GRACE M10 - Fasting and Ketoacidosis Flashcards

1
Q

Increase ___ and ___ to provide substrates for fuels

A

-proteolysis and lipolysis

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

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2
Q

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

A

glycogenolysis , 1.5 days

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3
Q

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

A

gluconeogenesis , 2-3 days

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4
Q

-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

A

3, 7, 2 wks

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5
Q

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

A

clinical hypoglycemia

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6
Q

During fasting, low glucose = ____ glucagon and ____ insulin

A

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

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7
Q

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

A

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

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8
Q

Alcoholic ketoacidosis (AKA): ketoacidosis with hypoglycemia

A

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

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9
Q

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

A

-glycerol to intermediate
-lactate x2

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10
Q

Ethanol withdrawal amplifies fasting ____ to cause ketoacidosis

A

fasting G:I ration and ketogenesis

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11
Q

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

A

1-2 days
-increased epi

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