A previously healthy 20-year-old girl is brought to the emergency department by her roommate because of abdominal pain, nausea, and vomiting for 6 hours. Over the past 6 weeks, she has also had increased frequency of urination, and she has been drinking more water than usual. She has lost 6 kg (13 lb) over the same time period despite having a good appetite. Her temperature is 37.8 C (100 F), blood pressure is 96/58 mm Hg, and pulse is 112/min She appears lethargic. Physical examination shows dry mucous membranes and her urine has a strong, fruity odor. Laboratory studies show a blood glucose level of 452 mg/dL and high anion gap metabolic acidosis. Urinalysis is positive for ketones. It is determined that the patient's insulin deficiency is causing increased production of gluconeogenic precursors that are subsequently converted to glucose in the liver. Which of the following enzymes is most likely to provide these precursor substrates?

Question

A previously healthy 20-year-old girl is brought to the emergency department by her roommate because of abdominal pain, nausea, and vomiting for 6 hours. Over the past 6 weeks, she has also had increased frequency of urination, and she has been drinking more water than usual. She has lost 6 kg (13 lb) over the same time period despite having a good appetite. Her temperature is 37.8 C (100 F), blood pressure is 96/58 mm Hg, and pulse is 112/min She appears lethargic. Physical examination shows dry mucous membranes and her urine has a strong, fruity odor. Laboratory studies show a blood glucose level of 452 mg/dL and high anion gap metabolic acidosis.  Urinalysis is positive for ketones.  It is determined that the patient's insulin deficiency is causing increased production of gluconeogenic precursors that are subsequently converted to glucose in the liver.  Which of the following enzymes is most likely to provide these precursor substrates?

Quizplus · Accepted Answer

Eductional Objective: Glycerol produced by the degradation of triglycerides in adipose tissue can be used by glycerol kinase in the liver and kidney to synthesize glucose during gluconeogenesis.

A Previously Healthy 20-Year-Old Girl Is Brought to the Emergency