Advanced Nutrition and Human

Metabolism 5th Edition Gropper Test

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 Chapter 7 – Integration and Regulation of Metabolism
and the Impact of Exercise and Sport

Multiple-Choice

Key Page(s)
c 254 1. What is the final common catabolic pathway for metabolism of carbohydrate,
protein and fat?
a. acetyl CoA; oxidation
b. gluconeogenesis; glycolysis
c. Krebs cycle; oxidative phosphorylation
d. lipolysis; ketogenesis

a 254 2. What intermediate’s formation in the Krebs cycle is interrelated to the

biosynthesis of heme?
a. succinyl CoA
b. oxaloacetate
c. citrate
d. fumarate

b 254 3. Which Krebs cycle intermediate can move from the mitochondria into the
cytoplast to become the initiator of fatty acid synthesis?
a. a-ketoglutarate
b. citrate
c. succinyl CoA
d. fumarate

d 256 4. Which cells lack a metabolic mechanism to convert glucose into energy
stores?
a. skeletal muscle
b. liver
c. adipose tissue
d. RBCs

c 254 5. In the human, most triacylglyerols are synthesized by the

a. adipose tissue.
b. heart.
c. liver.
d. brain.

65
c 256-258 6. Which of the following amino acids is glucogenic in the post-absorptive
state?
a. threonine
b. tyrosine
c. alanine
d. lysine

a 263 7. The lack of which muscle enzyme causes glucose, when phosphorylated in
the muscle, to be trapped?
a. glucose 6-phosphatase
b. glycerol 3-phosphatase
c. 6-phosphoglycerate dehydrogenase
d. glucokinase

c 258 8. How long does it take for the postabsorptive state to evolve into the fasted
state?
a. 12-18 hours
b. 24-36 hours
c. 18-48 hours
d. 36-72 hours

b 258 9. Amino acids from muscle breakdown provide the chief substrate for which
metabolic process?
a. glycolysis
b. gluconeogenesis
c. glycogenesis
d. hexosemonophosphate shunt

d 258 10. Which amino acid is considered purely ketogenic?

a. methionine
b. histidine
c. tryptophan
d. leucine

c 258-259 11. A protein-sparing shift in metabolism from gluconeogenesis to lipolysis

occurs during the
a. early fasting state.
b. fasting state.
c. starvation state.
d. fed state.

d 259 12. The brain cannot use fatty acids for energy because
a. it lacks enzymes for oxidation of fats.
b. it lacks mitochondria.
c. glycerol cannot cross the blood-brain barrier.
d. fatty acids cannot cross the blood-brain barrier.

66
a 261 13. Amino acids used primarily by muscle for synthesis of dispensable amino
acids and for protein synthesis are
a. branched-chain amino acids.
b. aromatic amino acids.
c. basic amino acids.
d. acidic amino acids.

d 261 14. Which amino acid produced by transamination of pyruvate with glutamic
acid provides a disposal route for nitrogen produced from the catabolism of
muscle amino acids?
a. histidine
b. tyrosine
c. tryptophan
d. alanine

c 254 15. In which organ does urea synthesis occur?

a. kidney
b. spleen
c. liver
d. pancreas

a 261 16. What amino acid plays an important role in controlling toxicity from
ammonia released during amino acid catabolism by the glutamate
dehydrogenase reaction?
a. glutamine
b. glycine
c. serine
d. valine

b 261 17. What is the primary communication system that assesses the body’s status in
relation to environment and relays appropriate commands to tissues/
organs?
a. endocrine system
b. nervous system
c. vascular system
d. respiratory

c 261 18. Which of the following is NOT transported by the vascular system?
a. regulatory hormonal messages from the endocrine system
b. oxygen from the respiratory system
c. regulatory neural messages from the nervous system
d. organic nutrients and minerals from the digestive system

67
d 262 19. Which hormone has the primary responsibility for directing energy
metabolism in the fed state?
a. growth hormone
b. ACTH
c. glucagon
d. insulin

a 262 20. Under the influence of insulin, which of the following pathways is
increased?
a. glycogenesis
b. glycogenolysis
c. phosphorylation of glycogen synthase
d. phosphorylation of glycogen phosphorylase

d 262 21. Which of the following actions of insulin occur only after hours or days?
a. membrane changes for glucose transport
b. inhibition of activity of catabolic enzymes
c. repression of synthesis of catabolic enzymes
d. promotion of cell replication

a 263 22. The primary stimulus for glucagon secretion is

a. alanine.
b. glucose.
c. cortisol.
d. epinephrine.

c 263 23. After three days of starvation, what proportion of the energy needs of the
brain are supplied by ketones?
a. one-eighth
b. one-fourth
c. one-third
d. one-half

a 263 24. What is the preferred source of energy used by muscles to spare protein
during prolonged starvation?
a. ketones
b. glucose
c. fatty acids
d. amino acids

b 266 25. What is the term used to describe the intensity of the workload that places
the highest possible demand on working muscles?
a. respiratory quotient
b. VO2 max
c. ATP-CP
d. lactic acid system

68
d 267 26. During exercise, which of the following contributes only minimally to the
amount of ATP used by working muscles?
a. muscle glycogen
b. blood glucose
c. plasma fatty acids
d. oxidation of amino acids

a 268-269 27. What is the limitation that shifts the predominant use of fat for energy at
low-intensity exercise to the predominant use of carbohydrate oxidation at
high-intensity exercise?
a. rate of production of ATP
b. rate of mobilization of fatty acids from the adipocytes
c. rate of transamination of amino acids
d. rate of muscle glycogen breakdown

b 269 28. Training enhances utilization of fat as the primary energy substrate during
submaximal exercise due to
a. enhanced activity of glycolytic enzymes.
b. enhanced activity of mitochondrial oxidative enzymes.
c. enhanced glucose uptake.
d. decreased carnitine acyltransferase.

b 277 29. Which of the following conditions is attributed to a primary failure of the β-
cells of the pancreas to secrete insulin?
a. hyperinsulinism
b. hyperglycemia
c. hyperlipidemia
d. hyperphosphatemia

b 265-266 30. If someone was consuming a high-protein diet to meet energy needs, they
would be using _____ oxygen relative to the amount of CO2 they were
generating (Hint: think RQ).
a. less
b. more
c. equal
d. not enough information

Enrichment (these questions are related to but go beyond the text chapter)

Key Page(s)
d 258-260 31. In the fasted state, you would find:
a. dephosphorylated glycogen synthase.
b. an increase in the amount of hexokinase.
c. allosteric inhibition of phosphofructokinase by NAD.
d. induction of pyruvate carboxylase.
e. more than one of the above

69
True/False

Indicate whether each of the following statements is true or false. If the statement is false, explain why it
is false.

Key Page(s)
F 261 1. Gluconeogenesis occurs exclusively in the liver.
Explanation: Also in the kidney.
T 261 2. The three major systems involved in metabolic integration are the (1)
nervous, (2) endocrine, and (3) vascular systems.
F 261 3. A fasted state is characterized by protein synthesis.
Explanation: A fed state is characterized by protein synthesis.
T 252-253 4. Acetyl-CoA is a branch point for a number of metabolic processes, including
carbohydrate, lipid, and cholesterol.
F 266 5. Based on the respiratory quotient calculation, the breakdown of any
macronutrient for energy involves the use of carbon dioxide, and the
generation of oxygen and water.
Explanation: Uses oxygen, generates CO2 and metabolic water.
T 262-263 6. Glucagon and insulin control metabolic pathways that reflect a fasting and
fed state, respectively; the primary signal to initiate this hormonal control is
the glucose concentration in the bloodstream.
F 258, 260 7. During very prolonged starvation nearing death, the body shifts from using
protein for energy to using fat stores.
Explanation: After fat stores are depleted, the only energy source left is protein.
F 254, 257-258 8. Muscle supplies its own glucose for energy needs by first using glycogen
stores, and then converting amino acids into glucose.
Explanation: Cannot convert AAs to glucose – it releases AAs into the bloodstream
and the liver converts them to glucose, and sends it back to the muscle.
T 267-269 9. The Cori cycle would be active under anaerobic conditions, such as excessive
muscle exertion.

Enrichment (these questions are related to but go beyond the text chapter)

F 257-259 10. All tissues prefer glucose first, and then fatty acids, to meet their energy
needs.
Explanation: Brain and red blood cells prefer glucose; muscle uses both; the liver
prefers fatty acids.
F 258 11. During fasting conditions, glucagon induces phosphoenolpyruvate
carboxykinase (PEPCK) and glucose 6-phosphatase as a means to increase
gluconeogenesis in muscles.
Explanation: Occurs in liver, not muscle.

70
F 262, 276 12. The abundance of GLUT 4 is increased by induction in response to a high-
CHO meal.
Explanation: Translocation, not induction.

Matching

Hormones: Match the regulatory hormones with their primary functions in integrative metabolism.

Key Page(s) Hormones Primary Functions

b 262 1. GI hormones a. stimulates liver glycogenolysis and
d 262 2. insulin gluconeogenesis
e 263 3. epinephrine b. amplify the response of pancreatic beta-cells to
a 263 4. glucagon glucose
c 263 5. glucocorticoids c. stimulate gluconeogenesis by acting on the muscle
to enhance release of alanine
d. stimulates removal of glucose from the blood and
anabolic reactions
e. primarily stimulates muscle glycogenolysis

Short Answer (with suggested answer key)

Page(s)
265-266 1. What is RQ and how is it important? Your answer should define RQ and clearly state
how it is used and what it tells someone. Be sure to provide examples of RQ values
and how they are interpreted.

Key: RQ = respiratory quotient = volume of CO2 expired / volume of O2 used. It tells you how
much oxygen is consumed to completely oxidize a macronutrient (to CO 2) in the process of
obtaining energy. For example, lipids are in a more reduced state, and thus they need more
oxygen to oxidize the carbon to CO2 (but that is also why we get more energy from them). In
contrast, CHOs are already partially oxidized (all those OH groups), and thus less oxygen is
needed.

For CHO: RQ = 1.0

For lipid: = 0.7
For protein: = 0.8

71
266-270 2. We discussed three (3) systems that play a role in supplying energy during
movement/ exercise. Name these three systems, describe briefly how they supply
energy, and discuss the temporal relationship between them during prolonged
exercise. Any figures should be completely labeled and explained.

Key:
• Creatine phosphate (CP)-ATP system – CP is a “storage” form of phosphate (in
muscle) that can be used to generate ATP from ADP – quick energy for short bursts of
exercise.
• Lactic acid system – this is basically anaerobic glycolysis. We generate energy (ATP)
from glucose or glycogen, but once we get to pyruvate, it goes to lactate rather than
acetylCoA. [Students may imply that we get energy from lactate (which we can, if we use
gluconeogenesis), but that is not what this is. It is simply glycolysis.] This system
functions for a little longer than CP-ATP, but at the same time. The lactate system
doesn’t merely take over when the CP-ATP is exhausted. Both operate simultaneously;
it’s just that the contribution of one system is favored over the other as a function of time.
• Aerobic system – same as above, but now, in the presence of oxygen, we can take the
pyruvate generated from glucose and/or glycogen, and allow it to enter the TCA cycle to
generate even more energy, rather than going to lactate. Also, this is on-going along with
other systems, but it becomes the major contributor later on. This system generates the
most energy, and also allows other sources of energy (e.g., fatty acids) to contribute more.

[If students re-draw the graph here to show the relationship between these systems and their
contribution to meeting energy needs as a function of time, that is fine as long as it was
appropriately drawn, labeled, and explained.]

256-263 3. “The Big Picture” – Metabolic Integration. Metabolic pathways are regulated to
maintain homeostasis in the face of changing environmental conditions, such as
nutrient supply. Describe how this is accomplished during the fed-fasted cycle; i.e.,
the progression from a fed state, to a postabsorptive/ fasting state, to starvation, to
prolonged starvation. Your answer should include specific processes/ metabolic
pathways that are favored under each condition – make sure to cover pathways that
are important to all three macronutrients (CHOs, lipids, protein). Also indicate the
signal(s) involved in modulating these pathways. An example is provided in the
table.

Fed Postabsorptive/ Starvation Prolonged

Fasting Starvation
↑ glycolysis

72
 Key:
Fed Postabsorptive/ Starvation Prolonged Starvation
Fasting
↑ glycolysis same signals
Signal: same signals
Signal: glucagon (in response Increases:
insulin (in response to low blood glucose) Increases: Gluconeogenesis
to high blood glucose) and epinephrine and Lipolysis (glycogen
cortisol stores are gone & Protein degradation
Increases in: need to spare body (lipid stores are
Glycolysis Increases in: protein) depleted; all that is
Glycogenolysis left is body protein,
Glucose uptake (via Ketogenesis including visceral
GLUT 4 Gluconeogenesis sources)
translocation)
Urea synthesis
Glycogenesis
Protein degradation
Lipogenesis
Lipolysis (a little)
Protein synthesis

261-263 4. Pick two (2) of the examples from question #3 and indicate specifically how the
signal you indicated in your answer is altering the pathway listed. For each example,
write a one sentence answer that includes the condition, the signals, the mechanism,
the protein/ enzyme, the tissue, and the result (all underlined in the example below).

Key:
Example: Under fed conditions, high blood glucose leads to insulin secretion by the pancreas,
which in turn induces expression of the key glycolytic enzyme phosphofructokinase in all
cells, thereby increasing glycolysis.

Many potential examples – the main thing is that students follow the format in the example,
and don’t leave out what cells or tissues the example was occurring in, or fail to mention the
name of the enzyme.

73
Essay

Page(s)
272-274 1. Select two examples of ergogenic supplements and explain what they are and what
they are supposed to do to enhance athletic performance.
269 2. Explain how endurance training increases an athlete’s ability to perform more
aerobically.
256-261 3. Describe the feed-fast cycle.
263 4. Explain the role of the catecholamines in muscle glycogenolysis.

Perspective – Diabetes: Metabolism Out of Control

Multiple-Choice

Key Page(s)
c 277 1. Uncontrolled hyperglycemia leads to dehydration because ketonuria and
glucosuria associated with acidosis cause water loss and an excessive loss of
what cation?
a. Cl
b. Ca
c. Na
d. Mg

b 276 2. In type 2 diabetes, insulin resistance in muscle and adipose tissue is most
likely associated with which of the following abnormalities?
a. impaired binding of insulin to tissue receptors
b. failure of GLUT4 transporters to translocate to the cell membrane
c. abnormal GLUT4 transporters
d. insufficient secretion of insulin from the pancreas

Essay

Page(s)
276-277 1. Discuss the interaction of factors associated with non-insulin-dependent diabetes
mellitus.

74
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Hugo was a great poet as well as a great romancer, George
Meredith, as we have endeavored to show, is a singer of peculiar
force as well as a master novelist, and among the later literary
figures of especial power we have Kipling, whose prose and poetry
about balance the scale of worth; but the exceptions are few, and the
logic of letters tends to show oneness of aim in the case of genius.
Thomas Hardy undoubtedly belongs to the ranks of great
novelists; his series of romances has been laid on the firm basis of
beauty and knowledge; he has hallowed a part of England peculiarly
rich in unique personality and natural charm; it belongs to him and
the heirship of his memory as validly as though it had been granted
him by the Crown. So well has he filled the office of fictionist that
there seems no need of an attempt on his part to enforce his fame
by appearing as a poet. The publication of “Wessex Poems” (New
York: Harper & Bros.) is indeed no positive declaration of such
ambition; it is perhaps put forth hesitatingly rather in response to
public demand than because of a conviction of its intrinsic merit. It
represents the fruit of odd moments punctuating a long literary
career. The character of the volume is what one might have
anticipated, although had it been of a wholly different sort it could
scarcely have created surprise. There are two Hardys—the man on
whose heart weighs the melancholy facts of human existence and
the happier artist in close and peaceful communion with the sweet
infinite spirit of nature. It is the former Hardy that figures in the
volume singularly unsoftened by any intimation of the other phase of
the writer.
The character of Hardy himself as existing behind the art-self is
one that inspires a peculiar interest. One would know it not simply to
gratify a curiosity that, indeed, is too much indulged of late in lines of
gross private revelation, but to weigh the justice of the charge of
wilful pessimism so generally made against him. The gloomy brow of
Hardy’s art seems far from being of that impersonal sort which
makes much of the modern melancholy of literature inexcusable as a
mere degenerate seeking.
One feels inclined to say that Hardy’s prose is poetry and his
poetry prose. The present volume reveals little of the genuine lyric
gift, but the singing while labored is not without force and individual
color. Some of the ballads possess considerable spirit, and where
character is outlined it cuts the consciousness with Hardy’s well-
known skill of vivid portraiture; as for instance, “The Dance at the
Phœnix,” describing the passion of an aged dame for the pleasures
of her youth how she steals forth from the bed of her good man to
foot it gaily at the inn and how on her return at morn she dies from
over-exertion; “Her Death and After” where the lover of a dead
woman sacrifices her fair fame for the sake of rescuing her child
from the cruelties of a stepmother; and “The Burghers,” a tale of
guilty lovers, and a husband’s unique conduct. In these, as in other
poems of the kind, one can not but feel that Hardy would have put
the matter so much better in prose; which, indeed, is what in some
cases he has done. Some of the contemplative verse has a
quaintness of expression which suggests the sonnets of
Shakespeare; the lines are frequently lame, but every now and then
there is a really virile phrase. In true old English style are some of
the lyrics, of which “The Stranger’s Song” is perhaps the most
successful:

O! my trade, it is the rarest one,

Simple shepherds all—
My trade is a sight to see;
For my customers I tie, and take ’em up on high,
And waft ’em to a far countree!

My tools are but common ones,

Simple shepherds all—
My tools are no sight to see;
A little hempen string, and a post whereon to swing,
Are implements enough for me!

To-morrow is my working day,

Simple shepherds all—
For the farmer’s sheep is slain, and the lad who did it
ta’en,
And on his soul may God ha’ mercy!
 That love proves itself at best a pathetic compromise is plainly
gleaned from the pages of the poems. There is sounded no joyous
though momentary content in heart-possession: nothing there we
find but a record of youth, its dreams darkened and blighted by the
false promises of time; bitter retrospect of age beholding a heavy
philosophy scrawling on all fair things of life and faith the epitaph of
fragility and decay. The earth-bound character of the poet’s thought
is well illustrated in the following lines:

If but some vengeful god would call to me

From up the sky, and laugh: “Thou suffering thing,
Know that thy sorrow is my ecstacy,
That thy love’s loss is my hate’s profiting!”

Then would I bear, and clench myself and die,

Steeled by the sense of ire unmerited;
Half-eased, too, that a Powerfuller than I
Had willed and meted me the tears I shed.

But not so. How arrives it joy lies slain,

And why unblooms the best hope ever sown?
—Crass casualty obstructs the sun and rain,
And dicing Time for gladness casts a moan....
These purblind Doomsters had as readily strown
Blisses about my pilgrimage as pain.

And again, in “Nature’s Questionings,” we find him conceiving the

“field, flock and lonely tree” as asking:

“Has some Vast Imbecility,

Mighty to build and blend,
But impotent to tend,
Framed us in jest, and left us now to hazardry?

“Or come we of an Automaton

Unconscious of our pains....
Or are we live remains
Of Godhead dying downwards, brain and eye now gone?”
 “Or is it that some high Plan Betides,
As yet not understood,
Of Evil stormed by Good;
We the Forlorn Hope over which Achievement strides?”

And having no conclusion for his own heart—

“No answerer I....

Meanwhile, the winds, and rains,
And Earth’s old glooms and pains,
Are still the same, and gladdest Life Death
Neighbors nigh.”

One instinctively compares this with Tennyson’s spirit of noble

meditation in “In Memoriam;” and it must be confessed that Hardy
suffers by comparison as lacking the essential attributes of Anglo-
Saxon courageousness. One regrets the publication of “Wessex
Poems,” for it reveals the character of a great writer in an
unfortunate and belittling light; to reconstruct one’s impression of his
power and personality one feels the need of reopening one of his
most delightful books, such as “The Woodlanders,” to breathe its
good smells of Mother Earth, and under its domination as an
exquisite pastoral production find there, and not in “Wessex Poems,”
Thomas Hardy, the poet.
—Edward A. Uffington Valentine.
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