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Clinical Chemistry 1 (Laboratory) > Blood Glucose Estimation Test (M) > Flashcards

Blood Glucose Estimation Test (M) Flashcards

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1
Q

True or False.

Glucose test is not routinely performed in the lab

A

False, because it is routinely performed in the lab

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2
Q

What clinical disorder can be diagnosed via glucose test?

A

Diabetes mellitus

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3
Q

What is the reference range for glucose test?

A

70 - 100 mg/dL

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4
Q

What is the unit for glucose test?

A

mg/dL

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5
Q

What are the sxs that can be used for glucose test?

A

1) Fasting venous plasma
2) Random Blood Sugar (RBS)
3) CSF
4) Synovial fluid
5) Serous fluid
6) Urine

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6
Q

What is the required time of fasting for fasting venous plasma sx?

A

8 - 10 hrs

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7
Q

What happens if the sx is unrefrigerated (there is a delay in testing)?

A

Decreases 7 mg/dL per hr

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8
Q

What happens if the sx is refrigerated (test can’t be done promptly)?

A

Decreases 2 mg/dL per hr

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9
Q

What is the result if whole blood is used as sx for glucose testing?

A

10 - 15% lower

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10
Q

The results if whole blood is used for glucose testing is lower than what?

A

Than serum and plasma

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11
Q

What is the percentage of the plasma concentrations of CSF?

A

60 - 70%

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12
Q

How to prevent the loss of glucose (in glucose test)?

A

Plasma glucose should be separated within an hour

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13
Q

What etubes should be used if glucose testing will be delayed?

A

Red, yellow, and gray tops

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14
Q

True or False.

Venous blood glucose is higher than capillary blood (RBS)

A

False, because venous blood glucose is lower than capillary blood (RBS)

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15
Q

How high or how low is venous blood glucose compared to capillary blood (RBS)?

A

It is lower than 7 mg/dL compared to capillary blood (RBS)

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16
Q

What tube is preferred to be used for glucose test?

A

Gray top

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17
Q

Why is gray top preferred to be used for glucose test?

A

Because it contains potassium oxalate / sodium fluoride

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18
Q

What is the action of enolase?

A

It inhibits glycolytic enzyme

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19
Q

2 mg of NaF per mL of blood prevents what?

A

It prevents glycolysis up to 48 hrs

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20
Q

What is the action of fluoride (sodium fluoride)?

A

It binds w/ magnesium w/c causes inhibition of enzyme enolase

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21
Q

What are the 2 types of methods of glucose estimation test?

A

1) Chemical method

2) Enzymatic method

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22
Q

What are the different methods under chemical method of glucose estimation test?

A

1) Oxidation - reduction
2) Hagedorn Jensen
3) Condensation method

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23
Q

What are the different methods under oxidation - reduction of glucose estimation test?

A

1) Folin-Wu
2) Nelson-Somogyi
3) Neocuprione (Neocupreine) method
4) Benedict’s method

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24
Q

What is the principle of oxidation - reduction?

A

The ability of glucose to directly reduce cupric ions to monovalent cuprous ions in the presence of heat

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25
Q

What are the chemical formulas for oxidation - reduction?

A

Heat: CuSo4 (cupric sulfide) + reducing substance -> Alkali: Cu2O (cuprous oxide) + oxidized substance -> color (blue / green to orange / red)

*heat and alkali rxns

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26
Q

What are the principles of Folin-Wu?

A

1) It uses tungstic acid to remove protein from serum

2) Measures sugar (FBS)

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27
Q

What are the principles of Nelson-Somogyi?

A

1) It uses zinc hydroxide

2) It measures true glucose (FBG)

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28
Q

What is the color of positive result of Neocuprione’s (Neocupreine’s) method?

A

(+) : yellow

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29
Q

What sx (and its volume) is used for Benedict’s test?

A

1 mL urine

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30
Q

What is the component of Benedict’s rgnt?

A

Copper sulfate

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31
Q

What is the chemical formula (or equation) of Folin-Wu?

A

Cu^+ + Phosphomolybdate acid -> phosphomolybdenum (blue)

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32
Q

What is the chemical formula (or equation) of Nelson-Somogyi?

A

Cu^+ + Arsenomolybdate acid -> arsenomolybdenum (blue)

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33
Q

What is the chemical formula (or equation) of Neocupreine method?

A

Cu^+ + neocuprine -> yellow to yellow-orange complex

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34
Q

What is the chemical formula (or equation) of Benedict’s method?

A

Copper sulfate (blue) + glucose + heat -> green -> yellow -> orange -> brick red

*color reactions depends on the intensity of the rxn

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35
Q

What is the principle of Hagedorn Jensen?

A

Potassium ferricyanide is reduced to potassium ferrocyanide when heated w/ alkaline solution by a reducing sugar / substance

36
Q

What is the chemical formula (or equation) of Hagedorn Jensen?

A

Potassium ferricyanide -> via the action of reducing substance -> potassium ferrocyanide

37
Q

What is the method under condensation method?

A

Ortho-toluidine, Dubowski

38
Q

What is the principle of Ortho-toluidine, Dubowski?

A

Glucose + O-toluidine in glacial acetic acid = N-glucosylamine (Blue-green color)

39
Q

What is the chemical formula (or equation) of Ortho-toluidine, Dubowski?

A

Glucose + O-toluidine -> via the action of HAc along w/ boiling (100 DC) -> Bluish-green complex (Glycosylamine)

40
Q

What is the meaning of GOD?

A

Glucose Oxidase

41
Q

What is the action of glucose oxidase?

A

It is an enzyme that catalyzes the oxidation of glucose to gluconic acid and hydrogen peroxide

42
Q

What are the characteristics of glucose oxidase?

A

1) It is very specific

2) It reacts only w/ beta-glucose

43
Q

What is the principle (or chemical formula / equation) of glucose oxidase?

A

Glucose + O2 -> via the action of GOD -> Gluconic acid + H2O2

H2O2 + 4-NH3-Antipyrine -> via the action of POD -> Quinonimine + H2O

44
Q

What are the different enzymatic methods?

A

1) Glucose oxidase

2) Hexokinase

45
Q

What is the reference method (enzymatic method)?

A

Hexokinase

46
Q

What is the principle of hexokinase?

A

Glucose-6-phosphate formed from glucose and ATP by hexokinase (HK) is oxidized by NAD in a rxn catalyzed by glucose-6-phosphate dehydrogenase (G6PD) to give NADPH, w/c is quantitated spectrophotometrically at 340 nm

47
Q

Where does G6P came from?

A

From glucose and ATP by HK

48
Q

What is quantitated spectrophotometrically?

A

NADPH

49
Q

NADPH is quantitated spectrophotometrically at how many nm?

A

340 nm

50
Q

What is the principle (chemical formula or equation) of hexokinase?

A

glucose -> via the action of HK ; ATP becomes ADP -> G6P -> via the action of HK ; NAD becomes NADH -> 6-phosphogluconate

51
Q

Is NADH same w/ NADPH?

A

Yes

52
Q

Answer the ff questions:

Given test: Hemoglobin A1C (%)

What are the diagnosis (interpretations) for the ff results (values):

1) < or equal to 5.6
2) 5.7 - 6.4
3) > or equal to 6.5

A

1) Normal
2) High risk / prediabetes
3) Diabetes

53
Q

What is the unit for HBA1C test?

A

%

54
Q

What should be done if the result for HBA1C test is > or equal to 6.5?

A

It is confirmed by repeat testing in absence of unequivocal hyperglycemia

55
Q

When is FPG measured?

A

After 8 - hr fast

56
Q

Answer the ff questions:

Given test: FPG (mg/dL)

What are the diagnosis (interpretations) for the ff results (values):

1) < or equal to 99
2) 100 - 125
3) > or equal to 126

A

1) Normal
2) Impaired fasting glucose
3) Diabetes

57
Q

What should be done if the result for FPG is > or equal to 126?

A

It should be confirmed by repeat testing in absence of unequivocal hyperglycemia

58
Q

What is the unit for FPG?

A

mg/dL

59
Q

Answer the ff questions:

Given test: PPG (mg/dL)

What are the diagnosis (interpretations) for the ff results (values):

1) < or equal to 139
2) 140 - 199
3) > or equal to 200

A

1) Normal
2) Impaired glucose tolerance
3) Diabetes

60
Q

What should be done if the result for PPG is > or equal to 200?

A

It should be confirmed by repeat testing in absence of unequivocal hyperglycemia

61
Q

What is the unit for PPG?

A

mg/dL

62
Q

When and how is PPG measured?

A

It is measured w/ an OGTT performed 2 hrs after 75 g oral glucose load

63
Q

Answer the ff questions:

Given test: Random plasma glucose (mg/dL)

What are the diagnosis (interpretations) for the ff results (values):
1) < or equal to 200

A

1) Diabetes

64
Q

What is the unit of random plasma glucose?

A

mg/dL

65
Q

What are associated w/ random plasma glucose?

A

1) Polyurea
2) Polydipsia
3) Polyphagia

66
Q

What are the 3 tubes that are used (in reality) for glucose oxidase?

A

1) GLU + Blank
2) GLU + Standard
3) GLU + Unknown

67
Q

What should be putted for the label of 3 tubes (used in glucose oxidase)?

A

1) Blank
2) Standard
3) Unknown

*can be shorten or short distinct labels can be used

68
Q

What is the process (or steps) for glucose oxidase?

A

1) Label test tubes
2) Transfer 1500 uL GLUCOSE working rgnt to each tube and place in a 37 DC H2O bath
3) Add 1 uL sx to each tubes
4) Gently mix the tubes
5) Incubate for 10 mins
6) Spectrophotometer: read and record A using 500 nm
7) Semi-automated chemistry analyzer: feed on the machine

69
Q

How many uL of glucose working rgnt is used?

A

1500 uL

70
Q

What is the temp of H2O bath?

A

37 DC

71
Q

What is the volume of the sx added to each tubes?

A

1 uL

72
Q

What is the time duration of incubation?

A

10 mins

73
Q

Using the spectrophotometer, at what nm should the A be read and recorded?

A

500 nm

74
Q

What is the reference range (of glucose oxidase?)?

A

70 - 100 mg/dL

75
Q

How many hours of fasting is required for fasting blood sugar?

A

8 - 10 hrs fasting

76
Q

When is RBS collected?

A

Anytime regardless of the meal

77
Q

When is 2 hr Postprandial Blood Sugar collected?

A

2 hrs after eating

78
Q

What are the principles (working principle) of HBA1C test?

A

1) It is a blood test that provides your average lvls of blood glucose over the past 2 - 3 mos (lifespan of RBCs)
2) No fasting required

79
Q

What is the lifespan of RBCs?

A

2 - 3 mos

80
Q

What is the meaning of FGSP?

A

Fructosamine Glycated Serum Protein

81
Q

What is the principle (working principle) of OGTT?

A

It measures blood glucose after you fast for at least 8 hrs

82
Q

What is the meaning of OGTT?

A

Oral Glucose Tolerance Test

83
Q

What is the result (normal?) of OGTT for nonpregnant pts?

A

75 g

84
Q

What is the result (normal?) of OGTT for pregnant pts?

A

100 g

85
Q

What is the result (normal?) of OGTT for children (not exceeding 75 g)?

A

0.75 g/kg of body weight

Clinical Chemistry 1 (Laboratory) (13 decks)

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