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Clinical Chemistry > Glucose > Flashcards

Glucose Flashcards

1
Q

Hyperglycemia

A

Blood glucose concentration above upper end of reference range (although typically > 200)

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2
Q

Hypoglycemia

A
  • Blood glucose concentration below lower end of reference range (although typically < 60)
  • due to insulin producing tumor, medications, etc.
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3
Q

Glycolysis

A

Process that breaks down glucose to pyruvate for the eventual production of energy

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4
Q

Glycogenesis

A

Formation of glycogen (storage form of glucose)

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5
Q

Glycogenolysis

A

Breakdown of glycogen for the release of glucose

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6
Q

Gluconeogenesis

A

Formation of glucose from non-carbohydrate sources (i.e., amino acids, triglycerides)

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7
Q

Polysaccharides, Disaccharides, Monosaccharides

A

carbohydrates
poly = > 10 sugar units
di = 2 sugar units
mono = single sugar

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8
Q

Ketoacidosis

A

acidic state of the body due to increased ketones (from the utilization of fats instead of glucose as an energy source)

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9
Q

Ketonemia

A

when ketones are found in the blood

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10
Q

Ketonuria

A

when ketones are found in the urine

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11
Q

Oral Glucose Tolerance Test (OGTT)

A

test used to help diagnose diabetes

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12
Q

Gestational Diabetes Milletus (GDM)

A

secondary diabetes that can be seen in pregnancy

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13
Q

3 monosaccharides utilized in the body

A

Glucose, galactose, fructose

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14
Q

3 disaccharides utilized in the body

A

sucrose, maltose, lactose

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15
Q

Lactose composition

A

glucose + galactose

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16
Q

Maltose composition

A

glucose + glucose

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17
Q

Sucrose composition

A

glucose + fructose

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18
Q

Polysaccharide storage

A

stored as glycogen or starch

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19
Q

Metabolism of carbohydrates

A

Broken down in the mouth by salivary amylase
Denatured in the stomach by acid
Disacchridases break down disaccharides in the intestine and monosaccharides are absorbed
Glucose is processed in the liver and is stored in fat cells or is sent to be utilized by other cells

20
Q

Major hormones controlling glucose blood levels

A

insulin and glucagon

21
Q

Pathways for G-6-P

A

Embden-Myerhof pathway for glycolysis
Hexose Monophosphate pathway
Converted to glycogen

22
Q

Insulin action

A

decreases blood glucose (glucose enters cells)

hypoglycemic agent

23
Q

Glucagon action

A

increases blood glucose (glycogenolysis, gluconeogenesis)

hyperglycemic agent

24
Q

Minor hormones controlling glucose

A

Epinephrine, cortisol (adrenal hormones)
Growth hormone, ACTH (pituitary hormones)
Thyroxine
Somatostatin

25
Q

Epinephrine action

A

increases blood glucose concentration through glycogenolysis, gluconeogenesis, etc.

26
Q

Cortisol action

A

increases blood glucose concentration through primarily gluconeogenesis using amino acids

27
Q

Growth hormone action

A

increases blood glucose concentration

28
Q

ACTH action

A

increases blood glucose concentration by stimulating cortisol release

29
Q

Thyroxine (T4) action

A

increases blood glucose concentration by increasing metabolic rate (faster protein turnover, more gluconeogenesis, increased glucose absorption in GI tract)

30
Q

Somatostatin (IGF) action

A

influences growth hormone

31
Q

Type I Diabetes

A
  • insulin-dependent diabetes mellitus
  • insulin deficiency
  • autoimmune destruction of beta islet cells
  • usually young people
32
Q

Type I Diabetes Chronic problems

A
  • retinopathy (optic nerve susceptible to excess glucose)
  • renal disease and nephropathy
  • peripheral neuropathy
33
Q

Type I Diabetes Lab Testing

A 
Fasting glucose
Urine specific gravity (increases with more glucose)
Serum and urine osmolalities
Ketones
Blood and urine pH
Electrolyte imbalance
34
Q

Type II Diabetes

A
  • non-insulin dependent diabetes mellitus
  • many are obese
  • 90% of diabetes cases are Type II
  • lack adequate insulin receptors or adequate insulin synthesis
  • treatment can lead to hypoglycemia
35
Q

Secondary Diabetes

A
  • diabetic state due to condition/disease
  • gestational diabetes
  • cancer of the pancreas (dec. insulin), pancreatitis
  • hemochromatosis
  • Cushings syndrome (inc. cortisol), acromegaly (inc. GH)
36
Q

Glucose methods

A

Glucose oxidase
Hexokinase method
Poloragraphic method

37
Q

Glucose oxidase

A
  • B-D glucose + glucose oxidase (enz) + O2 –> D-glucono-&-lactone –> Gluconic acid + H2O2
  • H2O2 + peroxidase (enz) + chromogen –> ox-chromogen + H2O
  • mutarotase converts a-D glucose to B-D glucose
  • can have interference of other substances with peroxidase
38
Q

Hexokinase method

A
  • most common method used
  • less susceptible to interference
  • glucose + hexokinase (enz) + ATP –> G-6-P + ADP
  • G-6-P + G-6-PD (enz) + NADP –> 6-phosgluc + NADPH + H
39
Q

Poloragraphic method

A
  • measures rate of O2 consumption with an electrode
  • uses glucose oxidase reagent
  • eliminate H2O2 produced with molybdate or catalase reactions
40
Q

Renal glucose limits

A

glucose is excreted in urine when above renal threshold

41
Q

Testing for unclear diabetes cases

A
  • 2 of these tests must be positive on separate days
  • symptoms + random glucose (> 200)
  • fasting glucose > 126
  • OGTT > 200
42
Q

Tests for monitoring diabetes

A
  • Hemoglobin A1C will show glucose control for last 2-3 months (RBC lifespan), normal is < 5.5%
  • Look for Ketonemia, Ketonuria with glucose > 300
  • Microalbumin increases in urine with glomerular damage
43
Q

Inborn errors of metabolism leading to hypoglycemia

A
  • Galactosemia
  • Fructosuria
  • Von Gierke’s
44
Q

Galactosemia

A
  • decreased galactose-1-phosphatase

- leads to inability to break down galactose to monosaccharide units

45
Q

Fructosuria

A
  • decreased fructo-1-phosphatase aldolase

- leads to excess fructose in the urine

46
Q

Von Gierke’s disease

A
  • decreased glucose-6-phosphatase
  • enzyme moves glycogen –> glucose into blood
  • leads to inability to utilize glucose (can’t break down glycogen and can’t make G6P)

Clinical Chemistry (8 decks)

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