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CASE 2 - Baby with episodes of hypoglycemia

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Since birth, a baby has had persistant episodes of hypoglycemia.

The baby is brought to a referral hospital to assess the cause of the current hypoglycemia. In one test, the infant is given a high-carbohydrate meal. Two hours later, an injection of glucagon is given, and the infant's blood glucose rises from 75 to 105 mg/dL. Ten hours later after the meal, the infant's blood glucose level is 60 mg/dL. Another injection is given, and the blood glucose remains at 60 mg/dL. The infant is immediately fed. From the information given, which of the following defects could be the cause of the infant's problem?

A) A defect in glucagon receptor
B) A deficiency in glucose-6-phosphatase
C) A deficiency in the liver glycogen phosphorylase
D) An inability to secrete adequate amount of glucagon
E) A problem in gluconeogenesis

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