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chem > Carbs > Flashcards

Carbs Flashcards

1
Q

medications for type 2

A

metformin/ glucophage: help reduce amount of sugar made by liver– eliminates through the urine and turn receptors inward

-will find glucose in the urine
-will not make more insulin

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2
Q

IF metformin/ glucophage doesn’t work go to

A

glipiZIDE or Januvia

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3
Q

GlipiZIDe/ Januvia

A

helps pancreas produce insulin
-eliminate sugar though urine

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4
Q

if previous dont work go to

A

victoza/ trulicity/ ozempic (last resort)

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5
Q

victoza/ trulicity/ ozempic actions

A

slows down bodies metabolism/ slow down sugar into blood stream
-prevents liver from making glucose and secretes more insulin

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6
Q

gestational diabetes if increased sugar intake

A

baby is also producing more insulin
-so after birth and cord is cut baby will have abrupt stop of sugar but its still increased amount of insulin — severe risk for becoming hypoglycemic

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7
Q

moms that are gestational diabetic have increased risk of

A

fetal lung immaturity

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8
Q

what week will baby have normal lung development

A

37

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9
Q

gestational babies lungs fully developed

A

40

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10
Q

what week are mothers tested for gestational diabetes

A

24-28

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11
Q

home glucose monitoring system

A

hand held glucose measure glucose
-about 10-12 % lower than actual draw would be
-interstitial fluid mixes and dilutes

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12
Q

high hematocrit

A

decreases blood glucose levels falsey bc RBC are using glucose

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13
Q

CGM- continuous monitoring system

A

-monitor all the time
-probe under skin
-will be diluted? checks done
-can be used in both types

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14
Q

microalbumin

A

-looks for small amount of albumin
-looks for renal failure (early stages)
- if kidney loses function can’t reabsorb protein- albumin first to leak
-done twice a year on diabetic

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15
Q

1 testing specimen for microalbumin

A

24 hour urine

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16
Q

normalbumin

A

<30

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17
Q

microalbumin

A

30-300

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18
Q

MACROalbumin

A

> 300

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19
Q

if doing random urine for microalbumin use

A

albumin to creatine ratio

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20
Q

what test is done if HgB A1C can’t be done

A

frutosamine

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21
Q

what occurs in the fructosamine test

A

glucose sticks to albumin in blood (glycosylated proteins) will stay for 2 weeks

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22
Q

another good time to do fructosamine test

A

if a diabetic is starting new medication or gestational diabetic

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23
Q

when can’t do fructosamine test

A

liver failure (increases values) and kidney failure (not enough albumin)

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24
Q

normal fructosamine levels

A

205-285

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25
Q

lactose intolerant

A

inability to breakdown lactose

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26
Q

lactose intolerant occurs because

A

deficient or absent lactase enzyme

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27
Q

babies aren’t lactose intolerant at birth

A

because breast milk contains lactose – need lactase enzyme

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28
Q

lac. intolerance occurs

A

changes in gut flora/ introduction of antibiotics

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29
Q

amount of processed foods we eat affect

A

gut flora

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30
Q

ways to diagnose lac. intolerance

A

elimination diet, lactose hydrogen breath test, standard lactose tolerance

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31
Q

elimination diet

A

eat no foods with lactose
if symptoms go away= lactose intolerant

32
Q

lactose hydrogen test

A

consume 25-50 g of lactose liquid
-breath samples taken 30 min- 3 hours

increase in hydrogen indicates malabsorption of lactose (can have false negatives)

33
Q

standard lactose intolerance

A

blood lactose levels
-if no decrease in lactose shows body isn’t breaking down it

34
Q

if diagnosed type 2

A

-doctor will want baseline insulin levels

AS medications change doctors will look at insulin levels

35
Q

increase in insulin but normal glucose

A

can be pancreatic tumor secreting insulin

36
Q

glycogen storage disease

A

inherited
-once stored body can’t break down glucose

37
Q

von gierke disease

A

defect in glucose 6 phosphate
-can’t break down glycogen into glucose

-become hypoglycemic -no storage breakdown
-go into metabolic acidosis

-hepatomegaly- bc main site of glycogen storage

short in height, intellectual disabilities

38
Q

avoid glycogen buildup

A

limit sugar intake, small amount of food
-body will utilize sugar= no excess storage

39
Q

galactosemia

A

-mentally slow, liver damage, vomitting

-aminoacidopathy
-infants tested
-enzyme deficiency in galactokinase
CAN’T breakdown galactose

for years did clinitest for reducing sugars but now
-GENETIC testing

40
Q

hexokinase

A

gold standard for glucose amounts (enzymatic rxn) specific glucose

END product: NADPH; proportional to amount of glucose in speciment

41
Q

glucose oxidase

A

-glucose specific
-more interfering substance– Hgb and BILLI

2 step process
1) measured amperometrically– oxygen consumption measures trinder rxn
2) photometric analyze
hydrogen peroxide mixed with chromagic (color production)

proportional to amount of glucose

42
Q

main source of energy for cells

A

carbs

43
Q

where are carbs stored

A

liver and muscle

44
Q

what is carbs stored as in the muscle

A

glycogen

45
Q

structure of carbs

A

carbon double bonded to oxygen and alcohol group

46
Q

most important monosaccharides

A

glucose, fructose, and galactose

47
Q

most important disaccharides

A

lactose, maltose, sucrose

48
Q

lactose components

A

glucose and galactose

49
Q

sucrose components

A

glucose and fructose

50
Q

maltose components

A

glucose and glucose

51
Q

polysaccharides

A

starch and glycogen

52
Q

carbs are hydrates of

A

aldehyde and ketone groups

53
Q

only hormone that can decrease blood sugar

A

insulin

54
Q

what enhances formation of lipids and proteins

A

insulin

55
Q

insulin inhibits breakdown of

A

glycogen

56
Q

another regulator of blood sugar

A

glycogen

57
Q

glucagon is produced by the ______ cells in the pancreas

A

alpha

58
Q

what is the main hormone for rapid increase of blood sugar

A

glucagon

59
Q

glucagon will tell the liver to break down _____ then fat

A

glycogen

60
Q

what does cortisol do

A

inhibit insulin and rapidly increases glucose

61
Q

cortisol finds new ways to get glucose through

A

fats and proteins

62
Q

finding new ways to get glucose in the body

A

gluconeogenesis

63
Q

metabolism of glucose

A

taken in as starch or glycogen

1)amylase- enzyme found in salivary glands or pancreas

2) gastric juices released and break down into usable sugars

64
Q

normal metabolism

A

sources of sugar– diet and hepatic output

after we take in sugar insulin levels rise

If we fast– breakdown of glycogen first, fats second, proteins last

Glycogenesis– control levels

When BS levels rise the liver will stop releasing glucose
-take in too much sugar – stored as glycogen and fat

65
Q

abnormal

A

hyperglycemia all the time
-either no insulin or insulin resistant

continued production of hyperglycemic state

no glucose= go to fat; leads to increased production of triglycerides

can get insulin from recombinant insulin -manufactured

66
Q

3 major ketones

A

acetate
acetoacetate
2-hydroxybutyric acid

67
Q

sodium imbalance

A

decreased because water comes out of cell to dilute glucose and also dilutes Na

68
Q

potassium imbalance

A

normally increases in DKA
-when cells open up K comes out a cell with water and blood levels rise
-body tries to drive hydrogen back into cell and K comes out

potassium increases risk of heart attack

69
Q

bicarb imbalance

A

increased because acid increased and bicarb fixes this (tums)

70
Q

chloride imbalance

A

increase levels

-1 time Na and Cl don’t follow each other
-some bicarb is used up so Cl is trying to reabsorb

71
Q

if you give insulin

A

need to watch potassium because it will drive back into cell to drive now glucose

72
Q

anion gap

A

(Na + K) - (Cl + HCO3)

normal : 9-16
no potassium: 8-12

73
Q

1 reason anion gap increased

A

DKA

74
Q

serum osmolarity

A

2Na + glucose/20 + BUN/3
normal= 275-300

75
Q

type 1 is also

A

lactic acidosis

76
Q

fasting specimen

A

10-12 hours
use serum or heparinized plasma

seperate cells asap or else cells keep using glucose

gray top stable for 72 hours

77
Q

Hgb A1C can’t do

A

after hemolytic event

need Hemoglobin A
-sickle cell can’t do this bc Hgb S

Norm <6

check twice a year
-can be increased due to injury

specimen= EDTA

chem (5 decks)

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