Endocrine 1 Flashcards
the conversion of glucose to fat
lipogenesis
what stops the excess glucose made by the liver?
insulin
the process of glucagon stimulating the liver to convert glycogen into glucose-1 phosphate and glucose, and putting it into the blood stream
glycogenolysis
which 2 organs can release glucose?
liver
kidney
the formation of glucose from non-carbohydrate carbon sources
gluconeogenesis
where does a majority of gluconeogenesis occur?
liver
what is glucose 6 phosphate called in skeletal muscle?
hexokinase
what is glucose 6 phosphate called in the liver?
glucokinase
what is needed in order for glucose 6 phosphate to release glucose?
glucose 6 phosphatase
where is glucose 6 phosphatase mostly found?
liver
some in kidney
which hormones regulate glycogen metabolism? (3)
insulin
glucagon
epinephrine
describe diabetes mellitus type 1
b-cells (islet) are destroyed and don’t make enough insulin
describe diabetes mellitus type 2
resistant to insulin
what kind of onset does DM1 have?
rapid
what kind of onset does DM2 have?
gradual
what is the most common risk factor for DM2?
obesity
how do gestational diabetes occur?
placental hormones block insulin in the mother
when is gestational diabetes recognized?
late pregnancy
a large baby due to gestational diabetes
macrosomia
what are the 3 common symptoms of diabetes?
polyuria
polydipsia
polyphagia
low insulin levels so glucose cannot be put into cells for energy; leads to glycolysis, forming ketones and makes the blood more acidic
diabetic ketoacidosis
what are 4 results that indicate DKA?
hyperglycemia
glucosuria
ketonemia
ketonuria
what is the most common cause of hyperglycemia?
diabetes
impaired breakdown of stored glycogen due to a missing enzyme
glycogen storage disease
what does glycogen storage disease lead to? (2)
buildup of glycogen in the liver
increased insulin in the blood
where does glycogen storage disease primarily occur?
liver
what is the gold standard to diagnose diabetes?
HbA1c
how often should non-pregnant individuals be screened for diabetes?
every 3 years
what is the best diagnosis test for diabetes, especially when screening for GDM?
oral glucose tolerance test
a test that monitors pancreatic function and tissue response to insulin
oral glucose tolerance test
when is the best time to do a glucose tolerance test?
morning
what is a normal glucose tolerance test level?
less than 140 mg/dL
how would a patient present if they have DKA?
hyperglycemia
dehydration
acidosis
DKA is mostly associated with which type of DM?
DM1
how is a glucose tolerance test taken? (4)
fasting for 8-12 hrs
patient drinks dextrose
draw at 1 hour mark
draw at 3 hour mark
to diagnose GDM, what must be the fasting glucose?
over 95 mg/dL
to diagnose GDM, what must be glucose in a glucose tolerance test after 1hr?
over 180 mg/dL
to diagnose GDM, what must be glucose in a glucose tolerance test after 2hr?
over 155 mg/dL
to diagnose GDM, what must be glucose in a glucose tolerance test after 3hr?
over 140 mg/dL
what are we looking for in a glucose tolerance test at the 3 hour mark?
glucose that has gone back to baseline
the measure of glycated proteins (glucose stuck to hemoglobin) in the RBCs
hemoglobin A1c
what does the level of HbA1c tell us?
the amount of glucose over 3 months
what is a normal HgA1c?
5.6 or below
what level of HbA1c indicates prediabetes?
5.7-6.4
what level of HbA1c indicates diabetes?
6.5 and above
how often to check a patient’s HbA1c if they are meeting treatment goals and have stable glycemic control?
2x a year
how often to check a patient’s HbA1c if they are not well controlled or meeting goals?
4x a year
formed by proinsulin and is secreted in the circulation; calculates the level of insulin being produced by the pancreas
C-peptide
what does C-peptide help us distinguish?
between DM1 and DM2
where does C-peptide come from?
kidney
what 5 conditions can be indicated when C-peptide levels are high?
DM2
cushing’s syndrome
insulinoma
kidney disease
low blood potassium
what 4 conditions can be indicated when C-peptide levels are low?
DM1
liver disease
addison’s disease
ineffective diabetes treatment
measures circulating glycosylated proteins and reflects glucose control over 2-3 weeks
fructosamine
what can cause a false low level of fructosamine in a patient?
if patient has low serum protein levels
what is the reference range for fructosamine?
170-285 umol/L
what proteins does fructosamine measure?
albumin
globulins
lipoproteins
most commonly used protein antigen found in neuroendocrine cells, and is detected in most of newly diagnosed DM1 patients
GADA
protein antigen found in islet b cells and neuroendocrine cells that is detected in most of DM1 children; levels fall soon after diagnosis
IA-2A
found in islet B cells and is detected in 70% of children with DM1; not commonly detected in adults
IAA
detected in most children with DM1; levels fall rapidly after diagnosis
ZnT8
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
ketone bodies
where is B-ketoacyl CoA transferase NOT present?
liver
ketone antibodies are most often associated with which type of DM?
DM1
what is used to test for ketone bodies?
sodium nitroprusside - reacts with acetoacetic acid
what does a positive ketone body test look like?
purple
what does chemically induced defects in sugar reabsorption in the PCT cause?
glycosuria
what does excretion of HMWP indicate?
glomerular damage
evaluates individuals at risk for ESRD; detects low albumin levels that are undetectable by routine reagent strips
microalbuminuria
what is the specimen of choice to measure microalbumin?
urine
specimen that allows for direct measure, is convenient for DM patients, and optimal for infants because small amounts are needed
whole blood (capillary blood)
which tube inhibits glucose metabolism by cells?
gray top
what does the gray top tube contain?
sodium flouride
specimen used for rapid analysis to prevent reduced levels secondary to bacterial metabolism if contaminated
CSF
