Special Tests
During this test, the involved foot is placed on the opposite knee, putting the hip into flexion, abduction, and external rotation.
What is FABER (Patrick’s test)?
This vitamin is primarily found in fruits, vegetables, and some fortified cereals. Its deficiency used to be associated with scurvy.
What is Vitamin C?
In MCAD deficiency, which metabolic pathway is most impaired, and why?
What is gluconeogenesis, because decreased fatty acid oxidation impairs gluconeogenesis?
In this condition, insulin fails to activate its receptor, leading to decreased inhibition of glucagon secretion and increased glycogenolysis and gluconeogenesis
What is Type 2 Diabetes?
In the fed state, what are the two forms of energy storage in the liver, and which represents short-term versus long-term storage?
What are glycogen for short-term storage and triglycerides for long-term storage?
A patient reports groin pain when the hip is flexed to 90°, adducted, and internally rotated. What test is positive?
What is FADIR?
A deficiency of this vitamin is common with lack of sunlight exposure and can result in rickets and osteomalacia.
What is Vitamin D?
In alcoholic hypoglycemia, what change caused by ethanol oxidation promotes the conversion of pyruvate to lactate and inhibits gluconeogenesis?
What is increased NADH?
A patient who has not eaten for a while develops hypoglycemia because inhibition of fatty acid oxidation increases dependence on glucose for energy and impairs gluconeogenesis.
What is MCAD deficiency?
During the fed state, which tissue increases glycolysis, glycogen synthesis, and fatty acid synthesis?
What is the liver?
During this test, the patient actively flexes one hip while allowing the opposite leg to extend toward the table. The extended leg cannot contact the table. What does this suggest?
What is hip flexor contracture?
Carrots are an example of a food source for this vitamin, which can also be obtained from eggs, milk, oily fish, and liver.
What is Vitamin A?
Why does a patient with Von Gierke disease develop high lactate?
What is increased glycolysis due to high levels of G6P?
A patient who has not eaten for a while has a high blood alcohol level and develops hypoglycemia. The oxidation of this substance produces excess NADH, which promotes pyruvate → lactate and inhibits gluconeogenesis.
What is alcoholic hypoglycemia?
During the fasted state, which two things are using significant glucose as fuel while most other tissues primarily use fatty acids?
What are the brain and RBCs?
During a unilateral leg stand, the pelvis drops on the non-weight-bearing side. Which muscle on the supported leg may be weak or not functioning?
What is the gluteus medius?
Although toxicity from the diet is not expected with this vitamin, excess supplementation can cause issues in patients taking blood thinners.
What is Vitamin E?
Why does a patient with Von Gierke disease develop high urate?
What is high G6P driving the pentose phosphate pathway, making PRPP and increasing purine synthesis?
A patient presents with hypoglycemia, hepatomegaly, enlarged kidneys, high lactate, and high urate due to deficiency of an enzyme that normally allows the liver and kidneys to release glucose into the blood.
What is Von Gierke disease?
What process breaks down triglycerides in adipose tissue to release fatty acids that can be used as an energy source during fasting?
What is lipolysis?
During this test, the affected hip is passively extended and the extremity is allowed to drop behind the patient. The extremity cannot drop to the level of the table. What does this suggest?
What is tightness in the IT band or its associated musculature?
A patient taking antibiotics develops a deficiency of this vitamin. What vitamin is deficient?
What is Vitamin K?
Why does insulin resistance in Type 2 Diabetes lead to increased glycogenolysis and gluconeogenesis?
What is decreased inhibition of glucagon secretion, resulting in more glucagon?
Which transporter is regulated by insulin and is found in adipose and skeletal tissue, making it active only in the fed state?
What is GLUT4?
What is the main metabolic difference between starvation and the fasted state that allows the brain to survive with less glucose?
What is increased ketone levels?