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CLINICAL PATHOLOGY > DIABETES LAB WORK-UP (CARBOHYDRATES) > Flashcards

DIABETES LAB WORK-UP (CARBOHYDRATES) Flashcards

1
Q

Anabolic hormone

A

Insulin

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2
Q

Glucagon is stimulated by:

A

Cortisol
AA
Exercise
Infection

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3
Q

Epinephrine ____ glucose level

A

Increase

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4
Q

activate adenylate cyclase

A

Epinephrine

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5
Q

Inhibits lipogenesis, glycogenesis

A

GH/ACTH

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6
Q

accelerate degradation of insulin

A

Thyroid hormone

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7
Q

Defect: Muscle phosphorylase

A

V (McArdle disease)

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8
Q

Defect: Phosphofructokinase

A

VII (Tarui disease)

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9
Q

Phosphoglycerate kinase

A

Phosphoglycerate kinase deficiency

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10
Q

Phosphoglycerate mutase M subunit

A

Phosphoglycerate mutase deficiency

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11
Q

Lysosomal acid alpha glucosidase (GAA) (acid maltase)

A

II/Pompe disease

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12
Q

standard clinical specimen

A

plasma (glucose)

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13
Q

appropriate if separated from cells within 30 minutes

A

serum (glucose)

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14
Q

levels are generally lower than plasma glucose levels by 10-15%

A

whole blood (HbA1c)

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15
Q

Whole blood (HbA1c) percentage varies

A
  1. Hematocrit
  2. Analysis technique
  3. Sample timing
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16
Q

Ways to slow down glycolysis:

A
  1. add an enzyme inhibitor (sodium fluoride / lithium iodoacetate)
  2. cooling of blood sample
  3. serum separation
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17
Q

Screening test for hyperglycemia and hypoglycemia:

A

Random blood sugar (RBS)

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18
Q

Criteria for hypoglycemia in adults

A

<55 mg/dl (3.0 mmol/L)

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19
Q

Criteria for hypoglycemia in infants:

A

<50 mg/dL (2.8 mmol)

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20
Q

American Diabetes Associations recommendation for

hyperglycemia:

A

If RBS is >160 mg/dL

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21
Q

gold standard for DM diagnosis

A

FBS

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22
Q

Normal values:

A

< 100 mg/dL (<5.6 mmol/L)

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23
Q

Diabetes mellitus

A

≥ 126 mg/dL (7.0 mmol/L)

2 or more occasions

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24
Q

Impaired FBS

A

100-125 mg/dL (5.6-6.9 mg/dL)

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25
Q

standardized glucose test

A

Oral glucose tolerance test

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26
Q

not recommended for routine clinical use

A

Oral glucose tolerance test

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27
Q

sensitive but not specific

A

Oral glucose tolerance test

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28
Q

Normal value for Oral Glucose Challenge

Test (OGCT)

A

< 140 mg/dL

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29
Q

If >140 mg/dL

A

proceed with OGTT

30
Q

Risk factors for GDM:

A
  1. Previous pregnancy with GDM
  2. LGA >8.8 lbs (4 kg)
  3. Overweight (BMI = >30)
  4. <25 years old
31
Q

Patients given 3 days 150 gram/day CHO diet

A

Preparatory phase

32
Q

What to avoid:

A
  1. inactivity
  2. illness/infection
  3. coffee/tea/alcohol
  4. smoking
  5. drugs:
  • salicylates
  • diuretics
  • anticonvulsants
  • oral contraceptives
33
Q

dextrose/glucose

A

100-300 mL

34
Q

adult/non-pregnant

A

75 gm

35
Q

pregnant

A

100 gm/75 gm

36
Q

children

A

1.75 gm/kg BW

37
Q

time period:

A

7-9 am

38
Q

baseline glucose after ________ of rest

A

30 minutes

39
Q

glucose load ingestion within _________

A

5 minutes

40
Q

impaired fasting glucose

A

FBS: 100-125 mg/dL

41
Q

impaired glucose tolerance

A

2 hr – 140-199 mg/dL (7.8-11.0 mmol/L)

42
Q

diabetes FPG

A

≥ 126 mg/dL (≥ 7.0 mmol/L)

43
Q

diabetes 2 hr

A

≥ 200 mg/dL (≥ 11.1 mmol/L)

44
Q

FPG (NIH consensus)

A

> 95 mg/dL (5.3 mmol/L)

45
Q

1 hr (NIH consensus)

A

> 180 mg/dL (10.0 mmol/L)

46
Q

2 hr (NIH consensus)

A

> 155 mg/dL (8.6 mmol/L)

47
Q

3 hr (NIH consensus)

A

> 140 mg/dL (7.8 mmol/L)

48
Q

2 or more abnormal values for GDM performed after OGCT

A

(two step method)

49
Q

FPG (IADPSG consensus)

A

> 92 mg/dL (5.1 mmol/L)

50
Q

1 hr (IADPSG consensus)

A

> 180 mg/dL (10.0 mmol/L)

51
Q

2 hr (IADPSG consensus)

A

> 153 mg/dL (8.5 mmol/L)

52
Q

one step method

A

75 gm OGTT

53
Q

screen and diagnose DM

A

2-hour postprandial glucose

54
Q

monitor glucose control

A

2-hour postprandial glucose

55
Q

performed following a meal

A

2-hour postprandial glucose

56
Q

maximum glucose values

A

60-90 mins after load

57
Q

2-hour postprandial glucose for adults

A

≤ 140 mg/dL (7.8 mmol/L)

58
Q

2-hour postprandial glucose for pregnant adults

A

100-129 mg/dL (5.6 mmol/L)

59
Q

Limitations for 2-hour postprandial glucose:

A
  1. Carbohydrate load
  2. Patient preparation
  3. Intercurrent infection
  4. Age of patient
60
Q

3-6% of total hemoglobin

A

Hemoglobin A1c

61
Q

increases 1-4 weeks after ↑ in blood glucose

A

Hemoglobin A1c

62
Q

HBA1C represents average blood glucose past ________.

A

2-4 months

63
Q

monitor patient compliance

A

Hemoglobin A1c

64
Q

differentiate short term stress related GT abnormality from DM

A

Hemoglobin A1c

65
Q

Normal

A

<5.7%

66
Q

Prediabetes

A

5.7 – 6.4%

67
Q

Diabetes

A

> 6.4%

68
Q

Good glycemic control

A

< 7.0%

69
Q

Source or error:

A

RBC survival

70
Q

Decrease values:

A

Hemolytic anemia

Phlebotomy pregnancy

71
Q

Increase values:

A

G6PD

Glycogen storage disease

CLINICAL PATHOLOGY (2 decks)

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