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Byeoinshallag Flashcards

1
Q

Atherosclerosis is promoted by

A

LDL:HDL ratio higher than 3:1

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2
Q

Mechanism of LDL

A

Hyperglycemia increase LDL, which gets taken up by macrophage, causes macrophage to become foam cell, which causes narrowing

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3
Q

Normal total plasma cholesterol

A

200, high risk is above 240

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4
Q

Normal HDL cholesterol (male and female)

A

Male: 40-50
Female: 50-60

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5
Q

LDL cholesterol normal

A

less than 130

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6
Q

CK-MB important for diagnoses of

A

reinfarction or extension of infarction

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7
Q

______is an excellent indicator of early acute myocardial infarction

A

Isoform ratio of 1.5 or greater

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8
Q

Troponin is highly specific for _______.Its disadvantage is

A

For myocardial injury, more specific than CK-MB

Has continued elevation, can’t diagnose reinfarction

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9
Q

A __________can rule out myocardial infarction

A

negative myoglobin

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10
Q

5 risk factors of myocardial infarction

A

Obesity, sedentary lifestyle , diabetes, unhealthy food, family history

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11
Q

Role of insulin in regulation of blood glucose

A

Increase uptake of glucose
Increase utilization of glucose
decrease glycogenolysis and gluconeogenesis

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12
Q

Ketone bodies

A

Acetoacetic acid - beta-hydroxybutyric acid - acetone

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13
Q

Causes of ketosis

A

decrease Insulin/anti-insulin ratio -> rate of ketogenesis exceeds rate of ketolysis as in:
Starvation - severe exercise

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14
Q

Ketogenic diet

A

Fats, FA, ketogenic aa and anti-insulins

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15
Q

Antiketogenic diet

A

carbohydrates, glucogenic amino acid, glycerol and insulin

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16
Q

Importance of ketogenesis

A
  1. Of great importance during starvation when fat represents the main source of
    energy
  2. KB can be oxidized easier than FA during fasting
  3. Brain adapts for FA oxidation 5 to 6 days from starvation
  4. So ketogenesis represents a preparatory step performed by the liver for
    complete oxidation of FA
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17
Q

Importance of C peptide

A

Measurement of endogenous insulin secretion in diabetics

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18
Q

2 Enzymes for insulin catabolism

A

GSH insulin transhydrogenase - insulin protease

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19
Q

2 Complications of DM

A

atherosclerosis - retinopathy

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20
Q

Metabolic diseases that can cause cataract

A

Diabetes mellitus

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21
Q

2 Tests for diagnosis of DM

A

Fasting and 2h post prandial blood glucose - OGTT

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22
Q

2 Tests for follow up (prognosis) of DM

A

Glycosylated Hb- Plasma fructosamine

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23
Q

2 Pathways activated and another 2 inhibited by insulin

A

Glycolysis, glycogenesis - Gluconeogenesis, glycogenolysis

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24
Q

Causes of insulin resistance

A

Hereditary: Insulin receptor mutation
Acquired: diet, physical activity

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25
Q

The most affected tissues by insulin resistance

A

Liver - muscle and adipose tissues

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26
Q

Causes of flat curve in OGTT

A

Malabsorption - Delayed evacuation - Hypopituitarism

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27
Q

Causes of lagging curve

A

Gastrectomy - Hyperthyroidism

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28
Q

Types of diabetic coma

A

Hyperglycemic: Diabetic ketoacidosis and Hyperosmolar coma

Hypoglycemic coma

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29
Q

Drugs used in treatment of diabetes

A

Sulfonylurea - Metformin

30
Q

Normal blood glucose

A

Fasting: Less than 100 - 2h PP: less than 140

31
Q

Diabetic blood glucose

A

Fasting: More than 126 - 2h PP :more than 200

32
Q

Markers for diagnosis of myocardial infarction

A

CKmb-Troponins -AST - Lactate dehydrogenase - Myoglobin

33
Q

Types of unconjugated hyperbilirubinemia (Jaundice)

A
  1. Neonatal physiological jaundice
  2. Hemolytic jaundice
  3. Congenital diseases (Crigler Najjar syndrome and Gilbert disease)
34
Q

Causes of neonatal physiological jaundice

A

Increased hemolysis - Immature liver

35
Q

Treatment of neonatal physiological jaundice

A

Phototherapy

36
Q

Causes of hemolytic jaundice

A 
Abnormal Hb
Congenital spherocytosis
Erythroblastosis fetalis 
Favism
Malaria
Incompatible blood transfusion
37
Q

Types of conjugated hyperbilirubinemia

A
  1. Obstructive jaundice
  2. Hepatocellular jaundice
  3. Congenital diseases (Dubin Johnson and Rotor syndromes)
38
Q

Causes of obstructive jaundice

A

Stone in common bile duct (CBD) - Cancer head of pancreas

39
Q

Causes of hepatocellular jaundice

A

Viral hepatitis - Liver toxins

40
Q

Type of jaundice characterized by elevation of both direct and indirect bilirubin

A

Hepatocellular jaundice

41
Q

Mechanism of action of 2 anti-diabetic drugs:

A

Sulfonylureas: increase insulin secretion as it blocks ATP sensitive K channels.

Metformin: improve insulin sensitivity.

Acarbose: the intestinal absorption of carbohydrates.

42
Q

GLP-1 Receptor Agonists does

A

increase insulin and decrease glucagon secretion

43
Q

Components of spectrophotometer: 5

A 
■     Light source (tungsten lamp) 
■    Wavelength selector
■    Cuvette
■    Photodetector
■ Read out device
44
Q

Examples of wave length selector (monochrmator)

A

Filter - Prism - diffraction grating

45
Q

The uptake of glucose by adipose tissue and skeletal muscles after carbohydrate
feeding is enhanced by insulin through

46
Q

Urine is normal and stool is dark colored in

A

hemolytic jaundice

47
Q

Urine is dark colored and stool is clay colored in

A

Hepatocellular jaundice and obstructive jaundice

48
Q

Source of blood glucose during early fasting is

A

Liver glycogenolysis

49
Q

The main action of GIT in regulation of blood glucose is

A

Prevents sudden increase in blood glucose

50
Q

Post-prandial hypoglycemia occurs in

A

Gastrectomy

51
Q

Pheochromocytoma causes

A

Hyperglycemic glucosuria

52
Q

The commonest cause of hyperglycemic glucosuria

A

Diabetes mellitus

53
Q

Kidneys decrease hyperglycemia by

A

Excretion in urine

54
Q

Ketone bodies are by products of metabolism of

55
Q

Ketosis is largely increased during

56
Q

Insulin is a protein hormone formed of Amino acids:

57
Q

Circulating C peptide contains………..amino acids::

58
Q

Secretion of glucose occurs due to increased intracellular

59
Q

Main amino acid that increases insulin secretion i

60
Q

Sulfonylurea is an anti-diabetic drug that increases insulin secretion through:

A

Blocking ATP sensitive K +channels

61
Q

Vitamin D increases insulin secretion through:

A

Increases the intracellular Ca+2

62
Q

Type I diabetes mellitus is mainly due to:

A

a. Autoimmune destruction of P cells

b. Viral destruction of P cells

63
Q

Diabetic ketoacidosis is more common in type I diabetes mellitus due to:

A

Absence of insulin

64
Q

Hyperosmolar non-ketotic coma is common in:

A

Elderly patient with type II DM

65
Q

Metformin is used as anti-diabetic drug as it:

A

Increases insulin sensitivity

66
Q

Which of the following hormones increases intestinal absorption of glucose

67
Q

In obstructive jaundice, which of the following enzymes is expected to be elevated

A

Alkaline phosphatase (ALP)

68
Q

Unconjugated hyperbilirubinemia is caused by:

A

Hemolytic anemia.

69
Q

Jaundice occurs when plasma bilirubin exceeds………….mg/dL

70
Q

Hyperglycemic glucosuria causes

A

Diabetes millletus
Adrenaline
Gastrectomy

71
Q

Normoglycemic glucosuria

A

Diabetes innocens
renal failure
Pregnancy

Practical (13 decks)

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