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 elevated; 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.
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- A client with Type 1 diabetes mellitus is admitted to the hospital in a semi-conscious state with fever, nausea, and vomiting. The urine sample was positive for ketone bodies. Which of the following statements regarding the client is correct? Question 80 options: a) Glucagon should be administered to stimulate glycogenolysis and gluconeogenesis in the liver b) An injection of insulin will decrease ketone-body production c) The client should be started on a glucose infusion to help them regain consciousness d) The client's blood glucose level is well below 4.4 mmol/LIn people with diabetes mellitus Type 1, explain the reason for:(a) ketoacidosis, and (b) ketonuria.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.
- A person is suspected with diabetes mellitus. He checks his blood glucose level by gluceose oxidase method. After the experiment, OD of his blood sample was obtained as 0.08. Based on the glucose standard curve seen in the virtual lab, calculate his blood glucose level. Is he had diabetes mellitus? (Note: Normal blood glucose level in our body is 70-110mg/dl). Find out the role and chemical reactions of the following reagents in the blood glucose level determination by glucose oxidase method. a) Sodium sulphate – Zinc sulphate solution b ) Glucose oxidase reagent c) Peroxidase A person did estimation of blood glucose level by glucose oxidase method by referring the virtual lab procedure. But he forgot to add ortho - toluidine reagent during glucose oxidase reagent preparation. a) What is the observation of the result?…An unresponsive client who has diabetes is brought to the emergency department with rapid, deep respirations. Additional findings include: blood glucose 24.9 mmol/L, arterial pH 7.2 and urinalysis showing presence of ketones and glucose. Which of the following statements best describes the underlying cause of this patient’s presentation? Question 64 options: a) Relative insulin deficiency, causing hyperglycemia, oxidative stress, renal dysfunction and acidosis b) Nocturnal elevation of growth hormone resulting in hyperglycemia in the morning c) Absolute insulin deficiency, increased counter-regulatory hormone, lipolysis and free fatty acid release d) Hypoglycemia causes release of glucagon, resulting in glycogenolysis and hyperglycemiaDKA and HHNKS are described as: Question 3 options: a) Life threatening hyperglycemic emergencies requiring immediate care b) Temporary hyperglycemic crises that require doubling up on insulin dose c) Chronic illness that causes nephropathy in the long-term d) Acid-base imbalance disorders, specifically metabolic acidosis
- (27) An 80-year old man witha 20-year old history of ashthma comes to the physician because of a 24 hour history of a running nose , sore throat , cough,muscle aches, and fatigue. His temperature is 39.5 degrees celcius (103.1F). Zanamivir is prescribed because it inhibits which of the following enzymes? (A) Aldolase (B) Kinase (C) N-acetyl glucosaminidase (D) Neuraminidase (E) TransglycosylaseThe hormones insulin and glucagon play an important role in the regulation of plasma glucose.a) Discuss the antagonistic actions of the hormones insulin and glucagon in regulating blood glucose levels within a narrow physiological range.A 35-year-old woman became severely depressed after the sudden death of her husband. Twomonths later, she was brought to the emergency room by her friend because of extremeweakness and lethargy. She appeared thin and pale. Upon history taking, the doctor found thatshe had not eaten for several weeks. Analysis of the plasma sample indicated elevated levels ofalanine, acetoacetate, β-hydroxybutyrate and blood urea nitrogen (BUN). However, her plasmaglucose concentration was low (55mg/dL). She was hospitalized, given intravenous feeding,antidepressant medications and subsequently shifted to a 1800kCal (7500kJ) diet. Her recoverywas uneventful.3.a) How could the patient maintain her plasma glucose levels within normal limits even though shewas not eating?b
- 8. In patients with diabetes mellitus type I, the biochemical disorders result from changes in fuel metabolism. One of these signs is acidosis. Explain why such patients have a deviation of blood pH from the norm? For this: d) specify the hormone that accelerates this precursor formation and provide appropriate charts, starting from the hormone binding to adipocyte and concluding with precursor formation, give an explanation to the charts.Explain the reason(s) for considering ketoacidosis as a serious life-threatening complication in patients with diabetes mellitus.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.