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CLINICAL CHEMISTRY > Carbohydrates > Flashcards

Carbohydrates Flashcards

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1
Q

Compounds (biomolecules) containing C, H, and O

A

Carbohydrates

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2
Q

Functional groups found in carbohydrates

A

C=O (carbonyl) and -OH (hydroxyl)

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3
Q

Major food source and energy supply for the body

A

Carbohydrates

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4
Q

The general formula for a carbohydrate

A

Cx(H2O)y

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5
Q

Different properties for the classification of carbohydrates

A

Size of the base carbon chain
Location of the CO function group
Number of sugar units
Stereochemistry of the compound

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6
Q

Carbohydrates classifications based on the number of carbons in the molecule

A

Trioses contain three carbons
Tetroses contain four
Pentoses contain five
Hexoses contain six

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7
Q

Example of carbohydrates reducing substances

A

Glucose
Maltose
Fructose
Lactose
Galactose

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8
Q

Most common non reducing carbohydrate

A

Sucrose

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9
Q

The primary energy source for brain, erythrocytes, and retina cells in human body

A

Carbohydrates

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10
Q

In order for a carbohydrate to be considered as reducing substance, they must contain _____

A

Active aldehyde and/or ketone group

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11
Q

Carbohydrates are hydrates of aldehyde or ketone derivatives based on the location of the CO functional group. True or False?

A

True

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12
Q

Two forms of carbohydrates

A

Aldose
Ketose

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13
Q

Carbohydrate that has a terminal carbonyl group (O=CH-)

A

Aldose

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14
Q

Carbohydrate that has a carbonyl group (O=C) in the middle linked to two other carbon atoms

A

Ketose

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15
Q

Known as the structural arrangement of atoms on a given molecule

A

Stereoisomers

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16
Q

If the hydroxyl group (OH) projects to the right in the Fisher projection, the sugar belongs to

A

Dextrorotatory series and receives the prefix D-

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17
Q

If the hydroxyl group (OH) projects to the left in the Fisher projection, the sugar belongs to

A

Levorotatory series and receives the prefix L-

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18
Q

The chaining of sugars relies on the formation of _____ that are bridges of oxygen atoms

A

Glycoside bonds

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19
Q

A glycosidic bond or glycosidic linkage is a type of covalent bond that joins a carbohydrate (sugar) molecule to another group, which may or may not be another carbohydrate. True or False?

A

True

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20
Q

The process of producing water molecule when two carbohydrate molecules join

A

Dehydration

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21
Q

The process of using water molecule to split carbohydrate, forming individual compounds

A

Hydrolysis

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22
Q

Simple sugars that cannot be hydrolyzed to a simpler form

A

Monosaccharides

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23
Q

Common examples of monosaccharides

A

Glucose
Fructose
Galactose

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24
Q

Sugar formed when two monosaccharide units are joined by a glycosidic linkage

A

Disaccharides

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25
Q

Common examples of disaccharides

A

Maltose
Lactose
Sucrose

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26
Q

Sugar chaining of 3 to 10 sugar units

A

Oligosaccharides

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27
Q

Sugar formed by the linkage of many monosaccharide units

A

Polysaccharides

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28
Q

Common examples of polysaccharides

A

Starch
Glycogen

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29
Q

What will happen if the bond forms with one of the other carbons on the carbohydrate other than the anomeric (reducing) carbon

A

The anomeric carbon is unaltered and the resulting compound remains a reducing substance

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30
Q

What will happen if the bond is formed with the anomeric carbon on the other carbohydrate

A

The resulting compound is no longer a reducing substance

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31
Q

Responsible for the digestion of nonabsorbable carbohydrate polymers to dextrins and disaccharides

A

Salivary and pancreatic amylase

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32
Q

Enzyme that further hydrolyze disaccharide to monosaccharides

A

Maltase

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33
Q

Enzyme that hydrolyze sucrose to glucose and fructose

A

Sucrase

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34
Q

Sugar that consists of 1 glucose, 1 fructose, and 1 galactose

A

Raffinose

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35
Q

Sugar that consists of 1 glucose, 1 fructose, and 2 galactose

A

Stachyose

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36
Q

Enzyme that hydrolyze lactose to glucose and galactose

A

Lactase

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37
Q

Venous system that returns blood from the digestive track to the liver

A

Hepatic portal system

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38
Q

The only carbohydrate to be directly used for energy or stored as glycogen

A

Glucose

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39
Q

Carbohydrates that must be converted to glucose before they can be used

A

Galactose
Fructose

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40
Q

The ultimate goal of the cell is to convert glucose to

A

Carbon dioxide and water

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41
Q

3 major metabolic pathways for carbohydrates

A

Embden-Meyerhof pathway

Hexose monophosphate (HMP) shunt

Glycogenesis

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42
Q

The first step for all three pathways requires glucose to be converted to _____ using the high energy molecule, _____

A

Glucose-6-phosphate; ATP

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43
Q

The reaction of converting glucose to glucose-6-phosphate is catalyzed by

A

Hexokinase

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44
Q

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

A

Glycolysis

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45
Q

Formation of glucose-6-phosphate from noncarbohydrate sources

A

Gluconeogenesis

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46
Q

Breakdown of glycogen to glucose for use as energy

A

Glycogenolysis

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47
Q

Conversion of glucose to glycogen for storage

A

Glycogenesis

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48
Q

Responsible for the straight forward production of glycogen from glucose

A

Glycogen synthase

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49
Q

Conversion of carbohydrates to fatty acids

A

Lipogenesis

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50
Q

Decomposition of fat

A

Lipolysis

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51
Q

Effect of glycolysis to plasma glucose concentration

A

Decreased

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52
Q

Effect of gluconeogenesis to plasma glucose concentration

A

Increased

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53
Q

Effect of glycogenolysis to plasma glucose concentration

A

Increased

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54
Q

Effect of glycogenesis to plasma glucose concentration

A

Decreased

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55
Q

Effect of lipogenesis to plasma glucose concentration

A

Decreased

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56
Q

Effect of lipolysis to plasma glucose concentration

A

Increased

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57
Q

Two major hormones responsible for blood glucose control

A

Insulin
Glucagon

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58
Q

Organ that produce insulin and glucagon

A

Pancreas

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59
Q

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

A

Insulin

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60
Q

Insulin is synthesized by

A

b-cells of islets of Langerhans in the pancreas

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61
Q

Insulin responds to

A

Increase in glucose

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62
Q

The only hormone that decreases glucose levels and can be referred to as a hypoglycemic agent

A

Insulin

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63
Q

The primary hormone responsible for increasing glucose levels

A

Glucagon

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64
Q

Glucagon is synthesized by

A

a-cells of islets of Langerhans in the pancreas

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65
Q

Glucagon responds to

A

Decrease in glucose

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66
Q

The hormone that increases glucose levels and can be referred to as a hyperglycemic agent

A

Glucagon

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67
Q

Two hormones produced by the adrenal gland that affects carbohydrate metabolism

A

Epinephrine
Glucocorticoids (cortisol)

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68
Q

Epinephrine is produced by

A

Adrenal medulla

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69
Q

Epinephrine is produced during

A

Stress

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70
Q

Effect of epinephrine in glucose level

A

Increased

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71
Q

How does epinephrine increase glucose levels?

A

Inhibits insulin secretion, increases glycogenolysis, and promotes lipolysis

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72
Q

Glucocorticoids primarily cortisol, are released from

A

Adrenal cortex (Zona fasciculata)

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73
Q

Hormone stimulating the release of glucocorticoids

A

Adrenocorticotropic hormone (ACTH)

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74
Q

Effect of glucocorticoids in glucose level

A

Increased

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75
Q

How does glucocorticoids increase glucose levels?

A

Decreases intestinal entry into the cell and increases gluconeogenesis, liver glycogen, and lipolysis

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76
Q

Two anterior pituitary hormones that promotes increased plasma glucose

A

Growth hormone
ACTH

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77
Q

Growth hormone is inhibited by

A

Increased glucose

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78
Q

How does ACTH increase plasma glucose levels?

A

Converts liver glycogen to glucose and promotes gluconeogenesis

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79
Q

Two other hormones that affects glucose levels

A

Thyroxine
Somatostatin

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80
Q

Thyroxine is released by

A

Thyroid gland

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81
Q

Somatostatin is produced by

A

d-cells of the islets of Langerhans of the pancreas

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82
Q

How does thyroxine affect plasma glucose levels

A

Increases plasma glucose levels by increasing glycogenolysis, gluconeogenesis, and intestinal absorption of glucose

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83
Q

How does somatostatin affect plasma glucose levels

A

Increases plasma glucose levels by the inhibition of insulin, glucagon, growth hormone, and other endocrine hormones

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84
Q

Embden-Meyerhof pathway is formally known as

A

Glycolysis

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85
Q

Hexose monophosphate (HMP) shunt is also known as

A

Pentose Phosphate Pathway or Phosphogluconate pathway

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86
Q

Metabolic pathway that allows the metabolic use of glucose to generate ATP, NADH, and several biosynthetic precursors such as 3-phosphoglycerate or pyruvate

A

Embden-Meyerhof pathway

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87
Q

Metabolic pathway for the conversion of glucose-6-phosphate to 6-phosphogluconic acid, which permits the formation of ribose-5-phosphate and NADPH

A

Hexose monophosphate (HMP) shunt

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88
Q

Metabolic pathway in which glucose-6-phosphate is converted to glucose-1-phosphate, which is then converted to uridine diphosphoglucose and then to glycogen by glycogen synthase

A

Glycogenesis

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89
Q

An increase in plasma glucose levels

A

Hyperglycemia

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90
Q

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

A

Diabetes mellitus

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91
Q

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

A

Type 1 DM

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92
Q

Includes hyperglycemia cases that result from insulin resistance with an insulin secretory defect

A

Type 2 DM

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93
Q

A type of diabetes that was retained in women who developed glucose intolerance during pregnancy

A

Gestational diabetes mellitus (GDM)

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94
Q

Other names of Type 1 DM

A

Insulin Dependent DM
Juvenile Onset DM
Brittle or Labile Diabetes
Ketosis-Prone Diabetes

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95
Q

Why is it called Juvenile Onset DM?

A

Because it is usually diagnosed with teens and young adults

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96
Q

Why is it called Brittle or Labile Diabetes?

A

Because it is associated with the severe and unpredictable swings in the blood glucose concentrations

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97
Q

Why is it called Ketosis-Prone Diabetes?

A

Because of the increase production of ketone bodies coming from fat metabolism

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98
Q

Autoantibodies causing cellular-mediated autoimmune destruction of the pancreas

A

Islet cell autoantibodies
Insulin autoantibodies
Glutamic acid decarboxylase autoantibodies
Tyrosine phosphatase IA-2 and IA-2B autoantibodies
Zinc transporter 8 antibody

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99
Q

Signs and symptoms of Type 1 DM

A

Polydipsia
Polyphagia
Polyuria
Rapid weight loss
Hyperventilation
Mental confusion
Possible loss of consciousness

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100
Q

Complications of Type 1 DM

A

Microvascular problems
Nephropathy
Neuropathy
Retinopathy

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101
Q

Management of Type 1 DM

A

Administration of insulin

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102
Q

A diabetes that has no known etiology; is strongly inherited; does not have β-cells autoimmunity; requires insulin replacement

A

Idiopathic type 1 diabetes

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103
Q

Type 2 DM os also known as

A

Non-Insulin Dependent DM
Maturity Onset or Adult Type DM
Stable Diabetes
Ketosis-Resistant Diabetes
Receptor-Deficient DM

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104
Q

Diabetes that constitutes the majority of the diabetes cases

A

Type 2 DM

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105
Q

Diabetes that constitutes only 5% to 10% of all cases of diabetes

A

Type 1 DM

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106
Q

Characteristics of Type 2 DM

A

Adult onset
Milder symptoms than in type I
Ketoacidosis is rare

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107
Q

Abnormal lipid concentration in the blood

A

Dyslipidemia

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108
Q

Complications of Type 2 DM

A

Macrovascular Problems
Coronary artery diseases
Cardiovascular Diseases

Microvascular Problems
Nephropathy
Neuropathy
Retinopathy

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109
Q

Any degree of glucose intolerance with onset or first recognition during pregnancy

A

Gestational Diabetes Mellitus (GDM)

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110
Q

Risks of GDM for infants

A

Respiratory Distress Syndrome
Hypocalcemia
Hyperbilirubinemia

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111
Q

High glucose concentration in the infant can delay the maturation of the lungs. True or False?

A

True

112
Q

Screening for GDM should be performed during

A

Between 24 and 28 weeks of gestation

113
Q

A condition when there is an increased Growth Hormone production by the pituitary gland

A

Acromegaly

114
Q

Growth Hormone is a hypoglycemic agent. True or False?

A

False; hyperglycemic agent

115
Q

A condition when there is an increased cortisol levels in the body

A

Cushing Syndrome

116
Q

Cortisol is a hyperglycemic agent. True or False?

A

True

117
Q

Risk factors of Type 1 DM

A

Genetics
Autoimmune
Environmental

118
Q

Risk factors of Type 2 DM

A

Genetic
Obesity
Sedentary lifestyle
Race/ethnicity
PCOS (Polycystic Ovarian Syndrome)

119
Q

Conditions that can result to diabetes

A

Genetic defects of β-cell function
Pancreatic disease
Endocrine disease
Drug or chemical induced
Insulin receptor abnormalities
Other genetic syndromes

120
Q

Condition that occur after the renal tubular transporter system for glucose becomes saturated

A

Glucosuria

121
Q

Renal threshold for glucose

A

160-180mg/dL

122
Q

Condition that causes plasma glucose concentration to reach a plateau around 300 to 500 mg/dL (17 to 28 mmol/L)

A

Hepatic glucose overproduction

123
Q

Describes a potassium level in blood that’s higher than normal

A

Hyperkalemia

124
Q

According to the ADA recommendations all adults beginning at the age of _____ should be tested for diabetes every _____

A

45y/o; 3 years

125
Q

Criteria for the diagnosis of DM

A

HbA1c ≥ 6.5%
FBS ≥ 126 mg/dL (≥ 7.0 mmol/L)
OGTT with a 2-hour post load (75g glucose load) level ≥ 200 mg/dL (≥ 11.1 mmol/L)
Symptoms of diabetes plus a RBS level ≥ 200 mg/dL (≥ 11.1 mmol/L)

126
Q

All nondiabetic pregnant women should be screened for GDM at _____ weeks of gestation

A

24-28

127
Q

Criteria for the diagnosis of GDM

A

FBS value ≥ 92 mg/dL (5.1 mmol/L)
1-hour value ≥ 180 mg/dL (10 mmol/L),
2-hour glucose value ≥ 153 mg/dL (8.5 mmol/L)

128
Q

A hyperpigmentation condition wherein the skin in the leg, armpit, and groin areas have dark patches

A

Acanthosis nigricans

129
Q

Decreased plasma glucose levels

A

Hypoglycemia

130
Q

Extremely elevated insulin levels in patients with pancreatic b-cell tumors

A

Insulinoma

131
Q

Diagnostic criteria for hypoglycemia

A

65 to 70 mg/dL (3.6 to 3.9 mmol/L) - glucagon and other glycemic factors are released

50 to 55 mg/dL (2.8 to 3.1 mmol/L) - observable symptoms of hypoglycemia appear

132
Q

Diagnostic criteria for an insulinoma

A

Glucose level ≥ 25 mg/dL (1.4 mmol/L) coincident with an insulin level ≥ 6 μU/mL (41.7 pmol/L)
C-peptide levels ≥ 0.2 nmol/L
Proinsulin levels ≥ 5 pmol/L
B-hydroxybutyrate levels ≤ 2.7 mmol/L

133
Q

Deficiency of a specific enzyme that causes an alternation of glycogen metabolism

A

Glycogen storage diseases

134
Q

The most common congenital form of glycogen storage disease

A

Von Gierke disease

135
Q

Correction for Von Gierke disease

A

Liver transplantation

136
Q

Von Gierke disease is characterized by

A

Severe hypoglycemia that coincides with metabolic acidosis, ketonemia, and elevated lactate and alanine

137
Q

GSD that does not cause hypoglycemia but does cause hepatomegaly

A

Glycogen debrancher enzyme deficiency

138
Q

A cause of failure to thrive syndrome in infants, is a congenital deficiency of one of three enzymes involved in galactose metabolism, resulting in increased levels of galactose in plasma

A

Galactosemia

139
Q

Correction for Galactosemia

A

Galactose must be removed from the diet

140
Q

Deficient Enzyme in Galactosemia

A

Galactose-1-phosphate uridyltransferase (most common)
Galactokinase
Uridine diphosphate galactose-4-epimerase

141
Q

Laboratory findings in Galactosemia

A

Hypoglycemia
Hyperbilirubinemia
Galactose accumulation in the blood, tissue, and urine following milk ingestion

142
Q

Cause of essential fructosuria

A

Fructokinase deficiency

143
Q

Cause of hereditary fructose intolerance

A

Defect in fructose-1,6-biphosphate aldolase B activity

144
Q

Cause of fructose-1,6-biphosphatase deficiency

A

Defect in fructose-1,6-biphosphatase

145
Q

Enzyme deficient in IA (Von Gierke) GSD

A

Glucose-6-phosphate

146
Q

Enzyme deficient in IB GSD

A

Glucose-6-phosphate translocase

147
Q

Enzyme deficient in II (Pompe) GSD

A

1,4-glucosidase

148
Q

Enzyme deficient and tissue affected in IIIA (Cori Forbes) GSD

A

De Brancher; Liver and muscle

149
Q

Enzyme deficient and tissue affected in IIIB GSD

A

De Brancher; Liver

150
Q

Enzyme deficient in IV (Andersen) GSD

A

Amylopectinase/Glycogen branching enzyme

151
Q

Enzyme deficient in V (Mc Ardle) GSD

A

Muscle phosphorylase

152
Q

Enzyme deficient in VI (Hers) GSD

A

Liver phosphorylase

153
Q

Enzyme deficient in VII (Tarui) GSD

A

Phosphofructokinase

154
Q

Enzyme deficient in VIII GSD

A

Adenyl kinase

155
Q

Enzyme deficient an tissue affected in IXA GSD

A

Phosphorylase kinase; Liver

156
Q

Enzyme deficient in IXB GSD

A

Phosphorylase; Liver and muscle

157
Q

Enzyme deficient in X GSD

A

Cyclic AMP-dependent kinase

158
Q

Enzyme deficient in XI (Fanconi Bickel) GSD

A

Glycogen transporter-2

159
Q

Enzyme deficient in 0 GSD

A

Glycogen synthase

160
Q

Specimens used to measure glucose

A

Whole blood
Serum
Plasma
CSF
Pleural fluid
Urine

161
Q

The glucose concentration in whole blood is approximately _____ lower than the glucose concentration in plasma

A

11%

162
Q

Serum or plasma must be refrigerated and separated from the cells within

A

1 hour

163
Q

Often used as an anticoagulant and preservative of whole blood for glucose determination

A

Sodium fluoride ions (gray-top tubes)

164
Q

Fasting plasma glucose values have a diurnal variation. True or False?

A

True

165
Q

Most commonly used specimen for glucose determination

A

Serum and plasma

166
Q

POCT device for glucose determination

A

Glucometer

167
Q

Conversion factor for glucose

A

0.0555

168
Q

The most common methods of glucose analysis use the enzyme

A

Glucose oxidase or hexokinase

169
Q

The most specific enzyme reacting with only b-d-glucose

A

Glucose oxidase

170
Q

Glucose oxidase converts b-d glucose to

A

Gluconic acid

171
Q

Reference method for glucose

A

Hexokinase method

172
Q

Screening test for DM

A

FBS/FBG

173
Q

Normal fasting glucose

A

70-99 mg/dL (3.9-5.5 mmol/L)

174
Q

Impaired fasting glucose

A

100-125 mg/dL (5.6-6.9 mmol/L)

175
Q

Provisional diabetes diagnosis

A

≥126 mg/dL (≥7.0 mmol/L)

176
Q

Individual with impaired fasting glucose are under

A

Prediabetic state

177
Q

Glucose testing that can be done anytime

A

RBS

178
Q

Glucose testing that is done 2 hours after eating

A

2-hour PPBS

179
Q

Most common test under GTT

A

Oral glucose tolerance test

180
Q

Glucose tolerance test for patients with malabsorption syndrome

A

Intravenous glucose tolerance test (IVGTT)

181
Q

In performing OGTT, the patient should be _____

A

Ambulatory

182
Q

In OGTT, what should we do if FBG is >140mg/dL

A

Test should be terminated

183
Q

In OGTT, what should we do if FBG is <140mg/dL

A

Glucose load should be given to the patient

184
Q

The glucose load for adult is

A

75 g

185
Q

The glucose load for children is

A

1.75g/kg body weight (up to a 75 g maximum is given)

186
Q

The glucose should be dissolved in _____ of water, and ingested within _____

A

300 mL; 5 minutes

187
Q

In OGTT, what should we do if the patient vomits?

A

Discontinue the test

188
Q

Fasting for OGTT

A

8-10 hrs, not >16hrs

189
Q

When (time) to perform OGTT?

A

Morning 7AM-9AM

190
Q

In OGTT, patient is asked to consume _____ CHO per day for _____ prior to the test

A

150g; 3 days

191
Q

Samples collected in pregnant women during OGTT

A

Fasting plasma glucose sample
1 hour sample
2 hours sample

192
Q

Samples collected in non-pregnant patient during OGTT

A

Fasting sample
2 hours OGTT

193
Q

Normal glucose tolerance

A

Two-hour PG ≤140 mg/dL (≤7.8 mmol/L)

194
Q

Impaired glucose tolerance

A

Two-hour PG 140-199 mg/dL (7.8-11.1 mmol/L)

195
Q

Provisional diabetes diagnosis (OGTT)

A

Two-hour PG ≥ 200 mg/dL (≥11.1 mmol/L)a

196
Q

Individuals with impaired glucose tolerance are at risk of having

A

Diabetes (pre-diabetic state)

197
Q

Is the term used to describe the formation of a hemoglobin compound produced when glucose reacts with the amino group of hemoglobin

A

Glycosylated hemoglobin/HbA1c

198
Q

A more reliable method of monitoring long-term diabetes control over the previous 2-3 month period

A

HbA1c

199
Q

Specimen for HbA1c

A

Whole blood in EDTA

200
Q

For every 1% increase in HbA1c, there is a _____ change in plasma glucose

A

35 mg/dL (2 mmol/L)

201
Q

Normal HbA1c value

A

4%-6%

202
Q

Relationship between HbA1c formation and plasma glucose concentration

A

Directly proportional

203
Q

Two factors determine the glycosylated hemoglobin levels

A

The average glucose concentration
Red blood cell life span

204
Q

HbA1c result that indicates increased risk for diabetes

A

5.7%-6.4%

205
Q

HbA1c result that indicates diabetes

A

≥ 6.5%

206
Q

HbA1c goal for nonpregnant adults in general is

A

<7%

207
Q

Preferred method of HbA1c measurement

A

Affinity chromatography

208
Q

HbA1c measurement method that is temperature dependent and affected by hemoglobinopathies

A

Cation exchange chromatography

209
Q

In cation exchange chromatography, the presence of HbF yields

A

False increased levels

210
Q

In cation exchange chromatography, the presence of HbS yields

A

False decreased levels

211
Q

In cation exchange chromatography, the presence of HbC yields

A

False decreased levels

212
Q

A common point-of-care instrument HbA1c assay is based on a

A

Latex immunoagglutination inhibition methodology

213
Q

Methods used to separate the various forms of hemoglobin

A

High-performance liquid chromatography (HPLC)
Electrophoresis

214
Q

Fructosamine is also known as

A

Glycosylated albumin
Glycated albumin
Plasma protein ketoamine

215
Q

Clinical use of fructosamine

A

Used for monitoring glucose control over the previous 3-6 weeks

216
Q

Reference value for fructosamine

A

205-285 μmol/L

217
Q

Chemical methods for glucose determination

A

Oxidation reduction method
Condensation method

218
Q

Principle of Alkaline Copper Reduction Method

A

Reduction of cupric ions to cuprous ions forming cuprous oxide in hot alkaline solution by glucose

219
Q

Substrate of Folin Wu Method

A

Cuprous ions + Phosphomolybdate

220
Q

Product of Folin Wu Method

A

Phosphomolybdic Acid or Phosphomolybdenum Blue

221
Q

Substrate of Nelson Somogyi Method

A

Cuprous ions + Arsenomolybdate

222
Q

Product of Nelson Somogyi Method

A

Arsenomolybdic Acid or Arsenomolybdenum Blue

223
Q

Substrate of Neocuprein Method

A

Cuprous ions + Neocuprein

224
Q

Product of Neocuprein Method

A

Cuprous-Neocuprein Complex
(Yellow or Yellow Orange)

225
Q

Reagent of Neocuprein Method

A

2,9-Dimethy-1,10-Phenantroline Hydrochloride

226
Q

It is used for the detection and quantitation of reducing substances in body fluids like body and urine

A

Benedict’s Method (Modification of Folin Wu)

227
Q

Stabilizing agent for Benedict’s Method

A

Citrate or tartrate

228
Q

Substrate of Benedict’s Method

A

Copper Sulfate (blue) + glucose + heat

229
Q

Product of Benedict’s Method

A

Brick red precipitate

230
Q

Process of Alkaline Ferric Reduction Method (Hagedorn Jensen)

A

Reduction of a yellow ferricyanide to a colorless ferrocyanide by glucose

231
Q

Principle of Alkaline Ferric Reduction Method (Hagedorn Jensen)

A

Inverse Colorimetry

232
Q

Result of Alkaline Ferric Reduction Method when using Colorimetry

A

Colored complex

233
Q

Result of Alkaline Ferric Reduction Method when using Inverse Colorimetry

A

Colorless ferrocyanide

234
Q

Substrates of Ortho-toluidine (Dubowski Method)

A

Glucose + Aromatic Amines

235
Q

Products of Ortho-toluidine (Dubowski Method)

A

Glycosylamine + Schiff’s base (green-colored end product)

236
Q

Enzymatic methods for glucose determination

A

Glucose dehydrogenase method
Glucose oxidase method
Hexokinase method

237
Q

Most specific enzyme in glucose determination

A

Hexokinase

238
Q

Enzymes used in glucose dehydrogenase method

A

Mutarotase: to produce B-D glucose
Glucose dehydrogenase: to produce reduced form of NAD (NADH)
Diaphorase: to see colored end product (blue)

239
Q

In Glucose dehydrogenase method, what is the relationship between NADH and the amount of glucose in the sample?

A

Directly proportional

240
Q

Colorimetric Glucose Oxidase Method is also known as

A

Saifer Gernstenfield Method

241
Q

Chromogens in Colorimetric Glucose Oxidase Method

A

3-methyl-2-benzothiazolinone hydrazone
N, N-dimethylaniline

242
Q

Coupling enzyme under the colorimetric glucose oxidase method

A

Peroxidase

243
Q

Interference in the colorimetric glucose oxidase method

A

Falsely decreased values: increased levels of uric acid, bilirubin, and ascorbic acid

Falsely increased values: bleach

244
Q

Measures the rate of oxygen consumption which is proportional to glucose concentration

A

Polarographic Glucose Oxidase Method

245
Q

Coupling enzymes under the polarographic glucose oxidase method

A

Catalase
Molybdate

246
Q

Maximum absorption peak of NADPH

A

340 nm (wavelength)

247
Q

Coupling enzyme under the Hexokinase method

A

G-6-PD

248
Q

Produced by the liver through metabolism of fatty acids

A

Ketones

249
Q

Ketones are produced when _____

A

The body detects a decrease in blood glucose

250
Q

Types of Ketones

A

Acetone
Acetoacetic acid
3-β-hydroxybutyric acid

251
Q

Most abundant form of ketones

A

3-β-hydroxybutyric acid (78%)

Acetone (2%)
Acetoacetic acid (20%)

252
Q

Specimen used for ketone measurements

A

Fresh serum or urine

253
Q

Elevated ketone levels are seen in

A

DM
Starvation/fasting
High-fat diets
Prolonged vomiting
GSD

254
Q

Accumulation of ketones in blood

A

Ketonemia

255
Q

Accumulation of ketones in urine

A

Ketonuria

256
Q

Different tests for ketones

A

Gerhardt’s test
Sodium nitroprusside test
Enzymatic test

257
Q

Principle of Gerhardt’s test

A

Ferric chloride reacts with acetoacetic acid to produce a red color

258
Q

Principle of Sodium nitroprusside test

A

Sodium nitroprusside reacts with acetoacetic acid to produce a purple color

259
Q

Enzymatic test for ketones

A

Uses 3-hydroxybutyrate dehydrogenase to detect 3-β-hydroxybutyric acid or acetoacetic acid

260
Q

Defined as persistent albuminuria in two out of three urine collections of 30 to 300 mg/24 h, 20 to 200 μg/min, or an albumin–creatinine ratio of 30 to 300 μg/mg creatinine

A

Microalbuminuria

261
Q

Clinical significance of microalbumin measurements

A

Useful to assist in diagnosis at an early stage and before the development of proteinuria

262
Q

Clinical proteinuria or macroalbuminuria is established with an albumin–creatinine ratio

A

≥300 mg/24 h
>200 μg/min
≥300 μg/mg

263
Q

Methods of Specimen Collection for microalbumin

A

Random spot collection for albumin-creatinine ratio
24-hour collection
Timed 4-hour overnight collection

264
Q

Preferred method for microalbumin measurement

A

Random spot collection for albumin-creatinine ratio

265
Q

Patient is determined to have microalbuminuria when

A

Two of three specimens collected within a 3- to 6-month period are abnormal

266
Q

Factors that may elevate the urinary excretion of albumin

A

Exercise within 24 hours
Infection
Fever
Congestive heart failure
Marked hyperglycemia
Marked hypertension

267
Q

The presence of autoantibodies to the b-islet cells of the pancreas is characteristic of

A

Type 1 diabetes

268
Q

A slower autoimmune β-cell destruction that can occur in adults

A

Latent Autoimmune Diabetes of Adulthood (LADA) / Type 1a

269
Q

Lab Findings in Hyperglycemia:

A

Decreased or absent insulin
Increased glucose in plasma and urine
Increased urine specific gravity
Ketones in serum and urine
Decreased blood and urine pH (acidosis)
Electrolyte imbalance

270
Q

Diabetes testing recommended by ADA

A

Hemoglobin A1c (HbA1c),
Fasting plasma glucose
2-hour 75 g OGTT

271
Q

Criteria for the testing and diagnosis of GDM: (NEW)

A

Fasting: > 95 mg/dL (5.3 mmol/L)
1-hour plasma glucose: ≥ 180 mg/dL (10.0 mmol/L)
2-hour plasma glucose: ≥ 155 mg/dL (8.6 mmol/L)
3-hour plasma glucose: ≥ 140 mg/dL (7.8 mmol/L)

272
Q

Classification of hypoglycemia

A

Postabsorptive (fasting)
Postprandial (reactive)

273
Q

Whipple triad

A

Hypoglycemic symptoms
Plasma glucose is low (< 50 mg/dL)
Symptoms are relieved by administration of glucose or glucagon

274
Q

Symptoms of hypoglycemia

A

Increased hunger
Sweating
Nausea and vomiting
Dizziness
Nervousness and shaking,
Blurring of sight,
Mental confusion

275
Q

Glucose is metabolized at room temperature at a rate of _____; at 4°C, glucose decreases by approximately _____

A

7 mg/dL/hour
2 mg/dL/hour

CLINICAL CHEMISTRY (10 decks)

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