Lab Findings and Disease Manifestations

Question 1

Ketones

Answer 1

Made by liver through breaking down fatty acids
Used in prolonged starvation or fasting

Question 2

Ketonemia

Answer 2

Ketones in the blood

Question 3

Ketonuria

Answer 3

Ketones in the urine

Question 4

What is Ketosis and how does it happen

Answer 4

High level of Ketone in blood
Starving/fasting
Low Carb diet
Prolonged vomiting
Glycogen Storage Disease

Question 5

Ketoacidosis

Answer 5

High concentration of Ketone Acids in the blood
Blood pH is very acidic

Question 6

Hypoglycemia

Answer 6

Blood Glucose concentration below fasting value
Results from decrease in Hepatic Glucose Production
cutoff of <= 50 mg/dL

Question 7

Drugs are the most prevalent cause of what in adults?

Answer 7

Postabsorptive Hypoglycemia

Question 8

How does Ethanol produce Hypoglycemia?

Answer 8

Inhibits Gluconeogenesis

Question 9

Requires dysfunction of more than 80% of the liver

Answer 9

Decreased Hepatic Glucose production

Question 10

Hyperglycemia

Answer 10

Increase in Plasma Glucose cause by imbalance of hormones

Question 11

What are the two ways Hypoglycemia can be classified?

Answer 11

Postabsorptive (fasting)
Postprandial (fed)

Question 12

What is Diabetes Mellitus?

Answer 12

Group of metabolic diseases
Hyperglycemia
Defects in insulin secretion or action

Question 13

What are the Chronic Complications patients are at risk for?

Answer 13

Microvascular and Macrovascular Pathology

Question 14

Microvascular Pathology

Answer 14

Diabetic Retinopathy (blindness)
Diabetic Nephropathy (renal failure)
Neuropathy (Nerves)

Question 15

How do we classify Diabetes?

Answer 15

Based on cause

Question 16

Type 1 Diabetes Mellitus

Answer 16

10% if all Diabetes cases
75% acquire before 18

Question 17

Characteristics of Type 1

Answer 17

Abrupt onset
Insulin Dependence
Ketosis Tendency

Question 18

What is Type 1 Idiopathic?

Answer 18

Showing no autoimmunity

Question 19

Type 2 Diabetes Mellitus

Answer 19

90% of Diabetes cases
Insulin resistance
Ketoacidosis

Question 20

What are the two major identifiers with Type 2 Diabetes?

Answer 20

Insulin Resistance (Weak insulin action)
B-cell Dysfunction (not enough insulin production)

Question 21

Describe the criteria for diagnosing Diabetes Mellitus

Answer 21

Fasting Plasma Glucose of >= 126 mg/dL
Oral Glucose Tolerance Test, 2 hour postload, >= 2oo mg/dL

Question 22

What are the two Prediabetic categories patients can be placed into and why?

Answer 22

Impaired Fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
No Diabetes Mellitus but above normal glucose levels

Question 23

Describe the ranges of Glucose from normal to Diabetes for both FPG and OGTT

Answer 23

FPG OGTT
>=126 Diabetes >=200
<125 Prediabetes <199
>=100 Prediabetes >=140
<100 Normal <140

Question 24

Gestational Diabetes Mellitus (GDM)

Answer 24

Any degree of Glucose intolerance with recognized pregnancy

Question 25

What are the maternal complication associated with GDM?

Answer 25

Cesarean Delivery Hypertension

Question 26

What is Glycated Hemoglobin

Answer 26

Blood saturated with sugars

Question 27

How is a Ketoamine formed?

Answer 27

Glucose attaches to hemoglobin

Question 28

What is the most common Glycosylated Hemoglobin?

Answer 28

Hemoglobin A1c (HbA1c)

Question 29

How do we use A1c to measure Blood Glucose Concentration?

Answer 29

Red blood cells live for 120 days Gives a picture of past 3 months

Question 30

What is the value of Hemoglobin A1c?

Answer 30

>= 6.5%

Question 31

What is the conversion of Lactate to Glucose in the Liver?

Answer 31

The Cori Cycle (Lactic Acid Cycle)

Question 32

What are the two types of Lactic Acidosis?

Answer 32

Type A: Hypoxic Conditions Type B: Metabolic Origin