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CASE FILES: BIOCHEMISTRY
C O M P R E H E N SIO N Q U E ST IO N S
For Questions 39.1 to 39.3 refer to the following case.
A 12-year-old girl is presented at the clinic with reports of frequent fainting
and lethargy. The girl is 5 ft tall and weighs 80 lb. Skin fold tests show an
abnormally low percentage of body fat mass.
[39.1] Which of the following is
least likely
to be consistent with the patient’s
symptoms?
A. Anorexia nervosa
B. Bulimia
C. Type I diabetes
D. Type II diabetes
[39.2] Which of the following hormones is likely to be severely diminished in
the patient described above?
A. Cortisol
B. Epinephrine
C. Glucagon
D. Insulin
[39.3] Which of the following metabolic fluxes would be most consistent in
this patient?
A. Protein^amino acids
B. Glucose^fatty acids
C. Glucose^glycogen
D. Fatty acids^triacylglycerol
A nsw ers
[39.1]
D. Individuals with type II diabetes tend to be either overweight
(a body mass index [BMI] between 25 and 30) or obese (BMI greater
than 30). This may be due in part to chronic hyperinsulinemia. In
contrast, decreased insulin levels associated with type I diabetes,
anorexia, and bulimia, will promote lipolysis and therefore decreased
adipose mass.
[39.2]
D. The low body weight and fat mass observed in the patient are con-
sistent with a metabolically “fasted” state. During such a condition,
circulating insulin levels will be low, whereas counterregulatory hor-
mones (e.g., glucagon, epinephrine, and cortisol) will be elevated.
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