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Lab Med > Endocrine 1 > Flashcards

Endocrine 1 Flashcards

1
Q

the conversion of glucose to fat

A

lipogenesis

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2
Q

what stops the excess glucose made by the liver?

A

insulin

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3
Q

the process of glucagon stimulating the liver to convert glycogen into glucose-1 phosphate and glucose, and putting it into the blood stream

A

glycogenolysis

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4
Q

which 2 organs can release glucose?

A

liver
kidney

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5
Q

the formation of glucose from non-carbohydrate carbon sources

A

gluconeogenesis

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6
Q

where does a majority of gluconeogenesis occur?

A

liver

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7
Q

what is glucose 6 phosphate called in skeletal muscle?

A

hexokinase

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8
Q

what is glucose 6 phosphate called in the liver?

A

glucokinase

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9
Q

what is needed in order for glucose 6 phosphate to release glucose?

A

glucose 6 phosphatase

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10
Q

where is glucose 6 phosphatase mostly found?

A

liver
some in kidney

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10
Q

which hormones regulate glycogen metabolism? (3)

A

insulin
glucagon
epinephrine

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11
Q

describe diabetes mellitus type 1

A

b-cells (islet) are destroyed and don’t make enough insulin

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12
Q

describe diabetes mellitus type 2

A

resistant to insulin

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13
Q

what kind of onset does DM1 have?

A

rapid

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14
Q

what kind of onset does DM2 have?

A

gradual

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15
Q

what is the most common risk factor for DM2?

A

obesity

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16
Q

how do gestational diabetes occur?

A

placental hormones block insulin in the mother

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17
Q

when is gestational diabetes recognized?

A

late pregnancy

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18
Q

a large baby due to gestational diabetes

A

macrosomia

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18
Q

what are the 3 common symptoms of diabetes?

A

polyuria
polydipsia
polyphagia

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19
Q

low insulin levels so glucose cannot be put into cells for energy; leads to glycolysis, forming ketones and makes the blood more acidic

A

diabetic ketoacidosis

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20
Q

what are 4 results that indicate DKA?

A

hyperglycemia
glucosuria
ketonemia
ketonuria

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21
Q

what is the most common cause of hyperglycemia?

A

diabetes

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22
Q

impaired breakdown of stored glycogen due to a missing enzyme

A

glycogen storage disease

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23
Q

what does glycogen storage disease lead to? (2)

A

buildup of glycogen in the liver
increased insulin in the blood

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24
Q

where does glycogen storage disease primarily occur?

A

liver

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25
Q

what is the gold standard to diagnose diabetes?

A

HbA1c

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26
Q

how often should non-pregnant individuals be screened for diabetes?

A

every 3 years

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27
Q

what is the best diagnosis test for diabetes, especially when screening for GDM?

A

oral glucose tolerance test

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28
Q

a test that monitors pancreatic function and tissue response to insulin

A

oral glucose tolerance test

29
Q

when is the best time to do a glucose tolerance test?

A

morning

30
Q

what is a normal glucose tolerance test level?

A

less than 140 mg/dL

31
Q

how would a patient present if they have DKA?

A

hyperglycemia
dehydration
acidosis

32
Q

DKA is mostly associated with which type of DM?

A

DM1

33
Q

how is a glucose tolerance test taken? (4)

A

fasting for 8-12 hrs
patient drinks dextrose
draw at 1 hour mark
draw at 3 hour mark

34
Q

to diagnose GDM, what must be the fasting glucose?

A

over 95 mg/dL

35
Q

to diagnose GDM, what must be glucose in a glucose tolerance test after 1hr?

A

over 180 mg/dL

36
Q

to diagnose GDM, what must be glucose in a glucose tolerance test after 2hr?

A

over 155 mg/dL

37
Q

to diagnose GDM, what must be glucose in a glucose tolerance test after 3hr?

A

over 140 mg/dL

38
Q

what are we looking for in a glucose tolerance test at the 3 hour mark?

A

glucose that has gone back to baseline

39
Q

the measure of glycated proteins (glucose stuck to hemoglobin) in the RBCs

A

hemoglobin A1c

40
Q

what does the level of HbA1c tell us?

A

the amount of glucose over 3 months

41
Q

what is a normal HgA1c?

A

5.6 or below

42
Q

what level of HbA1c indicates prediabetes?

A

5.7-6.4

43
Q

what level of HbA1c indicates diabetes?

A

6.5 and above

44
Q

how often to check a patient’s HbA1c if they are meeting treatment goals and have stable glycemic control?

A

2x a year

45
Q

how often to check a patient’s HbA1c if they are not well controlled or meeting goals?

A

4x a year

46
Q

formed by proinsulin and is secreted in the circulation; calculates the level of insulin being produced by the pancreas

A

C-peptide

47
Q

what does C-peptide help us distinguish?

A

between DM1 and DM2

48
Q

where does C-peptide come from?

A

kidney

49
Q

what 5 conditions can be indicated when C-peptide levels are high?

A

DM2
cushing’s syndrome
insulinoma
kidney disease
low blood potassium

50
Q

what 4 conditions can be indicated when C-peptide levels are low?

A

DM1
liver disease
addison’s disease
ineffective diabetes treatment

51
Q

measures circulating glycosylated proteins and reflects glucose control over 2-3 weeks

A

fructosamine

52
Q

what can cause a false low level of fructosamine in a patient?

A

if patient has low serum protein levels

53
Q

what is the reference range for fructosamine?

A

170-285 umol/L

54
Q

what proteins does fructosamine measure?

A

albumin
globulins
lipoproteins

55
Q

most commonly used protein antigen found in neuroendocrine cells, and is detected in most of newly diagnosed DM1 patients

A

GADA

56
Q

protein antigen found in islet b cells and neuroendocrine cells that is detected in most of DM1 children; levels fall soon after diagnosis

A

IA-2A

57
Q

found in islet B cells and is detected in 70% of children with DM1; not commonly detected in adults

A

IAA

58
Q

detected in most children with DM1; levels fall rapidly after diagnosis

A

ZnT8

59
Q

produced by the liver from the breakdown of lipids and extrahepatic tissues (heart and skeletal muscles) use this as a fuel source during prolonged starvation

A

ketone bodies

60
Q

where is B-ketoacyl CoA transferase NOT present?

A

liver

61
Q

ketone antibodies are most often associated with which type of DM?

A

DM1

62
Q

what is used to test for ketone bodies?

A

sodium nitroprusside - reacts with acetoacetic acid

63
Q

what does a positive ketone body test look like?

A

purple

64
Q

what does chemically induced defects in sugar reabsorption in the PCT cause?

A

glycosuria

65
Q

what does excretion of HMWP indicate?

A

glomerular damage

66
Q

evaluates individuals at risk for ESRD; detects low albumin levels that are undetectable by routine reagent strips

A

microalbuminuria

67
Q

what is the specimen of choice to measure microalbumin?

A

urine

68
Q

specimen that allows for direct measure, is convenient for DM patients, and optimal for infants because small amounts are needed

A

whole blood (capillary blood)

69
Q

which tube inhibits glucose metabolism by cells?

A

gray top

70
Q

what does the gray top tube contain?

A

sodium flouride

71
Q

specimen used for rapid analysis to prevent reduced levels secondary to bacterial metabolism if contaminated

A

CSF

Lab Med (19 decks)

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