A 62-year-old woman is brought to the emergency department after lying on the floor in her home for the past 2 days. The patient's neighbor called police after phone calls were not answered and no one opened the door. She was found awake on the bathroom floor lying in feces and urine. The patient says she fell and injured her right hip and was unable to get up to call for help. She did not eat or drink anything during that time. On examination, the patient appears dehydrated and has right hip tenderness. Laboratory studies show serum glucose of 72 mg/dL and positive urine ketones. Radiographs of the right hip show a right femoral neck fracture. Increased activity of which of the following enzymes is most likely contributing to both the serum and urine laboratory findings?

Question

A 62-year-old woman is brought to the emergency department after lying on the floor in her home for the past 2 days.  The patient's neighbor called police after phone calls were not answered and no one opened the door.  She was found awake on the bathroom floor lying in feces and urine.  The patient says she fell and injured her right hip and was unable to get up to call for help.  She did not eat or drink anything during that time.  On examination, the patient appears dehydrated and has right hip tenderness.  Laboratory studies show serum glucose of 72 mg/dL and positive urine ketones.  Radiographs of the right hip show a right femoral neck fracture.  Increased activity of which of the following enzymes is most likely contributing to both the serum and urine laboratory findings?

Quizplus · Accepted Answer

Eductional Objective: Hormone-sensitive lipase is found in adipose tissue, where it functions to drive the breakdown of stored triglycerides into free fatty acids and glycerol.  During times of starvation, this enzyme provides substrates for hepatic gluconeogenesis and ketone body formation.

A 62-Year-Old Woman Is Brought to the Emergency Department After