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Please Help with this Question

Discussion in 'Step I' started by slacker101, May 6, 2008.

  1. slacker101

    slacker101 New Member 2+ Year Member

    May 28, 2006
    Does anyone know where one could download the answers to the 2008 USMLE Step 1 release material. The link on the Kaplan website is not working. Thanks. Also could some please explain the answer to this question.

    "Infant has episodes of hypoglycemia and sever lactic acidemia. His abdomen is protuberant, and he has several skin xanthomas on his upper and lower extremities. His also has elevated triglycerides, and a percutaneous liver biopsy reveals both fat and glycogen deposits. Which is most likely?
    A) Glucose-6-phosphatase deficiency
    B) Hepatic glycogen phosphorylase deficiency
    C) Hyperlipidemia secondary to juvenile diabetes
    D) Lipoprotein Lipase Deficiencey
    E) Medium-Chain acy-CoA dehydrogenase deficiency
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  3. obiwan

    obiwan Junior Member 10+ Year Member

    Mar 26, 2006
    my guess would be von gierkes disease so choice A

    wiki-test prep has explainations for the 150
  4. docmd2010

    docmd2010 Senior Member 7+ Year Member

    Apr 17, 2005
    I'd also go with A. glycogen build up occuring because glucose can't get out into the blood stream, and elevated lipids because hsl is getting activating and mobilizing adipose. Von Gierke's is the likely diagnosis.
  5. obiwan

    obiwan Junior Member 10+ Year Member

    Mar 26, 2006
    does anyone know why exactly there is lactic acidosis with von Gierkes?
  6. InternationlDoc

    InternationlDoc Imported like a Ferrari 10+ Year Member

    Aug 21, 2005
    You can't reverse lactate --> pyruvate --> glucose (when going through gluconeogenesis) since your enzyme is missing. so lactic acid builds up due to lack of gluconeogenesis

    thats what I'd reason. No source.
  7. yohimbine1

    yohimbine1 7+ Year Member

    Mar 8, 2008
    I would say buildup of pyruvate and lactate
  8. DwyaneWade

    DwyaneWade Reiging *** Cynic 10+ Year Member

    May 7, 2006
    Right, the liver can't handle all the lactate coming from the rest of the body.

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