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Clinical Chem Snoopy style > Carbohydrates > Flashcards

Carbohydrates Flashcards

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1
Q

What are carbs?

A

compounds containing C,H,O
all contain C=O groups and -OH groups

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2
Q

What are the 4 classifications of Carbs?

A

size of base of carbon chain
location of CO functional group
# of sugar units
stereochemistry of compound

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3
Q

What are the two forms of carbohydrates?

A

aldose and ketose -> carb group in the middle ketone

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4
Q

What is the primary energy source of the Brain?

A

Carbs, natural are the best like grains

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5
Q

What is the smallest carb?

A

glyceraldyhede (3 carbs)

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6
Q

What is a fisher projection?

A

aldehyde group at top, straight chain or link for circular function

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7
Q

Is a fisher projection more accurate than a Haworth projection?

A

No, Haworth is more accurate

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8
Q

Describe a stereoisomer

A

same bonds, different spacial arrangement, assigned as D or L by height of highest carbon
D - natural, metabolize
L - version body can’t handle

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9
Q

Describe a monosaccharide

A

simple sugars that can’t be hydrolyzed to simpler forms
(hydrolysis splits sugar via water release
when two carbs join it uses water)

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10
Q

What are most common monosaccharides?

A

Glucose, fructose and galactose

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11
Q

T/F: we use D-glucose and need D-galactose to convert to glucose

A

true

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12
Q

Describe Disaccharides
common forms?

A

two monosaccharide units joined by glycosdic linkage
common forms: maltose/sucrose

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13
Q

Describe polysaccharides
Common forms?

A

formed by linkages of monosaccharides or oligosaccharides (3-10 units)
Common forms: starch (plant) and glycogen (animal)

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14
Q

What are some chemical properties of carbs?

A

some are reducing substances
most commonly are NON reducing - sucrose
can reduce other compounds when oxidized
MONO/DISACCHARIDES ARE REDUCERS

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15
Q

Metabolism of glucose and carbs are primary energy source for what? what cannot store carbs?

A

primary energy source for CNS
Nervous tissues can’t store carbs

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16
Q

Describe Glycogen

A

create or synthesize
increased glucose = don’t need glycogen
usage/storage/can be converted to fats
(glucose energy)

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17
Q

T/F Intestinal absorption is via jejunum villi/microvili and increases surface area/energy absorbed

A

True

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18
Q

T/F: Monosaccharides are easier to absorb

A

true

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19
Q

What uses the most glucose, then what else?

A

brain uses the most glucose, then rbc/wbc, then muscle or its conv to fat cells

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20
Q

T/F 3/4th of glucose comes from glycogen stored in the kindey

A

false, 3/4th glucose comes from glycogen stored in the liver

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21
Q

What is glycogenesis

A

glucose to glycogen (liver/muscle)

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22
Q

What is glycogenoisis

A

glycogen - glucose

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23
Q

What is gluconeogenesis

A

non CHO source (fatty acid) - glucose

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24
Q

What is glycolysis

A

glucose - CO2+H20+ATP

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25
Q

What is the renal threshold

A

proximal convoluted tubule 180mg/dl
>180mg spill over into urine

26
Q

What is lipogenesis

A

carbs - fatty acids

27
Q

What is lipolysis

A

decomposition of fats

28
Q

Describe the “Fed State”
what kind of synthesis
what cells
uptake of ?
increased insulin =
decreased insulin =

A

insulin from pancreatic Beta cells
anabolic synthesis
Promotes cellular uptake of glucose
Increased insulin = lipogenesis
glycogenesis

Decreased insulin = lipolysis
ketone formation
gluconeogenesis
glucogenosis

29
Q

Describe the “Fasting state”

A

glucagon release from pancreatic alpha cells
catabolic synthesis
liver: glycogen - glucose –> blood
Muscle: glycogen conv. to G6PO4 in muscle for energy

30
Q

Describe “Fight or flight” state

A

epinephrine from adrenal medulla action similar to glucagon

31
Q

Action of Hormones: Insulin increases what, decreases

A

increases : glycogenesis/glycolysis
lipogenesis
Decrease: glycogenolysis

32
Q

Action of hormones: Glucagon increases what?

A

increases glycogenolysis
gluconeogenesis

33
Q

Describe Hyperglycemia

A

diabetes mellitus, endocrine disorders, untreated leads to type 2 diabetes (acromegaly, Cushing syndrome)

Drugs: anesthetics
steroids

34
Q

What are some symptoms of diabetes?

Hgb A1C
Fasting plasma glucose
2hr plasma glucose
random plasma glucose

A

polyuria
polydipsia
unexplained weight loss

Hbg A1C >6.5%
fasting plasma glucose >126
2hr plasma glucose >200
random plasma glucose >200

35
Q

Describe T1D:
Type 1A:
Type 1B:

A

Juvenile onset 5-10yrs
Type 1A: beta cell destruction by autoimmune absolute insulin decreases pt must take insulin
acute onset/days to weeks
islet cell Ab
Type 1B: Idiopathic adults

36
Q

Describe T2D:

A

insulin resistant in peripheral tissues, secretory deficiency of B cells
variable insulin
associated w family hxt >40 obesity/lack of exercise

37
Q

Describe Gestational diabetes:

A

glucose intolerance during pregnancy in 2/3rd trimester of pregnancy

38
Q

Lab findings of hyperglycemia

A

decrease or absent insulin
increase glucose in plasma/urine
increase urine spec. gravity/serum osmolality
Ketones in serum/urine
decreased blood/urine pH

39
Q

Ref ranges:
normal fasting glucose
Impaired fasting glucose
Provisional diabetes diagnosis

A

N fasting glucose: 70-99
Impaired fasting: 100-125
Provis diabetes: >126

40
Q

Describe gestational diabetes:
1hr
2hr
3hr

A

frequent but transitory
greater risk of prenatal complication
Human placental lactogen
>140 on hour after 50g glucose

1hr: >180
2hr: >155
3hr: >140

41
Q

Describe the glucose tolerance test:
pt prep

A

pt prep
normal diet 3 days prior
no food after reg evening meal on day before
blood/urine
allow water but not gum

42
Q

describe Hypoglycemia:
caused by what
disease states?

A

insulin overdose
drugs: sulfon/antihistamines
alcoholism
insulinoma
galactosemia
glycogen storage disease

43
Q

Glucose tolerence test
Normal 2hr
impaired
provisional diabetes

A

2hr <140
impaired 140-199
provisional >200

44
Q

Glucose Tolerence test, describe level 1, 2 and 3

A

1: glucose alert value <70
2: clinical significance hypoglycemia <54
3: severe hypoglycemia no specific threshold

45
Q

T/F if serum/plasma are not separated from cells, glucose will continue to increase

A

false, glucose will be used and will cause a false decreased glucose result

46
Q

What is the renal threshold for reabsorbance of glucose
what does glycosuria look like?

A

threshold is <180
glycosuria looks like >180

47
Q

Determination of glucose uses what
decrease per hour?
what preserves?

A

whole blood, examples glucose monitors or at home
7% decrease/hr
sodium fluoride preserves 24hr at RT

48
Q

T/F lithium iodoacetate preserves glucose with no interference w urease

A

true

49
Q

T/F plasma and serum are 10-15% higher level than whole blood glucose

A

true

50
Q

CSF glucose
Urine glucose levels

A

CSF 40-70
Urine <500/24hr

51
Q

Briefly describe these measurements
Glucose oxidase
glucose hexokinase
Clinitst

A

GO: cheap
GHex: we use, end point reaction
Clinitst: least specific reducing in urine

52
Q

T/F you usually use glucose to measure/treat diabetes

A

false

53
Q

Describe Glycated hgb A

A

non enzymatic process of conversion of HgbA to HgbA1

54
Q

T/F alb can bind to proteins/glucose in cells that get glycolated and stays for whole time of your life

A

True it tis forever

55
Q

Describe Glycated Hgb

A

irreversible, reflects glucose levels 4-8wks
HgbA1c = 80% total glycogen
3-6% total hgb

56
Q

T/F HgbA1c decrease by 1% = microvascular complications being reduced by 40%

A

false, reduced by 35%

57
Q

Describe the Roche diagnostics briefly

Glycated serum Pt:

A

automated, doesn’t have risk w hgb variants
whole blood tests
avg blood glucose

Glycated serum Pt: alb turn over 2-3 wks
fructosanin?

58
Q

Describe carb. inborn errors of metabolism

A

glycogen storage disorders
lack of enzymes
increase tissue glycogen
limited lifespan

59
Q

Describe lactose intolerence

A

deficient intestinal mucosal lactase
GTT baseline
non flat curve (pain)

60
Q
A

Clinical Chem Snoopy style (8 decks)

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