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Clinical Chemistry > Glucose Lecture > Flashcards

Glucose Lecture Flashcards

1
Q

Ketones

A

by products of fats that are used to make energy instead of glucose

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2
Q

Ketoacidosis

A

when the body has a pH less than 7.35 due to the abundance of ketones

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3
Q

ketoniemia

A

ketones present in the blood

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4
Q

Ketonuria

A

ketones in the urine

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5
Q

OGTT

A

oral glucose tolerance test

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6
Q

GDM

A

gestational diabetes mellatius

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7
Q

Carbohydrates

A

carbon, hydrogen, oxygen w/ either an aldehyde or ketone configuration
major energy supply
monosaccharides- glucose, fructose, galactos
disaccharides - sucrose (glucose & fructose), lactose (glucose & galactose), maltose (2 glucose)
polysaccharides- glycogen, starch

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8
Q

Amylase

A

gland in saliva that helps break down starches

stomach acids denature the salivary enzymes

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9
Q

Metabolism of CHO

A

begins w/ salivary amylase -> stomach acids -> disaccharides in the intestines (lactase, maltase, sucrase bc GI only absorbs monosaccharides) -> monos absorbed-> glucose stored in fat cells or utilized in other cells

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10
Q

Glucose pathways

A

glucose-6-phosphate :
embden-myerhof pathway (glycolysis)
hexose monophosphate pathway
convert moiety to glycogen

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11
Q

Glycogenesis

A

conversion of glucose to glycogen

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12
Q

Glycogenolysis

A

conversion of glycogen to glucose

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13
Q

Gluconeogensis

A

glucose from non-CHO sources : amino acids etc

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14
Q

Glycolysis

A

breakdown of glucose to pyruvate or lactate

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15
Q

Glucose clinical reference

A

ranges : ~80-100 mg/dL
>125 mg/dL during fasting -> suspect diabetes
hemolyzed specimen can alter lab results

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16
Q

insulin

A

decreases blood glucose (hypoglycemic agent) via aiding in the uptake of glucose into the cells

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17
Q

glucagon

A

increases blood glucose (hyperglycemic agent)

uses glycogenolysis & gluconeogenesis to increase blood glucose levels

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18
Q

Epinephrine effect on blood glucose

A

glucose will increase

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19
Q

glucocorticoids (cortisol) effect on blood glucose

A

stimulates gluconeogenesis particularly to increase blood glucose levels
cortisol breaks down protein so the amino acids will be converted to glucose

20
Q

growth hormone effect on blood glucose

A

pituitary hormones

increases blood glucose

21
Q

ACTH effect on blood glucose

A

pituitary hormone

stimulates cortisol release (increases)

22
Q

Thyroxine (T4) effect on blood glucose

A

increases blood glucose

can speed up metabolism & a loss of T4 can decrease metabolism & can also aid in absorption of glucose in GI tract

23
Q

Somatostatin effect on blood glucose

A

can influence growth hormone (ergo increase blood glucose); also known as IGF
protein produced from the liver

24
Q

Insulin-dependent diabetes mellitus

A

insulin deficiency, often autoimmune destruction of beta cells of pancreas
affects about 10% of diabetic population

25
Q

chronic disease effects of diabetes

A

eyes- retinopathy: optic nerve is especially susceptible to excess glucose
kidneys- renal disease & nephropathy
blood vessels - peripheral neuropathy
ketoacidosis- not enough insulin to utilize glucose & cells start to break down fats

26
Q

general diabetic symptoms

A 
polydipsia - thirst
polyphagia- increased food consumption
polyuria - increased urine production
rapid weight loss 
hyperventilation
mental confusion ( brain is only getting ketones)
27
Q

Lab testing for diabetes

A 
fasting glucose >100 mg/dL
urine sp. gravity
serum & urine osmolalities
ketones present
blood & urine pH from ketoacidosis
electrolyte imbalance
hemoglobin A1c
28
Q

Diabetes type 2

A

non-insulin dependent diabetes mellitus
may be obesity related
affects 90% of diabetic population
often lack of adequate insulin-receptors on cells or lack of adequate insulin synthesis

29
Q

Glucose analyzer methods

A

2 major reactions
B-D-glucose + O2 -(glucose oxidase)-> D-glucono-&-lactone —> gluconic acid + H2O2
use perxoide produced in 2nd reaction:
H2O2 + chromogen –(peroxidase)–>ox-chromogen +H2O2

30
Q

glucose peroxidase

A

enzyme used in 1st reaction for glucose analyzing

specifically breaks down specifically beta-D glucose

31
Q

Perioxidase enzyme

A

used in many reactions although many things can inhibit the reactions

32
Q

Hexokinase method for analyzing glucose

A

glucose + ATP –(hexokinase enzyme)–> Gluc-6-PO4 + ADP
Gluc-6-PO4 + NADP –(G-6-PD enzyme)–> 6-phosgluc + NADPH + H+
most often method used on automated systems
amount of product formed NADPH relates to the amount of glucose in patietn sample
this reaction doesn’t differentiate between beta & alpha glucose orientations

33
Q

Poloragraphic glucose analyzer method

A

electrode method that measures O2 consumption by using reaction :
B-D glucose + O2 –(glucose oxidase)–> D-glucono-&-lactone –> gluconic acid + H2O2
eliminates H2O2

34
Q

Renal glucose limits

A

> 180 mg/dL in blood glucose will show up in the urine

35
Q

testing for suspected diabetics

A

symptoms + random glucose >200 mg/dL
fasting glucose >126 mg/dL
oral glucose tolerance test (OGTT) - where 75g glucose given & wait 2 hours to draw blood-> if value is >200 mg/dL is diabetic (if ~180 mg/dL impaired function not completely diabetic)
must have 2 positive on separate days to diagnose

36
Q

Hemoglobin A1c

A

will show glucose control over the last 2 -3 months
based on RBC survival of 120 days
>5.5-6% are out of control
6-7% are acceptable when monitoring diabetics
normal is <5.5%
glucose attachment to the RBC

37
Q

Monitoring diabetics

A

monitor for ketoacidosis, acute illness, stress, pregnancy, glucose >300 mg/dL
microalbumin

38
Q

Microalbumin

A

increases in urine when kidney glomerulus is damaged
chronic diabetic: 30-299 mg/24hr or albumin/creatinine ratio of 30-300 ug/ml creatine
may see microalbumin increases w/ exercise, infection, fever, increased BP, increased glucose, congestive heart

39
Q

macroalbuminemia

A

seen when >300 mg/24 hr or >300 ug/mg creatinine

40
Q

Hypoglycemia

A

<60 mg/dL blood glucose

may be due to insulin producing tumor or medications

41
Q

inborn errors of metabolism leading to hypoglycemia

A

galactosemia
fructosuria
von Gierke’s

42
Q

Galactosemia

A

inborn error of metabolism that may lead to hypoglycemia

decreased galactose-1-phosphatase & cannot utilize galatose as effectively

43
Q

Fructosuria

A

inborn error of metabolism that may lead to hypoglycemia -‘fructose in the urine’
decreased fructo-1-phophatase adolase

44
Q

Von Gierke’s

A

inborn error of metabolism that may lead to hypoglycemia - affects children glycogen builds up in the liver
decreased glucose-6-phosphatase : liver enzyme used for moving glycogen-glucose into the blood

45
Q

hellloo

Clinical Chemistry (23 decks)

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