Carbohydrates Flashcards
1
Q
The simplest carbohydrate
A
Glycol aldehyde
2
Q
Most common nunreducing sugar
A
Sucrose
3
Q
Pancreas
Exocrine:
Endocrine:
A
Enzymes (AMS, LPS)
Hormones (Insulin, glucagon, somatostatin)
4
Q
Hyperglycemic Hormones “GAG CHET”
A
Glucagon
ACTH
GH
Cortisol
Human Placental Lactogen
Epinephrine
Thyroxine
5
Q
Hyperglycemia (≥126 mg/dL)
Electrolyte Imbalance:
Increased:
Decreased:
A
Potassium
Sodium, Bicarbonate
6
Q
Hypoglycemia
= Symptoms
= Diagnostic
A
50-55 mg/dL
≤50 mg/dL
7
Q
Whipple’s triad (Hypoglycemia)
A
Low blood glucose concentration
Typical symptoms
Symptoms alleviated by glucose administration
8
Q
Ratio of BHA to AA in severe DM (Normal = 1:1)
A
6:1
9
Q
IDDM
A
Type 1 DM
10
Q
Juvenile Onset
A
Type 1 DM
11
Q
Brittle
A
Type 1 DM
12
Q
Ketosis-prone
A
Type 1 DM
13
Q
80-90% reduction of beta-cells
A
Symptomatic Type 1 DM
14
Q
HLA-DR3 and DR4
A
Type 1 DM
15
Q
(+) Glutamic acid decarboxylase (GAD65)
A
Type 1 DM
16
Q
(+) Insulin autoantibodies
A
Type 1 DM
17
Q
(+) Microalbuminuria: 50-200 mg/24 hours = Diabetic nephropathy
A
Type 1 DM
18
Q
(-) C-peptide
A
Type 1 DM
19
Q
Complications of Type I DM
A
Microvascular disorders:
Nephropathy Neuropathy Retinopathy
20
Q
NIDDM
A
Type 2
21
Q
Adult type/Maturity Onset
A
Type 2
22
Q
Stable
A
Type 2
23
Q
Ketosis-resistant
A
Type 2
24
Q
Receptor-deficient
A
Type 2
25
Insulin resistance: relative insulin deficiency
Type 2
26
Strong genetic predisposition
Type 2
27
Geneticist’s nightmare
Type 2
28
If untreated > glucose: >500 mg/dL > nonketotic hyperosmolar coma
Type 2
29
Screening: 1hr GCT (50g) – bet. 24 and 28 weeks of gestation
Gestational DM
30
Confirmatory: 3-hr GTT (100g)
Gestational DM
31
Infants: at risk for respiratory distress syndrome, hypocalcemia, hyperbilirubinemia
Gestational DM
32
After giving birth, evaluate 6-12 weeks postpartum
Gestational DM
33
Converts to DM w/in 10 years in 30-40% of cases
Gestational DM
34
OGTT (GDM)
FBS =
1-Hr =
2-Hr =
3-Hr =
GDM =
≥95 mg/dL
≥ 180 mg/dL
≥ 155 mg/dL
≥ 140 mg/dL
2 plasma values of the above glucose levels are exceeded
35
Impaired fasting glucose (Pre-diabetes)
FBS =
Impaired glucose tolerance FBS =
100-125 mg/dL
<126 mg/dL 2-Hr OGTT = 140-199 mg/dL
36
FBS
WB = [?] ower than in serum or plasma
VB = [?] lower than capillary and arterial blood
15%
7 mg/dL
37
60-70% of the plasma glucose
CSF glucose
38
Same with plasma glucose
Peritoneal fluid glucose
39
Plasma glucose increases w/ age
Fasting:
Postprandial:
Glucose challenge:
2 mg/dL/decade
4 mg/dL/decade
8-13 mg/dL/decade
40
Separate serum/plasma from the cells
w/in 1 hour (Preferably w/in 30 mins)
41
Glycolysis at room temperature
5-7%/hr
42
Glycolysis at refrigerated temperature
1-2 mg%/hr
43
Cupric Cuprous Cuprous oxide
Copper reduction methods
44
Cuprous ions + phosphomolybdate phosphomolybdenum blue
Folin Wu
45
Cuprous ions + arsenomolybdate arsenomolybdenum blue
Nelson-Somogyi
46
Cuprous ions + neocuproine Cuprous-neocuproine complex (yellow)
Neocuproine method
47
Reducing substances in blood and urine
Benedict’s method
48
Ferricyanide ---(Glucose)--> Ferrocyanide (Yellow) (Colorless)
Alkaline Ferric Reduction method (Hagedorn-Jensen)
49
Schiff’s base
Ortho-toluidine (Dubowski method)
50
Measures beta-D-glucose (65%)
Glucose oxidase
51
Converts alpha-D-glucose (35%) to beta-D-glucose (65%)
Mutarotase
52
Absorbance at 340nm
NADH/NADPH
53
Consumption of oxygen on an oxygen-sensing electrode
Polarographic glucose oxidase
54
GLUCOSE: Most specific method
Hexokinase method
55
GLUCOSE: Reference method
Hexokinase method
56
Uses G-6-PD
Hexokinase method
57
Most specific enzyme rgt for glucose testing
G-6-PD
58
Interfering substances (Glucose oxidase)
False-decreased
Bilirubin
Uric acid
Ascorbate
59
Major interfering substance in hexokinase method (false-decreased)
Hemolysis (>0.5 g/dL Hgb)
60
Cellular strip ; Strip w/ glucose oxidase, peroxidase and chromogen
Dextrostics
61
OGTT
(Single dose) = most common
(Double dose)
Drink the glucose load within
Janney-Isaacson method
Exton Rose
5 mins
62
For patients with gastrointestinal disorders (malabsorption)
IVGTT
63
Glucose: 0.5 g/kg body weight
IVGTT
64
Given w/in 3 mins
IVGTT
65
1st blood collection: after 5 mins of IV glucose
IVGTT
66
Ambulatory
OGTT
67
Fasting: 8-14 hours
OGTT
68
Unrestricted diet of 150g CHO/day for 3 days
OGTT
69
Do not smoke or drink alcohol
OGTT
70
Glucose load
= adult (WHO std)
= pregnant
= children
75 g
100 g
1.75 g glucose/kg BW
71
2-3 months
HbA1c
72
Glucose = beta-chain of
HbA1
73
= 35 mg/dL increase in plasma glucose
1% increase in HbA1c
74
HbA1c
= prolonged hyperglycemia
= cutoff
18-20%
7%
75
HbA1c Specimen:
EDTA whole blood
76
HbA1c Test:
Affinity chromatography (preferred)
77
High HbA1c
IDA and older RBCs
78
Low HbA1c
RBC lifespan disorders
79
2-3 weeks
Fructosamine (Glycosylated albumin/ plasma protein ketoamine)
80
Useful for patients w/ hemolytic anemias and Hgb variants
Fructosamine (Glycosylated albumin/ plasma protein ketoamine)
81
Not used in cases of low albumin
Fructosamine (Glycosylated albumin/ plasma protein ketoamine)
82
Fructosamine (Glycosylated albumin/ plasma protein ketoamine) Specimen:
Serum
83
Congenital deficiency of 1 of 3 enzymes in galactose metabolism
Galactosemia
84
Galactose-1-phosphate uridyl transferase (most common) Galactokinase
Uridine diphosphate galactose-4-epimerase
Galactosemia
85
Autosomal recessive
Essential fructosuria
Glycogen Storage Disease
86
Fructokinase deficiency
Essential fructosuria
87
Defective fructose-1,6-biphosphate aldolase B activity
Hereditary fructose intolerance
88
Failure of hepatic glucose generation by gluconeogenic precursors such as lactate and glycerol
Fructose-1,6-biphosphate deficiency
89
Defective glycogen metabolism
Glycogen Storage Disease
90
Glycogen Storage Disease Test:
IVGTT (Type I GSD)
91
Glucose-6-Phosphatase deficiency (most common worldwide)
Ia = Von Gierke
92
Alpha-1,4-glucosidase deficiency (most common in the Philippines)
II = Pompe
93
Debrancher enzyme deficiency
III = Cori Forbes
94
Brancher enzyme deficiency
IV = Andersen
95
Muscle phosphorylase deficiency
V = McArdle
96
Liver phosphorylase deficiency
VI = Hers
97
Phosphofructokinase deficiency
VII = Tarui
98
Glucose transporter 2 deficiency
XII = Fanconi-Bickel
99
CSF glucose: Collect blood glucose at least [?] before the lumbar puncture (Because of the lag in CSF glucose equilibrium time)
60 mins (to 2 hrs)
100
Normal CSF : serum glucose ratio
< 0.5
101
Formed during conversion of pro-insulin to insulin
C-peptide
102
Normal C-peptide : insulin ratio
5:1 to 15:1
103
Differentiate pancreatic insufficiency from malabsorption (low blood or urine xylose)
D-xylose absorption test
104
Acetoacetate
Gerhardt’s ferric chloride test
105
10x more sensitive to acetoacetate than to acetone
Nitroprusside test
106
Acetoacetate and acetone
Acetest tablets
107
Detects acetoacetate better than acetone
Ketostix
108
Detects beta-hydroxybutyrate but not widely used
KetoSite assay
109
RBS =
<140 mg/dL
110
FBS =
70-100 mg/dL
111
HbA1c =
3-6%
112
Fructosamine =
205-285 μmol/L
113
2-Hr PPBS =
<140 mg/dL
114
GTT:
30 mins =
1-Hr =
2-Hr =
3-Hr =
30-60 mg/dL above fasting
20-50 mg/dL above fasting
5-15 mg/dL above fasting
fasting level or below
115
O2 consumption α glucose concentration
Polarographic glucose oxidase
