nbmeq3 - candace

[ArchivalUser]

A 2-month-old boy is brought to the physician because
of a 6-week
history of persistent diarrhea and vomiting, most
pronounced after formula
feedings. He has had a 113-g (4-oz) weight loss since
birth. He
currently weighs 3100 g (6 lb 13 oz) and is 51 cm (20
in) in length. He
appears irritable. Examination shows jaundice. The
lungs are clear to
auscultation. No murmurs are heard. The liver is
palpated 2 to 3 cm
below the right costal margin, and the spleen is
palpated 1 to 2 cm below
the left costal margin. Laboratory studies show:


Serum
Glucose 35 mg/dL
Bilirubin (total) 2.3 mg/dL
Urine
Glucose negative
Reducing substances 3+

Which of the following is the most likely mechanism of
these findings?

A
) Decreased gluconeogenesis

B
) Decreased insulin secretion

C
) Increased glucagon secretion

D
) Increased gluconeogenesis

E
) Increased insulin secretion

F
) Insulin resistance

[ArchivalUser]

aaa

[ArchivalUser]

just wondering
if it g 6 phosphatase deff , thats mean the glucose is trapped in the liver and can't get out and as more gluconegenesis is going as more as glucose trapped and as more organomeggaly. so answer should be D
If it is A he shouldn't have hepatomegally.

any other points

[ArchivalUser]

Answer is A

Only 2 answers which explain hypoglycemia regardless of the cause in this case are

A. Decreased gluconeogenesis and E High insulin secretion

Choice is very unlikely in this. So the answer is A.

Coming to the cause diarrhoea, hsm and hypoglycemia after formula and urine reducing substances, it can be of many causes like, Galactosemia, hereditary fructose intolerance etc. Ithink Galactosemia is more likely.

But the answer doen't change- It's A