gluconeogenesis, the higher the blood sugar
29. The major glucocorticoid in humans

  1. Is produced by the adrenal medulla
  2. Is dexamethasone
  3. Is an androgen
  4. Reacts with receptors on the cell membrane of target cells
  5. Is cortisol
30. Your patient, who has type-1 diabetes, took twice her normal dose of insulin last night and was admitted this morning to the emergency room in a hypoglycemic coma.  All of the following contributed to her low blood sugar EXCEPT
  1. Insulin inhibited lipolysis in adipose so many tissues could not use fatty acids for energy
  2. When fatty acids were unavailable, the tissues used glucose even faster than normal
  3. The energy for gluconeogenesis was used instead to make ketone bodies
  4. Insulin inhibited glycogenolysis in the liver
  5. Insulin inhibited gluconeogenesis in the liver
31. Concerning the difference between type-1 and type-2 diabetes, all of the following are true EXCEPT
  1. In type-2, the pancreas cannot make enough insulin to lower the blood sugar to normal
  2. In type-1, the pancreas cannot make any insulin
  3. In type-2, the liver does not respond to insulin in a normal manner
  4. In type-2, the pancreas releases insulin more slowly than a normal person following a meal
  5. In type-2, ketoacidosis occurs on a regular basis
32. Your patient, Otto shape, gets up in the morning and jogs for 45 minutes.  He always eats dinner at 6:00 PM the night before but does not eat breakfast. All of the following are true EXCEPT
  1. Before he starts to jog, his blood glucose is maintained by glycogenolysis and gluconeogenesis
  2. When he starts to jog, both glycogenolysis and gluconeogenesis are increased by the increases in epinephrine
  3. Increased epinephrine activates phosphorylase a and phosphofructokinase-1 in liver
  4. Increased epinephrine activates phosphorylase a and phosphofructokinase-1 in muscle
  5. Jogging causes a large increase in the uptake of blood glucose into muscle
33. There are three irreversible reactions in glycolysis in the liver. One of them is
  1. Glucose-6-phosphatase that converts glucose-6-phosphate to glucose and phosphate
  2. Phosphofructokinase-1 that converts fructose-6-phosphate to fructose and phosphate
  3. Pyruvate kinase that converts phosphoenolpyruvate and ADP to pyruvate and ATP
  4. Hexokinase that converts ATP and glucose to glucose-6-phosphate and ADP
  5. Phosphofructokinase-1 that converts ATP and fructose-6-phosphate into fructose-2,6-bisphosphate and ADP
34. There are four reactions that are unique to gluconeogenesis. Which of the following is not one of them
  1. Pyruvate carboxylase that converts pyruvate and ATP into oxaloacetate, Pi, and ADP
  2. Phosphoenolpyruvate carboxykinase that converts oxaloacetate and GTP into GDP, CO2, phosphoenolpyruvate
  3. 3-phosphoglycerate kinase that converts 3-phosphoglycerate and ATP into 1,3-bisphosphoglycerate and ADP
  4. Fructose-1,6-bisphosphatase that converts fructose-1,6-bisphosphate into fructose-6-phosphate and Pi
  5. Glucose-6-phosphatase that converts glucose-6-phosphate into glucose and Pi
35. All of the following enzymes and metabolites are important in the conversion of odd chain fatty acids into glucose EXCEPT
  1. Propionyl CoA
  2. Acetoacetyl CoA
  3. Propionyl CoA carboxylase
  4. Methylmalonyl CoA
  5. Succinyl CoA

Answers:

1. Answer: D. Chapter 31, Objective 1: Describe the pathway for gluconeogenesis: Names: Functions: Substrates: Product: Control Enzymes: Regulation: Compartment(s): Tissues of interest: Back to question 1.
2. Answer: B. Chapter 31, Objective 2: There are three irreversible reactions in glycolysis, name the substrates and products of those reactions and the enzymes that catalyze them. There are four enzymes unique to gluconeogenesis that catalyze reactions that circumvent the irreversible reactions of glycolysis. Name the enzymes, reactants and products. Back to question 2.
3. Answer: E. Chapter 31, Objective 3: What are the sources of the gluconeogenic precursors and how are they converted into pyruvate, TCA cycle intermediates, or dihydroxyacetone phosphate? (Hint! Fig. 20.19 and Fig. 23.11) Back to question 3.
4. Answer: B. Chapter 31, Objective 4: Name the enzymes that convert lactate and alanine to pyruvate and that convert glycerol to dihydroxyacetone phosphate. Back to question 4.
5. Answer: C. Chapter 31, Objective 5: Explain why ingestion of large quantities of alcohol inhibits gluconeogenesis. Back to question 5.
6. Answer: D. Chapter 31, Objective 6: Most of our diet contains even numbered fatty acids. Can we form glucose from them? Some of our diet contains odd numbered fatty acids. Can we form glucose from them? How? Back to question 6.
7. Answer: E. Chapter 31, Objective 7: Describe the pathway for the conversion of pyruvate to phosphoenolpyruvate by naming the intermediates, the compartments, the control enzyme, and the allosteric regulator for the control enzyme. Include the terms pyruvate carboxylase, biotin, ATP, oxaloacetate, acetyl CoA, malate dehydrogenase, NADH, malate, phosphoenolpyruvate carboxykinase, GTP. Ignore aspartate. Back to question 7.
8. Answer: D. Chapter 31, Objective 8: Name the phosphatases that convert fructose-1,6-bisphosphate to glucose in liver. Back to question 8.
9. Answer: E. Chapter 31, Objective 9: How does fasting, stress, exercise, or a high protein meal affect the level of substrates for gluconeogenesis? Back to question 9.
10. Answer: C. Chapter 31, Objective 10: Explain the control of the conversion of pyruvate to phosphoenolpyruvate during gluconeogenesis. Name two enzymes in the pathway, a positive allosteric modifier activates one and one is activated principally by induction. Why isn't phosphoenolpyruvate converted to pyruvate and why isn't pyruvate converted to acetyl CoA during gluconeogenesis? Include the terms acetyl CoA, cyclic-AMP, phosphorylation, NADH, and, again, acetyl CoA in your answer. Back to question 10.
11. Answer: A. Chapter 31, Objective 11: Explain the activation of the fructose-1,6-bisphosphatase during gluconeogenesis. What prevents the reverse reaction and a futile cycle from occurring? Back to question 11.
12. Answer: D. Chapter 31, Objective 12: Name the enzyme that converts glucose-6-phosphate to glucose in liver. Back to question 12.
13. Answer: E. Chapter 31, Objective 13: Compare the energy used in the conversion of two moles of pyruvate to glucose with the energy generated during glycolysis when one mole of glucose is converted to two moles of pyruvate. Back to question 13.
14. Answer: E. Chapter 31, Objective 14: How is the energy used for gluconeogenesis obtained? Back to question 14.
15. Answer: C. Chapter 31, Objective 15: What are the major factors that regulate blood glucose? Back to question 15.
16. Answer: B. Chapter 31, Objective 16: What happens to the blood concentrations of insulin and glucagon and the insulin/glucagon ratio following ingestion of a high carbohydrate meal, a high protein meal, and a normal meal? Back to question 16.
17. Answer: D. Chapter 31, Objective 17: What is the fate of glucose in the liver following a normal or high carbohydrate meal? How does the increased blood glucose and the increased insulin/glucagon ratio affect the cAMP cascade, the activity of protein phosphatase, glycogen synthesis, glycogenolysis, glycolysis, gluconeogenesis, glycerol-3-phosphate synthesis, fatty acid synthesis, triacylglycerol synthesis, and VLDL synthesis? Back to question 17.
18. Answer: D. Chapter 31, Objective 18: In some tissues, an increase in blood insulin will substantially increase the glucose transporters in the cell membrane and the transport of glucose into cells. Which of these tissues react in this manner and which do not: muscle, adipose tissue, brain, and liver? Back to question 18.
19. Answer: E. Chapter 31, Objective 19: What is the affect of increased blood insulin upon glycogen synthesis in muscle? Back to question 19.
20. Answer: A. Chapter 31, Objectives 20: What are the affects of increased insulin upon glycerol-3-phosphate synthesis, fatty acid uptake from VLDLs, and triacylglycerol synthesis in adipose tissues? Back to question 20.
21. Answer: D. Chapter 31, Objectives 21: As blood glucose decreases and the insulin to glucagon ratio drops, the cyclic AMP cascade causes a change in the activities of the enzymes concerned with glycogen metabolism so that glucose is released into the blood. Be able to name all the intermediates in the proper order in this pathway. Use the terms glucagon receptor, G-protein, adenyl cyclase, cAMP, protein kinase A, regulatory subunits, catalytic subunits, phosphorylase kinase, phosphorylase, glycogen synthase, glucose-1-P, glucose-6-P, glucose-6-phosphatase, and glucose. Back to question 21.
22. Answer: B. Chapter 31, Objective 22: As blood glucose decreases and the insulin to glucagon ratio drops, the cyclic AMP cascade causes a change in the activities of the enzymes concerned with gluconeogenesis and glycolysis so that glucose is released into the blood. From the time when glucagon binds it's receptor, be able to name all the intermediates in the proper order in the pathway that activates fructose-1,6-bisphosphatase and inhibits phosphofructokinase-1 and pyruvate kinase. Use the terms glucagon receptor, G-protein, adenyl cyclase, cAMP, protein kinase A, regulatory subunits, catalytic subunits, phosphofructokinase-2/fructose-2,6-bisphosphatase, and fructose-2,6-bisphosphate. Back to question 22.
23. Answer: A. Chapter 31, Objective 23: As blood glucose decreases and the insulin to glucagon ratio drops, the cyclic AMP cascade causes an increase in lipolysis in adipose tissue. What are the products of lipolysis and how do liver and muscle use them? Include the terms fatty acids, glycerol, gluconeogenesis, energy, and ketone bodies. Back to question 23.
24. Answer: D. Chapter 31, Objective 24: Between 3 days and 6 weeks of starvation, what happens to the blood concentrations of glucose, free fatty acids, and ketone bodies? What happens to the total utilization of glucose by the body? What happens to the total utilization of fat by the body? Between 3 days and 6 weeks of starvation, what happens to total urinary nitrogen excretion? Note that total urinary nitrogen is at least 80% urea. Explain this change in urea excretion. Back to question 24.
25. Answer: B. Chapter 31, Objective 25: Be able to state the major source of glucose (ingested, glycogenolysis, or gluconeogenesis) used by a sedentary person following ingestion of a meal. For example, at l hour, 4 hours, 16 hours, and 30 hours. Assume that the subject was sedentary. What would happen to this timetable if the person were running a marathon? Back to question 25.
26. Answer: A. Chapter 31, Objective 26: What values does the American Diabetes Society use to define diabetes and pre-diabetes from fasting blood glucose? Back to question 26.
27. Answer: C. Chapter 31, Objective 27: Concerning Al Martini who has not eaten and has been drinking heavily for the past three days, explain his hypoglycemia in terms of the reactions that are inhibited and why they are inhibited? Back to question 27.
28. Answer: C. Chapter 31, Objective 28: Concerning Emma Wheezer: What were the effects of dexamethasone that contributed to muscle weakness and hyperglycemia? Back to question 28.
29. Answer: E. Chapter 31, Objective 29:What is the major glucocorticoid in humans? Back to question 29.
30. Answer: C. Chapter 31, Objective 30: Concerning Di Abietes, who suffers from Type I diabetes and is in a coma because she took an overdose of insulin 13 hours ago. (1) how can you tell from her rate and depth of respiration that she is not suffering from diabetic ketoacidosis? (2) what had happened to the normal pathways for energy production in the fasting state? Include fatty acid mobilization, ketone body synthesis, glycogenolysis, and gluconeogenesis. Back to question 30.
31. Answer: E. Chapter 31, Objective 31: Concerning Di Abietes, who suffers from Type I diabetes, what is the pathogenesis of her disease? What is the pathogenesis of Type 2 diabetes? Back to question 31.
32. Answer: C. Chapter 31, Objective 32: Concerning Otto Shape who is now in shape and jogs in the morning before breakfast. How does he maintain his blood glucose levels? Does increased blood epinephrine help this process? Back to question 32.
33. Answer: C. Chapter 31, Objective 2: Concerning Otto Shape who is now in shape and jogs in the morning before breakfast. How does he maintain his blood glucose levels? Does increased blood epinephrine help this process? Back to question 33.
34. Answer: C. Chapter 31, Objective 3: Concerning Otto Shape who is now in shape and jogs in the morning before breakfast. How does he maintain his blood glucose levels? Does increased blood epinephrine help this process? Back to question 34.
35. Answer: B. Chapter 31, Objective 6: Most of our diet contains even numbered fatty acids. Can we form glucose from them? Some of our diet contains odd numbered fatty acids. Can we form glucose from them? How?Back to question 35.