Glycogen Synthesis & Breakdown | USMLE Step 1
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A 4-year-old girl has recurrent morning shakiness that improves after breakfast. Her growth is normal, and her liver is not enlarged. During evaluation, fasting plasma glucose is 44 mg/dL with β-hydroxybutyrate 3.6 mmol/L and lactate 1.2 mmol/L. Ninety minutes after a carbohydrate-containing meal, glucose is 196 mg/dL and lactate is 4.7 mmol/L.