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NBME 16 Answers

nbme16/Block 1/Question#34 (reveal difficulty score)
A 39-year-old woman with type 1 diabetes ...
Stimulation of hepatic glucose production ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: biochem pharm

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 +4  upvote downvote
submitted by โˆ—torticollis(4)

If she ain't taking beta blocker... why this patient does not present any symptomatology before during hypoglycemic episode?

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 +3  upvote downvote
submitted by โˆ—bingcentipede(355)

T1DM, she's getting hypoglycemia. The most appropriate medication is glucagon, which would stimulate hepatic (not skeletal muscle) glucose production

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neurotic999  isn't there something about the glucagon response being absent in diabetics. i'm not sure in which question bank i came across this point, but i have it written in my FA with no further explanation (my bad). anyone else with the same doubt? https://care.diabetesjournals.org/content/35/8/1757 https://pubmed.ncbi.nlm.nih.gov/4581053/ +
fatboyslim  ^Yes, because in T1DM there is not only destruction of the pancreatic beta cells (make insulin), but also alpha cells (make glucagon) +



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