In a patient with starvation for 72 hrs which of the following would be seen a) Increase glycogenolysisb) Increased ketosis due to breakdown of fatsc) Degradation of proteinsd) Increased gluconeogenesis

72 hours starvation is the junctional period between early stage (first stage) and intermediate stage (second stage) of fasting. At this time (72 hours of starvation) option b, c and d all are correct. But, the best answer here is d i.e. increased gluconeogenesis. Let us see each option one by one. Glycogen stores are depleted in 16-18 hours. Breakdown of fat (lipolysis) and ketogenesis occurs in the later part of the first stage. But fatty acids and ketone bodies are utilized mainly during the second and third stage. Further, lipolysis provides glycerol, which is used for gluconeogenesis. Protein degradation occurs, but it is to provide alanine for gluconeogenesis. Gluconeogenesis is maximum on the third day and it is responsible for maintenance of blood glucose in early as well as in late stages of starvation. Thus, the best answer here is gluconeogenesis. If we put except in the question, then the answer will become 'a' i.e., glycogenolysis, as glycogen stores are depleted in 16-18 hours.