Learn / FMK
Every FMK condition
299 diseases, deficiencies, toxicities and drug mechanisms harvested from every FMK deck — the ones sprinkled through a single bullet as much as the ones with their own slide. Pick what you're given and what you have to name, or let it cycle; distractors come from the same category so you have to discriminate (hypoketotic vs. ketotic hypoglycemia, which GSD, which urea-cycle enzyme…). Every answer shows the whole card with the lecture and slide.
Carbohydrate · FMK 03.4
Alcohol-induced (alcoholic) hypoglycemia Acquired / not inherited
Defect / target: Ethanol oxidation (ADH + ALDH) → ↑↑ NADH/NAD⁺ ratio
Mechanism: Excess NADH drives pyruvate → lactate (LDH) and OAA → malate (MDH), depleting both key gluconeogenic substrates so a fasting, glycogen-depleted binge drinker cannot make glucose.
↑ Accumulates: NADH, lactate, malate· ↓ Deficient: pyruvate, oxaloacetate, glucose
Presentation: confusion, seizures, diaphoresis, tachycardia after a binge in a fasting individual (e.g., 34-year-old, glucose 38 mg/dL after 24 h without food)
Labs: ↓ glucose, ↑ lactate, ↑ anion-gap metabolic acidosis
Treatment: IV dextrose + thiamine (thiamine BEFORE glucose in chronic alcoholics)
NADH is HIGH → everything PILES UP on the NADH side: Pyruvate→Lactate, OAA→Malate → GNG blocked → hypoglycemia
Learn the mechanism: Ethanol metabolism →Reasoning case →
FMK 03.4 Fructose, Galactose & Ethanol Metabolism · slide 17, 19, 24, 25; FMK 03.1 slide 12, 24; FMK 04.4 slide 26