Exam 4: Lipids and Carbs Flashcards

1
Q

What are some properties we can use to classify carbohydrates?

A

Size and base of carbon chain, location of C=O functional group, number of sugar units, stereochemistry of the compound

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2
Q

What is the primary function of carbohydrates?

A

Serve as a source of energy

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3
Q

What are the monosaccharide components of sucrose?

A

Glucose + Fructose

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4
Q

What are the monosaccharide components of lactose?

A

Glucose + Galactose

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5
Q

What are the monosaccharide components of maltose?

A

Glucose + Glucose

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6
Q

D-Glucose vs L-Glucose

A

D glucose has hydroxyl groups on the right side, L glucose has hydroxyl groups on the left side

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7
Q

Examples of polysaccharides

A

Starch, glycogen, cellulose, chitin

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8
Q

What are proteoglycans?

A

Protein core that is heavily glycosylated - found in connective tissues and can provide hydration to tissues and enable tissues to endure compressional forces

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9
Q

Examples of glycoproteins

A

Antibodies, hormones, coagulation factors

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10
Q

Examples of reducing sugars

A

All monosaccharides, all disaccharides except sucrose

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11
Q

What is the criteria to be a reducing sugar?

A

Must have a free aldehyde or ketone group

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12
Q

What enzyme breaks down carbohydrates?

A

Amylase

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13
Q

Amylopectin vs amylose

A

Amylopectin is branched form of starch
Amylose is unbranched form of starch

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14
Q

What is the body’s primary source of energy?

A

Glucose metabolism (carbs)

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15
Q

What system relies on a steady supply of glucose because it cannot store it?

A

Nervous system

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16
Q

What is the end product of Embden-Meyerhof Pathway?

A

Pyruvate, ATP (aerobic glycolysis)
Lactate, ATP (anaerobic glycolysis)

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17
Q

What is the end product of the hexose monophosphate shunt?

A

NADPH and ribose-5-phosphate

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18
Q

What is the end product of glycogenesis?

A

Glycogen

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19
Q

What is the storage form of glucose?

A

Glycogen

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20
Q

What metabolic pathway for glucose can produce the sugar used in nucleotide synthesis?

A

Hexose-monophosphate shunt

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21
Q

What tissues are capable of glycogenolysis?

A

Liver tissues only

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22
Q

What tissues are capable of glycogenesis?

A

Liver and muscle tissue

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23
Q

Glycolysis

A

Metabolism of glucose molecule to pyruvate or lactate for production of energy

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24
Q

Gluconeogenesis

A

Formation of glucose-6-phosphate from noncarbohydrate sources

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25
Q

Glycogenolysis

A

Breakdown of glycogen to glucose for use as energy

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26
Q

Glycogenesis

A

Conversion of glucose to glycogen for storage

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27
Q

Lipogenesis

A

Conversion of carbohydrates to fatty acids

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28
Q

Lipolysis

A

Decomposition of fat

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29
Q

How are blood glucose levels maintained in short fasting periods?

A

Glycogenolysis and Gluconeogenesis

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30
Q

How are blood glucose levels maintained in prolonged fasting periods?

A

Gluconeogenesis

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31
Q

How are blood glucose levels maintained in postprandial periods?

A

Glycogenesis, Lipogenesis

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32
Q

What cells secrete glucagon?

A

alpha cells of islets of Langerhans in the pancreas

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33
Q

What does glucagon do ?

A

Increase glycogenolysis and increase gluconeogenesis (raises blood sugar)

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34
Q

What secretes epinephrine? How does epinephrine affect blood glucose?

A

Adrenal cortex; increased blood glucose rapidly

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35
Q

Where is growth hormone produced? What affect does it have on blood glucose levels?

A

Anterior pituitary; increases blood glucose

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36
Q

Where is ACTH produced? What affect does it have on blood glucose levels?

A

Anterior pituitary; increases blood glucose

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37
Q

Where is somatostatin produced? What affect does it have on blood glucose levels?

A

Delta cells of the pancreas; increases blood glucose and acts as an intermediate between insulin and glucagon

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38
Q

Where is cortisol produced? What affect does it have on blood glucose levels?

A

Adrenal cortex; increases blood glucose

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39
Q

Where is thyroxine produced? What affect does it have on blood glucose levels?

A

Thyroid gland; increases glucose

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40
Q

Where is human placental lactogen produced? What affect does it have on blood glucose?

A

Placenta; increases blood glucose by breaking down fats

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41
Q

Where is insulin secreted from? How does it affect blood glucose?

A

Secreted by beta cells of islets of langerhans in the pancreas; only hormone that decreases blood glucose

42
Q

What are the major targets of insulin?

A

Liver, skeletal muscle, adipose tissue

43
Q

Insulin should be 1:1 with _______.

A

C-peptide

44
Q

What four symptoms can be seen in diabetes patients?

A

Hyperglycemia
Polydipsia
Polyuria
Polyphagia

45
Q

Type 1 Diabetes

A

Complete lack of insulin production; autoimmune condition that is typically juvenile-onset

46
Q

Type 2 Diabetes

A

No response to insulin/insulin-resistant (Adult-onset) associated with obesity

47
Q

Is Type 1 or Type 2 diabetes more common?

A

Type 2

48
Q

Treatment for type 1 vs type 2 diabetes

A

type 1: insulin injections
type 2: lifestyle changes

49
Q

Beta cells in type 1 vs type 2 diabetes

A

type 1: beta cells are destroyed
type 2: beta cells are in tact

50
Q

Symptoms of type 1 vs type 2 diabetes

A

type 1: polydipsia, polyphagia, polyuria, DKA
type 2: minimal symptoms –> difficult to detect

51
Q

What are some causes of secondary diabetes mellitus?

A

Pancreatic disease, genetic defects of Beta cell function, Endocrine disease (cushing’s, acromegaly, hyperthyroidism), drug or chemical induced insulin receptor abnormalities (phenytoin)

52
Q

The breakdown of what compounds result in the production of ketones?

A

Breakdown of fatty acids

53
Q

What are the typical symptoms for diabetic ketoacidosis?

A

Blood acidosis, high ketones, elevated glucose levels, fruity/sweet smelling urine

54
Q

Which diabetes type is prone to diabetic ketoacidosis?

A

Type 1

55
Q

What is unique about CNS tissues with respect to glucose?

A

Nervous system cannot store glucose and relies heavily on the intake of glucose. It uses a very large amount of the glucose we take in daily.

56
Q

What does out of control type 2 diabetes lead to?

A

HHS

57
Q

How can gestational diabetes affect the baby both before birth and after birth?

A

Can cause hypoglycemia in babies due to extra insulin made during pregnancy. They can be more at risk for diabetes later in life.

58
Q

What are some causes of hypoglycemia in adults?

A

Too much insulin administration
Not eating enough food
Excessive ethanol intake
Hepatic failure
Addison’s disease
Insulinomas
Septicemia

59
Q

What are some causes of hypoglycemia in neonates?

A

Premature birth
Maternal toxemia
Maternal diabetes
Gestational diabetes

60
Q

What does a glycosylated hemoglobin value tell us about most patients’ glycemic control? What time frame does this represent?

A

The glycosylated hemoglobin test shows what a person’s average blood glucose level was for the 2 to 3 months before the test. This can help determine how well a person’s diabetes is being controlled over time.

61
Q

What laboratory methodologies for glucose are most specific? Why don’t we use it as often?

A

Hexokinase; it is expensive

62
Q

saturated vs monounsaturated vs polyunsaturated fats

A

saturated fats have no C=C
monounsaturated fats have 1 C=C
polyunsaturated fats have many C=C

63
Q

What is a normal response to an oral glucose tolerance test?

A

Increase in blood glucose to 120, dips back to normal after 2 hours. (Two hour PG <140 mg/dL)

64
Q

What two main factors affect the glycosylated hemoglobin level?

A

Average glucose concentration and RBC lifespan

65
Q

What is the most common glycosylated hemoglobin formed?

A

Hemoglobin A1C

66
Q

What test may be offered in some cases as an alternative to A1c? What patients might this benefit?

A

Fructosamine; might benefit patients with abnormal hemoglobins or anemia for a more accurate result.

67
Q

What is the criteria for the diagnosis of diabetes?

A

Fasting plasma glucose >126 mg/dL
2 hour plasma glucose >200 mg/dL during OGTT
A1C >6.5%
Random plasma glucose >200 mg/dL

68
Q

Major contributors to serum osmolality are:

A

Glucose
Sodium
Urea nitrogen
Chloride

69
Q

What tests might be used to evaluate long-term glucose management/control?

A

Fructosamine, Glycosylated hemoglobin, Urinary protein/urinary microalbumin, kidney function

70
Q

How does management of acute versus chronic hyperglycemia differ?

A

Acute management utilizes glucose measurements, ABG, electrolyes, ketones, lactate, and osmolality measurements. Chronic management is more in depth tests.

71
Q

Function of lipids

A

Store energy, composed in cell membranes

72
Q

What are the basic differences between cis and trans fatty acids?

A

Cis hydrogens on same side of double bond
Trans hydrogens on opposite side of double bond

73
Q

Basic structure of a triglyceride

A

Three fatty acid molecules attached to one glycerol by ester bonds - no charged or polar groups (hydrophobic)

74
Q

Basic structure of a phospholipid

A

Two fatty acid molecules and a phospholipid head group attached to glycerol

75
Q

Basic structure of cholesterol

A

Unsaturated steroid alcohol containing 4 rings and a single C-H side chain tail similar to fatty acid

76
Q

What compound is used as the precursor for the steroid hormones and vitamin D3?

A

Cholesterol

77
Q

What is cholesteryl ester?

A

esterified form of cholesterol; delivers cholesterol and fatty acids to organs

78
Q

What are the three ketone bodies?

A

Beta-hydroxybutyrate, Acetone, Acetoacetate

79
Q

Which lipoproteins contain the most lipids? The most protein?

A

Most lipids and least protein: Chylomicrons
Most proteins and least lipids: HDLs

80
Q

Describe the structure of a typical lipoprotein molecule.

A

Contains lipids and proteins; size of lipoprotein correlates with lipid content

81
Q

Function of lipoproteins

A

Transports lipids to the peripheral cells

82
Q

Chylomicrons; where is it produced? size? rich in _____? primary role?

A

Largest/least dense; produced by intestine; rich in triglycerides; delivers dietary lipids to the liver

83
Q

How are exogenous triglycerides transported in plasma?

A

Chylomicrons

84
Q

How are endogenous triglycerides transported in plasma?

A

LDLs

85
Q

What are the four lipoproteins?

A

Chylomicrons, VLDLs, HDLs, LDLs

86
Q

VLDLs; where are they produced? What are they rich in? What is the major function?

A

Produced by the liver; Rich in triglycerides; Major carriers of endogenous triglycerides

87
Q

LDLs; what is the function?

A

Major carrier of cholesterol to peripheral cells

88
Q

What is the major carrier of endogenous triglycerides?

A

VLDL

89
Q

What is the major carrier of cholesterol to peripheral cells?

A

LDLs

90
Q

HDLs; produced where? function? size?

A

Smallest and most dense; Synthesized by liver and intestine; ability to remove excess cholesterol from peripheral cells

91
Q

Do women or men have a higher HDL content? Why?

A

Women, due to production of estrogen (uses cholesterol)

92
Q

Tangier disease

A

Genetic condition associated with low HDL levels; significant risk factor involved with increased risk of cardiovascular disease

93
Q

What is the Friedewald equation?

A

Used to calculate LDL
LDL = Cholesterol - HDL - (Triglycerides/5)

94
Q

What are the two major problems associated with the Friedewald equation?

A
  1. Using measurements of 3 things so more room for error
  2. If triglycerides >400, cannot use this equation
95
Q

What are the types of hypolipidemia?

A

Tangier disease (Low HDL)
Abetalipoproteinemia (Low LDL)
Hypobetalipoproteinemia (Low LDL)

96
Q

What are the typical lipid panel components?

A

Cholesterol
HDL
Calculated LDL
Triglycerides
Cholesterol/HDL Ratio

97
Q

Normal reference range for total cholesterol

A

<200

98
Q

Normal reference range for HDL

A

> 40

99
Q

Normal reference range for LDL

A

<100

100
Q

Normal reference range for triglycerides

A

<150

101
Q

What causes lipemia in blood specimens in the lab?

A

Non-fasting patients; high levels of fat in the blood