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Clinical Chemistry > CARBOHYDRATES LEC > Flashcards

CARBOHYDRATES LEC Flashcards

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1
Q

Carbohydrates contain a ___ and ___ functional groups

A

carbonyl and hydroxyl

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2
Q

How does glucose enter tissues like skeletal muscle and adipose tissue?

A

With the help of insulin by stimulating the expression of glucose transporter 4

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3
Q

Which organ is completeley dependent on glucose for energy production?

A

The brain

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4
Q

2/3 of glucose utilization in resting adults occur in ___

A

CNS

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5
Q

Carbohydrates may be classified according to:

A

Number of carbons
Location of carbonyl functional group
Number of sugar units

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6
Q

Major storage form of glucose in man

A

glycogen

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7
Q

Percentage of glycogen stored in the liver and skeletal muscle

A

85% and 15%, respectively

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8
Q

microvascular complications of DM

A

nephropathy, neuropathy, retinopathy

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9
Q

macrovascular complication of DM

A

atherosclerosis

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10
Q

intermediate products of glucose metabolism

A

pyruvic acid. lactic acid, acetylcoA

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11
Q

end products of glucose metabolism

A

CO2, H20, ATP

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12
Q

Why does no CHO degradation happens in the stomach?

A

The salivary amylase is inactivated by gastric acid (ph 1-3 due to HCl content)

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13
Q

____ of glucose on C6 into ____ by ___. This process traps the glucose inside the cell

A

Phosphorylation; glucose 6- phosphate ; hexokinase

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14
Q

____ of glucose 6-phosphate into _____ by _____

A

Isomerization; fructose 6-phoshapte ; phosphoglucomutase

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15
Q

_______ of fructose 6-phosphate on C1 forming _____ by ______

A

Phosphorylation;1-6 fructose biphosphate; phosphofructokinase

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16
Q

____ of fructose 1,6-biphosphate into isomers ___ and ____ by ____

A

Split; DHAP and GAP; aldolase

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17
Q

____ of DHAP into ____ by ____

A

Conversion; GAP; triose phosphate isomerase

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18
Q

_____ and phosphorylation at C1 into _____ by ____

A

Dehydrogenation; 1-3 biphosphoglycerate; glyceraldehy 3-phosphate dehydrogenase

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19
Q

___ of the high energy bond at C1 by _____ yielding ATP and the product ____

A

Hydrolysis; phosphoglycerate kinase; 3-phospholycerate

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20
Q

___of phosphate from C3 to ____ forming ____ by _____

A

Shifting;C2; 2-phosphoglycerate; phosphoglycerate mutase

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21
Q

___ of 2-phosphoglycerate by ___ forming

A

Dehydration; enolasel phosphoenolpyruvate

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22
Q

____ of the high energy bond yielding ___ and ___ by the enzyme ____

A

Hydrolysis; pyruvate; ATP pyruvate kinase

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23
Q

lycolysis (EMP Pathway is ____

A

anaerobic

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24
Q

In the presence of oxygen, pyruvate is further oxidized to ____

A

CO2

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25
Q

In the absence of O2, pyruvate can be fermented to

A

lactate or ethanol

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26
Q

Responsible of the synthesis of reduced glutathione and NADPH to protect cells from oxidative stress

A

Pentose Phosphate Shunt/Hexose Monophosphate Pathway

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27
Q

Maintains iron in the ferrous (Fe2+) state since ferric (Fe3+) are incapable of binding oxygen

A

Methemoglobin Reductase Pathway

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28
Q

Responsible for the synthesis of 2,3- diphosphoglycerate to enhance oxygen delivery to tissues

A

uebering-Rapaport Pathway

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29
Q

beta cells produce:

A

insulin, islet amyloid polypeptide or amylin

30
Q

alpha cells produce:

A

glucagon

31
Q

delta cells produce

A

somatostatin

32
Q

PP/F cells produce

A

pancreatic polypeptide

33
Q

ratio of C-peptide to insulin

A

5:1 or 15:1

34
Q

Duct cells: ____ and section is controlled by ____

A

bicarbonate ions; secretin

35
Q

Acinar cells: Digestive enzymes which include ___, ____, ___, and ___ whose secretion is controlled by ___

A

pancreatic amylase, lipase, trypsinogen and chymotrypsinogen; cholecystokinin

36
Q

Analogy:
Post prandial state: ______
_____: Glycogenolysis
Long fasting state: _____

A

Glycolysis
Short fasting state
Gluconeogenesis

37
Q

Only hypoglycemic hormone

A

Insulin

38
Q

Why is the ratio of C-peptide to insulin in the serum 5:1 to 15:1

A

increased hepatic clearance of insulin

39
Q

Actions of insulin

A
  1. Promotes cellular entry of glucose into the insulin- sensitive tissues (liver, skeletal muscle and adipose) as energy source through glycolysis
  2. Promotes glycogenesis
  3. Promotes lipogenesis
  4. Inhibits glycogenolysis
40
Q

The primary hyperglycemic hormone

A

glucagon

41
Q

major INHIBITORY hormone

A

somatostatin

42
Q 
Each hormone is being secreted by: 
Cortisol: \_\_\_\_
epinephrine: \_\_\_\_\_
Somatotrophin:\_\_\_\_\_
Thyroxine:\_\_\_\_
A

Zona fasciculata of the adrenal cortex
Chromaffin cells of the adrenal medulla
Anterior pituitary gland
Follicular cells of the thyroid gland

43
Q

HYPERGLYCEMIA: LAB FINDINGS

A
  1. Increased plasma and urinary glucose
  2. Increased urine specific gravity
  3. Increased serum osmolality
  4. Ketones in serum or urine
  5. Decreased blood and urine pH (acidosis)
  6. Hyponatremia: decreased plasma sodium (due to losses [polyuria] and shift of water from cells)
  7. Hyperkalemia: increased plasma potassium (cellular shift secondary to acidosis)
  8. ↓pCO2 due to Kussmaul Kien respiration (deep rapid respirations)
  9. Decreased bicarbonate
  10. Increased anion gap
44
Q

Ketosis develops in DM from excessive synthesis of _______ which can be reversed by insulin administration.

A

acetyl-CoA

45
Q

Nerve damage, known as _____occurs in 60% to 70% of people with diabetes

A

diabetic neuropathy

46
Q

Former names of Type 1 DM

A

Insulin-dependent diabetes mellitus, juvenile onset diabetes mellitus, Brittle diabetes, Ketosis-prone diabetes

47
Q

Autoantibodies responsible for beta cell destruction

A

Antibody to GAD65: highest sensitivity (91%), more common in adults

Insulin autoantibodies (IAAs): more common in children

Autoantibodies to insulinoma-associated protein 2 (IA-2)

Autoantibodies to zinc transporter 8 (ZnT8)

48
Q

Former names of Type 2 DM

A

non-insulin dependent DM, adult- type/maturity-onset DM, stable diabetes, ketosis- resistant, receptor-deficient DM

49
Q

untreated type II DM will result to _______ due to overproduction of glucose accompanied by ___-,___,____

A

nonketotic hyperosmolar come; severe dehydration ; electrolyte imbalance; increased BUN and creatinine

50
Q

risk factor for Type 2 DM

A

Overweight (BMI ≥25 kg/m2),

Sedentary lifestyle

Family history of diabetes

Advanced age (≥45 years)

Ethnicity (African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders)

Polycystic ovary disease

History of gestational diabetes

Delivery before diabetes of a baby weighing more than 9 pounds

Hypertension, vascular disease or dyslipidemia (HDL cholesterol ≤35 mg/dL and/or triglyceride level ≥250 mg/ dL)

HbA1c of 5.7% or greater

Impaired fasting glucose or impaired glucose tolerance,
Other conditions associated with insulin resistance (i.e., acanthosis nigricans)

51
Q

____ is high in diabetic ketoacidosis and ___ with treatment whereas ____ and ____ rise on treatment

A

Beta-hydroxybutyrate (ketone body) ; falls; acetoacetic acid and acetone

52
Q

T or F: Reagent strips for detection of ketones is used to monitor recovery for diabetic ketoacidosis since the strip is sensitive to presence of beta- hydroxybutyrate.

A

FALSE; not used to monitor recovery for DKA since the strip is not sensitive to Beta-hydroxybutyrate

53
Q

Which is used to monitor recovery from DKA?

A

anion gap

54
Q

OTHER SPECIFIC TYPES OF DIABETES

A
  1. Pancreatic disorders/pancreatectomy
  2. Endocrine disorders: Cushing’s syndrome, pheochromocytoma, acromegaly, hyperthyroidism
  3. Drug or chemical inducers: dilantin and pentamidine (anticonvulsants)
  4. Genetic syndromes: Down syndrome, Klinefelter syndrome, Turner syndrome etc.
  5. Exocrine disorders: cystic fibrosis, neoplasia, hemochromatosis.
55
Q

Screening for GDM should be performed between ___ weeks of gestation

A

24-28

56
Q

One Step Approach: ____

Two Step: _____

A

IADPSG

NIH

57
Q

One Step Approach:

Uses a ____ oral glucose tolerance test, measuring glucose levels after fasting and at 1 and 2 hours

A

75 gram

58
Q

Criteria for OGTT

A
  1. Ingest at least 150 g/day of carbohydrates for the
    3 days preceding the test without limitation in physical activity
  2. The test should be performed after an overnight 8- to 14-hour fast.
  3. The individual should not eat food; drink tea, coffee, or alcohol; or smoke cigarettes during the test, and he or she should be seated
59
Q

Major cause of hypoglycemia

A

use of insulin or insulin secretagogue drugs (sulfonylureas)

60
Q

T or F: Severe hypoglycemia if not corrected in a timely fashion can be fatal

A

T

61
Q

Whipple’s triad

A

Symptoms consistent with hypoglycemia

Low plasma glucose

Alleviation of symptoms upon glucose administration

62
Q

Classification of hypolgycemia (8)

A
  1. Drug induced
  2. Severe medical illness
  3. hormonal deficiencies
  4. endogenous hyperinsulinism
  5. autoimmune hypoglycemia
  6. non-islet cell tumor hypoglycemia
  7. hypoglycemia of infancy and childhood
  8. alimentary hypoglycemia
63
Q

____ and ____ are most commonly affected by defects in glycogen metabolism, as these tissues have abundant quantities of glycogen.

A

Liver, skeletal muscle

64
Q

liver glycogenosis usually manifests as ___ and ____

A

hypoglycemia; hepatomegaly

65
Q

muscle glycogenosis usually manifests as ___, ___, ___, ____

A

muscle cramps; exercise intolerance; fatigue; weakness

66
Q

Common name and enzyme deficient for Ia(L) and Ib(L)

A

Von Gierke; glucose 6-phosphatase; glucose 6-phosphatase translocase

67
Q

II(M): ____: acid maltase

A

Pompe

68
Q

Congenital deficiency of one of the three enzymes involved in the conversion of galactose into glucose.

A

Galactose-1-phosphate uridyl transferase

Galactokinase

Uridine diphosphate galactose 4-epimerase

69
Q

An autosomal recessive disorder characterized by accumulation of fructose in blood and urine due to lack of fructokinase

A

Essential fructosuria

70
Q

What enzyme is deficient in hereditary fructose intolerance which leads to inadvertent accumulation of fructose 1-phosphate

A

aldolase

71
Q

In fructose 1-6 biphosphatase deficiency, there is an impaired hepatic synthesis of gluconeogenic precursors ___, ___, and alanine leading to hypoglycemia

A

lactate, glycerol, alanine

Clinical Chemistry (4 decks)

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