Kinesiology 1070A/B Lecture Notes - Lecture 15: Circadian Rhythm, Sewage Treatment, Cognitive Disorder

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oliveshark818

19 Nov 2018

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It can be a multi-behavioural intervention (eg. exercise and other techniques) It can look at other outcomes besides cognitive function (though for the results and implications you want to focus on cognitive function as the primary outcome) Study: the effect of a meditative movement intervention on quality of sleep in the elderly . It requires trained individuals: there is a cost associated with it. Implications: exercise has an effect on reducing ahi and the underlying causes of osa in patients with osa, **while other treatments treat it, they don"t target what is actually causing it. In middle-aged women, programmed exercise improved sleep quality, but had no significant effect on the severity of insomnia: current evidence should be interpreted with caution due to small number of studies. Implications: suggests that resistance training may be an effective treatment option for improving sleep quality in older adults. Video: large-scale rct that examined the effect of exercise on individuals (northwestern.

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OOC #3 Due: Monday, March 19, 2018, 5pm CASE: The Runnersâ Experiment, Integration of Metabolism Case Study Overview This case is designed to help students understand the importance of glucogenic substrates in human metabolism and the interconnections between carbohydrate, fat, and protein metabolism in humans. Because the focus of this case is the integration of metabolic pathways, we recommend that students be exposed to the topics through Chapter 23 (Chapters 19 and 20 are not necessarily required); referring to Sections 27.4 and 27.5 of the textbook (Stryer 8E) before beginning this case may also be useful for this out-of-class assignment. You may work individually or in groups to complete this case study, but you must submit your own work in Canvas (âEnter your ooc #3 answers hereâ). You are encouraged to refer to your textbook throughout the case, and internet access is permitted, although it is not necessary for the completion of the case. You will need to iteratively acquire, analyze, and integrate data as you progress through the case and answer assessment questions found throughout the case. You are encouraged to carefully consider investigation options; guessing is discouraged. Your score on this assignment will reflect correct answers. Learning Objectives This case is intended for remediating or extending student capabilities in these difficult topics: 1) The real-world applications of the study of human metabolism. Students will: â¢ Use real biochemical tests to evaluate and âsolveâ a metabolic disorder case. â¢ Consider the importance of factors like personal and family history, diet, medications taken, and symptoms in solving a biochemical case. 2) Critical and interrelated pathways in human central metabolism. Students will: â¢ Review carbohydrate, lipid, and amino acid metabolic pathways. â¢ Review fatty acid metabolism and recognize the distinctions between the oxidation of even- and odd-chain fatty acids. 3) Connections between carbohydrate, fat, and protein metabolism in humans. Students should be able to: â¢ Outline and explain the importance of glucogenic substrates in human metabolism. o Understand why the inability to convert acetyl-CoA to glucogenic substrates in humans leads to protein wasting. o Explain the importance of ketone body formation and ammonia transport/disposal in human metabolism. â¢ Explain the important differences between the metabolic intermediates produced by the oxidation of even- vs. odd-chain fatty acids. 4) Practice critical thinking skills involving data. Students will: â¢ Evaluate data provided by metabolite and enzyme tests. â¢ Integrate multiple pieces of biochemical data. âThe Runnersâ Experimentâ, Integration of Metabolism Case Study Introduction Race day had come. âFinallyâ thought Michael. He was a marathon veteran, but this race was different. He felt terrible: âProbably a coldâ he had told his girlfriend, but nothing was going to stop him today. Today was the day he would finally prove his brother Dave wrong and he had 26.2 miles to do it. The two young men shook hands shortly before the race started. Dave was thin, like Michael, but not âgauntâ. Michaelâs girlfriend Jan, had actually used that word to describe Michael a few days prior. His cheeks had receded recently. âSeriously, you should stop this... you look terrible!â Jan said. âItâs just pre-race training... and of course, the experimentâ he thought. âIâll be fine!â he assured her with a wink before leaving their apartment. âToday is the day we settle this!â he now called to Dave as they took off down the race route. But Dave only smiled and accelerated to leave Michael behind. As Dave disappeared into the crowd, Michael called out: âItâs not about speed! Itâs about endurance dummy!â, but Dave was too far ahead to hear. 1 For weeks they had been talking about their plan, the experiment, and how much money they were going to make. Michael smiled to himself and then put his head down to focus on the run. Dave was long gone but Michael was certain that he would see him again soon enough... that is, until he started to feel dizzy... Juan had worked at several marathon-medical tents before. It was always the same: people try to run the race without training properly, and they end up at the tents. Most are dehydrated and exhausted, others just âhit the wallâ, when their bodies run out of glycogen and some even have heart attacks, mainly due to poor training. This particular day wasnât very hot, but it didnât take much to overwhelm people during a marathon. Working the races was a nice excuse for an ER doctor to get out in the sun for a few hours on the weekend and a chance to help some people... for Juan that was as addicting as running. Two hours in and Juan was bored. The chatter on the radio was the same as always: dehydrated runners at both tents, and one elderly person from the crowd had to be treated for heat exhaustion, just from standing too long... so far it was a slow day. Suddenly the radio chatter picked up. The ambulance from the medical tent at the 10-mile mark was headed in to his direction with a young man who was unresponsive. The incoming call was interrupted by a second voice: the ambulance from the medical tent at the 20-mile mark ALSO had an unresponsive man. âWhat are the odds?â Juan thought. The two ambulances arrived simultaneously. Runner ID tags identified both subjects immediately: Michael and Dave Gard, two brothers! Dave was unconscious, but otherwise looked OK. When Juan saw Michael however, he was startled into action; he would not have guessed that the two men were brothers! You are a biochemistry student who is shadowing an ER doctor who has just admitted two young males. One man, Dave, regained consciousness prior to arrival, while the other, Michael, regained consciousness only after arriving at the hospital and is still delirious. Neither man was particularly dehydrated, having drunk water during the race. Both have been stabilized, but blood and urine samples from before they were treated are available for you to test. It is up to you to discover what might be the problem with the two brothers. Consider that there are two primary questions to answer in this case study: â¢ What caused both brothers to lose consciousness during the race? Here are some potential biochemical hypotheses for you to consider: Ketoacidosis Lactic acidosis Ammonia toxicity Mercury poisoning Acute hyperglycemia due to type II diabetes Hypoglycemia Phenylketonuria Maple-syrup urine disease â¢ What is the biochemical explanation for the differences in the conditions of the two brothers? You may now conduct additional investigations to explore the details of this case and to test hypotheses so that you can eventually answer both of these questions. Note: for this case, you are encouraged to explore ALL possible investigations to gather as much information as possible to explain the brothersâ conditions before finishing the case by continuing to the final assessments. You will be scored on this exercise based on your answers to assessment questions found throughout the case so you are STRONGLY encouraged to use your textbook to complete this exercise; you may also use the internet as necessary. RECOMMENDED INITIAL INVESTIGATIONS: Evaluate the overall physical appearance of the two brothers including insect bites or other injuries Results: The men are identical in height. Dave has a lean, athletic build, but is not unusually thin for a long- distance runner. Michael, on the other hand, appears to be severely emaciated. You note sunken eyes and 2 cheek bones and protruding ribs, indicating a lack of not only body fat but also muscle tone. No injuries or other abnormalities are apparent. Investigate past medical history including current medications Results: Neither man smokes, drinks, or uses illegal drugs. They are not on any medications. Dave reports that Michael had not been feeling well prior to the race, but had thought that he was âjust coming down with a cold or somethingâ. Given that the men were both avid marathoners, no one apart from Michaelâs girlfriend Jan had been concerned about Michaelâs recent and rapid weight-loss. Investigate the relationship between the two brothers in greater detail Dave explains that the two of them are not just brothers, they are best friends and despite their grossly different appearances at the moment, they are identical twins! He says: âBefore we started our experiment just a few weeks ago, most people couldnât tell us apart!â Dave mentioned something about an experiment; you could ask him more about this. The following is now a new investigation option: Ask Dave about âThe Experimentâ Results: Dave tells you that the two brothers had been planning to develop a new dietary supplement company, Gard Nutraceuticals, selling purified fish oil, which they believe is a health panacea. They disagreed on the best fish oil to bring to market however, so the men had been conducting an experiment to settle this disagreement. Both had been taking fish-oil pills along with a multi-vitamin for the past three weeks while they tapered back their training runs dramatically. When you press Dave about what else he and Michael were eating, shockingly he says ânothingâ. They had been eating enough fish oil to consume 3000 Calories per day, which is normal for marathon training (approximately 330 grams of fish oil per day). Each brother had been touting a different product: Michael was taking wild-caught salmon oil, while Dave was eating oil from a flathead (striped) mullet. The bet was to determine whether fish oil was an adequate caloric- replacement supplement for athletes, and whose product was better. To make the decision unambiguous, the pair was going to use the marathon to decide the winner since the boys had nearly identical marathon times in previous races. The details of this fish-oil experiment may merit further investigation. In particular, some fish contain high levels of mercury, which could be toxic if consumed in large quantities. You now have the following two new investigation options available to you: Test hair for common toxins (heavy metals and narcotics) and ask Dave about mercury contamination in the supplements Investigate the composition of the dietary supplements the subjects were eating SECONDARY INVESTIGATIONS: DETERMINE BLOOD SERUM CONCENTRATIONS OF: Common immunoglobins (IgG, IgA, IgM) and ammonium (NH4+) levels Results for Dave: All values for immunoglobin concentrations are at the low end of the normal ranges, which is normal for someone finishing a marathon. (normal ranges: [IgG] = 560â1800 mg/dL; [IgM] = 45â250 mg/dL; [IgA] = 100â400 mg/dL); [NH4+] = 20 mmol/L (normal range: 12- 48 mmol/L) Results for Michael: Severely low levels of IgG, IgM, and IgA. [NH4+] = 67 mmol/L (normal range: 12â48mmol/L)

1. Which of the following might cause the concentration of ammonium ions found in the blood to increase? (Select ALL that apply!) A. An increase in the rate of fatty acid catabolism by Î²-oxidation B. An increase in the rate of protein and amino acid catabolism C. An increase in the rate of glucose oxidation through the pentose phosphate pathway D. An increase in the rate of glucose oxidation through glycolysis and the citric acid cycle E. A defect in the urea cycle F. Galactosemia G. Lactose intolerance

Free fatty acids (FFAs) and triacylglycerides (TAGs) Results for Dave: 500 mg/dL FFAs (normal range: 190â420 mg/dL); 190 mg/dL TAGs (normal range: 40â150 mg/dL) Results for Michael: 660 mg/dL FFAs (normal range: 190â420 mg/dL); 230 mg/dL TAGs (normal range: 40â150 mg/dL) Glucose and Glycosylated Hemoglobin (HbA1c as a marker) Results for Dave: [Glc] = 39 mg/dL (normal range: 70â110 mg/dL) Note: This value indicates severe hypoglycemia; HbA1c = 4.4% (normal range: 4â6.5%) Results for Michael: [Glc] = 31 mg/dL (normal range: 70â110 mg/dL) Note: This value indicates severe hypoglycemia; HbA1c = 3.2% (normal range: 4â6.5%)

2. When a typical person runs a marathon, they do not become severely hypoglycemic to the extent that either Michael or Dave did. Some people consume carbohydrates during the race in the form of foods, gels, or sports drinks that have added sugar. However, even when dietary carbohydrates are not consumed during the race, how does the body of a healthy individual maintain adequate levels of blood glucose during sustained aerobic exercise such as running a marathon? (Select ALL that apply!) Hint: You may wish to review pages 657-661, 698-699, & 814-819 of Stryer 8E before attempting this question! In addition, remember to consider the sources of glucose, not ATP. A. Even numbered fatty acids are catabolized and the carbon is used for gluconeogenesis in the liver. B. Muscles run gluconeogenesis and export glucose into blood. C. Ketone bodies are produced by adipose cells and converted into glucose by the liver. D. Muscles convert lactate back into glucose and export this glucose back out into the blood. E. The exclusively ketogenic amino acids (leucine and lysine) are deaminated and the carbon skeletons used to synthesize glucose. F. Glucogenic amino acids are deaminated and the carbon skeletons used to synthesize glucose. G. Most blood glucose will come from the breakdown of muscle glycogen (glycogenolysis) and the export of this glucose from muscles to the blood. H. Most blood glucose will come from the breakdown of brain glycogen (glycogenolysis) and the export of this glucose from brain to the blood. I. Most blood glucose will come from the breakdown of liver glycogen (glycogenolysis) and the export of this glucose from the liver to the blood.

H3O+ ions: blood pH Results for Dave: pH = 7.31 (normal range: 7.35â7.45) Results for Michael: pH = 7.2 (normal range: 7.35â7.45) The physician you are shadowing tells you that a value of 7.31 indicates acidosis but this value will not normally cause a loss of consciousness. A pH value of 7.2 indicates severe acidosis and could result in neurological problems. 4 Ketone bodies (acetoacetate and acetone) Results for Dave: low but detectable levels (normal range: undetectable) Results for Michael: dangerously high levels of both found.

3. What macromolecules can be catabolized such that the resulting carbon can be used to create ketone bodies? A. Fatty acids B. Amino acids C. Glucose D. Glycogen E. All of the above can be used to produce acetyl-CoA, so they can all be used to make ketone bodies.

4. When are ketone bodies produced in an otherwise healthy human being? A. When fatty acid levels in the blood are low B. When glutamine levels in the blood are low C. When glucose levels in the blood are low D. When lactate levels in the blood are low E.

When blood pH is low Lactate and pyruvate Results for Dave: [lactate] = 2.0 meq/L (normal range: 0.5â2.2 meq/L); [pyruvate] = 0.05 meq/L (normal range: 0â0.11 meq/L) Results for Michael: [lactate] = 0.7 meq/L (normal range: 0.5â2.2 meq/L); [pyruvate] = 0.02 meq/L (normal range: 0â0.11 meq/L) DETERMINE URINE CONCENTRATIONS OF: branched-chain a-keto acids Results for both Dave and Michael: undetectable levels (normal range: undetectable)

5. What would an increased amount of branched-chain a-keto acids in the urine indicate? (Select ALL that apply!) A. A defect in fatty acid catabolism B. A defect in fatty acid transport C. A defect in a citric acid cycle enzyme D. A defect in carbohydrate metabolism E. A defect in amino acid catabolism F. Phenylketonuria G. Lactose intolerance H. Maple-syrup urine disease phenyl-pyruvate (a phenylketone)

Results: Both Dave and Michael: undetectable levels (normal range: undetectable)

6. What would an increased amount of phenyl-pyruvate in the urine indicate? (Select ALL that apply!) A. A defect in fatty acid catabolism B. A defect in fatty acid transport C. A defect in a citric acid cycle enzyme D. A defect in carbohydrate metabolism E. A defect in amino acid catabolism F. Phenylketonuria G. Lactose intolerance H. Maple-syrup urine disease

SPECIFIC ENZYME TESTS: Lactate dehydrogenase (LDH) Results for both Dave and Michael: [LDH] = 150 U/L (normal range: 110â210 U/L) Liver Asp amino-transaminases (AST) and Ala amino-transferase (ALT) Results for Dave: Both enzymes are within normal range (normal range: 7â55 U/L) Results for Michael: Both enzyme expression levels are elevated. Pyruvate dehydrogenase (PDH) Results for both Dave and Michael: PDH complex activity= 2.5 nmol/(minâ¢mg) (normal range: 2â 2.5 nmol/(minâ¢mg) Test cells for Electron Transport Chain enzyme activities Results for both Dave and Michael: ETC enzyme activities were normal. SPECIAL INVESTIGATIONS Test hair for common toxins (heavy metals and narcotics) and ask Dave about mercury contamination in the supplements Results: Dave immediately points out that they worked with a chemist to extensively purify the fish oils to remove any mercury contamination. An independent laboratory verified that there are only trace levels of mercury left in their formulations, and Dave brings up the documentation on his smart-phone, showing that the analysis is good. Mercury toxicity will be negligible regardless of how much oil is consumed. Also, no heavy metals or narcotics were detected in hair samples from either brother. Investigate the composition of the dietary supplements the subjects were eating. Results: Complete hydrolysis followed by esterification of the TAGs in the two fish oil samples allowed fatty acid composition to be analyzed by gas chromatography. The table shows the compositions of oil consumed by Dave (from the striped mullet Mugil cephalus) and Michael (from Atlantic salmon Salmo salar) Dave Michael 16:0 fatty acid 11% 16% 16:1â7 fatty acid 5% 6% 18:1â9 fatty acid 15% 20% 20, 22, or 24 carbon omega-3 or omega-6 fatty acids 36% 45% 15, 17, 19, and 21 carbon fatty acids 25% 4% 12 or 14 carbon fatty acids 6% 7% Unidentified 2% 2% 6

7. What is the most significant difference between these two fish oil samples in terms of their fatty acid compositions? Note: it may be helpful to briefly review fatty acid structure and nomenclature from Section 12.1, pages 342-344, Table 12.1 of Stryer 8E before answering this question. A. The oil that Dave is consuming is much higher in saturated fatty acids than Michaelâs oil. B. The oil that Dave is consuming is much higher in oleic acid than Michaelâs oil. C. The oil that Dave is consuming is much higher in palmitic acid than Michaelâs oil. D. The oil that Michael is consuming is much higher in omega-3 fatty acids than in omega-6 fatty acids. E. The oil that Dave is consuming is much higher in odd-numbered fatty acids than Michaelâs oil. F. The oil that Michael is consuming is much higher in unsaturated fatty acids than Daveâs oil.

8. What is different about the metabolism of odd- vs. even-numbered fatty acids? (Select ALL that apply!) A. Odd-numbered fatty acids are not broken down by Î²-oxidation. B. Odd-numbered fatty acids are primarily broken down by Ï-oxidation. C. Odd-numbered fatty acids cannot be broken down by humans. D. Odd-numbered fatty acids require additional enzymatic steps to fully degrade. E. Odd-numbered fatty acids do not require carnitine in order to be transported into the mitochondria. F. Odd-numbered fatty acid metabolism produces a four-carbon succinyl group attached to CoA.

9. What is an important consequence of producing succinyl-CoA at the end of odd-numbered fatty acid metabolism rather than the normal product by Î²-oxidation of even-numbered fatty acids? A. Acetyl-CoA is a citric acid cycle intermediate but succinyl-CoA is not. B. Acetyl-CoA is glucogenic but succinyl-CoA is strictly ketogenic. C. Succinyl-CoA is glucogenic, but acetyl-CoA is strictly ketogenic. D. None of the above are true.

10. Review again which brother is taking which oil and which oil contains a large percentage of odd- numbered fatty acids. What is a critical physiological consequence of this difference? A. Michael can make ketones from the oil in his diet but Dave cannot. B. Dave can make ketones from the oil in his diet but Michael cannot. C. Michael can make ATP using the oil in his diet but Dave cannot. D. Dave can make ATP using the oil in his diet but Michael cannot. E. Dave can make far more glucose from the oil in his diet than Michael can. F. Michael can make glucose from the oil in his diet but Dave cannot. You have uncovered a critically important aspect of this case. As you continue your investigation, consider what biochemical consequences might occur when someone is not consuming glucose and cannot convert the food that they are eating into glucose. ENDING THE CASE AND THE ASSESSMENT QUESTIONS: The student should be able to fully explain the reason(s) for Dave and Michaelâs incidents in biochemical and physiological terms, including reasons for the significant differences between the two brothersâ conditions and to fully justify and completely explain their reasoning based on the evidence gathered. Criteria to complete the case are the selection of ALL possible investigation options and completion of the associated assessment questions. If all of the criteria are not met: you may be missing vital information to sufficiently explain this incident. Assessment Questions for âThe Runnersâ Experimentâ

11. The citric acid cycle begins with the condensation of acetyl-CoA with oxaloacetate. Possible sources for carbon that may be converted into acetyl-CoA in active muscle include: (Select ALL that apply!) A. Pyruvate B. Î²-oxidation of fatty acids C. Amino acid catabolism D. Conversion of ketone bodies from the blood back to acetyl-CoA E. Stored glycogen in the muscle

12. Though not included in the case, both men had elevated levels of the enzymes carnitine acyltransferase I and II. Why might the men have elevated levels of these enzymes? A. These enzyme levels rise after eating a carbohydrate-rich meal to aid in carbohydrate metabolism (glycolysis). B. Carnitine levels rise after eating and these enzymes are expressed to catabolize the extra carnitine. C. Both men are producing abnormally high levels of these enzymes as a side effect of utilizing amino acids for energy. D. These enzymes are elevated because both men are getting their energy primarily from Î²- oxidation and these enzymes are needed for fatty acids to be transported into the mitochondria. E. Likely both men have high levels of these enzymes because they are identical twins and share a genetic polymorphism.

13. Why is glucose a necessary fuel in the human body and what organs or cell types rely most heavily on glucose? A. Most human tissues cannot use glucose as an energy source. B. Glucose is necessary for the continued function of the Na+/K+ pump, and the brain is the only organ that uses glucose as an energy source. C. During exercise, the brain stops using glucose so that it can be used by the muscles. D. Glucose is necessary because it is used by almost all tissues for energy and biosynthesis, and the brain relies almost entirely on glucose as an energy source. E. Glucose is necessary because it is the only source of energy that can fully be oxidized to produce ATP, and the liver relies heavily on glucose as its sole energy source.

14. During their three-week, pre-marathon self-experiment, both Daveâs and Michaelâs livers had to produce some glucose. Which of the following molecules could be used by the liver to create the glucose that is needed to supply the brain and other tissues in a healthy person on a normal diet? (Select ALL that apply) A. Pyruvate B. Lactate C. Glycerol D. Any citric acid cycle intermediate (this excludes acetyl-CoA!) E. Even-chain fatty acids F. Alanine G. Acetyl-CoA 8

15. Which of the following statements about even-chain fatty acids is/are FALSE? (Select ALL that apply) A. The product of the oxidation of even-numbered fatty acid chains is multiple acetyl groups bound to CoA molecules. B. Humans have all the appropriate enzymes necessary to use even-chain fatty acids as glucogenic precursors through their conversion to acetyl-CoA. C. A difference between even-chain and odd-chain fatty acids is that only odd-chain fatty acids produce propionyl groups bound to CoA. D. The products of the oxidation of an odd-numbered fatty acid chain are multiple 3-carbon propionyl groups bound to CoA. E. The products of the oxidation of an odd-numbered fatty acid chain are acetyl groups and a final propionyl group attached to CoA.

16. What is happening to Dave and Michael in regard to their metabolisms? (Select ALL that apply) A. Because the human body cannot create glucose from even-chain fatty acid oxidation, both runners are starving their bodies of glucose due to their restrictive diets. B. Most of their energy is coming from fatty acid oxidation, so ketone bodies are being produced to free up CoA for continued Î²-oxidation. C. The brothers have compromised immune systems because of a genetic disorder that affects their metabolism. D. Their diet high in fatty acids resulted in a large build-up of glycogen in their livers and muscles. E. Excessive fatty acid oxidation resulted in protein wasting, which led to acidification of the blood.

17. What are the functions of Asp aminotransferase (AST) and Ala aminotransferase (ALT)? And why are they elevated in Michael? A. These enzymes function in glucose catabolism, catalyzing the transfer of an amino group; levels of these enzymes would be elevated due to the excessive protein wasting occurring in Michaelâs body to meet his need to produce glucose in the absence of other dietary gluconeogenic substrates. B. These enzymes function in fatty acid catabolism, catalyzing the transfer of a hydroxyl group; levels of these enzymes would be elevated due to excessive glycogenolysis occurring in Michaelâs body to meet his need to produce glucose in the absence of other dietary gluconeogenic substrates. C. These enzymes function in protein catabolism, catalyzing the transfer of an amino group; levels of these enzymes would be elevated due to the excessive protein wasting occurring in Michaelâs body to meet his need to produce glucose in the absence of other dietary gluconeogenic substrates. D. These enzymes function in protein catabolism, catalyzing the transfer of an amino group; levels of these enzymes would be elevated due to the excessive ketone body production that is occurring in Michaelâs body to meet his need for energy sources in the absence of other dietary gluconeogenic substrates. E. These enzymes function in ketone body catabolism, catalyzing the transfer of an amino group; levels of these enzymes would be elevated due to the excessive ketone body production that is occurring in Michaelâs body to meet his need for energy sources in the absence of other dietary gluconeogenic substrates.

18. Why are Michaelâs blood ammonia levels elevated and why are high levels of ammonia dangerous? A. Ammonia levels in the blood are high due to the rapid degradation of proteins; high levels of ammonia lead to dangerous levels of ketone bodies in muscle. B. Ammonia levels in the blood are high because of burning calories from vigorous exercise; high levels of ammonia lead to dangerous levels of ketone bodies in muscle. C. Michaelâs blood ammonia is high due to the rate of ketone body production in his body; high levels of ammonia are dangerous because ammonia passes easily through the blood-brain barrier and is highly toxic to the brain. D. Ammonia levels are high because it is a byproduct of Î²-oxidation of fatty acids; high levels of ammonia lead to dangerous levels of ketone bodies. E. Michaelâs blood ammonia is high due to the rate of protein wasting (catabolism of non-essential proteins to provide glucogenic carbon skeletons) in his body; high levels of ammonia are dangerous because ammonia passes easily through the blood-brain barrier and is highly toxic to the brain.

19. What is/are the source(s) of the excessively high levels of ketone bodies in Michael but not Dave? (Select ALL that apply) A. Ketone bodies are being formed from catabolism of carbohydrates for energy metabolism. B. Ketone bodies are being formed as a byproduct of excessive glycogenolysis. C. Ketone bodies are being formed from ketogenic amino acids released from protein catabolism. D. Ketone bodies are being formed from the products of Î²-oxidation of fatty acids from both stored triglycerides and the ingested fish oil. E. Ketone bodies are being produced in Michaelâs brain to provide energy for the liver. F. Michael is producing large amounts of ketone bodies because he is severely hypoglycemic and has likely been hypoglycemic for most of the past few weeks.

20. Why are the two twins experiencing such different symptoms? (Select ALL that apply) A. Michael probably has a genetic inborn error in metabolism that Dave does not. B. One brother is in much better shape for the run than the other because of training. C. Michaelâs case is more severe because he relies on glycolysis (by way of lactic acid fermentation) for energy. D. Michaelâs supplement has almost no odd-numbered fatty acids, so his body is undergoing more protein wasting, and producing dangerous levels of ketones. E. Daveâs case is milder because the supplement he is taking contains a significant amount of odd- numbered fatty acids, some of which may be used to produce glucose. F. The twins exhibit minor variations in metabolic adaptation to dietary changes based on their genetics.

21. Which of the following would likely be true if the brothers were NOT identical twins? A. Carnitine levels would be higher in Dave than in Michael. B. Their bodies would have used different sources of energy to respond to a long term run. C. They would not have overexerted their bodies because they would be less competitive if they were not identical twins. D. The brothers would have had the same amount of ketone production. E. It would be more difficult to determine the impact of diet in this case because there would have been a greater chance that their differing symptoms were due to genetic variation in metabolism.

22. What is causing Michaelâs neurological issues and what is the cause of this problem? (Select ALL that apply) A. Michael is exhibiting the first signs of diabetes, trigged by the vigorous run. B. Michael has depleted his main stores of glucose and is therefore experiencing neurological effects from hypoglycemia. C. Michael has severe hypoglycemia and ketoacidosis because of metabolic failures, both which are known to affect mental status. D. As a result of excessive protein and amino acid degradation, Michael is also experiencing mild ammonia toxicity, which is likely exacerbating his neurological issues. E. Michael is experiencing side effects of extreme dehydration.

mauvewallaby334

*Please refer to the attached file.

You are writing a rough draft for the essay part 1,

This writing practice will focus on

Steps *1 and *2 below:

___________________

FIVE STEPS OF WRITING~*1- Prewrite*2-Draft 3- Revise 4- Edit/Proofread 5- Publish

Expository Essay Part 1

Student Resource

EXPOSITORY ESSAY

– explains, points out

Used in articles, essays, exam questions

- Used to report on research

- Used to share information, give directions

REVIEW:

Elements of Expository Essay:

Thesis

–

Thesis Statement states topic, introduces supporting points

Structure

–

- Organization - often by Cause/Effect, Problem/Solution, Compare/Contrast

- Supporting paragraphs (at least one per supporting point)

- Use of formatting, graphics, and multi-media where appropriate

- Conclusion - relates to thesis and pulls supporting points together

Style

–

- Formal tone - complete sentences; conventional construction and language

- Active voice

Assignment:

Complete the first

two

steps in writing an Expository Essay.

You can use the sample writing prompt on Page 3 or choose a topic based on stories/articles of

your choosing. Page 3 also gives a sample thesis and outline based on the writing prompt. If

writing on your own topic and texts, choose three texts from different genres – e.g., short story,

science fiction, poetry, memoir, informational text, etc.

Step 1)

Prewrite

– Write your thesis statement.

– Determine the structure and organization (e.g., compare/contrast).

– Make an Outline (should include the thesis statement plus a list of

supporting points and a conclusion).

Step 2)

Draft

– Follow your Outline.

– Consider the audience's knowledge of and experience with the topic.

– Give concrete examples (each supporting point should be at least one

paragraph).

– Relate each point back to the thesis statement.

– Draw a conclusion that relates to the thesis statement and ties the

supporting points together.

Expository Essay Part 1

Student Resource

EXPOSITORY ESSAY - SAMPLE THESIS AND OUTLINE

WRITING PROMPT

Compare/contrast the authors' treatments of the theme of

taking

responsibility

in three different genres of text:

Short Story

–"Through the Tunnel,"

Science

Fiction

– "A Sound of Thunder," and

Informational Text

– "Quit blaming; take responsibility."

Thesis

Authors Lessing, Bradbury, and Gitomer, writing in three different textual genres,

each address the theme of taking responsibility by contrasting instances of responsible and

irresponsible behavior and drawing the conclusion of the benefits of taking responsibility.

Supporting paragraphs

– with formatting (subtitles):

1. Short Story

– Lessing ("Through the Tunnel") contrasts Jerry's irresponsible/ responsible

behavior and draws conclusion responsibility is best – Jerry feels better about himself.

- Irresponsible: Jerry tries to get attention, be accepted by other boys; wants to swim

through tunnel before ready (examples from story)

- Responsible: Jerry stops trying to please other boys; adopts his quest; trains and works

to be prepared (examples from story)

- Lessing draws unstated conclusion of benefits of taking responsibility

(contrasts Jerry's feelings before and after quest)

2. Science Fiction

– Bradbury ("A Sound of Thunder") contrasts Time Safari Inc.'s/ Eckels'

responsible/irresponsible behavior and graphically illustrates the devastating results of

irresponsibility.

- Irresponsible: Eckels' uncaring, irresponsible attitude (examples in story)

- Responsible: Time Safari's careful planning and preparation for the hunt

(examples

from story)

- Bradbury ends story showing dramatic impact of being irresponsible, implying the

benefits of responsibility

3. Informational Text

–

Gitomer ("Quit blaming; take responsibility") compares salespeople

with politicians in their tendency to avoid taking responsibility and contrasts that attitude with

suggestions on taking responsibility to achieve success.

- Irresponsible: Salespeople and politicians blame others for their failures

(specific examples from article)

- Responsible: Suggestions on how they can take responsibility by

studying failures and

making them successes (examples in article)

- Gitomer concludes that salespeople (and politicians) can achieve results

they seek by

overcoming obstacles and taking responsibility

Conclusion

Authors Lessing, Bradbury, and Gitomer, writing in three different textual

genres, each address the theme of taking responsibility by contrasting instances of responsible

and irresponsible behavior, concluding that taking responsibility brings the best r

This writing practice will focus on

Steps *1 and *2 below:

___________________

FIVE STEPS OF WRITING ~* 1-Prewrite* 2- Draft 3- Revise\ 4- Edit/Proofread 5- Publish

Expository Essay Part 1

Student Resource

EXPOSITORY ESSAY

– explains, points out

Used in articles, essays, exam questions

- Used to report on research

- Used to share information, give directions

REVIEW:

Elements of Expository Essay:

Thesis

–

Thesis Statement states topic, introduces supporting points

Structure

–

- Organization - often by Cause/Effect, Problem/Solution, Compare/Contrast

- Supporting paragraphs (at least one per supporting point)

- Use of formatting, graphics, and multi-media where appropriate

- Conclusion - relates to thesis and pulls supporting points together

Style

–

- Formal tone - complete sentences; conventional construction and language

- Active voice

Assignment:

Complete the first

two

steps in writing an Expository Essay.

You can use the sample writing prompt on Page 3 or choose a topic based on stories/articles of

your choosing. Page 3 also gives a sample thesis and outline based on the writing prompt. If

writing on your own topic and texts, choose three texts from different genres – e.g., short story,

science fiction, poetry, memoir, informational text, etc.

Step 1)

Prewrite

– Write your thesis statement.

– Determine the structure and organization (e.g., compare/contrast).

– Make an Outline (should include the thesis statement plus a list of

supporting points and a conclusion).

Step 2)

Draft

– Follow your Outline.

– Consider the audience's knowledge of and experience with the topic.

– Give concrete examples (each supporting point should be at least one

paragraph).

– Relate each point back to the thesis statement.

– Draw a conclusion that relates to the thesis statement and ties the

supporting points together.

Expository Essay Part 1

Student Resource

EXPOSITORY ESSAY - SAMPLE THESIS AND OUTLINE

WRITING PROMPT

Compare/contrast the authors' treatments of the theme of

taking

responsibility

in three different genres of text:

Short Story

–"Through the Tunnel,"

Science

Fiction

– "A Sound of Thunder," and

Informational Text

– "Quit blaming; take responsibility."

Thesis

Authors Lessing, Bradbury, and Gitomer, writing in three different textual genres,

each address the theme of taking responsibility by contrasting instances of responsible and

irresponsible behavior and drawing the conclusion of the benefits of taking responsibility.

Supporting paragraphs

– with formatting (subtitles):

1. Short Story

– Lessing ("Through the Tunnel") contrasts Jerry's irresponsible/ responsible

behavior and draws conclusion responsibility is best – Jerry feels better about himself.

- Irresponsible: Jerry tries to get attention, be accepted by other boys; wants to swim

through tunnel before ready (examples from story)

- Responsible: Jerry stops trying to please other boys; adopts his quest; trains and works

to be prepared (examples from story)

- Lessing draws unstated conclusion of benefits of taking responsibility

(contrasts Jerry's feelings before and after quest)

2. Science Fiction

– Bradbury ("A Sound of Thunder") contrasts Time Safari Inc.'s/ Eckels'

responsible/irresponsible behavior and graphically illustrates the devastating results of

irresponsibility.

- Irresponsible: Eckels' uncaring, irresponsible attitude (examples in story)

- Responsible: Time Safari's careful planning and preparation for the hunt

(examples

from story)

- Bradbury ends story showing dramatic impact of being irresponsible, implying the

benefits of responsibility

3. Informational Text

–

Gitomer ("Quit blaming; take responsibility") compares salespeople

with politicians in their tendency to avoid taking responsibility and contrasts that attitude with

suggestions on taking responsibility to achieve success.

- Irresponsible: Salespeople and politicians blame others for their failures

(specific examples from article)

- Responsible: Suggestions on how they can take responsibility by

studying failures and

making them successes (examples in article)

- Gitomer concludes that salespeople (and politicians) can achieve results

they seek by

overcoming obstacles and taking responsibility

Conclusion

Authors Lessing, Bradbury, and Gitomer, writing in three different textual

genres, each address the theme of taking responsibility by contrasting instances of responsible

and irresponsible behavior, concluding that taking responsibility brings the best r

isaiahh223g

Andrea Smith was taking notes for her biology exam. Her professor has told her that the exam would cover, in part, the di erences between sexual and asexual reproduction. As she reviewed her notes and prepared for todayâs class, she was thinking about her own reproductive dilemma. If only asexual reproduction were the case for humans, maybe she wouldnât be in this mess. Or at least there wouldnât be questions about who was the father of her twins. âDwelling on it isnât going to help me prepare for class, and right now I have got to nish this chapter on animal reproduction,â she thought. She tried to concentrate and forget about her current dilemma as she feverishly typed on her notepad:

Asexual or sexual reproduction: 3 types of asexual reproduction: (1) ssion: separation of a parent organism into two or more individuals of equal size, (2) budding: growth of new individuals from outgrowths of existing organisms, and (3) fragmentation accompanied by regeneration: the breaking of the body into several pieces, some or all of which develop into new complete individuals through the regrowth of lost body parts. NOTE: Be able to explain the di erences between sexual and asexual reproduction!

She suddenly let out a long sigh. âItâll be ne,â she thought. âI just hope that none of my family or friends watches the show. What was I thinking when I agreed to this? But thatâs what Xavier wanted, and I will do whatever it takes to prove he is the father. Besides I am going to need the money if I have to take care of these babies on my own!â

e next day in class she was feeling even more nervous and was becoming increasingly angry as she thought about her current situation. Her thoughts were interrupted by the sound of her professorâs voice:

âOK, class,â her teacher was saying, âthat wraps up asexual reproduction. Letâs move on to reproductive cycles
and patterns. Most animals exhibit cycles in their reproductive activity. Reproductive cycles are often controlled
by hormonal and environmental cues. Animals may reproduce either exclusively asexually or sexually while other animals alternate between the two methods. For example, some animals can lay eggs of two types, depending on
the environment and/or season. One egg type matures only if it is fertilized while the other type does not require fertilization for development, a process called parthenogenesis. Some animals, and in rare cases humans, have both male and female reproductive systems. Some hermaphrodites can fertilize themselves, but most must mate with a member of the same species. Please look over these handouts and answer the questions that follow.â

As the other students read through the assignment, Andrea was thinking: âIâm dealing with a case of sexual reproduction that no doubt started with the fertilization of my egg with, hopefully, Xavierâs sperm. at reminds me, I need to make sure I go over internal and external fertilization again in my notes. Iâm not sure I completely understand it.â

All this started the night Xavier had come came over to talk to Andrea about their break-up. He had smelled and looked so good that evening. e events of that night had left Andrea wondering if there was really some truth to that stu about pheromones, which Andrea has learned in her class were chemical signals released by one organism that in uence the behavior of another individual of the same species. Even though Andrea had met someone else and had

âAn Unusual Case of Animal Reproductionâ by Powell and Tillman Page 1

been seeing Neo for a while, she hadnât been able to resist Xavier. Neither she nor Xavier had behaved like themselves that night. It was unlike them not to use some barrier method of contraception. As the class wrapped up, Andreaâs mind was still on her upcoming appearance on a daytime talk show. In some ways she was dreading it; but she was determined to prove what she believed she had known all along: at Xavier was the father of her twins.

Questions

1. What is the di erence between asexual and sexual reproduction?
2. List and de ne some types of asexual reproduction. Give one example of each. 3. What is the di erence between parthenogenesis and hermaphroditism?
4. What is the di erence between internal and external fertilization?
5. What is the function of pheromones?

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE

âAn Unusual Case of Animal Reproductionâ by Powell and Tillman

Page 2

Part II â The Pregnancy

âI canât believe it has come to this! Airing our dirty laundry on national television. I never thought Xavier would let things get so out of hand.â

It was late and Andrea was so upset she couldnât sleep. She tried studying for the upcoming exam, but she couldnât concentrate. She decided to get an early start on packing. She was so angry with Xavier. How could he have left her pregnant and alone, she thought, as she neatly added her new dress to the bag? How could he think that their babies might belong to someone else? She grabbed her journal, about to add it to the bag, but instead sat in her cozy corner chair and began to read:

January 12, 2007

Iâm pregnant with twins! Sometimes itâs still hard to believe because it was so unexpected. I feel like I am about to pop! I know that Xavier is the father of my babies and I canât wait for us to be a family. But he has doubts about it all because he knows that I met someone else during the brief time that we split up. And he wants to be sure that he is the father before we can move on. But what if it is Neo, the new guy I met? ereâs a slight chance but I doubt it. I know the exact time of conception. It was the night Xavier came over to talk about our relationship. It was a little over a week after that night that the pregnancy test detected the increase in HCG. I guess I just missed him so much.

I do regret that Xavier hasnât been around much during the pregnancy. He has missed the development of our babies. In the past months, I have heard the babiesâ heartbeats and felt them moving around. I wish he would come back because itâs obvious that I am pregnant now. Hopefully we can talk through our di erences and get back together before the pregnancy gets di cultâthe frequent urination and back pain my OB/GYN keeps warning me about. I know there is no way he will ever let me go through labor alone. I only pray the contractions are not more than I can bear. Xavier seems committed to the idea of a paternity test. Hopefully it wonât come to that, but if it does, weâre going to a daytime show to gure all this out.â

âWow! at seems like a lifetime ago,â she thought. âNow we have these beautiful twins and we donât seem any closer to becoming the real family I dreamed about. Well this will all be over in a couple of days. I am 110% con dent that the twins belong to Xavier, not Neo. I canât wait to see the look on Xavierâs face and hear him apologize once he sees the results of the paternity test!â

Questions

1. What does Andrea mean by time of conception?
2. How is HCG used to determine pregnancy?
3. List some changes that occur with the fetus/mother during the 1st, 2nd, and 3rd trimesters. 4. What hormones are responsible for inducing and regulating labor?
5. What trimester is Andrea in during this journal entry?

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE

âAn Unusual Case of Animal Reproductionâ by Powell and Tillman

Page 3

Part III â The Results

Andrea replayed the words over and over again in her mind: âXavier, you ARE the father!â She was ecstatic. Finally, she could breathe, knowing that Xavier was the father of her babies. en she heard what the host had to say next...

âNeo...YOU ARE the father!â
Andrea looked around in disbelief. She heard herself saying, âWhat do you mean? You just said Xavier was the father!

If Xavier is the father, how can he be the father?â she asked as she pointed toward Neo.

âWell, this is a rst, even for our show. But it appears that your twins were fathered by both of these men.â

âI canât believe it. e rst time I do something like this and I end up with twins and two fathers! Not only did I expose myself to potentially deadly STDs, but now I have two children, whom I have no doubt that I will be raising alone, and I have put my school career in jeopardy,â Andrea thought.

She still couldnât believe this was really happening to her. How was it possible that her TWINS have di erent fathers? What were the events that must have happened within her body that could lead to these circumstances? She grabbed her

journal from her bag and ipped back to the entry describing her feelings the day she found out she was having twins:

August 23, 2006

I just came back from another Drâs appointment. Dr. Blossom informed me that I am having two babiesâ twinsâfraternal. I donât know if they are boys or girls yet. One could be a boy and the other a girl. I still canât believe this has happened. Xavier has to be the father. He has to be! I will have to just play the hand I have dealt myself. How stupid was I? I was going to practice abstinence after Xavier and I broke up...and I certainly wasnât planning on meeting and getting involved with Neo! I canât believe that Neo and I didnât use a condom either. And itâs no excuse that we had been drinking. I just got caught up in the moment with Xavierâgoing down memory lane and things got all sentimental. I could have at least thought to use the rhythm method and kept track of when ovulation may occur. is has to be the most irresponsible thing I have ever done! Why did I stop taking my birth control pills anyway? And I have no idea where I put that diaphragm. Undoubtedly, some people will judge me as the type of woman who should have a tubal ligation that would permanently prevent any pregnancy.

Everything hit her at that very second. She closed her journal and just sat there for a moment. Andrea was reminded that she had stopped taking the pill the month before she became pregnant. She remembered that physicians recommend that a woman wait at least one cycle after she stops taking the pill before becoming pregnant because there is a chance that multiple ovulations may occur. Did it have something to with oogenesis? Andrea was so confused she just couldnât keep things straight in her mind. She thought about it for a minute to let it all sink in.

Andrea sat back and thought about the lecture on animal reproduction the week before. She pulled out her lecture notes on the menstrual cycle, the basic foundation of everything that she was going through.

Questions

1. Describe the two types of cycles that occur in female mammals (menstrual vs. estrous).

2. Compare and contrast the sterilization techniques (vasectomy and tubal ligation) and the temporary and reversible methods discussed in the case.

3. What are the functions of GnRH, FSH, LH, estrogen, and progesterone?

4. How can the paternity results be explained? Your answer should consider the amount of time before and after ovulation a woman is at risk for pregnancy and how long sperm can survive in the reproductive tract. Your discussion may include the following terms: ova, oogenesis, and fertilization, etc.

â¢

Image in title block dervied from licensed image Â© CLIPAREA.comâFotolia.com, ID #21458691. Case copyright held by the National Center for Case Study Teaching in Science, University at Bu alo, State University of New York. Originally published December 8, 2011. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE

âAn Unusual Case of Animal Reproductionâ by Powell and Tillman Page 4

Andreaâs Lecture Notes: The Female Reproductive Cycle

(I) e female reproductive cycle involves both the uterus and the ovaries:

Menstrual cycle = uterine cycle
â¢ Refers to the speci c changes that occur in the uterus

Ovarian cycle
â¢ Cyclic events in the ovaries that regulate the menstrual/uterine cycle

(II) Hypothalamus secretes gonadotrophin-releasing hormone (GnRH) which stimulates the anterior pituitary to secretefollicle stimulating hormone (FSH) and luteinizing hormone (LH) into the blood. FSH and LH regulate the ovarian cycle.

~OVARIAN CYCLE:

Folicular Phase

FSH and LH stimulate a follicle to grow

e growing follicle releases estrogen

Ovulation

â¢ An LH surge triggers ovulation

Luteal Phase

LH stimulates ruptured follicle to become corpus luteum

Corpus luteum secretes estrogen and progesterone, which inhibits LH and FSH secretion from the pituitary

Corpus luteum disintegrates

Estrogen and progesterone levels decrease, releasing the inhibitory e ect on the hypothalamus and the

pituitary

FSH and LH are released and a new cycle begins

(III) Ovarian hormones, estrogen and progesterone, regulate the uterine (menstrual) cycle ~UTERINE CYCLE:

Proliferative Phase

â¢ increasing estrogen levels causes the uterine lining (endometrium) to thicken: prepares the uterus for

implantation of the blastocyst

Secretory Phase
â¢ increased levels of estrogen and progesterone following ovulation maintains the endometrium by increasing

blood supply and growth of endometrial glands that secretes nutrients

Menstrual Flow Phase
â¢ decreased levels of estrogen and progesterone cause the uterine arteries to spasm, depriving the endometrium

of blood: endometrium disintegrates, resulting in menstruation

Based on the information in the case study, Animal Reproduction, please answer the following questions.

Andrea is pregnant and is trying to calculate the time of conception.What is time of conception and how is it determined?

What are the functions of GnRH, FSH LH, estrogen and progesterone in pregnancy?

Andrea is having twins but the babies have two different fathers.Explain the difference between fraternal and identical twins.Which are these?How could the babies have different fathers?

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