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Clinical Chemistry > CARBOHYDRATES > Flashcards

CARBOHYDRATES Flashcards

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1
Q

Hydrates of aldehyde or ketone derivatices based on the location of the CO functional group

A

Carbohydrates

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2
Q

Simplest Carbohydrate (CHO)

A

Glycol Adlehyde

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3
Q

Only carbohydrate to be directly used for energy or stored as glycogen

A

Glucose

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4
Q

The ___ is completely dependent on blood glucose for energy produce
2/3 of glucose utilization in adults occurs in CNS

A

Brain

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5
Q

Glucose metabolism generates ___ as intermediate products

A

Pyruvic Acid
Lactic Acid
Acetylcoenzyme A

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6
Q

Product of complete oxidation of glucose

A

CO2
H2O
ATP

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7
Q

Reducing substances/ sugars

A

Glucose
Maltose
Fructose
Lactose
Galactose

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8
Q

Most common nonreducing sugar

A

Sucrose

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9
Q

Nonreducing sugars do not contain what?

A

Active ketone or aldehyde group

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10
Q

Both an endocrine and exocrine organ in the control of carbohydrate metabolism

A

Pancreas

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11
Q

Why is pancreas an endocrine gland?

A

It secretes hormones:
Insulin
Glucagon
Somatostatin

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12
Q

Why is pancreas an exocrine gland?

A

It produces and secretes Amylase

breakdown of ingested complex carbohydrates

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13
Q

Primary hormone responsible for the entry of glucose

A

Insulin

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14
Q

Where is Insulin synthesized in the pancreas

A

Beta cells

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15
Q

Normally released whn glucose levels are high

A

Insulin

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16
Q

Only hormone that decreases glucose levels
also called as a Hypoglycemic agent

A

Insulin

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17
Q

Insulin Promotes what

A

Glycogenesis
Lipogenesis
Glycolysis

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18
Q

Glucose to Gylcogen

A

Glycogenesis

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19
Q

Glucose to Fatty Acid

A

Lipogenesis

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20
Q

Glucose to Pyruvate or Lactate to Energy

A

Glycolysis

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21
Q

Glycogen to Glucose

A

Glycogenolysis

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22
Q

Glucose-6-phosphate from non-carbohydrate sources

A

Gluconeogenesis

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23
Q

Fats to Energy

A

Lipolysis

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24
Q

Primary hormone responsible for increasing glucose
(Hyperglycemic agent)

A

Glucagon

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25
Q

What cell synthesizes Glucagon

A

Alpha cells of Islets of Langerhans in the Pancreas

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26
Q

Other hormones that tend to increase glucose concentration:

5

A
  1. Cortisol & Corticosteroids
  2. Catecholamines
  3. Growth Hormone
  4. Thyroid Hormone
  5. Adrenocorticotropic hormone (ACTH)
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27
Q

Produced by delta cells of the islets of Langerhans of the pancreas

A

Somatostatin

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28
Q

Somatostatin function

A

Primarily inhibits the action of insulin, growth hormone and glucagon

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29
Q

Increase in blood glucose concentration
Toxic to beta cell function and impairs insulin secretion

A

Hyperglycemia

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30
Q

FBS level of a Hyperglycemic patient

A

(> /= 126 mg/dL)

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31
Q

Laboratory findings in Hyperglycemia

A
  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)
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32
Q

Which type of DM patients are more likely to produce ketones?

A

Type 1 Diabetes Mellitus patients

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33
Q

Results from an imbalance between glucose utilization & production

Decreased glucose levels

A

Hypoglycemia

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34
Q
  1. Low blood glucose concentration
  2. Typical symptoms
  3. Symptoms alleviated by glucose administration
A

Whipple’s triad

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35
Q

Group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin receptors, or both

A

Diabetes Mellitus

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36
Q

Fasting plasma glucose concentration result that are diagnostic of DM

A

Greater than or Equal to 126 mg/dL

(On more than one testing)

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37
Q

Fasting plasma glucose concentration result that are diagnostic of DM

A

Greater than or Equal to 126 mg/dL

(On more than one testing)

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38
Q

When plasma glucose levels exceeds 180 mg/dL with normal renal function

A

Glucosuria

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39
Q

Other name for Type 1 Diabetes Mellitus

A
  1. Insulin-Dependent Diabetes Mellitus (IDDM)
  2. Juvenile Onset Diabetes Mellitus
  3. Brittle Diabetes
  4. Ketosis-Prone Diabetes
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40
Q

Result of a cellular-mediated autoimmune destruction of the Beta cells of the pancreas

A

Type 1 DM

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41
Q

Type 1 Diabetic Individuals have ___ due to loss of pancreatic beta cells

A

Insulinopenia

Absolute Insulin Deficiency

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42
Q

Signs & Symptoms

T1DM

A
  1. Polyuria
  2. Polydipsia
  3. Polyphagia
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43
Q

Other name for Type Type 2 Diabetes Mellitus

A
  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
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44
Q

Due to an individual’s resistance to insulin

Insulin deficiency

A

Type 2 DM

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45
Q

Type 2 DM is associated with strong ___ predisposition & not related to an autoimmune disease

A

Genetic

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46
Q

Characterized by impaired ability to metabolize carbohydrate, usually caused by a deficiency of insulin, metabolic or hormonal changes

A

Gestational Diabetes Mellitus

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47
Q

Screening for Gestational DM should be performed between?

A

24 and 28 weeks of gestation

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48
Q

Revised Diagnostic Criteria for GDM?
1. FBS
2. 1-hour OGTT
3. 2-hour OGTT

A
  1. > /= 92 mg/dL
  2. > /= 180 mg/dL
  3. > /= 153 mg/dL
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49
Q

Infants born to diabetic mothers are at increased risk for

A

Respiratory distress syndrome
Hypocalcemia
Hyperbilirubinemia

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50
Q

Standard clinical specimen

A

Venous plasma glucose

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51
Q

Fasting glucose in whole blood is ___ than in serum or plasma

A

15% LOWER

52
Q

At Room temp, glycolysis decreases glucose by ____ in normal uncentrifuged coagulated blood

A

7 mg/dL/hour

53
Q

Reaction of Cupric Ions to Cuprous ions forming Cuprous oxide in hot alkaline solution by glucose

A

Alkaline Copper Reduction Method

54
Q

End result: Phosphomolybdic Acid or Phosphomolybdenum Blue

A

Folin Wu Method

55
Q

End Product:
Arsenomolybdic Acid or
Arsenomolybdenum Blue

A

Nelson Somogyi Method

56
Q

End Product:
Cuprous-Neocuproine Complex

Yellow or Yellow-Orange

A

Neocuproine Method

57
Q

Used for detection & quantification of reducing substances in body fluids
Stabilizing agent: Citrate/ Tartrate

A

Benedict’s Method

Modification of Folin Wu

58
Q

Involves reduction of a yellow ferricyanide to colorless ferricyanide

Inverse Colorimetry

A

Hagedorn Jensen

Alkaline Ferric Reduction Method

59
Q

Uses Glacial HAC
End: Glycosylamine + Schiff’s Base

A

Dubowski Method

Ortho-toluidine

60
Q

Measures the B-D glucose
Also meausres CSF & Urine glucose

Enzymatic Method

A

Glucose Oxidase Method

61
Q

Uses enzymes:
Glucose Oxidase & Peroxidase

H2O2 is measured

A

Saifer Gernstenfield Method

Colorimetric Glucose Oxidase Method

62
Q

Uses enzymes:
Glucose Oxidase & Peroxidase

H2O2 is measured

A

Saifer Gernstenfield Method

Colorimetric Glucose Oxidase Method

63
Q

Measures the rate of Oxygen Consumption which is PROPORTIONAL to Glucose Concentration

A

Polarographic Glucose Oxidase

64
Q

What enzymes are used in Polarographic Glucose Oxidase?

A
  1. Glucose Oxidase
  2. Catalase
  3. Molybdate
65
Q

Most specific glucose method, also the reference method

A

Hexokinase Method

66
Q

Enzymes used in Hexokinase Method

A
  1. Hexokinase
  2. Glucose-6-phoshate dehydrogenase
67
Q

Not affected by presence of ascorbic acid or uric acid

A

Hexokinase method

68
Q

Glucose is reduced to produce a chromophore that is measured spectrophotometrically

A

Glucose Dehydrogenase Method

69
Q

Amount of NADH generated is ___ to the glucose concentration

A

proportional

70
Q

Added to shorten the time necessary to reach equilibrium

A

Mutarotase

71
Q

Glucose Testing in Urine

A

Clinitest tablets

72
Q

Most commonly used method of OGTT

A

Janney-Isaacson Method

Single dose method

73
Q

Most commonly used method of OGTT

A

Janney-Isaacson Method

Single dose method

74
Q

Used for DM patients with gastrointestinal disorders

A

Intravenous Glucose Tolerance Test

75
Q

Criteria for FPG
1. Non-Diabetic
2. Impaired PG
3. DM

A
  1. < 100 mg/dL
  2. 100-125 mg/dL
  3. > =126 mg/dL
76
Q

Categories of OGTT
1. Normal
2. Impaired GTT
3. DM

A
  1. <140 mg/dL
  2. 140-199 mg/dL
  3. > =200 mg/dL
77
Q

Diagnostic Criteria for Diabetes Mellitus
1. RBS
2. FBS
3. 2-HR
4. HbA1c

A
  1. > =200 mg/dL
  2. > = 126 mg/dL
  3. > =200 mg/dL
  4. > = 6.5%
78
Q

Also known as Glycated Hemoglobin

A

Glycosylated Hemoglobin
HbA1c

79
Q

What hemoglobin is irreversibly glycosylated at one or both N-terminal valines of the B-chains

A

Hemoglobin A

80
Q

Significance of HbA1c

A

Reliable method in monitoring long-term glucose control

81
Q

HbA1c reflects average blood glucose level over the previous ___

A

2-4 months

82
Q

HbA1c is not suitable for patients with:

because they have low HbA1c

A

Shortened RBC lifespan

83
Q

HbA1c is falsely increased in:

A

Older RBCs & Patients with IDA

84
Q

For every 1% change in HbA1c value, ___ is added to plasma glucose

A

35 mg/dL

85
Q

Normal HbA1c

A

< 5.7%

86
Q

Increased risk HbA1c

A

5.7% - 6.4%

87
Q

HbA1c
DM

A

(>= 6.5%)

88
Q

Also known as Glycosylated or Glycated Albumin
Plasma Protein Ketoamine

A

Fructosamine

89
Q

Fructosamine

A

reflection of short term glucose control (3-6 wks)

90
Q

Fructosamine is used for monitoring diabetic individuals with:

A

Chronic Hemolytic Anmeia
Hemoglobin variants (Hb C or Hb S)
Decreased RBC lifespan

91
Q

Congenital deficiency of one of 3 enzymes involved in galactose metabolism
Caused by failure to thrive syndrome in infants

A

Galactosemia

92
Q

3 Enzymes involved in Galactosemia

A
  1. galactose-1-phoshphate uridyl transferase (GALT)
  2. galactokinase (GALK)
  3. uridine diphosphate galactose-4-epimerase (GALE)
93
Q

Most common enzyme deficiency in Galactosemia

A

Galactose-1-phosphate uridyl transferase (GALT)

94
Q

Autosomal recessive disorder characterized by Fructokinase deficiency

A

Essential Fructosuria

95
Q

Fructokinase catalyzes conversion of?

A

Fructose to Fructose-1-phosphate

96
Q

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

A

Hereditary Fructose Intolerance

97
Q

Defect in Fructose-1,6-biphosphate results in failure of hepatic glucose generation of:

A

Gluconeogenic precursors such as:
Lactate & Glycerol

98
Q

Inherited Autosomal Recessive trait
Inherited deficiencies of enzymes that control the synthesis or breakdown of glycogen

A

Glycogen Storage Disease

99
Q

Most common GSD
Associated with Hyperlipidemia

A

Von Gierke
Type 1a

No Glucose-6-Phosphatase

100
Q

Type 1B

A

G6P translocase

101
Q

Type II

A

Pompe
1,4 Glucosidase

102
Q

Type IIIa

A

Cori Forbes
De brancher

Liver & Muscle

103
Q

Type IIIa

A

Cori Forbes
De brancher

Liver & Muscle

104
Q

Type IIIb

A

De brancer

Liver

105
Q

Type IIIb

A

De brancer

Liver

106
Q

Type IV

A

Andersen
Brancher

107
Q

Type V

A

McArdle
Muscle Phosphorylase

108
Q

Type VI

A

Hers
Liver Phosphorylase

109
Q

Type VII

A

Tarui
Phosphofructokinase

110
Q

Type VIII

A

Adenyl kinase

111
Q

Type IXa

A

Phosphorylase kinase

112
Q

Type IXb

A

Phosphorylase

liver & muscle

113
Q

Type X

A

Cyclic AMP-dependent kinase

114
Q

Type XI

A

Fanconi-Bickel
Glucose transporter-2

115
Q

40 to 60% of the blood plasma glucose level

A

CSF Glucose

116
Q

Markedly decreased CSF glucose & increased WBC count

A

Bacterial Meningitis

117
Q

Reference Value
Child

A

60-80 mg/dL

118
Q

Reference Value
Adult

A

40-70 mg/dL

119
Q

Formed during conversion of pro-insulin to insulin
Reliable indicators for pancreatic and insulin secretion

A

C-Peptide Test

120
Q

Reference Value
C-peptide Test

A

0.90 - 4.3 ng/mL

121
Q

Normal ratio of B-hydroxybutyrate & acetoacetic acid is

A

1:1

122
Q

Ratio is greatly increased in

A

Diabetic Ketoacidosis

123
Q

Reacts only with Acetoacetate

A

Gerhardt’s ferric chloride test

124
Q

10x more sensitive to acetoacetate

A

Nitroprusside test

125
Q

Detects acetoacetate & acetone in lesser degree

A

Acetest tablets

126
Q

Detects acetoacetate better than acetone

A

Ketostix

127
Q

Detects B-hydroxybutyrate

A

KetoSite assay

Clinical Chemistry (16 decks)

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