carbs, lipids & LPPs, NPNs, proteins Flashcards
ability to maintain steady glucose concentration in the blood
glucoregulation
glucose hormone produced by the alpha-cells of the islets of Langerhans in the pancreas
glucagon
in what part of the cell does TCA cycle occur
mitochondria
routine examination that assesses glucose homeostasis
FBS
in OGTT, patient undergoes unrestricted diet of _ CHO per day for _ before testing
150 g, 3 days
standard glucose load for OGTT according to WHO
75 g
mode of administration of tolbutamide in the tolbutamide tolerance test
intravenous
part of “glucose tolerance factor”
chromium
plasma glucose returns to normal level _ hours after eating
(1.5) - 2 hours
long-term glucose monitoring (2-3 months)
glycosylated hemoglobin (HbA1c)
short-term glucose monitoring (2-3 weeks)
fructosamine
preferred specimen for blood glucose determination
plasma or (serum)
fasting blood glucose is _ than in serum or plasma
10-15% lower
venous blood glucose is _ than capillary blood (due to tissue metabolism)
7 mg/dL lower
capillary blood glucose is _ with arterial blood glucose
same
a 10% contamination with 5% dextrose will increase blood glucose by
500 mg/dL
glycolysis at room temperature
7 mg/dL/hour
glycolysis at refrigeration temperature
2 mg/dL/hour
hallmark of diabetes mellitus
hyperglycemia
the earliest and most sensitive indicator of kidney damage (nephropathy) in diabetes
microalbuminuria
cause of hyperglycemia during pregnancy
hormonal changes
overzealous treatment of DM may lead to _
hypoglycemia
symptoms of hypoglycemia appear at what glucose level?
50-55 mg/dL
blood glucose level diagnostic for hypoglycemia
<50 mg/dL
biological substances that are insoluble in water & most biologic fluids
triglycerides
steroids are derived from
non-glyceride lipids
lipoprotein found in obstructive jaundice & LCAT deficiency
Lp(X)
fasting period to produce reliable lipid profile result
12 hours
lipid greatly affected by non-fasting specimens
triglycerides
fasting has _ effect on cholesterol
little
triglycerides will increase how many hours after a meal?
2 hours
serum is lipemic when triglyceride levels exceed
400 mg/dL
triglyceride level if plasma is clear
<200 mg/dL
triglyceride level that causes hazy/turbid plasma
> 300 mg/dL
triglyceride level that causes milky plasma
> 600 mg/dL
anticoagulant for lipoprotein assay and preservation
EDTA
what is the purpose of acetic anhydride in Liebermann-Burchard assay?
solvent and dehydrating agent
enzymatic methods for cholesterol determination utilize what enzymes
cholesterol esterase & cholesterol oxidase
LDL can be calculated from measurements of _, _, & _ by Friedewald approximation
total cholesterol, TAG & HDL
LDL = total cholesterol - _ - triglycerides/5
HDL
what is the formula for VLDL (in mg/dL) using Friedewald method
VLDL = TAG/5
what is the formula for VLDL (in mmol/L) using Friedewald method
VLDL = TAG/2.175
what is the formula for VLDL (in mg/dL) using De Long method
VLDL = TAG/6.5
what is the formula for VLDL (in mmol/L) using De Long method
VLDL = TAG/2.825
Friedewald equation should not be used when plasma TAG exceeds _
400 mg/dL
stain(s) used in the lipoprotein electrophoresis
Sudan black B, oil red O
reference method for quantitation of lipoproteins
ultracentrifugation
24-hour plasma standing test is used to test _
chylomicrons
produces floating creamy layer
chylomicrons
largest lipoprotein
chylomicrons
the chylomicrons must be transported through the _ to the blood
lymphatic system
surrogate marker for HDL
Apo A1
minor lipoproteins
IDL, Lp(a)
apolipoprotein need for receptor binding in IDL & production of chylomicron remnants
Apo E
LPP that is primary target of cholesterol lowering therapy
LDL
primary marker for CHD risk
LDL
lipopathy asocciated with acanthocytosis, abetalipoproteinemia & mutation of MTTP gene
Bassen-Kornzweig syndrome
familial HDL deficiency
Tangier disease
thyroid disorder with low cholesterol and triglycerides
hyperthyroidism
thyroid disorder with high cholesterol and triglycerides
hypothyroidism
Patient TAG value is 1036 mg/dL. This value is associated with what condition?
pancreatitis
xanthelasma is most commonly caused by?
hypercholesterolemia
renin plays a vital role in controlling _
blood pressure & fluid balance
renin converts angiotensinogen to _
angiotensin 1
angiotensin 1 becomes _
angiotensin 2
angiotensin 2 causes _ which increases _
vasoconstriction, blood pressure
angiotensin II causes vaso_ of the _ arterioles & vaso_ of the _ arterioles
vasodilation, afferent; vasoconstriction, efferent
measures the ability of the kidneys to eliminate a substance from the blood
clearance test
it is a measure of the completeness of a 24-hour urine collection
creatinine clearance
most commonly used clearance test to estimate glomerular filtration rate
creatinine clearance
what is 1440 in the creatinine clearance formula?
constant (24 hours = 1440 minutes)
an endogenous substance used as an alternative for creatinine clearance
cystatin C
creatinine is derived from what amino acid(s)?
methionine, arginine, glycine
creatinine is freely filter by the glomerulus, not reabsorbed, but minimally secreted by the _
renal tubules
Enzymatic (uric acid): UV method uses what enzyme?
uricase
uricase convert uric acid into _
allantoin (dec. absorbance)
uric acid absorbs light strongly in the region around _
285nm (UV region)
reference method for measurement of NPNs (urea)
IDMS (Isotope Dilution Mass Spectrometry)
reagent in the urea determination that uses colorimetry forming a yellow end-product
diacetyl monoxime (DAM)
indirect method to measure urea
Berthelot
most frequently used method to measure creatinine that uses alkaline picrate reagent
Jaffe reaction
Jaffe reagent
alkaline picrate
alkaline picrate contains
NaOH & saturated picric acid
accurate results of creatinine measurements are obtained when these reagents are used (2)
Lloyd’s reagent & Fuller’s Earth reagent
creatinine levels in the blood are affected by _
muscle mass
normal ratio of BUN to creatinine
10-20:1
product of purine metabolism
uric acid
use of chemotherapeutic agents increases what NPN?
uric acid
metabolism of uric acid, and not of other NPNs is impaired
gout
absence of the enzyme hypoxanthine guanine phosphoribosyltransferase is seen in _
Lesch-Nyhan syndrome
in the Caraway method, uric acid reacts with phosphotungstic acid to produce what color?
tungsten blue
an elevated concentration of urea (& creatinine) in the blood is called
azotemia
very high plasma urea concentration accompanied by renal failure is called
uremia or uremic syndrome
early predictor of acute kidney injury (AKI)
Neutrophil Gelatinase-Associated Lipocalin (NGAL)
BUN and creatinine will be significantly elevated if the GFR is decreased by at least _
50%
major waste product of protein catabolism
urea
product of amino acid deamination
ammonia / (urea)
marker for hepatic coma (hepatic encephalopathy)
ammonia
appropriate sample for ammonia determination
freshly drawn blood
effect of cigarette smoking on plasma ammonia determination
increased
in SPE, using a buffer solution at pH 8.6, proteins exhibit _
net negative charge
the most negatively charged serum protein
albumin
serum protein electrophoretic pattern (anode to cathode)
albumin > a1 > a2 > b > y
plasma samples are NOT recommended for standard protein electrophoresis due to
pseudo beta-gamma bridging effect
cause of relative hyperproteinemia
dehydration
cause of artifactual hyperalbuminemia
prolonged tourniquet application
cause of dysproteinemia
clonal proliferation of B/plasma cells
what is common in multiple myeloma and Waldenstrom’s macroglobulinemia?
increased IgM
myoglobin level of >300 ug/L, when will you report result?
immediately
a plasma protein that is not routinely tested but can be used as a marker for nutrition
fibronectin
low A/G ratio may indicate _ (4)
autoimmune disease
multiple myeloma
cirrhosis, or
kidney disease
dye for albumin that is more sensitive than hydroxyazobenzene benzoic acid (HABA)
Bromcresol Green (BCG)
