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    Subjects/Biochemistry/Enzyme Kinetics — Michaelis-Menten
    Enzyme Kinetics — Michaelis-Menten
    hard
    flask-conical Biochemistry

    A 28-year-old woman with a family history of hereditary fructose intolerance presents with severe hypoglycemia, hepatomegaly, and lactic acidosis after consuming a fruit-based meal. Genetic testing reveals a deficiency in aldolase B. In vitro studies of her hepatic tissue show that the enzyme fructokinase (which catalyzes the first step of fructose metabolism) exhibits normal Vmax but a markedly reduced Km for fructose. Blood fructose levels are significantly elevated (12 mM; normal <1 mM). Based on Michaelis-Menten kinetics, which statement best explains why this patient develops severe hypoglycemia despite high fructose availability?

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