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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
The most affected tissues by insulin resistance
Liver - muscle and adipose tissues
26
Causes of flat curve in OGTT
Malabsorption - Delayed evacuation - Hypopituitarism
27
Causes of lagging curve
Gastrectomy - Hyperthyroidism
28
Types of diabetic coma
Hyperglycemic: Diabetic ketoacidosis and Hyperosmolar coma Hypoglycemic coma
29
Drugs used in treatment of diabetes
Sulfonylurea - Metformin
30
Normal blood glucose
Fasting: Less than 100 - 2h PP: less than 140
31
Diabetic blood glucose
Fasting: More than 126 - 2h PP :more than 200
32
Markers for diagnosis of myocardial infarction
CKmb-Troponins -AST - Lactate dehydrogenase - Myoglobin
33
Types of unconjugated hyperbilirubinemia (Jaundice)
1. Neonatal physiological jaundice 2. Hemolytic jaundice 3. Congenital diseases (Crigler Najjar syndrome and Gilbert disease)
34
Causes of neonatal physiological jaundice
Increased hemolysis - Immature liver
35
Treatment of neonatal physiological jaundice
Phototherapy
36
Causes of hemolytic jaundice
``` Abnormal Hb Congenital spherocytosis Erythroblastosis fetalis Favism Malaria Incompatible blood transfusion ```
37
Types of conjugated hyperbilirubinemia
1. Obstructive jaundice 2. Hepatocellular jaundice 3. Congenital diseases (Dubin Johnson and Rotor syndromes)
38
Causes of obstructive jaundice
Stone in common bile duct (CBD) - Cancer head of pancreas
39
Causes of hepatocellular jaundice
Viral hepatitis - Liver toxins
40
Type of jaundice characterized by elevation of both direct and indirect bilirubin
Hepatocellular jaundice
41
Mechanism of action of 2 anti-diabetic drugs:
Sulfonylureas: increase insulin secretion as it blocks ATP sensitive K channels. Metformin: improve insulin sensitivity. Acarbose: the intestinal absorption of carbohydrates.
42
GLP-1 Receptor Agonists does
increase insulin and decrease glucagon secretion
43
Components of spectrophotometer: 5
``` ■ Light source (tungsten lamp) ■ Wavelength selector ■ Cuvette ■ Photodetector ■ Read out device ```
44
Examples of wave length selector (monochrmator)
Filter - Prism - diffraction grating
45
The uptake of glucose by adipose tissue and skeletal muscles after carbohydrate feeding is enhanced by insulin through
GLUT-4
46
Urine is normal and stool is dark colored in
hemolytic jaundice
47
Urine is dark colored and stool is clay colored in
Hepatocellular jaundice and obstructive jaundice
48
Source of blood glucose during early fasting is
Liver glycogenolysis
49
The main action of GIT in regulation of blood glucose is
Prevents sudden increase in blood glucose
50
Post-prandial hypoglycemia occurs in
Gastrectomy
51
Pheochromocytoma causes
Hyperglycemic glucosuria
52
The commonest cause of hyperglycemic glucosuria
Diabetes mellitus
53
Kidneys decrease hyperglycemia by
Excretion in urine
54
Ketone bodies are by products of metabolism of
fat
55
Ketosis is largely increased during
Fasting
56
Insulin is a protein hormone formed of Amino acids:
51
57
Circulating C peptide contains...........amino acids::
31
58
Secretion of glucose occurs due to increased intracellular
Ca+2
59
Main amino acid that increases insulin secretion i
Arginine
60
Sulfonylurea is an anti-diabetic drug that increases insulin secretion through:
Blocking ATP sensitive K +channels
61
Vitamin D increases insulin secretion through:
Increases the intracellular Ca+2
62
Type I diabetes mellitus is mainly due to:
a. Autoimmune destruction of P cells | b. Viral destruction of P cells
63
Diabetic ketoacidosis is more common in type I diabetes mellitus due to:
Absence of insulin
64
Hyperosmolar non-ketotic coma is common in:
Elderly patient with type II DM
65
Metformin is used as anti-diabetic drug as it:
Increases insulin sensitivity
66
Which of the following hormones increases intestinal absorption of glucose
Thyroxine
67
In obstructive jaundice, which of the following enzymes is expected to be elevated
Alkaline phosphatase (ALP)
68
Unconjugated hyperbilirubinemia is caused by:
Hemolytic anemia.
69
Jaundice occurs when plasma bilirubin exceeds.............mg/dL
2
70
Hyperglycemic glucosuria causes
Diabetes millletus Adrenaline Gastrectomy
71
Normoglycemic glucosuria
Diabetes innocens renal failure Pregnancy

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