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Chem (Clinicals) > carbohydrates > Flashcards

carbohydrates Flashcards

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1
Q

All carbohydrates have…

A

C-H-O and aldehyde or ketone group

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2
Q

Reducing sugars

A

Reduce other compounds, useful in copper reaction, Benedict’s reaction

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3
Q

Nonreducing sugars

A

Sucrose

No active ketone or aldehyde group

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4
Q

Monosaccharides

A

Glucose
Fructose
Galactose

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5
Q

Disaccharides

A

Maltose (glu + glu)
Lactose (glu + gal)
Sucrose (fru + glu)

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6
Q

Polysaccharides

A

Starch (broken down by amylase)

Glycogen (glucose-6-phosphatase for breakdown; only created in liver)

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7
Q

What kind of bonds connect simple sugars?

A

Glycoside

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8
Q

glycogen

A

polysaccharide (chains of glucose)

storage form of glucose found in the liver

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9
Q

Glycogenesis

A

Formation of glycogen from glucose

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10
Q

Glycogenolysis

A

Breakdown of glycogen in liver. Glycogen is converted back to glu-6-phos for entry into the glycolytic pathway.

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11
Q

Gluconeogenesis

A

Creation of glucose from amino acids (non-carb sources). Utilization of amino acids for energy.

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12
Q

Ketone bodies

A

Formed from breakdown of triglycerides.
Brain can use ketone bodies as source of energy.
Very acidic- can cause ketoacidosis.

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13
Q

action of insulin

A

allows entry of glucose into cell for utilization. Decreases glucose levels

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14
Q

insulin is made by…

A

beta-cells of islets of Langerhans in pancreas

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15
Q

Insulin causes…

A

glycogenesis, glycolysis, and inhibits glycogenolysis

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16
Q

Insulin is released when…

A

Glucose levels are high

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17
Q

Insulin is secreted as ______ and then cleaved into ______ and _______

A

Proinsulin
Insulin
C-peptide

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18
Q

Glucagon action

A

Increased glucose levels, causes glycogenolysis and gluconeogenesis.

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19
Q

Glucagon released due to….

A

decreased plasma glucose

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20
Q

glucagon released by ….

A

alpha-cells of islets of langerhans (pancreas)

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21
Q

somatostatin action

A

Inhibits insulin, glucagon, growth hormone and other endocrine hormones.
Net effect: increase glucose levels

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22
Q

Somatostatin released by,,,

A

d-cells of islets of langerhans

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23
Q

Pancreatic hormones for glucose regulation

A
  1. Insulin (decrease)
  2. Glucagon (increase)
  3. somatostatin (increase)
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24
Q

growth hormone action regarding glucose

A

Increases glucose by decreasing entry into cell and increasing glycolysis.

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25
Q

Growth hormone released by

A

pituitary (stimulated by low glu levels)

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26
Q

Adrenal hormones that regulate glucose

A
  1. Glucocorticoids

2. Catecholamines

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27
Q

Glucocorticoid action on glucose

A

Increases glu by decreasing entry into cells

increases gluconeogenesis, glycogenolysis and lipolysis

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28
Q

main glucocorticoid

A

Cortisol

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29
Q

Cortisol release controlled by…

A

ACTH

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30
Q

Catecholamines action on glucose

A

Increase glu by inhibiting insulin,

increasing glycogenolysis

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31
Q

Cortisol released by …

A

adrenal glands

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32
Q

catecholamines released by…

A

adrenal glands

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33
Q

catecholamine released due to ….

A

stress

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34
Q

Thyroid hormone (thyroxin) action on glucose

A

increases glucose levels by glycogenolysis, gluconeogenesis, intestinal absorption

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35
Q

Glucose levels only decreased by this hormone

A

insulin

36
Q

Type 1 diabetes cause

A

beta-cell destruction of islet of langerhans, can’t produce insulin. Usually damage from autoimmune response.
Combo of genes & environment.

37
Q

Type 2 diabetes cause

A

Resistance to insulin and insulin secretory defect

Genetics + age + lifestyle

38
Q

Most NIDDM meds work to:

A

help body use insulin, make insulin receptors more sensitive to the insulin the body produces

39
Q

Impaired glucose tolerance

A

“gray zone,” prediabetic. glucose levels between normal & diabetic.

40
Q

IDDM

A

Insulin dependend DM (type 1)

41
Q

NIDDM

A

Non-insulin dependent DM (type 2)

42
Q

DKA

A

diabetic ketoacidosis

43
Q

Gestational diabetes is:

A

any degree of glucose intolerance with onset during pregnancy due to hormones and metabolic changes

44
Q

Neonatal complications from Gestational diabetes:

A

respiratory distress, hypocalcemia, hyperbilirubinemia, hypoglycemia (from fetal insulin secretion and overabundance of maternal glucose)

45
Q

ketoacidosis

A

usually seen in Type 1 diabetes, metabolic acidosis

46
Q

Mechanism of ketoacidosis

A

Acetoacetate, acetone & beta-hydroxybutyric acid produced from fatty acids, cause decrease in pH.

47
Q

Signs & symptoms of DKA

A

patient will breathe deeply or hyperventilate to blow off CO2, increased serum and urine osmolality, electrolyte imbalance (increased K+)

48
Q

Hypoglycemia

A

Decreased glucose levels, nonspecific term. Observable signs will appear around 50 to 55 mg/dL.
symptoms: lightheadedness, dizziness, loss of consciousness

49
Q

When do we use Whipple’s Triad?

A

When a pt with diabetes presents with possible hypoglycemia

50
Q

What 3 things are in Whipple’s triad?

A
  1. symptoms of hypoglycemia
  2. glucose concentration is low at the time of symptoms
  3. symptoms resolve when the glucose level is corrected
51
Q

postparandial syndrome

A

hypoglycemic symptoms that occur after eating without actually being hypoglycemic (>55 mg/dL)

52
Q

Insulinoma

A

beta-cell tumor

leads to increased insulin production and decreased glucose levels

53
Q

Glycogen storage diseases

A

Deficiency of enzyme(s) that alters glucose metabolism.
More than 1 enzyme can be deficient, usually only one is. Congenital disorder.
Example- von Gierke disease: pt lacking G6. decreased glucose, metabolic acidosis, ketones, increased lactate. Need liver transplant. Also see increased lipids and abnormal response to epinephrine in these patients.

54
Q

Galactosemia

A

Congenital disorder. Lack of enzymes in galactose pathway. Increased serum galactose and decreased glucose. Screen for in newborns. Causes failure to thrive, need diet modifications to treat.

55
Q

Normal serum glucose range

A

70-100 mg/dL

56
Q

Normal CSF glucose

A

40-70 mg/dL

57
Q

best sample for serum glucose testing

A 
sodium fluoride (gray top) tube
stops glycolysis, can store sample
58
Q

Copper reduction test

A

Benedict’s reaction. In an alkaline medium, cupric ions change to cuprous ions, forming a red precipitate. Measures reducing substances.

59
Q

Glucose oxidase test

A

Double enzyme reaction; more interferences than hexokinase

Glu –(glu oxidase)–> gluconic acid + H2O2
H2O2 –(peroidase)–> color formation, H2O + O2

60
Q

Hexokinase reaction

A

Reference method, coupled enzymatic reaction

glu –(hexokinase)–> Glu-6-phosphate
glu-6-phos –(G6PD)–> 6-phosphogluconate + NAPDH

61
Q

Normal 2 hour OGTT

A

<140 mg/dL

62
Q

increased risk 2 hour OGTT

A

140-199 mg/dL

63
Q

abnormal OGTT 2 hour

A

200 or above

64
Q

OGTT for pregnant women screen

A

24-28 weeks of pregnancy
50 gram glucose load, test at 1 hour
cutoff= 140 mg/dL

65
Q

complete OGTT for pregnant women

A

If screening >140 mg/dL
100 gram load, 3 hour test (draw at fasting, 1, 2 and 3 hours). If over level at any draw can diagnose as GDM.
Cutoff = 140 or above

66
Q

New 2-hour OGTT for pregnant women ranges

A

(75 gram load; not a national standard)
0-hour: 92 or above
1-hour: 180 or above
2-hour: 153 or above

67
Q

fasting glucose normal

A

<100 mg/dL

68
Q

Fasting glucose increased risk (impaired/prediabetic)

A

100 to 125 mg/dl

69
Q

fasting glucose abnormal

A

126 or above (diagnostic for DM)

70
Q

Random/casual abnormal glucose level

A

200 or above, diagnostic for DM

71
Q

2 HRPP

A

2-hour post parandial

not standardized, carb load unknown, pt drawn 2 hours after eating

72
Q

A1C test methods

A

HPLC, electrophoresis, ion exchange, immunoassay

73
Q

What can interfere with A1C results?

A

abnormal hemoglobin, hematologic disorders

74
Q

A1C normal range

A

<5.7% (equal to or less than 5.6%)

75
Q

A1C impaired range

A

5.7-6.4%

76
Q

A1C for DM Dx

A

6.5% or above

77
Q

In A1C, glucose reacts with amino group of Hgb to form ____

A

ketoamine

78
Q

Diabetes diagnosis criteria:

A

Results proven on subsequent day with any of the 4:

1) fasting plasma glucose 126 mg/dL or above
2) Random plasma glucose 200 or above with diabetic symptoms
3) 2 hour plasma glucose >200 mg/dL during OGTT using 75 g glucose load
4) Hgb A1C 6.5% or greater

79
Q

Urine albumin test

A

small albumin filtration as nephropathy begins. Can’t be caught with normal dipstick (not sensitive enough.
Run in conjunction with A1C.

80
Q

Urine albumin test method

A

nephelometry

81
Q

fructosamine

A

back up test to A1C if that cannot be used

Glycation of amines on proteins, similar to A1C but protein turnover 1-3 weeks

82
Q

LTT

A

Lactose tolerance test; test for lactase deficiency.
50 grams of lactose given to fasting pt, glucose concentrations measured to test for lactase activity.

Historical test- replaced with other tests for lactose intolerance.

83
Q

XTT

A

Xylose tolerance test. 5 carbon sugar not normally found in blood. Used to evaluate intestinal malabsorption (ex Sprue).
Xylose given, then urine and serum xylose levels measured

84
Q

Lactate

A

Used to test anaerobic metabolism, tissue oxygenation, ketoacidosis, and (mostly) sepsis

85
Q

Autoimmune tests for DM

A

islet cell Abs (B-cells in pancrease. Cause of Type 1?)
insulin antibodies
others

86
Q

C-peptide

A

Used for evaluating hypoglycemia. Helps diagnose B-cell tumors and assess B-cell activity

Chem (Clinicals) (4 decks)

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