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CLINICAL CHEMISTRY > CIULLA_CARBOHYDRATES > Flashcards

CIULLA_CARBOHYDRATES Flashcards

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1
Q

Fasting blood glucose level of a hyperglycemic patient

A

> 100 mg/dL

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2
Q

Fasting blood glucose level of a hypoglycemic patient

A

<50 mg/dL

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3
Q

process required to maintain blood glucose levels during long fasts

A

gluconeogenesis

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4
Q

how long before glycogen stores are used up?

A

24-48 hrs

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5
Q

During a fast, the blood glucose level is kept constant by mobilizing ____________ stores in the liver

A

glycogen

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6
Q

hormone produced by the beta cells of the pancreatic islets of Langerhans

A

insulin

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7
Q

Where is insulin produced

A

beta cells of pancreatic islets of Langerhans

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8
Q

hormone which promotes the entry of glucose into liver, muscle, and adipose tissue to be
stored as glycogen and fat

A

insulin

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9
Q

hormone which inhibits the release of glucose from the liver

A

insulin

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10
Q

hormone synthesized by delta cells of the pancreatic islets of
Langerhans

A

somatostatin

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11
Q

where is stomatostatin produced

A

delta cells of the pancreatic islets of Langerhans

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12
Q

inhibits secretion of insulin, glucagon, and growth hormone, resulting in an increase in plasma glucose level

A

somatostatin

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13
Q

somatostatin promotes (increase/decrease) in plasma glucose level

A

increase

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14
Q

Hormones secreted by the anterior pituitary that raise blood glucose levels

A 
Growth hormone
Adrenocorticotropic hormone (ACTH)
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15
Q

Where is ACTH secreted

A

anterior pituitary

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16
Q

Secreted by the adrenal glands; stimulates glycogenolysis, lipolysis,
and gluconeogenesis

A

Cortisol

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17
Q

where is epinephrine secreted

A

medulla of the adrenal glands

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18
Q

secreted by the medulla of the adrenal glands. It stimulates glycogenolysis and lipolysis

A

Epinephrine

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19
Q

Epinephrine (inhibits/promotes) secretion of insulin

A

inhibits

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20
Q

Physical or emotional stress causes increased secretion of this hormone

A

epinephrine

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21
Q

Epinephrine causes (increase/decrease) in blood glucose levels

A

increase

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22
Q

Secreted by the alpha cells of the pancreatic islets of Langerhans

A

glucagon

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23
Q

where is glucagon secreted

A

alpha cells of pancreatic islets of Langerhans

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24
Q

increases blood glucose by stimulating glycogenolysis and gluconeogenesis

A

glucagon

thyroxine

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25
Q

where is thyroxine secreted

A

thyroid gland

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26
Q

increases glucose absorption from the intestines

A

thyroxine

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27
Q

T/F:

Glucose is normally present in the urine.

A

FALSE

Glucose is NOT normally present in the urine

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28
Q

Glucose is filtered by the ________ and reabsorbed by the ___________.

A

glomeruli, tubules

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29
Q

A condition wherein the blood glucose level is elevated and glucose appears in
the urine.

A

glucosuria

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30
Q

Individual’s renal threshold for glucose

A

160-180 mg/dL

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31
Q

When blood glucose reaches or exceeds renal threshold, the renal tubular transport mechanism becomes (unsaturated/saturated), which causes glucose to be excreted into the urine

A

saturated

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32
Q

condition characterized by deficiency of insulin

A

insulinopenia

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33
Q

TYPE OF DIABETES:

Characterized by insulinopenia, a deficiency of insulin

A

TYPE I

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34
Q

TYPE OF DIABETES:

Individuals require treatment with insulin to sustain life.

A

TYPE I

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35
Q

TYPE OF DIABETES:

Most individuals exhibit it as an autoimmune disorder where beta cells of the islets of Langerhans are destroyed by the body.

A

TYPE I

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36
Q

TYPE OF DIABETES:

Peak incidence is in childhood and adolescence, but it may occur at any age

A

TYPE I

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37
Q

Peak incidence of TYPE I DM

A

childhood and adolescence

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38
Q

Primary symptoms of diabetes mellitus

A

polydipsia
polyuria
polyphagia

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39
Q

Can produce excess ketones, resulting in diabetic ketoacidosis

A

Ketosis-prone

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40
Q

TYPE OF DIABETES:

Defect in insulin secretion and cellular resistance to insulin

A

TYPE II

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41
Q

TYPE OF DIABETES:

Individuals are not dependent on treatment with insulin.

A

TYPE II

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42
Q

TYPE OF DIABETES:

Individuals generally respond to dietary intervention and oral hypoglycemic agents, but some may require insulin therapy.

A

TYPE II

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43
Q

TYPE OF DIABETES:

Associated with obesity and sedentary lifestyle

A

TYPE II

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44
Q

TYPE OF DIABETES:

associated with individuals over the age of 40

A

TYPE II

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45
Q

Without exogenous insulin or oral hypoglycemic
medication, these individuals will have an elevated glucose but will not
go into diabetic ketoacidosis.

A

Non-ketosis prone

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46
Q

TYPE OF DIABETES:

Ketosis-prone

A

TYPE I

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47
Q

TYPE OF DIABETES:

Non-ketosis prone

A

TYPE II

48
Q

onset of diabetes mellitus during pregnancy

A

Gestational diabetes mellitus

49
Q

T/F:

After childbirth, women diagnosed with GDM generally returns to normal metabolism

A

TRUE

50
Q

T/F:

Women who were diagnosed with GDM have an increased chance of developing Type II diabetes later in life.

A

TRUE

51
Q

inherited diseases involving the deficiency of particular enzymes and may cause defects in the normal metabolism of glycogen

A

Glycogen storage diseases

52
Q

ENZYME DEFICIENT IN:

von Gierke, Type I

A

Glucose-6-phosphatase deficiency

53
Q

ENZYME DEFICIENT IN:

Pompe, type II

A

a-1,4-glucosidase deficiency

54
Q

ENZYME DEFICIENT IN:

Cori, type III

A

Amylo-1,6-glucosidase deficiency

55
Q

GLYCOGEN STORAGE DISEASE:

Glucose-6-phosphatase deficiency

A

von Gierke, type I

56
Q

GLYCOGEN STORAGE DISEASE:

a-1,4-glucosidase deficiency

A

Pompe, type II

57
Q

GLYCOGEN STORAGE DISEASE:

Amylo-1,6-glucosidase deficiency

A

Cori, type III

58
Q

characterized by a deficiency or absence of galactokinase,

galactose 1-phosphate uridyl transferase, or uridyl diphosphate glucose-4-epimerase

A

Galactosemia

59
Q

Enzymes deficient in galactosemia

A

galactokinase

galactose 1-phosphate uridyl transferase, or

uridyl diphosphate glucose-4-epimerase

60
Q

disorder lacking in certain enzymes which prevent metabolism of galactose

A

Galactosemia

61
Q

T/F:

Glycogen is found in milk as component of lactose

A

FALSE

Galactose

62
Q

Galactosemia are generally identified in (adults, infants)

A

infants

63
Q

most common enzyme deficient in galactosemia, which leads to excessive galactose in blood and excretion in urine

A

galactose 1-phosphate uridyl transferase

64
Q

Normal fasting plasma glucose

A

<100 mg/dL

65
Q

Impaired fasting glucose (IFG) levels

A

100-125 mg/dL

66
Q

Provisional diagnosis of diabetes mellitus is done at what FPG levels

A

greater than or equal to 126 mg/dL

67
Q

Diagnostics for the presence of DM

A

Casual plasma glucose level of greater than or equal to 200 mg/dL

Fasting plasma glucose greater than or equal to 126 mg/dL

Plasma glucose level of greater than or equal to 200 mg/dL of an OGTT

68
Q

The American Diabetes Association (does not, does) recommend OGTT for routine clinical use

A

does not.

69
Q

A woman who is at high risk for GDM should be tested when?

A

Initial screening early in pregnancy

If not found to have GDM during the initial screening, retest at 24-28 weeks of gestation

70
Q

Women of average risk of GDM should be tested when?

A

24-28 weeks of gestation

71
Q

GDM diagnostics

A

Plasma glucose of greater than or equal to 126 mg/dL

Casual plasma glucose of greater than or equal to 200 mg/dL

72
Q

Glucose test involving oral ingestion of 100 g of glucose for pregnant women

A

OGTT

73
Q

how many grams of glucose must be orally ingested in performing OGTT for testing GDM

A

100 g

74
Q

Two-step approach explanation

A

Initial screening: 50 g oral glucose load
(random)

Plasma tested at 1 hr

OGTT performed when test value exceeds glucose threshold value of greater than or equal to 140 (or 130) mg/dL

75
Q

an initial screening is performed
using a 50-g oral glucose load (time of day or time of last meal not
relevant). Plasma is tested at 1 hour.

This is called:

A

Glucose challenge test

76
Q

List the criteria for diagnosing GDM (OGTT)

A

Fasting plasma glucose of >95 mg/dL

1-hr plasma glucose >180 mg/dL

2-hr plasma glucose >155 mg/dL

3-hr plasma glucose >140 mg/dL

77
Q

Alternative for 100 g oral glucose load in diagnosing GDM

A

Use a 50g or 75g glucose load and measure glucose through the 2-hr period

78
Q

Patient preparation for OGTT according to WHO

A

Unrestricted carbohydrate rich diet for 3 days before test with physical activity

Restrict medication on test day

12-hr fasting

No smoking

79
Q

OGTT oral glucose load

A

Adult: 75g in 300-400 mL of water

Children: 1.75 g/kg up to 75g of glucose

GDM: 50g, 75g, 100g

80
Q

T/F:

OGTT involves timed measurements of plasma glucose before and after ingesting a specific amount of glucose

A

TRUE

81
Q

When is plasma glucose specimen collected for OGTT

A

Plasma glucose specimen collected fasting at 10 minutes before glucose load

2 hrs after ingestion of glucose

82
Q

OGTT results based on WHO criteria:

Fasting plasma glucose 110-125 mg/dL

A

Impaired fasting glucose (IFG)

83
Q

OGTT results based on WHO criteria:

Fasting plasma glucose level less than or equal to 126 mg/dL

2-hr plasma glucose level (OGTT) 140-199 mg/dL

A

Impaired glucose tolerance (IGT)

84
Q

Impaired glucose tolerance criteria

A

Fasting plasma glucose level less than or equal to 126 mg/dL

2-hr plasma glucose level 140-199 mg/dL

85
Q

OGTT results based on WHO criteria:

For Diabetes mellitus

A

Fasting plasma glucose level greater than or equal to 126 mg/dL

2-hr glucose greater than or equal to 200 mg/dL

86
Q

3 forms of hemoglobin A

A

HbA1a
HbA1b
HbA1c

87
Q

Main form of glycosylated hemoglobin

A

HbA1c

88
Q

3 forms of hemoglobin A are referred to as:

A

Glycated/Glycosylated hemoglobin

89
Q

Measurement of glycated hemoglobin reflects blood glucose levels for
the past ____________ months.

A

2-3

90
Q

formed from the nonenzymatic, irreversible

attachment of glucose to hemoglobin A1

A

glycated hemoglobin

91
Q

Techniques used to measure glycated hemoglobin

A

Affinity chromatography
Ion-exchange chromatography
High-performance liquid chromatography

92
Q

Glycated hemoglobin specimen

A

Nonfasting blood specimen

93
Q

Tube used for glycated hemoglobin test

A

EDTA

94
Q

Glycated hemoglobin reference range

A

4-6% HbA1c

Effective treatment range <7% HbA1c

95
Q

Measurement of fructosamine reflects blood

glucose levels for (how long) before sampling.

A

2-3 weeks

96
Q

Techniques used to measure fructosamine

A

Spectrophotometric/Colorimetric methods
Affinity chromatography
High-Performance Liquid Chromatography

97
Q

Ketoamine linkage forms between glucose and protein, mainly represented
by albumin. This forms _______.

A

Fructosamine

98
Q

Fructosamine reference range

A

205-285 umol/L

99
Q

microalbumin analysis specimen

A

Random urine

100
Q

Measurement of albumin excretion is useful for patients with what disease?

A

Renal complications of DM

101
Q

microalbumin analysis always requires the simultaneous analysis of _______.

A

creatinine

102
Q

Microalbumin analysis is reported as

A

albumin/creatinine ratio

103
Q

Microalbuminuria values

A

greater than or equal to 30 mg albumin/g creatinine

104
Q

Methods of Measurement of Plasma Glucose

A

Glucose oxidase method

Hexokinase method

105
Q

Reference range for plasma glucose (adult fasting)

A

74-99 mg/dL

106
Q

normal end product of glucose metabolism

A

pyruvate

107
Q

product of glucose metabolism under conditions of oxygen deficit (anaerobic metabolism)

A

lactate

108
Q

aid in assessing the degree of oxygen deprivation that is occurring

A

lactate production & accumulation + measurement

109
Q

T/F:

Change in the blood lactate level precedes a change in blood pH

A

TRUE

110
Q

How is lactate metabolized?

A

liver via gluconeogenesis

111
Q

caused by depressed oxygen

levels that may occur in acute myocardial infarction, congestive heart failure, shock, pulmonary edema, and so on

A

Type A lactic acidosis

112
Q

caused by
metabolic processes that may occur in diabetes mellitus, renal disorders, liver
disease, ingestion of toxins (salicylate overdose and excess ethanol), and so on

A

Type B lactic acidosis

113
Q

Special specimen handling for lactate

A

Avoid using tourniquet
Place specimen on ice
Centrifuge specimen and remove plasma

114
Q

Using tourniquet in specimen collection for lactate will falsely (decrease/increase) blood lactate levels

A

Falsely increase.

Due to venous stasis

115
Q

Tubes used for lactate measurement

A

Gray-top

Sodium fluoride, potassium oxalate

116
Q

Lactate reference range

A

0.5-1.3 mmol/L

CLINICAL CHEMISTRY (8 decks)

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