Carbohydrates Flashcards
Differentiate type 1 fr type 2 diabetes
•type 1 (beta cell destruction with absolute insulin deficiency)
type 2 (insulin resistance and an insulin secretory defect)
False about carbs
A.measured in serum or plasma only
B.bconcentration in blood is normally controlled within narrow limits by many hormones
C.most significant in carb metab- insulin
A
Whole blood pwede rin
Which is not produced by the endocrine pancreas? A. amylase B. insulin C. glucagon D. somatostatin
A
incretins are peptide hormones secreted by enteroendocrine cells. they affect all except: A. pancreatic function B. gastric emptying C. bile production D. intestinal motility
C
False about insulin A. facilitates ketogenesis B. produced @ beta cells C. in-charge of glycogen formation D. AOTA
A
glucagon in charge dito
False about glucagon A. facilitates ketogenesis B. produced @ delta cells C. acts primarily in the liver D. AOTA
B
alpha cells produce this
false about somatostatin A. facilitates glucose uptake B. produced @ delta cells C. inhibits insulin and glucagon secretion D. AOTA
A
insulin in charge dito
produced in F cells A. pancreatic polypeptide B. insulin C. glucagon D. somatostatin
A
Which is/are false?
A. Anabolism is favored when there is a relative decrease in the insulin-to-glucagon ratio
B. Catabolism is favored with a relative increase in the insulin-to-glucagon ratio
C. C-peptide and proinsulin measurements appear to be less affected by hemolysis
D. Serum glucagon levels are rarely measured in clinical practice
A and B
baliktad kasi
false about amylin
A. It can inhibit insulin secretion, slow gastric emptying, and inhibit postprandial glucagon secretion
B. Low levels: seen in type 2 diabetes
C. its analogs may be helpful in diabetes management by limiting postprandial glucose excursions
B
type 1 dapat
pramlintide acetate - available for use by injection before major meals in patients with insulin-requiring diabetes
This substance is composed of? A. amylase B. insulin C. glucagon D. amylin
D
False about proinsulin
A. may cross-react with insulin in some insulin radioimmunoassays
B. healthy infants and preterm neonates have higher amounts than adults
C. it has a longer half-life than insulin
D. it has none of the biological activity of insulin
D
Elevated proinsulin + metabolites have been found in all except: (basis: the lecture slides) A. Type 2 diabetes B. Pre-type 1 diabetes C. Pancreatitis D. Familial hyperproinsulinemia
C
proinsulin –> insulin ; what segment is removed in the last step? Its levels are measured in hypoglycemic states to help identify the cause of the hypoglycaemia.
identify
C- peptide
Which is true?
A. C-peptide & insulin are secreted in equal amounts at the portal vein, hence they have equal ratio in serum.
B. In healthy individuals, the half-life of both C-peptide is shorter than insulin.
C. In cirrhosis, hyperinsulinemia is observed as the result of decreased hepatic insulin clearance.
D. In normal individuals, the molar ratio of C-peptide to insulin in the fasting state is 1 : 5
C
Define hepatic insulin clearance.
approximately 50% of insulin is rapidly removed by its initial passage through the liver
a high insulin level in the presence of a low glucose level may suggest all, except:
A. Inappropriate secretion or administration of insulin
B. Additional insulin needed for secretion, to keep blood glucose levels normal
C Presence of insulin-secreting tumours
D.Extremely low insulin and proinsulin levels with hypoglycemic symptoms
D
elevated dapat
Differentiate insulinoma patients from hypoglycaemic patients using insulin
- Insulinoma patients: high insulin and C-peptide levels
- Hypoglycemic patients using insulin: high insulin levels and low C-peptide levels Commercially available insulin preparations are free of C-peptide and proinsulin
Normal fasting plasma glucagon concentrations: identify range
25–50 pg/mL
What effect refers to the greater and earlier insulin response to the oral administration of glucose compared with intravenous glucose?
incretin effect
Enumerate the 2 Most important incretins in the regulation of insulin secretion:
- Glucagon-like peptide 1 (GLP-1)
* Glucose-dependent insulinotropic peptide (GIP)
Which is not a function of glucagon-like peptide 1?
A. rapidly stimulate glucagon secretion in response to a meal,
B. inhibition of gastric emptying
C. promote weight loss
D. stimulate beta cell proliferation
A
insulin dapat
What inactivates GLP-1 by removing two N-terminal amino acids?
Dipeptidyl peptidase-4
Name a once- weekly glucagon-like peptide-1 (GLP- 1) agonist for the management of type II diabetes.
dulaglutide
false about somatostatin A. has nonendocrine function B. not found in pituitary gland C. inhibits insulin and glucagon secretion D. AOTA
B
Name 2 long-acting somatostatin analogs used to treat neuroendocrine tumors, and other disorders of the pancreas and gastrointestinal tract.
ocreotide
lanreotide
Three enzyme systems used in glucose measurement - enumerate
glucose dehydrogenase
glucose oxidase
hexokinase
Two general methods used in glucose measurement - enumerate
Electrical current
Spectrophotometry
Enzyme in-charge when electric current is used to measure glucose
Glucose dehydrogenase
Enzymes in-charge when spectrophotometry is used to measure glucose
mutoarotase
Glucose dehydrogenase
Diaphorase
End color of product when spectrophotometry is used to measure glucose
Blue color
Which does not hinder glucose oxidase method for glucose meas? A.low conc of uric acid B.high conc ascorbic acid C.low conc bilirubin D.high conc citric acid
B and D
A and C - dapat high!
False about glucose oxi method
A)can be coupled to the ferricyanide/ferricyanidecouple to produce an electrical current
B) system is dependent on the partial pressure of O2 because oxygen will compete in the reaction to form hydrogen peroxide
C)the higher the partial pressure of O2, the higher is the electrically measured glucose
C
Dapat inverse ang proportion
Capillary glucose tests, using point-of-care devices, should not be used to diagnose diabetes or hypoglycemic disorders. T/F
T
Which may not affect result obtained fr point of care device?
A.hypertriglyceridemia
B.hypertension
C.measurements outside of the hematocrit or temperature range
B
Hypotension dapat
Which is false?
A. Central Luzon - highest DM prev (2013)
B. DM: more at the urban and the rich
C. Females have higher freq fr 18-49 y/o then males have higher freq fr > 50 y/o
C
Baliktad
To classify diabetes as such: which is not part?
A. Hyperglycemia
B. FBS = 200 mg/dL
D. NOTA
B
> = dapat
True about pre-diabetes
A. Glucose homeostasis is abnormal
B. Insulin therapy not required
C. Formal oral glucose tolerance test is usually used to diagnose it
D. C-peptide level isvery low or undetectable
B
Not measured @ metabolic syndrome A.fasting glucose B.osmotic pressure C.waist circumference D.serum triglycerides E.HDL cholesterol
B
blood dapat
False about type 1 diabetes
A.absolute insulin deficiency and beta cell destruction
B.most commonly diagnosed in young people & onset can occur at infancy only
C.only after most of the beta cells are destroyed that hyperglycemia develops
D.related to the inheritance of specific immune response genes associated with HLA-DR/DQ on chromosome 6
B
onset - any age
Enumerate the antibody markers for type 1 diabetes. Which is most common in kids? In adults?
glutamic acid decarboxylase (GAD65) insulin autoantibodies (IAA),
islet cell antigen 512 autoantibodies (ICA512);
GAD65 - adults
IAA - kids
Enumerate 2
preferred tests for ADA diagnosis, type 2 diabetes i
fasting plasma glucose or HbA1c levels
GLYCEMIC CONTROL: which is false?
A.improved glycemic control is associated with preventing or delaying the progression of microvascular complications in diabetes
B.standard of care is to measure
FBS levels every 3–6 months to monitor glycemic control
C.BOTA
D.NOTA
B
HbA1c dapat
Which is true?
A. A Schiff acid is formed when Hb reacts with glucose
B. The Schiff acid becomes a Schiff base, or almidine
C. Schiff base turns into glycosylated Hb (ketoamine)
C
Schiff base agad, ok.
False abt defn of HbA1c
A.hemoglobin A that is reversibly glycosylated at one or both N-terminal valines of the Hb’s β-chains
B.including hemoglobin that may also (but not solely) be glycosylated on lysine residues.
C.BOTA
D.NOTA
A
Irreversibly dapat
False about glycolysated haemoglobin testing
A.provides an index of average blood glucose levels over the past 2–4 months
B.older erythrocytes contributing to a greater extent than younger ones
C. may be measured via immunoassay, chromatography, electrophoresis, and enzyme methods
B
baliktad
False about GHb Assay
A. Hemoglobinopathies(HbSS, HbSC, HbCC) associated with high red blood cell turnover and the need for transfusions will adversely affect accuracy
B.Vitamins C and E can falsely increase levels by stimulating glycosylation
C. Chronic alcohol use, lead poisoning & opiate use may affect results
B
lower levels c/o inhibiting glycosylation
False about ketone testing
A.using urine or blood, is particularly important for individuals with type 2 diabetes mellitus to detect B.ketone bodies are products of fatty acid degradation
C.may be useful in pregnancy and in determining the cause of hypoglycemic disorders
A
type 1 dapat
β-hydroxybutyricacid, acetoacetic acid, and acetone - these are \_\_ bodies: products of fatty acid degradation A. acetone B. carboxyl C. ketone D. NOTA
C
hypoglycemia has both neurogenic & neuroglycopenic symptoms. differentiate the 2
neurogenic: c/o autonomic nervous system
neuroglycopenic: c/o low glucose supply to CNS
Classify whether neurogenic (NG) or neuroglycopenic (NGP) symptom of hypoglycaemia A. dizziness B. palpitations C. blurred vision D. anxiety E. hunger F. seizure
A, C, F - NGP
B, D, E - NG
Most often cause of glycogenases
inherited deficiencies of enzymes that control the synthesis or breakdown of glycogen
Which is not a hepatic glycogenase? A. Forbes' disease B. Anderson's disease C. Hers disease D. Pompe disease
D
Which is not a hepatic glycogenase? A. von Gierke disease B. LD Deficiency C. Tarul disease D. Pompe disease
A
Which hepatic glycogenase has muscle symptoms? A. von Gierke disease B. Fanconi-Bickel syndrome C. Forbes' disease D. Hers disease
C
Which hepatic glycogenase always has high creatinine kinase level? A. Phosphoglycerate mutase deficiency B. LD Deficiency C. Pyruvate kinase deficiency D. Pompe disease
A
This enzyme is not directly part of galactose metabolism
A.Galactokinase
B.galactose-1-phosphate
C.uridyltmutase
D.uridine diphosphate galactose-4-epimerase
C
uridyltransferase dapat
False about fructose metab disorders
A.Essential fructosuria–results from fructokinase(F→F1P) deficiency.
B.Hereditary fructose intolerance -defect of fructose-1,6-biphosphate aldolase B activity
C.Fructose-1,6-diphosphatase deficiency – results in failure of muscle glucose generation by luconeogenicprecursors
C
liver dapat
False about lactic acid
A. a product of pyruvic acid metabolism
B. most of which is derived from glucose via the glycolytic pathway and deamination of glutathione
C. is eliminated by buffering by extracellular buffers and removal by the liver and kidneys
B
alanine, not glutathione
Excessive accumulation of l-lactic acid is caused by ___ fill in the blanks!!
overproduction and/or underutilization of l-lactate (the levorotary form of lactic acid
The diagnosis of diabetes requires a fasting plasma glucose >__mg/dL on at least 2 occasions or a casual plasma glucose level >__ mg/dL(11.1 mmol/L).
126
200
Normal fasting plasma glucose is ___ mg/dL and normal glucose levels 2 hours post glucose load are ___ mg/dL
Which is false?
A.Oral glucose tolerance tests should be performed to diagnose gestational diabetes.
B.Whole blood capillary glucose values obtained with pointofcare devices are used to diagnose diabetes or hypoglycemic disorders.
C.Glycated hemoglobin (HbA1C) >6.5% on at least 2 occasions can be used to diagnose diabetes.
B
Dapat confirmed pa sa lab
Which is true?
A.HbA 1C levels should be performed every 6 months in individuals with diabetes to monitor glycemic control B.Reliability and accuracy are diminished in the presence of shortened red blood cell survival, lower mean blood cell age, or need for transfusions.
C.BOTA
D.NOTA
A
3 months dapat
Sodium nitroprusside chains are useful for ___. But Why are sodium nitroprusside strips are not useful for monitoring diabetic therapy?
Ketone testing
The strips do not detect βhydroxybutyrate. βlevels are high in diabetic ketoacidosis (DKA) and fall with treatment, whereas acetoacetic acid and acetone levels rise with treatment,
Tests for autoimmune type 1 diabetes may be used for routine screening of asymptomatic nondiabetic individuals except in research setting. T/F
F
May not be used unless research
Glycogen storage diseases that primarily affect the liver usually manifest with __ & __
Hepatomegaly
Hypoglycemia
muscle glycogenases commonly cause 4 things, enumerate
muscle cramps, weakness, fatigue and exercise intolerance.
