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clinical chem 1 > Carbohydrates > Flashcards

Carbohydrates Flashcards

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1
Q

What are the 4 categories for carbohydrate classification

A
  • size of carbon chain
  • location of CO functional group
  • number of sugar units
  • stereochemistry
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2
Q

What are the two forms of carbs

A

Aldose and ketose

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3
Q

What display of carbohydrates is the most accurate
- Hawthorne
- open Fischer
- cyclic Fischer

A

Hawthorn

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4
Q

what is the purpose of microvilli

A

increase surface area on intestines to increase absorption

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5
Q

what must polysaccharides be converted to to enter the blood

A

monosaccharides

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6
Q

glycogenesis

A

creation of glycogen in liver and muscle

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7
Q

glycogenolysis

A

break down of glycogen to release glucose

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8
Q

gluconeogenesis

A

creation of new glucose from non carb sources such as fatty acids

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9
Q

glycolysis

A

formation of atp, CO2 and water from glucose

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10
Q

lipogenesis

A

conversion of carbs to fatty acids

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11
Q

lipolysis

A

decomposition of fat

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12
Q

glycogen

A

storage form for glucose

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13
Q

what is the renal threshold

A

where blood sugar is so high, glucose spills past kidney filtration and into urine (>180 mg/dL)

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14
Q

A diabetic patient comes into the doctor’s office with a fasting blood sugar of 192 mg/dL and a HbA1c value of 14%. Based on these results, what statement best describes the patient.
- diabetes mellitus is managed
- diabetes mellitus is not managed
- values not indicative of diabetes mellitus

A

diabetes mellitus not managed

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15
Q

Of the following glucose levels, which would you expect to result in glucose in the urine?
- 32 mg/dL
- 162 mg/dL
- 172 mg/dL
- 192 mg/dL

A

192 mg/dL
>180 mg/dL is over the renal threshold

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16
Q

Diabetic condition formed when a person’s own immune system destroys the islet cells of the pancreas, resulting in impaired production of insulin.
- type 1 diabetes
- type 2 diabetes
- gestational diabetes

A

type 1

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17
Q

describe glucose processing during a ‘fed state’

A

insulin from pancreatic beta cells released to lower blood glucose levels

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18
Q

what glucose pathways are activated from insulin release during ‘fed state’

A
  • lipogenesis (fat creation)
  • protein synthesis
  • glycogenesis
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19
Q

what glucose pathways are activated in low insulin level environments

A

lipolysis (breakdown of fat)
ketone formation
gluconeogenesis
glycogenolysis

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20
Q

during ‘fasting state’ where does the body get glucose

A

glucagon triggers glycogen conversion to glucose in the liver -> released into the blood

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21
Q

what is the purpose of somatostatin and what cell releases it

A

released by delta cells in the pancreas to regulate alpha and beta cell activity

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22
Q

what cell in the pancrease releases glucagon

A

alpha pancreatic cells
-> converts glycogen to glucose for low glucose lvl response

23
Q

what cell in the pancreas releases insulin

A

beta cells to convert glucose uptake in adipose tissue or muscle or glycogen creation
(lipogenesis, glycolysis or gluconeogenesis)

24
Q

how does epinephrine impact insulin and glucagon

A

inhibits insulin and stimulates glucagon/glycogenolysis to increase blood glucose

25
Q

define hyperglycemia

A

high blood glucose

26
Q

describe endocrine disorders linked to high blood glucose lvls

A
  • acromegaly (inc growth hormone)
  • cushing syndrome (inc cortisol)
  • thyrotoxicosis (increase pancreatic activity)
  • pheochromocytome (inc epinephrine)
  • diabetes mellitus
27
Q

list diagnostic criteria for diabetes mellitus with symptoms

A
  • Hgb A1c >6.5%
  • fasting plasma >126 mg/dL
  • 2hr plasma glucose >200 mg/dL
  • random blood glucose >200mg/dL with symptoms
28
Q

describe type 1 diabetes

A

beta cell destruction by autoimmune process leading to absolute insulin deficiency

29
Q

describe type 2 diabetes

A

insulin resistance in peripheral tissue and an insulin secretory defect of beta cells

30
Q

name other types/causes of diabetes

A
  • pancreatic, hormonal disease
  • drug/chemical toxicity
  • insulin receptor abnormalities
  • no renal or retinal complications
31
Q

define normal fasting glucose

A

70-99 mg/dL or 3.9-5.5 mmol/L

32
Q

define impaired fasting glucose

A

100-125 mg/dL or 5.6-6.9mmol/L

33
Q

define provisional diabetes diagnosis (fasting plasma glucose levels)

A

> 126 mg/dL or >7 mmol/L

34
Q

describe gestational diabetes mellitus

A
  • diabetes due to pregnancy
  • 50g glucose screen >140 mg/dL
35
Q

what are the two approaches to diagnosing gestational diabetes

A
  • one step: 3 measurements over 2 hrs
  • two step: 4 measurements over 3 hrs
36
Q

define normal and impaired glucose tolerance in oral glucose test

A
  • normal 2 hr plasma glucose <140 mg/dL
  • impaired 2 hr plasma glucose 140-199 mg/dL
37
Q

define levels of hypoglycemia classification

A
  • lvl 1: glucose <70mg/dL
  • lvl 2: glucose <54 mg/dL
  • lvl 3: no specific glucose threshold, pt not responding
38
Q

true or false:
not separating serum/plasma from cells soon after collection will cause a false decrease of glucose

A

true
cells will continue to metabolize glucose and lower levels

39
Q

how can a whole blood specimen be preserved for glucose testing

A

NaF for 24 hrs

40
Q

RR for plasma/serum glucose

A

70-105 mg/dL

41
Q

what method is commonly used to measure glucose

A

hexokinase - endpoint rxn

42
Q

how does hgb A1c indicate management of diabetes mellitus

A
  • hgb is glycated for full life cycle
  • hgb A1c = 80% of total glycohgb
  • measurements of A1c can indicate past glucose intake levels
  • RR 3-6% hgb
43
Q

define inborn errors of carbohydrate metabolism

A
  • lactose intolerance: deficiency in intestinal mucosal lactase
  • ketones: complication of uncontrolled diabetes mellitus (acid base imbalance)
44
Q

examples of disaccharides

A
  • lactose
  • sucrose
  • maltose
45
Q

hyperglycemia causes (etiology)

A
  • diabetes mellitus
  • endocrine disorders (acromegaly, cushings, pheochromocytoma, thyrotoxicosis)
  • drugs (anesthetics and steroids)
46
Q

what happens if hyperglycemia goes untreated

A

diabetes complications
- nerve damage
- eye disease
- kidney damage

47
Q

hypoglycemia etiology

A
  • insulin over dose
  • drugs
  • alcoholism
  • insulinoma
  • galactosemia
  • glycogen storage diseases
48
Q

long term effects of untreated hypoglycemia

A

brain starved of glucose
- seizures
- coma
- death

49
Q

most common non-reducing substance

A

sucrose

50
Q

C-peptide

A

by-product of insulin production

51
Q

define reducing substances

A

carbs that can reduce other compounds while being oxidized

52
Q

what is the Hgb A1c percent relating to 126 mg/dL glucose

A

6%

53
Q

what is the Hgb A1c percent relating to 154 mg/dL glucose

A

7%

54
Q

what is the Hgb A1c percent relating to 212 mg/dL glucose

A

9%

clinical chem 1 (23 decks)

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