Carbohydrates

Question 1

Carbohydrates

Answer 1

The major food source and energy supply for the body and are stored primarily as liver and muscle glycogen.

Question 2

Oligosaccharides

Answer 2

Chain containing 2 to 10 sugar units joined by glucosidic linkages

Question 3

Polysaccharide

Answer 3

Chain containing greater than 10 sugars all joined by glycosidic linkages

Question 4

Glycolysis

Answer 4

Metabolism of glucose molecule to pyruvate or lactate for production of energy.

Question 5

Gluconeogenesis

Answer 5

Formation of glucose-6-phosphate from noncarbohydrate sources

Question 6

Glycogenolysis

Answer 6

Breakdown of glycogen to glucose for use as energy

Question 7

Glycogenesis

Answer 7

Conversion of glucose to glycogen for storage

Question 8

Lipogenesis

Answer 8

Conversion of carbohydrates to fatty acids

Question 9

Lipolysis

Answer 9

Decomposition of fat

Question 10

Insulin

Answer 10

The primary hormone responsible for the entry of glucose into the cell.

Question 11

Synthesis of insulin

Answer 11

Synthesized by the beta cells of islets of Langerhans in the pancreas; these cells detect an increase in body glucose, they release insulin.

Question 12

When is insulin released?

Answer 12

When glucose levels are high.

Question 13

Glucagon

Answer 13

The primary hormone responsible for increasing glucose levels.

Question 14

Synthesis of glucagon

Answer 14

Synthesized by the alpha cells of the islets of Langethans in the pancreas and released during stress and fasting states. When these cells detect a decrease in body glucose, they release glucagon.

Question 15

Epinephrine

Answer 15

Produced by the adrenal medulla, increases, plasma glucose by inhibiting insulin secretion, increasing glycogenolysis, and promoting lipolysis.

Question 16

Glucocorticoids

Answer 16

Primarily cortisol, released from the adrenal cortex by stimulation by adrenocorticotropic hormone (ACTH), promote increase plasma glucose.

Question 17

Growth Hormone

Answer 17

Increases plasma glucose by decreasing the entry of glucose into the cells and increasing glycolysis.

Question 18

Thyroxine

Answer 18

Increases plasma glucose levels by increasing glyogenolysis, gluconeogeneis, and intestinal absorption of glucose.

Question 19

Somatostatin

Answer 19

Produced by the gamma-cells fo the islets of Langerhans of the pancreas, increases plasma glucose levels by inhibition of insulin, glucagon, growth hormone, and other endocrine hormones.

Question 20

Hyperglycemia

Answer 20

An increase in plasma glucose levels.

Question 21

Diabetes mellitus

Answer 21

A group of metabolic diseases characterized by hyperglycemia resulting from defects of insulin secretion, insulin action, or both.

Question 22

Type 1 diabetes

Answer 22

Characterized by inappropriate hyperglycemia primarily a result of pancreatic islet beta-cell destruction and a tendency to ketoacidosis.

Question 23

Type 2 diabetes

Answer 23

Includes hyperglycemia cases that result from insulin resistance with an insulin secretory defect. An intermediate stage in which the fasting glucose in increased above normal limits but not the level of diabetes, has been names impaired fasting glucose.

Question 24

Gestation diabetes mellitus (GDM)

Answer 24

Defined as any degree of glucose intolerance with onset or first recognition during pregnancy due to metabolic or hormonal changes.

Question 25

Four methods of diagnosis of Diabetes Mellitus

Answer 25

(1) HbA1C greater than or equal to 6.5%, (2) fasting plasma glucose greater than or equal to 126 mg/dL, (3) and oral glucose tolerance test with a 2-hour post-load level greater than or equal to 200 mg/dL and, (4) symptoms of diabetes plus a random plasma glucose level greater than or equal to 200 mg/dL.

Question 26

Results of hypoglycemia

Answer 26

Brain fuel deprivation, resulting in impaired judgment and behavior, seizures, comas, function brain failure, and death.

Question 27

Severe hypoglycemia

Answer 27

Requires assistance to actively administer carbohydrates and glucagon or take other corrective actions.

Question 28

Document symptomatic hypoglycemia

Answer 28

Symptoms of hypoglycemia

measured plasma glucose concentration <=70 mg/dL

Question 29

Asymptomatic hypoglycemia

Answer 29

No symptoms of hypoglycemia

measured plasma glucose concentration <=70 mg/dL

Question 30

Probably symptomatic hypoglycemia

Answer 30

Symptoms typical of hypoglycemia

No plasma glucose determination performed

Question 31

Pseudohypoglycemia

Answer 31

Symptoms of hypoglycemia

Measured plasma glucose concentration >70 mg/dL but approaching that level

Question 32

What method can glucose be measured?

Answer 32

Serum, plasma, or whole blood. Primarily serum or plasma.

Question 33

Two most common methods for testing for glucose concentrations? Which is more accurate?

Answer 33

Glucose oxidase or hexokinase. Hexokinase more accurate.

Question 34

Methodology for 2-hour postprandial test.

Answer 34

The patient drinks a standardized (75 g) glucose load and a glucose measurement is drawn 2 hours later. If that level is greater than or equal to 200 mg/dL and is confirmed on a subsequent day by either an increased random or fasting glucose level, the patient is diagnosed with diabetes.

Question 35

Glycosylated hemoglobin

Answer 35

the term used to describe the formation of a hemoglobin compound produced when glucose (a reducing sugar) reacts with the amino group of hemoglobin (a protein).

Question 36

Clinical significance of glycosylated hemoglobin

Answer 36

The glucose molecule attaches nonenzymatically to the hemoglobin molecule to form a ketoamine. The rate of formation is directly proportional to the plasma glucose concentrations. Because the average RBC lives ~120 days, the glycosylated hemoglobin level at any one time reflects that average blood glucose level over the previous 2 to 3 months.

Question 37

For glycosylated hemoglobin measurement, what are the methods based on structural differences?

Answer 37

Immunoassays and affinity chromatography.

Question 38

For glycosylated hemoglobin measurement, what are the methods based on charge differences?

Answer 38

Ion-exchange chromatography, electrophoresis, isoelectric focusing, and high-pressure liquid chromatography

Question 39

Ketones

Answer 39

Bodies that are produced by the liver through metabolism of fatty acids to provide a ready energy source from stored lipids at times of low carbohydrate availability.

Question 40

What are the three ketone bodies?

Answer 40

Acetone, acetoacetic acid, and 3-beta-hydroxybutyric acid

Question 41

Ketonemia

Answer 41

The accumulation of ketones in blood

Question 42

Ketonuria

Answer 42

The accumulation of ketones in urine

Question 43

Two methods of ketone measurement

Answer 43

Nitroprusside and enzymatic

Question 44

Albuminuira

Answer 44

Measurements that are useful to assist in diagnosis of diabetic kidney disease at an early stage and before the development of proteinuria.

Question 45

Thyroxine

Answer 45

Secreted by the thyroid gland and its release is stimulated by TSH. It increases plasma glucose levels by increased glycogenolysis, increased gluconeogenesis, and increased intestinal absorption.