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NBME 23 Answers

nbme23/Block 3/Question#3 (36.0 difficulty score)
An 18-hour-old male newborn is 61 cm (24 in) ...
Decreased gluconeogenesisπŸ”
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 +17 
submitted by sajaqua1(524),
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yotsubato  His glycogen concentration is high, since he's been hyperglycemic with lots of insulin until birth. +3  
alexb  Also explains why he's 12 pounds. +3  
krewfoo99  Also, think of it like this: Insulin causes hypoglycemia, thus this baby must have increased insulin. It is also an anaobolic hormone which is clear by the babys weight. Insulin increases glycogen synthase activity, and causes an increase in concentrations of glycogen. Decrease in insulin would do exactly the opposite +1  
tyrionwill  fetus of a mom with DM will develop pancreatic beta cell hyperplasia, which leads to insulinemia trying to reduce the blood glucose. after birth, the excessive blood glucose will be automatically withdrawn while the insulin at that moment is still high, which leads to hypoglycemia. +2  



 +1 
submitted by macrohphage95(7),
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ym tdngursndiane of eth qotnesiu is ttah he is kaigns ubota teh aeusc of leatnano pyiygeomchl.a

as uyo wnko snlniiu lwli be ghih latyerpanl ude ot megcpheyriyla and ighh veesll iwll .spesisrt

os if yuo ntkih taobu .oa..ehmhgeciylytp orlman eosepsnr rfo hte lycoengg oreonccnntita si ot racdesee sa( wlel sa lggnecoy hss)aneyt nda hte sleouioeggscenn ot ecieonars.s a onsrep tiwh eairmpid sneiuggosecneol cwh(hi is rlnba)moa is emro lekily to vloepde yglmciyaoehp