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Clinical Chemistry Review > Carbohydrates > Flashcards

Carbohydrates Flashcards

1
Q

The simplest carbohydrate

A

Glycol aldehyde

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2
Q

Most common nunreducing sugar

A

Sucrose

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3
Q

Pancreas
Exocrine:
Endocrine:

A

Enzymes (AMS, LPS)

Hormones (Insulin, glucagon, somatostatin)

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4
Q

Hyperglycemic Hormones “GAG CHET”

A

Glucagon
ACTH
GH
Cortisol
Human Placental Lactogen
Epinephrine
Thyroxine

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5
Q

Hyperglycemia (≥126 mg/dL)
Electrolyte Imbalance:

Increased:
Decreased:

A

Potassium

Sodium, Bicarbonate

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6
Q

Hypoglycemia
= Symptoms
= Diagnostic

A

50-55 mg/dL

≤50 mg/dL

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7
Q

Whipple’s triad (Hypoglycemia)

A

Low blood glucose concentration
Typical symptoms
Symptoms alleviated by glucose administration

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8
Q

Ratio of BHA to AA in severe DM (Normal = 1:1)

A

6:1

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9
Q

IDDM

A

Type 1 DM

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10
Q

Juvenile Onset

A

Type 1 DM

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11
Q

Brittle

A

Type 1 DM

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12
Q

Ketosis-prone

A

Type 1 DM

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13
Q

80-90% reduction of beta-cells

A

Symptomatic Type 1 DM

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14
Q

HLA-DR3 and DR4

A

Type 1 DM

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15
Q

(+) Glutamic acid decarboxylase (GAD65)

A

Type 1 DM

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16
Q

(+) Insulin autoantibodies

A

Type 1 DM

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17
Q

(+) Microalbuminuria: 50-200 mg/24 hours = Diabetic nephropathy

A

Type 1 DM

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18
Q

(-) C-peptide

A

Type 1 DM

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19
Q

Complications of Type I DM

A

Microvascular disorders:
Nephropathy Neuropathy Retinopathy

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20
Q

NIDDM

A

Type 2

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21
Q

Adult type/Maturity Onset

A

Type 2

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22
Q

Stable

A

Type 2

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23
Q

Ketosis-resistant

A

Type 2

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24
Q

Receptor-deficient

A

Type 2

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25
Q

Insulin resistance: relative insulin deficiency

A

Type 2

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26
Q

Strong genetic predisposition

A

Type 2

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27
Q

Geneticist’s nightmare

A

Type 2

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28
Q

If untreated > glucose: >500 mg/dL > nonketotic hyperosmolar coma

A

Type 2

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29
Q

Screening: 1hr GCT (50g) – bet. 24 and 28 weeks of gestation

A

Gestational DM

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30
Q

Confirmatory: 3-hr GTT (100g)

A

Gestational DM

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31
Q

Infants: at risk for respiratory distress syndrome, hypocalcemia, hyperbilirubinemia

A

Gestational DM

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32
Q

After giving birth, evaluate 6-12 weeks postpartum

A

Gestational DM

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33
Q

Converts to DM w/in 10 years in 30-40% of cases

A

Gestational DM

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34
Q

OGTT (GDM)
FBS =
1-Hr =
2-Hr =
3-Hr =
GDM =

A

≥95 mg/dL

≥ 180 mg/dL

≥ 155 mg/dL

≥ 140 mg/dL

2 plasma values of the above glucose levels are exceeded

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35
Q

Impaired fasting glucose (Pre-diabetes)
FBS =
Impaired glucose tolerance FBS =

A

100-125 mg/dL

<126 mg/dL 2-Hr OGTT = 140-199 mg/dL

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36
Q

FBS
WB = [?] ower than in serum or plasma
VB = [?] lower than capillary and arterial blood

A

15%

7 mg/dL

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37
Q

60-70% of the plasma glucose

A

CSF glucose

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38
Q

Same with plasma glucose

A

Peritoneal fluid glucose

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39
Q

Plasma glucose increases w/ age
Fasting:
Postprandial:
Glucose challenge:

A

2 mg/dL/decade

4 mg/dL/decade

8-13 mg/dL/decade

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40
Q

Separate serum/plasma from the cells

A

w/in 1 hour (Preferably w/in 30 mins)

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41
Q

Glycolysis at room temperature

A

5-7%/hr

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42
Q

Glycolysis at refrigerated temperature

A

1-2 mg%/hr

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43
Q

Cupric  Cuprous  Cuprous oxide

A

Copper reduction methods

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44
Q

Cuprous ions + phosphomolybdate  phosphomolybdenum blue

A

Folin Wu

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45
Q

Cuprous ions + arsenomolybdate  arsenomolybdenum blue

A

Nelson-Somogyi

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46
Q

Cuprous ions + neocuproine  Cuprous-neocuproine complex (yellow)

A

Neocuproine method

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47
Q

Reducing substances in blood and urine

A

Benedict’s method

48
Q

Ferricyanide —(Glucose)–> Ferrocyanide (Yellow) (Colorless)

A

Alkaline Ferric Reduction method (Hagedorn-Jensen)

49
Q

Schiff’s base

A

Ortho-toluidine (Dubowski method)

50
Q

Measures beta-D-glucose (65%)

A

Glucose oxidase

51
Q

Converts alpha-D-glucose (35%) to beta-D-glucose (65%)

A

Mutarotase

52
Q

Absorbance at 340nm

A

NADH/NADPH

53
Q

Consumption of oxygen on an oxygen-sensing electrode

A

Polarographic glucose oxidase

54
Q

GLUCOSE: Most specific method

A

Hexokinase method

55
Q

GLUCOSE: Reference method

A

Hexokinase method

56
Q

Uses G-6-PD

A

Hexokinase method

57
Q

Most specific enzyme rgt for glucose testing

58
Q

Interfering substances (Glucose oxidase)
False-decreased

A

Bilirubin
Uric acid
Ascorbate

59
Q

Major interfering substance in hexokinase method (false-decreased)

A

Hemolysis (>0.5 g/dL Hgb)

60
Q

Cellular strip ; Strip w/ glucose oxidase, peroxidase and chromogen

A

Dextrostics

61
Q

OGTT
(Single dose) = most common
(Double dose)
Drink the glucose load within

A

Janney-Isaacson method

Exton Rose

5 mins

62
Q

For patients with gastrointestinal disorders (malabsorption)

63
Q

Glucose: 0.5 g/kg body weight

64
Q

Given w/in 3 mins

65
Q

1st blood collection: after 5 mins of IV glucose

66
Q

Ambulatory

67
Q

Fasting: 8-14 hours

68
Q

Unrestricted diet of 150g CHO/day for 3 days

69
Q

Do not smoke or drink alcohol

70
Q

Glucose load
= adult (WHO std)
= pregnant
= children

A

75 g

100 g

1.75 g glucose/kg BW

71
Q

2-3 months

72
Q

Glucose = beta-chain of

73
Q

= 35 mg/dL increase in plasma glucose

A

1% increase in HbA1c

74
Q

HbA1c
= prolonged hyperglycemia
= cutoff

75
Q

HbA1c Specimen:

A

EDTA whole blood

76
Q

HbA1c Test:

A

Affinity chromatography (preferred)

77
Q

High HbA1c

A

IDA and older RBCs

78
Q

Low HbA1c

A

RBC lifespan disorders

79
Q

2-3 weeks

A

Fructosamine (Glycosylated albumin/ plasma protein ketoamine)

80
Q

Useful for patients w/ hemolytic anemias and Hgb variants

A

Fructosamine (Glycosylated albumin/ plasma protein ketoamine)

81
Q

Not used in cases of low albumin

A

Fructosamine (Glycosylated albumin/ plasma protein ketoamine)

82
Q

Fructosamine (Glycosylated albumin/ plasma protein ketoamine) Specimen:

83
Q

Congenital deficiency of 1 of 3 enzymes in galactose metabolism

A

Galactosemia

84
Q

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

A

Galactosemia

85
Q

Autosomal recessive

A

Essential fructosuria

Glycogen Storage Disease

86
Q

Fructokinase deficiency

A

Essential fructosuria

87
Q

Defective fructose-1,6-biphosphate aldolase B activity

A

Hereditary fructose intolerance

88
Q

Failure of hepatic glucose generation by gluconeogenic precursors such as lactate and glycerol

A

Fructose-1,6-biphosphate deficiency

89
Q

Defective glycogen metabolism

A

Glycogen Storage Disease

90
Q

Glycogen Storage Disease Test:

A

IVGTT (Type I GSD)

91
Q

Glucose-6-Phosphatase deficiency (most common worldwide)

A

Ia = Von Gierke

92
Q

Alpha-1,4-glucosidase deficiency (most common in the Philippines)

A

II = Pompe

93
Q

Debrancher enzyme deficiency

A

III = Cori Forbes

94
Q

Brancher enzyme deficiency

A

IV = Andersen

95
Q

Muscle phosphorylase deficiency

A

V = McArdle

96
Q

Liver phosphorylase deficiency

97
Q

Phosphofructokinase deficiency

A

VII = Tarui

98
Q

Glucose transporter 2 deficiency

A

XII = Fanconi-Bickel

99
Q

CSF glucose: Collect blood glucose at least [?] before the lumbar puncture (Because of the lag in CSF glucose equilibrium time)

A

60 mins (to 2 hrs)

100
Q

Normal CSF : serum glucose ratio

101
Q

Formed during conversion of pro-insulin to insulin

102
Q

Normal C-peptide : insulin ratio

A

5:1 to 15:1

103
Q

Differentiate pancreatic insufficiency from malabsorption (low blood or urine xylose)

A

D-xylose absorption test

104
Q

Acetoacetate

A

Gerhardt’s ferric chloride test

105
Q

10x more sensitive to acetoacetate than to acetone

A

Nitroprusside test

106
Q

Acetoacetate and acetone

A

Acetest tablets

107
Q

Detects acetoacetate better than acetone

108
Q

Detects beta-hydroxybutyrate but not widely used

A

KetoSite assay

109
Q

RBS =

A

<140 mg/dL

110
Q

FBS =

A

70-100 mg/dL

111
Q

HbA1c =

112
Q

Fructosamine =

A

205-285 μmol/L

113
Q

2-Hr PPBS =

A

<140 mg/dL

114
Q

GTT:
30 mins =
1-Hr =
2-Hr =
3-Hr =

A

30-60 mg/dL above fasting

20-50 mg/dL above fasting

5-15 mg/dL above fasting

fasting level or below

115
Q

O2 consumption α glucose concentration

A

Polarographic glucose oxidase

Clinical Chemistry Review (15 decks)

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