Glucose Pathways
Miscellaneous
Baby Al
GSD1
Other GSDs
100

Where is glucokinase found? What is the Km and Vmax of glucokinase relative to hexokinase?

Found in liver and pancreatic beta cells. 

Higher Km (lower affinity)

Higher Vmax

100

How does glucose enter and exit intestinal epithelial cells?

Glucose enters the epithelial cells via SGLT1 receptors that co-transport Na+ and glucose into the cell using Na+ traveling down its concentration gradient to move glucose

Glucose (along with fructose and galactose), can diffuse through GLUT2 transporters into the blood stream.

100

What caused Baby Albert to have seizures?

Hypoglycemia. The brain is glucose-dependent and has low glycogen stores. 

  • Massive cascades of axon depolarization caused by failure of Na/K pump and accidental release of excitatory neurotransmitters (NT)

  • Infants have really high excitatory NT relative to inhibitory NT, increasing their risk for seizure.
100

What is the difference between GSD 1a and 1b? How did the detergent test help us narrow down between the two?

1a: G6Pase deficiency

2a: G6PT deficiency

  • Without detergent: pyrophosphatase activity but no G6Pase activity.  

  • With detergent: G6Pase activity is restored and pyrophosphate activity is maintained. Detergent disrupts membranes, so this test reveals that glucose-6-phosphatase is functional but that the T1 transporter is not (confirms GSD Ib)


100

What enzyme is deficient in GSD V (McArdle's), and what are the symptoms?

Deficiency in myophosporylase

Muscle cannot break down glycogen. Get painful muscle cramps, myoglobinuria (red urine) with strenuous exercise                                                       


    

                                                       


    

200

How did dysfunctional glucose metabolism cause lactic acidosis in Albert?

Because G6P cannot be converted to glucose, G6P will be shunted to different pathways. In a hypoglycemic state, G6P will go through glycolysis, increases the amount of pyruvate, which will turn into lactic acid by LDH.

200

Ceftriaxone inhibits this enzyme in bacterial cells

What is Transpeptidase (a penicillin-binding-protein)

200

Why was Baby Albert positive for ketones and have a high level of triglycerides?

Without glucose, his muscles were using ketones for energy

Glucagon is activating release of triglycerides from fat stores to promote beta oxidation and gluconeogenesis (which will not be effective at restoring blood glucose in GSD I)

200

What are the roles of the G6PT1, G6PT2, and G6PT3?

T1 lets G6P into the ER to be dephosphorylated by G6Pase. 

T2 is a bidirectional phosphate channel. 

T3 lets glucose back out into the cytoplasm.

200

Which enzyme is deficient in GSD II and what are the symptoms?


Pompe's Disease. 

Lysosomal a-1,4-glucosidase (acid maltase). Impaired glycogen breakdown. Causes cardiomyopathy, hypotonia, exercise intolerance

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