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CCHM LAB (2) > Glucose > Flashcards

Glucose Flashcards

1
Q

Specimen Collection and Storage: normal hematocrit

A

whole blood glucose is 10-12% lower than plasma glucose

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2
Q

Specimen Collection and Storage: Capillary blood glucose

A

2-5 mg/dl higher than venous blood

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3
Q

Possible samples glucose method

A

Serum
CSF
Whole Blood
Synovial Fluid
Urine

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4
Q

Standard specimen glucose method

A

Fasting venous sample

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5
Q

Specimen Consideration

A

Uncentrifuged coagulated blood

Prolonged standing: 7 mg/dL per hour (RT)

Separated nonhemolyzed sterile serum

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6
Q

Specimen consideration: Uncentrifuged coagulated blood

A

Lower 5-7 % in 1 hour

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7
Q

Specimen Consideration: Prolonged
standing

A
  • 7 mg/dL per hour (RT)
  • 40C - 1-2 mg/dL per hour
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8
Q

Specimen Consideration: Separated nonhemolyzed sterile serum (25oC)

A

8 hrs

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9
Q

Specimen Consideration: Separated nonhemolyzed sterile serum (40oC)

A

72 hrs

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10
Q

CHOICE OF SAMPLE:

A

Serum should be separated from the clot within 0.5 to 1 hour

NaF: 2mg/ml of blood or iodoacetate

NaF - 2 mg for up to 48 hrs

Binds with Ca and Mg

inhibition of enolase

Precautions in sample collection to prevent glucose utilization by leukocytes (WBC)

RBC have all the enzymes necessary to metabolize glucose

The sample should be kept cool

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11
Q

Other samples for glucose testing urine sample reagent

A

5 mL glacial acetic acid
5g sodium benzoate (24 hr specimen)
Chlorhexedine
0.1% sodium nitrate w/ 0.01% benzethonium chloride

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12
Q

Tests for Glucose
Measurement

A

Random Blood Sugar
Fasting Blood Sugar (FBS)
Two-hour post prandial test (PPBS)
Glucose Tolerance Test
Oral glucose tolerance test

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13
Q

Requested during insulin shock and hyperglycemic ketonic coma.

A

Random blood sugar

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14
Q

The test should be performed after an 8 hour fast

A

Fasting blood sugar

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15
Q

The test is performed two hours after meal

A

2 hrs post prandial test

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16
Q

Used to determine how well the body metabolizes glucose over a required period of time

A

Glucose tolerance test

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17
Q

Used for diagnosis of gestational diabetes

A

Glucose tolerance test

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18
Q

Glucose tolerance test is used to diagnose

A

Gestational diabetes

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19
Q

Not generally recommended for routine clinical use for diagnosis of DM

A

Glucose tolerance test

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20
Q

Kinds of Glucose Tolerance
Tests

A

Oral Glucose Tolerance Test

Intravenous Glucose Tolerance Test

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21
Q

Oral glucose tolerance test 2 types

A

Janney-isaacson method
Exton rose method

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22
Q

Most common single dose method oral glucose tolerance test

A

Janney-isaacson method

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23
Q

Divided oral dose or double dose method oral glucose tolerance test

A

Exton rose method

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24
Q

Janney-isaacson method AKA

A

Single dose method

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25
Q

Exton rose method AKA

A

Divided oral dose
Double dose method

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26
Q

Used for DM patients with gastrointestinal disorders

A

Intravenous glucose tolerance test

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27
Q

Intravenous glucose tolerance test used for dm patient with

A

Gastrointestinal disorder

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28
Q

Intravenous glucose tolerance test body weight

A

0.5 g of glucose/kg of body weight

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29
Q

Oral glucose tolerance test Requirements:

A

• Patient must be ambulatory
• Patient to be tested should ingest at least 150 g of CHO 3 days prior to testing
• Patient should not eat food, drink tea, coffee or alcohol, vigorously exercise, or smoke cigarettes during the test
• Patient must fast the night before the testing is performed

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30
Q

Procedure for
OGTT

A

Collect the fasting blood sample

Instruct the patient to drink the glucose load

Collect blood sample after 1°, 2° and 3°

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31
Q

Categories of Oral Glucose Tolerance

A

Normal glucose tolerance
Impaired glucose tolerance
Provisional diabetes diagnosis

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32
Q

Normal glucose tolerance value

A

2-h PG < 140 mg/dl

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33
Q

Impaired glucose tolerance value

A

2-h PG 140-199 mg/dl

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34
Q

Provisional diabetes diagnosis value

A

2-h PG > 200 mg/dl

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35
Q

If the 1 hour postload glucose level is 140 mg/dL (7.8 mmol/L), a complete _______ three-hour oral glucose tolerance test should be performed

A

100g

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36
Q

TEST USED TO DIAGNOSE
GESTATIONAL DIABETES a _______ oral glucose load is recommended as basis of initial
diagnosis.

A

50 g

37
Q

CRITERIA USED TO DIAGNOSE
DIABETES: FBS level that is greater than or equal to ____________ (7.0 mmol/L) on at least 2 occasions

A

126 mg/dL

38
Q

CRITERIA USED TO DIAGNOSE
DIABETES : Two-hour postprandial glucose greater than __________ (7.8 mmol/L).

A

140 mg/dL

39
Q

CRITERIA USED TO DIAGNOSE
DIABETES: Symptoms of hyperglycemia which include

A

polyuria (increased urine) , polyphagia (extreme hunger), polydipsia (extreme thirst)

40
Q

CRITERIA USED TO DIAGNOSE
DIABETES: A two-hour postload glucose of _______________ in an OGTT.

A

200 mg/dL or greater than

41
Q

CRITERIA USED TO DIAGNOSE
DIABETES : HbA1C of _________ or equal to 6.5%

A

greater than or equal to 6.5%

42
Q

CRITERIA USED TO DIAGNOSE
DIABETES

A

FBS is greater than (126mg/dl)
2 hour postprandial is greater than (140mg/dl)
Symptoms of hyperglycemia
2 hour postload glucose 200mg/dl
HbA1C is greater than or equal 6.5%

43
Q

Monitoring Test for Diabetes
Mellitus

A

Glycosylated hemoglobin
Fructosamine

44
Q

Determined for DM once in 3 months

A

Glycosylated hemoglobin

45
Q

ideal HbA1C valu

A

<7%

46
Q

Factors affecting HBA1c

A

• Average glucose concentration
• RBC life span

47
Q

Hemoglobinopathies, increased red
cell turnover

A

pregnancy
recent blood loss
transfusion
erythropoietin
therapy/hemolysis

48
Q

Laboratory Testing of HbA1c: Specimen requirement

A

Ethylenediaminetetraacetid acid whole blood samples (hemolysate)

49
Q

2 Categories of HbA1c

A

Charge difference
Structural characteristics of glycogroups on hemoglobin

50
Q

Categories under Charge differences

A

cation exchange chromatography, electrophoresis,
isoelectric focusing

51
Q

preferred method for HbA1c

A

Affinity chromatography

52
Q

HbA1c attaches to the ________ group of the resin and is selectively eluted
from the resin bed using a buffe

A

boronate group

53
Q

HbA1c attaches to the boronate group of the_______ and is selectively eluted
from the resin bed using a buffe

A

resin

54
Q

Point of care HbA1c

A

latex immunoagglutination inhibition methodology

55
Q

Monitor test for DM Once in 3 weeks

A

Fructosamine

56
Q

Affected by albumin levels or hypoalbuminemia

A

• Liver disease
• Malabsorption
• Burns
• Nephrotic syndrome

57
Q

Glucometer aka

A

Point of care blood glucose meter

58
Q

Glucometer factor

A

1.11 concentration

59
Q

Glucometer reaction

A

Glucose oxidase/peroxidase chromogen reaction

60
Q

Glucometer factor

A

1.11 concentration

61
Q

Factors affecting accuracy and reproducibility: glucometer

A

User variability
Hematocrit → the presence of anemia (false increase); polycythemia (false
decrease)
Defective reagent strips and instrument malfunction
Other variables: altitude, temperature, humidity, hypotension, hypoxia, high
triglyceride concentrations

62
Q

Ketones specimen

A

Fresh serum/urine

63
Q

Ketones method or test used

A

Gerhardt’s test

64
Q

Copper Reduction Methods

A

Folin wu method
Nelson-somogyi method
Neocupreine method
Benedict’s method/fehlings method

65
Q

Method that uses PMA

A

Folin wu method

66
Q

Accurate but labor intensive and difficult to automate

A

Nelson-somogyi method

67
Q

Cu+ reduces AMA to molybdenum blue

A

Nelson-somogyi method

68
Q

Cu + neocupreine → yellow to yellow orange

A

Neocupreine method

69
Q

Inverse colorimetry method

A

Ferric reduction (hagedorn jensen)

70
Q

Ferric reduction Yellow → colorless measured at

A

400nm

71
Q

Most sensitive
method glucose

A

Dubowski method - o-toluidine method

72
Q

Uses acetic
acid

A

Dubowski method

73
Q

Dubowski method that is used but
carcinogenic
and poisonous

A

O-toluidine

74
Q

Wavelengths used dubowski method

A

630nm

75
Q

Method that very specific to a substrate

A

Enzymatic method

76
Q

first enzymatic reaction used

A

Glucose oxidase method

77
Q

H2O2 measurement:

A

Trinders method
Peroxidase method

78
Q

O2 is measured by:

A

Clark electrode
Ortho-dianisidine method

79
Q

Disadvantage of Glucose
Oxidase Reaction

A

Glucose oxidase can only measure beta glucose

80
Q

2 types of glucose

A

Alpha glucose
Beta glucose

81
Q

Type of glucose 35% cannot be oxidized

A

Alpha glucose

82
Q

Type of glucose 65% the only type which
can be oxidized

A

Beta glucose

83
Q

Generally accepted method for measuring glucose

A

Hexokinase method

84
Q

Uses alkaline ferricyanide
reagent

A

Autoanalyzer method

85
Q

Gave falsely high results because
several compounds in serum alse
were oxidized by ferricyanide

A

Ferricyanide method

86
Q

Ferricyanide method wavelength

A

400 nm

87
Q

Used in establishing correct insulin
amount for next dose

A

Dextrostics

88
Q

Widely used as a method of
screening for hypoglycemia of the
newborn

A

Dextrostic

89
Q

Employs a paper strip impregnated
with an enzyme-chromogen system

A

Dextrostic

CCHM LAB (2) (5 decks)

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