Fed and Fasted State Metabolism

Question 1

____ availability and the needs of ____are balanced in the body by level of nutrients hormone levels and nerve impulse

Answer 1

Fuel
Tissue

Question 2

The ____ state is immediately after a meal, and last 2 to 4 hours. After that the body switches to a ____ State. If there’s no further nutrition, there is a transition to the ____ state, which can persist for weeks.

Answer 2

Fed
Fasted
Starved

Question 3

Dietary fuels are transported from the ___ of the gut to the ___ in digestion. Excess fuels are stored as ____, fat, and protein.

Answer 3

Lumen
Blood
Glycogen

Question 4

_____ promotes storage pathways. These stored fuels are made available for later use by ___, cortisol and catecholamines.

Answer 4

Insulin
Glucagon

Question 5

If glucose concentration is high in the blood _____ is released from pancreatic beta cells. This represses ___ release from pancreatic alpha cells.

Answer 5

Insulin
Glucagon

Question 6

In the fasted state ____ is the dominant hormone. ____ ____ catabolism is being performed in this state.

Answer 6

Glucagon
Amino acid

Question 7

In the Fed state ____ is the dominant hormone. _____ catabolism is being performed.

Answer 7

Insulin
Carbohydrate

Question 8

In the starved state ____ along with catecholamines and cortisol, are the dominant hormones. ___ ____ catabolism is being performed.

Answer 8

Glucagon
Fatty acid

Question 9

What is the significance of the ratio of insulin to C-peptide?

Question 10

Pancreatic beta cells express the ____ gene. It is first translated as a single large protein, which is then processed into 2 chains through removal of the ___ ____. Disulfide bonds link the two peptide chains after the C-peptide is removed.

Answer 10

INS1
C-peptide

Question 11

Insulin synthesis:
Pancreatic beta cells produce insulin as a large _____. A signal protein directs it to the lumen of the ___ ____ is the first cut off, followed by removal of the C-peptide in the ___. ____ bonds link the two peptide chains. Mature insulin is stored in ___ ____ stabilized by zinc atoms.

Answer 11

Pre-protein
Endoplasmic reticulum
Golgi
Disulfide
hexameric crystals

Question 12

Blood glucose enters the liver cell through the high Kd ____ transporter, and is oxidized to generate ___. The high level of ATP, then inhibits ____ channels, causing depolarization of the cell. This causes voltage gated ____ channels to open. An influx of ____ causes proteins on insulin containing vesicles to fuse with the ___ ___ and release insulin to the blood.

Answer 12

GLUT2
ATP
K+
Calcium
Calcium
Plasma membrane

Question 13

The insulin receptor is a ___ ____. When insulin binds, it activates a kinase that phosphorylates ____ on itself and other proteins. This makes more binding sites, and ___ ___ at the membrane.

Answer 13

Tyrosine kinase
Tyrosine
Aggregate proteins

Question 14

The insulin receptor has two main signaling arms:
Through ___ ____ to PKB and through ____ to MAPK.

Answer 14

Phosphatidylinositol 3-kinase (P13-kinase)

Grb2

Question 15

PI 3-kinase phosphorylates the membrane phospholipid _____ _____ to form phosphatidylinositol 3,4,5-triphosphate. PI-3,4,5-trisP then recruits ___ and ___. PKB is phosphorylated by ____ and activated. It’s phosphorylates many substrates to promote ____ processes.

Answer 15

Phosphatidylinositol 4,5-biphosphate
PDK1 and PKB
PDK1
Anabolic

Question 16

Grb2 recruits ___ to the membrane which is a ____ nucleotide exchange factor (GEF), allowing Ras to swap guanosine diphosphate for guanosine triphosphate. This activates ____ which then binds and activates ___. Raf initiates a cascade of phosphorylation’s ultimately activating transcription factors that remodel gene expression to promote ____.

Answer 16

SOS
Guanosine
Ras
Raf
Anabolism

Question 17

Insulin ____ the uptake of glucose in skeletal muscles and adipocytes and promotes it’s conversion to ____ ___ and ____. While activating a storage pathways, insulin also ____ the corresponding pathways that release stored fuels.

Answer 17

Promotes
Fatty acids
Glycogen
Represses

Question 18

In the muscle and adipose cells, ____ activation by insulin results in translocation of intracellular vesicles that contain the ____ glucose transporter to the plasma membrane. This increases the rate of glucose uptake in these tissues.

Answer 18

AKT
GLUT4

Question 19

Insulin promotes the storage of excess carbohydrate as the Glucose polymer ____. The activation of ___ ___ __ (PKB or Akt) and ___ _____ activates glycogen synthesis and inactivates glycogen phosphorylase.

Answer 19

Glycogen
Protein kinase B
Protein phosphatase -1

Question 20

Protein phosphatase-1 inhibits _____ and activates ____ synthesis.

Answer 20

Glycogenolysis
Glycogen

Question 21

If nutrition exceeds the immediate work demands, storage pathways are activated:

Answer 21

Glycogen synthesis
Fatty acids synthesis
Cholesterol synthesis
Protein synthesis

Question 22

When dietary carbohydrates are depleted in the fasted state, the liver supplies ____ to the rest of the body.
_____: generating glucose from stores within the liver.
_____: generating glucose from substrates that come from outside the liver

Answer 22

Glucose
Glycogenolysis
Gluconeogenesis

Question 23

Low blood glucose is detected by the ____ and the ___.

Answer 23

Hypothalamus
Pancreas

Question 24

____ is the hungry hormone. It is released into the circulation when there is low glucose, concentration and low levels of insulin. ____, ____, and ____ can also stimulate release.

Answer 24

Glucagon
Cortisol
Epinephrine
Norepinephrine

Question 25

Glucagon signals through a _____ ___ protein, coupled receptor, which results in mobilization of _____.

Answer 25

Heterotrimeric G cAMP

Question 26

Glucagon synthesis: The hormone glucagon is encoded on the ___ gene. The gene encodes a large pre-protein which is cut into the active hormone ____.

Answer 26

GCG Glucagon

Question 27

Glucagon is stored in vesicles within pancreatic ___ ____ cells, until low blood glucose stimulates, it’s released into the blood.

Answer 27

Islet alpha

Question 28

In high glucose conditions, insulin released by beta cells inhibits glucagon release by ____ alpha cells.

Answer 28

Adjacent

Question 29

Glucagon has ____ effects in multiple tissues. With respect to carbohydrate metabolism, its most important effect is to increase ____ _____ output.

Answer 29

Pleiotropic Hepatic glucose

Question 30

The liver and Adipose are the tissues most affected by glucagon. Glucagon promotes _____ in adipose, and ___ and ____ in the liver, while repressing _____ and fatty acid synthesis.

Answer 30

Lipolysis Glycogenolysis Gluconeogenesis Glycogenogenesis

Question 31

When glucagon binds the heterotrimeric G protein coupled receptor, the alpha subunit exchanges ____ for ____ and becomes active. The active alpha subunit then activates ___ ___ which produces cAMP

Answer 31

GDP GTP Adenyl cyclase

Question 32

_____ is a second messenger. It’s levels are further regulated by the action of phosphodiesterase.

Answer 32

cAMP

Question 33

cAMP binds to the regulatory subunits of ___ ___ __, causing them to dissociate from the catalytic subunits, this active protein kinase A then phosphorylates substrates that promote the liberation of ___ ___.

Answer 33

Protein kinase A Stored fuels

Question 34

After cAMP causes dissociation of protein kinase A, PKA then phosphorylates ___ ____ that Cleve glucose from glycogen. PKA phosphorylation of ____ _____ reprograms transcription.

Answer 34

Cytoplasmic enzymes Transcription factors

Question 35

In the fasted state, hormone sensitive ____ is active and cuts triacylglycerol into ___ ___ and ____.

Answer 35

Lipase Fatty acids Glycerol

Question 36

In the fasted state, hormone sensitive ____ is active and cuts triacylglycerol into ___ ___ and ____.

Answer 36

Lipase Fatty acids Glycerol

Question 37

In the fasted state, hormone sensitive ____ is active and cuts triacylglycerol into ___ ___ and ____.

Answer 37

Lipase Fatty acids Glycerol

Question 38

Fasted state summary:

Answer 38

Question 39

_____ is a glucocorticoid hormone that is synthesized from cholesterol in the adrenal gland. It is lipid soluble and can diffuse across the plasma membrane. It binds nuclear receptors and activates transcription factors. It increases ______ to increase blood glucose levels.

Answer 39

Cortisol Gluconeogenesis

Question 40

_____ is a catecholamine derived from the amino acid tyrosine. _____ is an intermediate in Epinephrine synthesis. ____ circulates in the blood and binds and activates adrenergic receptors. ____ is primarily a signaling molecule for neural synapses.

Answer 40

Epinephrine Norepinephrine Epinephrine Norepinephrine

Question 41

Mutations in the ___ gene are associated with the development of endocrine tumors, including insulinomas

Answer 41

MEN1

Question 42

Multiple endocrine neoplasm type one (MEN1) is a syndrome in which patients get multiple tumors in ____ tissue

Answer 42

Endocrine

Question 43

The MEN1 gene encodes the protein ___. It’s precise function is unclear, but it is known to associate with histone remodeling complexes.

Answer 43

Menin

Question 44

MLL modulates the histone code at histone three, lysing for the lysine can either be mono di or tri- ____.

Answer 44

Methylated

Question 45

When menin interacts with the MLL complex, it generates a specific ___ ___ that increases transcription of genes that negatively regulate the cell cycle and ____ tumor development. When menin function is lost due to mutation, this growth, inhibitory function is lost and ___ development is more likely.

Answer 45

Methyl code Inhibit Tumor

Question 46

The steroid hormone receptor family includes the ____ receptor, _____ receptor, and ____ ___ receptor. They function as ligase activated transcription factors. hormones bind the receptors intracellularly. ligand binding displaces ____ ___ proteins (HSP), causing receptor dimerization and translocation to response elements within gene promoters.

Answer 46

Glucocorticoid Estrogen Vitamin D Heat shock

Question 47

C peptide cleavage helps ___ insulin into the correct form. Our patient has increased C peptide, therefore has ____ insulin levels when she does not need it. Too much ___ insulin. Taking too much glucose out of the blood causing ___.

Answer 47

Fold Insulin Active Hypoglycemia

Question 48

After C peptide is removed, ____ insulin is two peptide chains held together by ___ bonds

Answer 48

Active Disulfide

Question 49

Fed state: Glucose enters the pancreatic Beta cell via _____ only when blood glucose is high. The beta cell performs ____ to make ATP. ATP also acts as an ___ ___ of potassium channels, causing depolarization. This opens a ____ channel. Calcium then acts as a second messenger to assist insulin containing ____ to fuse with the plasma membrane. The insulin is then released into the ___.

Answer 49

GLUT2 Glycolysis Allosteric inhibitor Calcium Vesicles Blood

Question 50

After insulin binds to a tyrosine kinase receptor on a cell, _____ occurs and ATP is phosphorylated

Answer 50

Dimerization

Question 51

Protein phosphatase-1 ____ the activity of the major pathway activities and phosphorylations of the Fasted state glucagon

Answer 51

Erases

Question 52

Ras activates Raf, raf activates the ____ pathway which influences gene expression

Answer 52

MAPK

Question 53

If the muscle is doing work, glucose is converted to ___. If the muscle is not doing work, glucose is converted to ____.

Answer 53

CO2 Glycogen

Question 54

____ expression occurs rapidly in skeletal muscle cells.

Answer 54

GLUT4

Question 55

PKB is the same as ____.

Answer 55

Akt

Question 56

____ is a glucose polymer.

Answer 56

Glycogen

Question 57

Protein phosphatase-1 (PKB) ___ Glycogenolysis and ____ glycogen synthesis

Answer 57

Inhibits Activates

Question 58

____ maintains glucose levels overnight

Answer 58

Glycogenolysis

Question 59

_____ provides amino acids for gluconeogenesis. ____ provides glycerol for gluconeogenesis.

Answer 59

Proteolysis Lipolysis

Question 60

___ ___ converts ADP to cAMP

Answer 60

Adenalyl cyclase

Question 61

_____ converts cAMP to 5’ AMP, inactivating it

Answer 61

Phosphodiesterase

Question 62

Answer 62

Fed state

Question 63

Answer 63

Insulin

Question 64

Answer 64

80 to 140 mg/dL

Question 65

Answer 65

Proteolysis

Question 66

Answer 66

Gluconeogenesis

Question 67

Answer 67

Disruption in glucose homeostasis hypoglycemia

Question 68

Answer 68

Overproduction of insulin

Question 69

_____ is a tumor in the pancreas that secrets insulin unregulated

Answer 69

Insulinoma