CARBOHYDRATES Flashcards
1
Q
Hydrates of aldehyde or ketone derivatices based on the location of the CO functional group
A
Carbohydrates
2
Q
Simplest Carbohydrate (CHO)
A
Glycol Adlehyde
3
Q
Only carbohydrate to be directly used for energy or stored as glycogen
A
Glucose
4
Q
The ___ is completely dependent on blood glucose for energy produce
2/3 of glucose utilization in adults occurs in CNS
A
Brain
5
Q
Glucose metabolism generates ___ as intermediate products
A
Pyruvic Acid
Lactic Acid
Acetylcoenzyme A
6
Q
Product of complete oxidation of glucose
A
CO2
H2O
ATP
7
Q
Reducing substances/ sugars
A
Glucose
Maltose
Fructose
Lactose
Galactose
8
Q
Most common nonreducing sugar
A
Sucrose
9
Q
Nonreducing sugars do not contain what?
A
Active ketone or aldehyde group
10
Q
Both an endocrine and exocrine organ in the control of carbohydrate metabolism
A
Pancreas
11
Q
Why is pancreas an endocrine gland?
A
It secretes hormones:
Insulin
Glucagon
Somatostatin
12
Q
Why is pancreas an exocrine gland?
A
It produces and secretes Amylase
breakdown of ingested complex carbohydrates
13
Q
Primary hormone responsible for the entry of glucose
A
Insulin
14
Q
Where is Insulin synthesized in the pancreas
A
Beta cells
15
Q
Normally released whn glucose levels are high
A
Insulin
16
Q
Only hormone that decreases glucose levels
also called as a Hypoglycemic agent
A
Insulin
17
Q
Insulin Promotes what
A
Glycogenesis
Lipogenesis
Glycolysis
18
Q
Glucose to Gylcogen
A
Glycogenesis
19
Q
Glucose to Fatty Acid
A
Lipogenesis
20
Q
Glucose to Pyruvate or Lactate to Energy
A
Glycolysis
21
Q
Glycogen to Glucose
A
Glycogenolysis
22
Q
Glucose-6-phosphate from non-carbohydrate sources
A
Gluconeogenesis
23
Q
Fats to Energy
A
Lipolysis
24
Q
Primary hormone responsible for increasing glucose
(Hyperglycemic agent)
A
Glucagon
25
What cell synthesizes Glucagon
Alpha cells of Islets of Langerhans in the Pancreas
26
Other hormones that tend to increase glucose concentration:
| 5
1. Cortisol & Corticosteroids
2. Catecholamines
3. Growth Hormone
4. Thyroid Hormone
5. Adrenocorticotropic hormone (ACTH)
27
Produced by delta cells of the islets of Langerhans of the pancreas
Somatostatin
28
Somatostatin function
Primarily inhibits the action of insulin, growth hormone and glucagon
29
Increase in blood glucose concentration
Toxic to beta cell function and impairs insulin secretion
Hyperglycemia
30
FBS level of a Hyperglycemic patient
(> /= 126 mg/dL)
31
Laboratory findings in Hyperglycemia
1. Inc glucose in plasma & urine
2. Inc urine specific gravity
3. Ketonuria & Ketonemia
4. Dec blood & urine pH (Acidosis)
5. Electrolyte imbalance (Dec Na, Inc K, Dec HCO3)
32
Which type of DM patients are more likely to produce ketones?
Type 1 Diabetes Mellitus patients
33
Results from an imbalance between glucose utilization & production
| Decreased glucose levels
Hypoglycemia
34
1. Low blood glucose concentration
2. Typical symptoms
3. Symptoms alleviated by glucose administration
Whipple's triad
35
Group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin receptors, or both
Diabetes Mellitus
36
Fasting plasma glucose concentration result that are diagnostic of DM
Greater than or Equal to 126 mg/dL
| (On more than one testing)
37
Fasting plasma glucose concentration result that are diagnostic of DM
Greater than or Equal to 126 mg/dL
| (On more than one testing)
38
When plasma glucose levels exceeds **180 mg/dL** with normal renal function
Glucosuria
39
Other name for Type 1 Diabetes Mellitus
1. Insulin-Dependent Diabetes Mellitus (IDDM)
2. Juvenile Onset Diabetes Mellitus
3. Brittle Diabetes
4. Ketosis-Prone Diabetes
40
Result of a cellular-mediated autoimmune destruction of the Beta cells of the pancreas
Type 1 DM
41
Type 1 Diabetic Individuals have ___ due to loss of pancreatic beta cells
Insulinopenia
| Absolute Insulin Deficiency
42
Signs & Symptoms
| T1DM
1. Polyuria
2. Polydipsia
3. Polyphagia
43
Other name for Type Type 2 Diabetes Mellitus
1. Non-Insulin Dependent Diabetes Mellitus
2. Adult Type/ Maturity Onset Diabetes Mellitus
3. Stable Diabetes
4. Ketosis-Resistant Diabetes
5. Receptor-Deficient Diabetes Mellitus
44
Due to an individual's resistance to insulin
| Insulin deficiency
Type 2 DM
45
Type 2 DM is associated with strong ___ predisposition & not related to an autoimmune disease
Genetic
46
Characterized by impaired ability to metabolize carbohydrate, usually caused by a deficiency of insulin, metabolic or hormonal changes
Gestational Diabetes Mellitus
47
Screening for Gestational DM should be performed between?
24 and 28 weeks of gestation
48
Revised Diagnostic Criteria for GDM?
1. FBS
2. 1-hour OGTT
3. 2-hour OGTT
1. >/= 92 mg/dL
2. >/= 180 mg/dL
3. >/= 153 mg/dL
49
Infants born to diabetic mothers are at increased risk for
Respiratory distress syndrome
Hypocalcemia
Hyperbilirubinemia
50
Standard clinical specimen
Venous plasma glucose
51
Fasting glucose in whole blood is ___ than in serum or plasma
15% LOWER
52
At Room temp, glycolysis decreases glucose by ____ in normal uncentrifuged coagulated blood
7 mg/dL/hour
53
Reaction of Cupric Ions to Cuprous ions forming Cuprous oxide in hot alkaline solution by glucose
Alkaline Copper Reduction Method
54
End result: Phosphomolybdic Acid or Phosphomolybdenum Blue
Folin Wu Method
55
End Product:
Arsenomolybdic Acid or
Arsenomolybdenum Blue
Nelson Somogyi Method
56
End Product:
Cuprous-Neocuproine Complex
| Yellow or Yellow-Orange
Neocuproine Method
57
Used for detection & quantification of reducing substances in body fluids
Stabilizing agent: Citrate/ Tartrate
Benedict's Method
| Modification of Folin Wu
58
Involves reduction of a yellow ferricyanide to colorless ferricyanide
| Inverse Colorimetry
Hagedorn Jensen
| Alkaline Ferric Reduction Method
59
Uses Glacial HAC
End: Glycosylamine + Schiff's Base
Dubowski Method
| Ortho-toluidine
60
Measures the B-D glucose
Also meausres CSF & Urine glucose
| Enzymatic Method
Glucose Oxidase Method
61
Uses enzymes:
Glucose Oxidase & Peroxidase
| H2O2 is measured
Saifer Gernstenfield Method
| Colorimetric Glucose Oxidase Method
62
Uses enzymes:
Glucose Oxidase & Peroxidase
| H2O2 is measured
Saifer Gernstenfield Method
| Colorimetric Glucose Oxidase Method
63
Measures the rate of Oxygen Consumption which is PROPORTIONAL to Glucose Concentration
Polarographic Glucose Oxidase
64
What enzymes are used in Polarographic Glucose Oxidase?
1. Glucose Oxidase
2. Catalase
3. Molybdate
65
Most specific glucose method, also the reference method
Hexokinase Method
66
Enzymes used in Hexokinase Method
1. Hexokinase
2. Glucose-6-phoshate dehydrogenase
67
Not affected by presence of ascorbic acid or uric acid
Hexokinase method
68
Glucose is reduced to produce a chromophore that is measured spectrophotometrically
Glucose Dehydrogenase Method
69
Amount of NADH generated is ___ to the glucose concentration
proportional
70
Added to shorten the time necessary to reach equilibrium
Mutarotase
71
Glucose Testing in Urine
Clinitest tablets
72
Most commonly used method of OGTT
Janney-Isaacson Method
| Single dose method
73
Most commonly used method of OGTT
Janney-Isaacson Method
| Single dose method
74
Used for DM patients with gastrointestinal disorders
Intravenous Glucose Tolerance Test
75
Criteria for FPG
1. Non-Diabetic
2. Impaired PG
3. DM
1. < 100 mg/dL
2. 100-125 mg/dL
3. >=126 mg/dL
76
Categories of OGTT
1. Normal
2. Impaired GTT
3. DM
1. <140 mg/dL
2. 140-199 mg/dL
3. >=200 mg/dL
77
Diagnostic Criteria for Diabetes Mellitus
1. RBS
2. FBS
3. 2-HR
4. HbA1c
1. >=200 mg/dL
2. >= 126 mg/dL
3. >=200 mg/dL
4. >= 6.5%
78
Also known as Glycated Hemoglobin
Glycosylated Hemoglobin
HbA1c
79
What hemoglobin is irreversibly glycosylated at one or both N-terminal valines of the B-chains
Hemoglobin A
80
Significance of HbA1c
Reliable method in monitoring long-term glucose control
81
HbA1c reflects average blood glucose level over the previous ___
2-4 months
82
HbA1c is not suitable for patients with:
| because they have low HbA1c
Shortened RBC lifespan
83
HbA1c is falsely increased in:
Older RBCs & Patients with IDA
84
For every 1% change in HbA1c value, ___ is added to plasma glucose
35 mg/dL
85
Normal HbA1c
< 5.7%
86
Increased risk HbA1c
5.7% - 6.4%
87
HbA1c
DM
(>= 6.5%)
88
Also known as Glycosylated or Glycated Albumin
Plasma Protein Ketoamine
Fructosamine
89
Fructosamine
reflection of short term glucose control (3-6 wks)
90
Fructosamine is used for monitoring diabetic individuals with:
Chronic Hemolytic Anmeia
Hemoglobin variants (Hb C or Hb S)
Decreased RBC lifespan
91
Congenital deficiency of one of 3 enzymes involved in galactose metabolism
Caused by failure to thrive syndrome in infants
Galactosemia
92
3 Enzymes involved in Galactosemia
1. galactose-1-phoshphate uridyl transferase (GALT)
2. galactokinase (GALK)
3. uridine diphosphate galactose-4-epimerase (GALE)
93
Most common enzyme deficiency in Galactosemia
Galactose-1-phosphate uridyl transferase (GALT)
94
Autosomal recessive disorder characterized by Fructokinase deficiency
Essential Fructosuria
95
Fructokinase catalyzes conversion of?
Fructose to Fructose-1-phosphate
96
Defect of fructose 1,6-biphosphate aldolase B activity in liver, kidney and intestine
Inability to convert fructose-1-phosphate and fructose-1,6-biphosphate into dihydroxyacetone phosphate, glyceraldehydes
Hereditary Fructose Intolerance
97
Defect in Fructose-1,6-biphosphate results in failure of hepatic glucose generation of:
Gluconeogenic precursors such as:
Lactate & Glycerol
98
Inherited Autosomal Recessive trait
Inherited deficiencies of enzymes that control the synthesis or breakdown of glycogen
Glycogen Storage Disease
99
Most common GSD
Associated with Hyperlipidemia
Von Gierke
Type 1a
| No Glucose-6-Phosphatase
100
Type 1B
G6P translocase
101
Type II
Pompe
1,4 Glucosidase
102
Type IIIa
Cori Forbes
De brancher
| Liver & Muscle
103
Type IIIa
Cori Forbes
De brancher
| Liver & Muscle
104
Type IIIb
De brancer
| Liver
105
Type IIIb
De brancer
| Liver
106
Type IV
Andersen
Brancher
107
Type V
McArdle
Muscle Phosphorylase
108
Type VI
Hers
Liver Phosphorylase
109
Type VII
Tarui
Phosphofructokinase
110
Type VIII
Adenyl kinase
111
Type IXa
Phosphorylase kinase
112
Type IXb
Phosphorylase
| liver & muscle
113
Type X
Cyclic AMP-dependent kinase
114
Type XI
Fanconi-Bickel
Glucose transporter-2
115
40 to 60% of the blood plasma glucose level
CSF Glucose
116
Markedly decreased CSF glucose & increased WBC count
Bacterial Meningitis
117
Reference Value
Child
60-80 mg/dL
118
Reference Value
Adult
40-70 mg/dL
119
Formed during conversion of pro-insulin to insulin
Reliable indicators for pancreatic and insulin secretion
C-Peptide Test
120
Reference Value
C-peptide Test
0.90 - 4.3 ng/mL
121
Normal ratio of B-hydroxybutyrate & acetoacetic acid is
1:1
122
Ratio is greatly increased in
Diabetic Ketoacidosis
123
Reacts only with Acetoacetate
Gerhardt's ferric chloride test
124
10x more sensitive to acetoacetate
Nitroprusside test
125
Detects acetoacetate & acetone in lesser degree
Acetest tablets
126
Detects acetoacetate better than acetone
Ketostix
127
Detects B-hydroxybutyrate
KetoSite assay
