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MTAP 2 - CC1 (Trans) > Criteria for Diagnosis of DM to other types of DM > Flashcards

Criteria for Diagnosis of DM to other types of DM Flashcards

1
Q

Requested during insulin shock and hyperglycemic ketonic coma

A

Random Plasma Glucose/ Random Blood
Sugar/RBS

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2
Q

Reference value for RBS

A

<160 mg/dL

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3
Q

T/F: If RBS is ≥160 mg/dL → perform FBS/ HbA1c/ 2-hr OGTT for confirmation

A

TRUE

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4
Q

Measure of overall glucose homeostasis
It is affected by Diurnal Variation (higher in the morning than in the afternoon)

A

Fasting Plasma Glucose

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5
Q

Reference value for FPG

A

70-99 mg/dL

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6
Q

If FBG is done in the afternoon, the result will

A

falsely decrease

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7
Q

FBG increase with age for how many per decade?

A

2mg/dL (per decade)

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8
Q

o Uses standardized Glucose Load (75g equivalent complete meal)
o After the 2-hour after meal, the patient must not eat anything

A

2nd hour Post Prandial Blood Glucose

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9
Q

Reference value for 2hr Post prandial Glucose

A

60-140 mg/dL

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10
Q

Diabetic value for 2hr PPG

A

≥200 mg/dL

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11
Q

2hr PPG increase with age for how many mg per decade

A

4 mg

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12
Q

Called “glycosylated/glycated” because glucose is non-enzymatically attached to one or both beta chain of the hemoglobin

A

Glycosylated (Glycated) Hemoglobin (HbA1c)

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13
Q
  • referred test to assess long-term glycemic control
  • Reflects the average glucose level over the past 2-3 months
A

Glycosylated (Glycated) Hemoglobin (HbA1c)

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14
Q

Decrease RBC life span in hemolytic anemia or hemoglobinopathies will cause

A

False decrease HbA1c

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15
Q

Substitute test for patient with hemolytic anemia and hemoglobinopathies

A

Fructosamine

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16
Q

Reference value: HbA1C

A

Adult: 4.0-6.0 % (American Diabetes Association: <5.7%) ▪ Pediatrics:<7.5%

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17
Q

Diabetic value for HbA1C

A

≥6.5%

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18
Q

Prediabetes value for HbA1c

A

5.7-6.4%(normal but at risk)

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19
Q
  • Most widely used to assess short-term glycemic control (3-6 weeks)
  • Specimen: Serum with or without fasting
A

Fructosamine/Glycosylated/Glycated albumin/Plasma Protein Ketoamine

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20
Q

Methods used for fructosamine

A

HPLC, Affinity chromatography, photometric assay

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21
Q

Interference for fructosamine

A

High uric acid, triglyceride and bilirubin levels, heparin, hemolysis

22
Q

You cannot perform this if the patient has
hypoalbuminemia (albumin less than or equal 30 g/dL because

A

It will cause false decrease fructosamine

23
Q

Reference value for Fructosamine

A

205-285 umol/L

24
Q
  • It is used to determine how well the body metabolizes glucose over a required period of time
  • Recommended for diagnosis of GDM
    Not routinely performed in patient with DM
A

Glucose Tolerance Test (Multiple Sugar test)

25
Q

Recommended method for Non-pregnant patients

A

Oral Glucose Tolerance Test

26
Q

Reference value for OGTT

A

2hr - 60-140 mg/dL

27
Q

Diabetic value for OGTT

A

2hr, ≥ 200 mg/dL

28
Q

Value of impaired glucose tolerance for OGTT

A

140-199 mg/dL

29
Q

Requirement for OGTT

A
  • Patient should be ambulatory/able to walk (the only test in clinical chemistry that requires ambulatory patient and not performed on bedridden patients)
  • Unrestricted diet of 150g carbohydrate/day for 3 days prior to test
  • Restrictions: Exercise, food intake, drinking (only water), smoking
  • Fasting for at least 10 hours
  • Must be performed in the morning
30
Q

Smoking and alcohol can __ blood glucose

A

Increase

31
Q

Glucose load standards

A

▪ 75 grams – WHO standard glucose load
▪ 100grams–pregnant; as requested
▪ 1.75 grams of glucose/KBW - children (max. 75g)

32
Q
  • Performed on patients with gastrointestinal disorders (malabsorption syndrome)
  • Glucose load: 0.5 g/KBW (administer within 3 mins)
A

Intravenous Glucose Tolerance Test

33
Q

Janney-Isaacson Method also known as

A

Single-Dose method

34
Q

Steps for Janney-Isaacson Method

A

Steps:
a. Extract first blood sample (FBS)
b. Administer standard glucose load (75g)
c. Collect 1 hour, 2 hour, and 3 hour blood samples after glucose loading
- Total of 4 blood samples (including FBS)
d. Patient is not allowed to eat before collecting all four blood samples (he or she can only after collection of the 3 hour blood sample)

35
Q

Called double-dose because it uses 100g glucose load then, divide into 2

A

Exton Rose Method (Double-Dose/Divided Oral Dose Method)

36
Q

Exton Rose Method (Double-Dose/Divided Oral Dose Method) steps

A
  • Extract first blood sample (FBS)
  • Administer 1st half of the glucose load (50g)
  • Collect blood sample; 30 minutes after the first glucose load Administer remaining 2nd half of glucose load (50g)
  • Collect blood again 30 minutes after the 2nd glucose load
  • Total of 3 blood samples including FBS
37
Q
  • Recommended by International Association of Diabetes and Pregnant Study Groups (IADPSG)
  • Type of OGTT performed among pregnant women 24-28 weeks age of gestation who are not previously diagnosed with diabetes mellitus (can be used as screening method)
A

One-step Method

38
Q

In one step method, this is the ff criteria to diagnose GDM

A

Patient has GDM if one of the following criteria is met:
o FBS: ≥92 mg/dL
o 1hr: ≥180 mg/dL
o 2nd hr: ≥153 mg/dL

39
Q

Recommended by the National Institute of Health (NIH)

A

Two-step method

40
Q

In two-step method, this criteria is used fi diagnose GDM

A

Patient has GDM if the patient met 2 out of 4 criteria
▪ FBS:>95mg/dL
▪ 1st hour: ≥180 mg/dL ▪ 2nd hour: ≥155 mg/dL ▪ 3rd hour: ≥140 mg/dL

41
Q

Removal of pancreas or any disorder can alter the normal production of insulin which may lead to hyperglycemia then, Type 1 DM

A

Pancreatic Disorders/Pancreatectomy

42
Q

Increase cortisol

A

Cushing’s Syndrome

43
Q

Increased catecholamines

A

Pheochromocytoma

44
Q

Increased in Growth hormones

A

Acromegaly

45
Q

Increase in Thyroid hormone (T3 and T4)

A

Hyperthyroidism

46
Q

Drugs or chemical inducer of Beta Cell dysfunction

A
  • Dilantin
  • Pentamidine
47
Q

Drugs or chemical causing impairment of Insulin action

A
  • Thiazides
  • Glucocorticoids
48
Q

It can cause Type 1 DM due to immune defect

A

Down Syndrome (Trisomy 21)

49
Q

Causes immune defect

A

Klinefelter’s (XXY)

50
Q

Shows severe insulin resistance – Type 2 DM

A

Rabson-Mendengall and Leprechaunism

51
Q

Death of brain cells
Causes DM

A

Huntington’s chorea

52
Q
  • Occurs among females
  • Partial or complete depletion of one X chromosomes
A

Turner’s Syndrome

MTAP 2 - CC1 (Trans) (7 decks)

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