The pyruvate dehydrogenase complex (PDC) serves as a key met…

The pyruvate dehydrogenase complex (PDC) serves as a key metabolic junction, linking glycolysis to the tricarboxylic acid (TCA) cycle by converting pyruvate into acetyl-CoA. The multienzyme complex, located in the mitochondrial matrix, consists of three core enzymes: E1 (pyruvate dehydrogenase), E2 (dihydrolipoyl transacetylase), and E3 (dihydrolipoamide dehydrogenase). Proper functioning of PDC requires five cofactors: thiamine pyrophosphate (TPP), lipoic acid, Coenzyme A (CoA), FAD, and NAD⁺. PDC activity is tightly regulated. It is activated by low-energy signals such as increased ADP, NAD⁺, and CoA, and inhibited by its products, NADH and acetyl-CoA. In fasting conditions, increased fatty acid oxidation generates acetyl-CoA and NADH, inhibiting PDC and shifting pyruvate toward gluconeogenesis. The enzyme complex is also subject to covalent regulation: pyruvate dehydrogenase kinase (PDK) phosphorylates and inactivates PDC, while pyruvate dehydrogenase phosphatase (PDP) reactivates it via dephosphorylation. Dysregulation of PDC contributes to metabolic inflexibility and various pathologies. Dichloroacetate (DCA), an investigational drug, inhibits PDK, thereby keeping PDC active, which is of therapeutic interest in lactic acidosis and certain cancers. Arsenite, a toxic metalloid, irreversibly binds to lipoic acid, inactivating E2 and arresting oxidative metabolism. Thiamine deficiency, as seen in Wernicke-Korsakoff syndrome or alcoholism, impairs E1 function, disrupting oxidative glucose metabolism and increasing lactate production. In a patient with chronic alcoholism presenting with confusion, ataxia, and ophthalmoplegia, which of the following mechanisms most likely contributes to elevated lactate levels?

During a health counseling session using the Micro-skills Co…

During a health counseling session using the Micro-skills Counseling Approach, the following exchange takes place:          Client: I can follow this diet when I’m at home, but with the kind of job I have that puts  me on the road five or six days a month, I have to eat in restaurants, and then I  really blow my diet.             Helper: You’re saying that you have success on the diet when you can eat at home, but you’re  not very successful when you eat away from home.  Is that about right?   The helper’s response is an example of which of the following Responding Skills?

During a health counseling session using the micro-skills ap…

During a health counseling session using the micro-skills approach, the following exchange takes place between the client and helper:          Client: I don’t know. Trying to study for the final exam in one night seems so useless. There is just so much information to know.          Helper: You feel very discouraged about your prospects for passing the exam.   The helper’s response is an example of which of the following Responding Skills?