Carbohydrates Flashcards
Carbohydrates are hydrates of ___________ and __________.
Aldehydes
Ketones
Major food source of the human body.
Carbohydrates
Major organ that controls CHO metabolism
Pancreas
________ and _______ are the major hormones that regulate CHO metabolism.
Insulin
Glucagon
Major organ consumer of CHO
Brain
____ of body’s glucose are consumed predominantly by the Brain
2/3
CHO are stored primarily as _______ and _______ glycogen.
Liver and Muscle
Simplest CHO
Glycol Aldehyde (2-hydroxyethanal)
Most common Monosaccharide
Glucose - Blood Sugar (Dextrose)
Only KETOSE group of monosaccharide sugars
Fructose - Fruit/Semen Sugar
Give their other names of Disaccharides:
Maltose
Sucrose
Lactose
Maltose - Beer Sugar
Sucrose - Table Sugar
Lactose - Milk Sugar
Give their components of Disaccharides:
Maltose
Sucrose
Lactose
Maltose - Glucose + Glucose
Sucrose - Glucose + Fructose
Lactose - Glucose + Galactose
Only non-reducing sugar
Sucrose
Most common polysaccharide
Starch (plants)
Glycogen (Animals)
CHO Digestion and Absorption
FOOD - MOUTH —–salivary amylase—– OLIGOSACCHARIDES —— STOMACH ——inactivates amylase —— SMALL INTESTINES —–pancreatic amylase —— DISACCHARIDES —– brush border enzymes (maltase) ——- MONOSACCHARIDE —– MICROVILLI —– SGLT 1/GLUT 5/GLUT 2 —– LIVER (hepatic vein) —– stores as glycogen/circulate in blood —– BLOOD —– ENERGY
Pancreas is Endocrine - secretes _________, _________, _________.
Pancreas is Exocrine - secretes __________.
Pancreas is Endocrine - secretes INSULIN, GLUCAGON, SOMATOSTATIN
Pancreas is Exocrine - secrets AMS
Hyperglycemic Pathways
Gluconeogenesis
Glycogenolysis
Lipolysis
Hypoglycemic Pathway
Insulin
Islets of Langerhans have ______ different type of cells.
Four (4) Beta-cells Alpha-cells Delta-cells F-cells
Blood Glucose Pattern after a meal:
30 mins:
1 hr:
2 hrs:
4 hrs:
30 mins: fastest rise
1 hr: Peak
2 hrs: Normal
4 hrs: Reactive Hypoglycemia/Alimentary
Glucose normalizes within ______ hours after a meal
2-3 hrs
Whipple’s Triad
- Decreased blood glucose
- Observable Symptoms: Neurogenic and Neuroglycopenic
- Elevated symptoms after glucose administration.
Hypoglycemia can be classified as __________ and ____________.
Post-absorptive (fasting) Hypoglycemia
Post-prandial (reactive) Hypoglycemia
Hyperglycemia
Increase ________, _____, _____ in Urine
Electrolyte Imbalance: Low - ___, ____ ; High - _____
Hyperglycemic State
Increase Glucose, Ketones, SG in Urine
Electrolyte Imbalance: Low - Na, pH, HCO3 ; High - K
_________ known as deep respiration that occurs in normally sleeping or comatose px.
Kussmaul’s Respiration
______________ is a group of metabolic diseases characterized by HYPERglycemia resulting from the defects in insulin _______ and ______, or both.
DM is a group of metabolic diseases characterized by HYPERglycemia resulting from the defects in insulin SECRETION and ACTION, or both.
Diagnostic Criteria for DM:
FBS: > 126 mg/dL
RBS: > _______
2hr PP: > _______
Hba1c: > 6.5%
Diagnostic Criteria for DM:
FBS: > 126 mg/dL
RBS: > 200 mg/dL
2hr PP: > 200 mg/dL
Hba1c: > 6.5%
Type I DM vs. Type II DM
Pathogenesis: Onset: Symptoms: Incidence: Ketosis: Autoantibodies: C-peptide Test: Dependence:
Type I
Pathogenesis: Autoimmune B-cell destruction Onset: Juvenile Symptoms: Abrupt Incidence: 5-10% Ketosis: Ketosis prone (common) Autoantibodies: Positive C-peptide Test: Undetectable/Decrease Dependence: Insulin Dependent
Type II
Pathogenesis: Insulin receptor resistance Onset: Adult Symptoms: Gradual Incidence: 90-95% (Most common) Ketosis: Ketosis resistant (rare) Autoantibodies: Negative C-peptide Test: Detectable/Increase Dependence: Insulin Independent
Gestational Diabetes Mellitus is a degree of glucose tolerance with onset of first recognition during ________.
Pregnancy
GDM maybe gone after delivery but may return after ____ years in some cases.
10 years
According to AMA, all adults older than 45 y.o. should have measurement of FBS every __ years.
3 years
PREFFERED test for diagnosing DM is _________.
FBS
Renal Threshold
160-180 mg/dL
CSF Glucose
60-70%
Blood should be separated within ___ mins - __ hour, due to _______ by blood cells.
30 mins - 1 hr
Loss of glucose
Rationale: This is to prevent loss of glucose by blood cells
_______ is used as an anticoagulant and preservative for glucose id analysis is delayed.
Sodium Fluoride
Rationale: Fluoride is antiglycolytic
Standard Specimen for Glucose Determination
Fasting venous plasma
Fasting blood sugar should be ______, but not greater than ______
8-10 hrs, but not > than 16 hrs.
At room temperature, glucose decreases at a rate of _______
7 mg/dL
At ref (4C) glucose decreases approximately to ______
2 mg/dL
Recall: 10% contamination with 5% dextrose will increase glucose by ________
500 mg/dl
Whole blood is lower than ______ glucose level than serum or plasma
10-15%
_________ tests to differentiate Type I DM to Type II, evaluates for Hypoglycemia and this is a biproduct from pro-insulin to insulin.
C-peptide (Directly proportional to Insulin Lvl)
C-peptide conversion factor
0.333
C-peptide to Insulin Ratio
> 5-15:1
Screening time for GDM
24th - 28th week of pregnancy
Procedure in OGTT
- Collect _______
- Drink Glucose Load (____)
- Collect blood after ____, _____.
Procedure in OGTT
- Collect fasting blood (baseline)
- Drink Glucose Load (75g)
- Collect blood after 1 hr, 2 hrs.
Glucose load by WHO standard
Adults
Kids
Obese
Adult: 75g
Kids: 1.75g/kg
Obese: 100g
Guideline for OGTT
- Should consume normal to high CHO intake (________) for __ days.
- Fasting: _____
- Should be tested in the ______ due to diurnal variation.
- Patient should be ______.
- Test is terminated if FBS is _______.
- Glucose load for adults is ____ and should drink within __ minutes.
- Should consume normal to high CHO intake (150g/day) for 3 days.
- Fasting: 8-10 hrs
- Should be tested in the MORNING due to diurnal variation.
- Patient should be AMBULATORY.
- Test is terminated if FBS is >140 mg/dl.
- Glucose load for adults is 75g and should drink within 5 minutes.
Recalls (Sept, 19).
BMI
Obese:
Overweight:
Recalls (Sept, 19)
BMI
Obese: >30
Overweight: 25-29.9
Arterial/Capillary whole blood is higher in venous blood approximately _____.
7 mg/dL
Equilibrium for Plasma and CSF Glucose
1 hr
For every 100 mg/dl rise of Serum glucose, sodium decreases by _______.
1.6 mmol/L
For every 1% change in HbA1c, there is an increase of _____ in plasma glucose.
35 mg/dl
Time intake for GTT
OGTT - ______
IVGTT - ______
OGTT - 5 mins
IVGTT - 3 mins
Average fasting for plasma glucose
10 hrs
_____ is requested during emergency, insulin shock, hyperglycemic ketonic coma
RBS
Measure overall glucose hemostasis
FBS
Determine ho well the body metabolizes glucose
OGTT
HbA1c vs. Fructosamine Test
Other Names: Monitoring: Reflects: Tested every: Specimen:
HbA1c
Other Names: Glycated Hb Monitoring: Long Term Reflects: 2-4 months previously Tested every: 3-6 MONTHS Specimen: EDTA Whole Blood
Fructosamine
Other Names: Glycated albumin Monitoring: Short Term Reflects: Tested every: 3-6 WEEKS Specimen: Serum
________ utilizes reducing property of glucose in a HOT ALKALINE SOLN.
Alkaline Copper Reduction
______ and _____ that contain alkaline of cupric ions stabilized by Citrate and Tartrate.
Benedict’s (Citrate) and Fehling’s (Tartrate)
_________ uses INVERSE colorimetry which reduces YELLOW to COLORLESS ferricyanide by glucose.
Alkaline Ferric Reduction - Hagedorn Jensen
Glucose Oxidase only measure ________ specifically
B- D glucose
_______ used to facilitate conversion of a- D glucose to b- D glucose
Mutaratose
Reference Method in Glucose
Hexokinase Method
Most specific reagent in Hexokinase Method
G6PD
Self-Monitoring of Blood Glucose
Type 1: Monitored ____/day
Type 2: ________
Type 1: Monitored 3-4x/day
Type 2: Frequency is unknown
GSD: Viagra Pills Causes A Muscle Hardening Tight when Fucked!
Type 1 a - Von Gierki; \_\_\_\_\_\_\_\_\_ Type 2 - Pompei; \_\_\_\_\_\_\_\_ Type 3a - \_\_\_\_\_\_\_; \_\_\_\_\_\_\_ Type 4 - \_\_\_\_\_\_; Brancher Type 5 - Mcardle; \_\_\_\_\_\_\_ Type 6 - \_\_\_\_\_\_ Disease; \_\_\_\_\_ Phosphorylase Type 7 - Tarui; \_\_\_\_\_\_ Type 11 - \_\_\_\_\_\_\_\_\_\_; \_\_\_\_\_\_\_
Type 1 a - Von Gierki; G-6 Phosphate Type 2 - Pompei; 1,4 Glucosidase Type 3a - Cori Forbes; De Brancher Type 4 - Andersen; Brancher Type 5 - Mcardle; Muscle Phosphorylase Type 6 - Hers Disease; Liver Phosphorylase Type 7 - Tarui; Phosphofructokinase Type 11 - Fanconi Bickel; Glucose transporter
GSD that affects;
Muscle - __, __
Liver - __, __, __, __, __, __
Muscle: 5 & 7
Liver: 0. 1, 3, 4, 6, 9
GSD that both affects the Muscle and Liver
Type 3a
Type 9b