GRACE M10 - Fasting and Ketoacidosis

Question 1

Increase ___ and ___ to provide substrates for fuels

Answer 1

-proteolysis and lipolysis

amino acids and glycerol for liver gluconeogenesis and fatty acids for beta oxidation and for ketogenesis to make ketone bodies

Question 2

Increased G:I ratio activates ____ enzymes rapidly = glycogen is gone in about ___ days

Answer 2

glycogenolysis , 1.5 days

Question 3

Increased G:I ratio increases ____ slowly to peak at ____ days (increase substrates and lipolysis to glycerol)

Answer 3

gluconeogenesis , 2-3 days

Question 4

-By day ____ of a fast, brain starts to use ketone bodies in place of glucose
-By day ____, KB use = ~glucose use
-By ____, KB = 2/3 (max) and glucose = 1/3

Answer 4

3, 7, 2 wks

Question 5

Normal hepatic glucose production and fall in body glucose use usually maintain enough plasma [glucose] during fasting to prevent _____

Answer 5

clinical hypoglycemia

Question 6

During fasting, low glucose = ____ glucagon and ____ insulin

Answer 6

increase glucagon and decrease insulin

but increase in plasma KB = mildly increase insulin = G:I ratio plateaus = adipose lipolysis plateaus = substrate generation for ketogenesis slows and [KB] doesn’t rise enough to cause a problem

Question 7

Diabetic ketoacidosis (DKA): life-threatening ketoacidosis with hyperglycemia

Answer 7

o Maximum G:I ration drives maximum cellular fuel production = ketogenesis and hepatic glucose production
o Maximum ketogenesis and bicarb loss cause life-threatening ketoacidosis

Question 8

Alcoholic ketoacidosis (AKA): ketoacidosis with hypoglycemia

Answer 8

Ethanol metabolism inhibits gluconeogenesis and promotes ketogenesis during fasting to cause hypoglycemia

Question 9

Alcoholic ketoacidosis
-NADH decreases conversion of ____ required for to a gluconeogenesis
-NADH decreases use of ___ in gluconeogenesis and instead causes liver to secrete ____

Answer 9

-glycerol to intermediate
-lactate x2

Question 10

Ethanol withdrawal amplifies fasting ____ to cause ketoacidosis

Answer 10

fasting G:I ration and ketogenesis

Question 11

Classic AKA includes ___ days with no food or fluid intake = ____ epinephrine secretion and alcohol metabolism in liver explain dramatic decrease in plasma glucose and increase in plasma

Answer 11

1-2 days
-increased epi