NBME 20 Answers : Block 2 : #30 = A 78-year-old man is brought to the emergency ...

nbme20/Block 2/Question#30

A 78-year-old man is brought to the emergency ...

Cortisol

+1 upvote downvote
submitted by hayayah(244),

He's not eating enough.

One of cortisol's functions is to increase gluconeogenesis, lipolysis, and proteolysis.

+0 upvote downvote
submitted by asdfghjkl(1),

Anyone know why IGF-1 wouldn't be increased as well? GHRH is stimulated in hypoglycemic states.

nala_ula Honestly, it's something that has confused me for a while. Why is it that GH secretion is stimulated by hypoglycemia? I mean, it's literally called growth hormone (for growth!), and hypoglycemia, which is basically a "starvation" state, will stimulate this hormone? +

shaeking https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529368/ This might help answer your question. I basically didn't pick IGF-1 because it would increase the uptake of glucose leading to a worsen hypoglycemic state. Didn't have a true reason otherwise. +

temmy IGF-1 is regulated by insulin. so it will be decreased because insulin levels are also low. +

nala_ula thank you @shaeking! +