Chemistry - Carbohydrates, Lipids, and Proteins

Question 1

What causes hyperglycemia?

Answer 1

Diabetes mellitus, other endocrine disorders, acute stress, pancreatitis.

Question 2

What causes hypoglycemia?

Answer 2

Insulinoma, insulin-induced hypoglycemia, hypopituitarism.

Question 3

What is the clinical significance of cholesterol?

Answer 3

Limited value for predicting risk of coronary artery disease (CAD) by itself. Used in conjunction with HDL & LDL cholesterol.

Question 4

What is the reference range for total cholesterol?

Answer 4

<200 mg/dL.

Question 5

What are the HDL reference ranges?

Answer 5

> 60 mg/dL (Desirable range), 40-59 mg/dL (Gray area), < 40 mg/dL (High risk for heart disease).

Question 6

What is the clinical significance of HDL?

Answer 6

Inversely related to CAD.

Question 7

What is the LDL reference range?

Answer 7

< 100.

Question 8

What is the clinical significance of LDL?

Answer 8

Risk factor for CAD.

Question 9

What is the reference range for triglycerides?

Answer 9

<150 mg/dL.

Question 10

What is the clinical significance of triglycerides?

Answer 10

Risk factor for CAD.

Question 11

What is the reference range for total protein?

Answer 11

6.4 - 8.3 g/dL.

Question 12

What does an increase in total protein indicate?

Answer 12

Dehydration, chronic inflammation, multiple myeloma.

Question 13

What does a decrease in total protein indicate?

Answer 13

Nephrotic syndrome, malabsorption, overhydration, hepatic insufficiency, malnutrition, agammaglobulinemia.

Question 14

What is the reference range for albumin?

Answer 14

3.5 - 5 g/dL.

Question 15

What does an increase in albumin indicate?

Answer 15

Dehydration.

Question 16

What does a decrease in albumin indicate?

Answer 16

Malnutrition, liver disease, nephrotic syndrome, chronic inflammation.

Question 17

What is the role of albumin?

Answer 17

Regulates osmotic pressure; largest fraction.

Question 18

How is albumin measured?

Answer 18

Measured by dye binding (BCG or BCP).

Question 19

What is the reference range for microalbumin in urine?

Answer 19

50-200 mg/24 hr predictive of diabetic nephropathy.

Question 20

What does an increase in microalbumin in urine indicate?

Answer 20

Diabetics at risk of nephropathy.

Question 21

What hormone responds to decreases in glucose?

Answer 21

Insulin.

Question 22

What is the function of insulin?

Answer 22

Responsible for entry of glucose into cells. Increases glycogenesis.

Question 23

What hormones respond to increases in glucose?

Answer 23

Glucagon, Cortisol, Epinephrine, Growth Hormone, Thyroxine (T3).

Question 24

What is the cause of Type 1 Diabetes mellitus?

Answer 24

Autoimmune destruction of beta cells. Absolute insulin deficiency. Genetic predisposition (HLA-DR 3/4).

Question 25

What is the cause of Type 2 Diabetes mellitus?

Answer 25

Insulin resistance in peripheral tissue. Insulin secretory defect of beta cells. Associated with obesity.

Question 26

What causes Gestational Diabetes Mellitus (GDM)?

Answer 26

Placental lactogen inhibits action of insulin.

Question 27

What are common tests for Diabetes Mellitus?

Answer 27

Random plasma glucose, Fasting plasma glucose (FPG), 2hr plasma glucose, Oral glucose tolerance test, HbA1c.

Question 28

What are the risk factors for Metabolic Syndrome?

Answer 28

↓ HDL-C, ↑ LDL-C, ↑ triglycerides, ↑ blood pressure, ↑ blood glucose.

Question 29

What is the order of migration in Protein Electrophoresis (fastest to slowest)?

Answer 29

Albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, gamma globulin.

Question 30

What does Protein Electrophoresis show in acute inflammation?

Answer 30

↑ alpha-1 & alpha-2.

Question 31

What does Protein Electrophoresis show in chronic infection?

Answer 31

↑ alpha-1, alpha-2, & gamma.

Question 32

What does Protein Electrophoresis show in cirrhosis?

Answer 32

Polyclonal ↑ (all fractions) in gamma with beta-gamma bridging.

Question 33

What does Protein Electrophoresis show in monoclonal gammopathy?

Answer 33

Sharp ↑ in 1 immunoglobulin ('M spike'). ↓ in other fractions.

Question 34

What does Protein Electrophoresis show in polyclonal gammopathy?

Answer 34

Diffuse ↑ in gamma.

Question 35

What does Protein Electrophoresis show in hypogamma globulinemia?

Answer 35

↓ gamma.

Question 36

What does Protein Electrophoresis show in nephrotic syndrome?

Answer 36

↓ albumin, ↑ alpha-2.

Question 37

What does Protein Electrophoresis show in alpha-1 antitrypsin deficiency?

Answer 37

↓ alpha-1.

Question 38

What does Protein Electrophoresis show in a hemolyzed specimen?

Answer 38

↑ beta or unusual band between alpha-2 & beta.

Question 39

What does Protein Electrophoresis show in plasma?

Answer 39

Extra band (fibrinogen) between beta & gamma.

Question 40

What is the clinical significance of BUN?

Answer 40

↑ kidney disease; ↓ overhydration or liver disease.

Question 41

What is the clinical significance of creatinine?

Answer 41

↑ kidney disease.

Question 42

What is the clinical significance of uric acid?

Answer 42

↑ gout, renal failure, ketoacidosis, lactate excess, high nucleoprotein diet, leukemia, lymphoma, polycythemia; ↓ administration of ACTH, renal tubular defects.

Question 43

What is the clinical significance of ammonia?

Answer 43

↑ liver disease, hepatic coma, renal failure, Reye's syndrome.