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CC1 > Lec 12: Intro To Glucose > Flashcards

Lec 12: Intro To Glucose Flashcards

1
Q

• low blood glucose
• CNS symptoms
• Improvement of symptoms upon glucose administration

A

Whipple’s triad

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2
Q

Type of hypoglycemia that occurs before eating.

A

Post absorptive or Fasting hypoglycemia

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3
Q

Type of hypoglycemia usually seen occurring 2 hours after eating.

A

Reactive or Postprandial hypoglycemia

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4
Q

Symptoms:
• increased hunger
• sweating
• nausea and vomiting
• dizziness
• nervous and shaking
• blurring of speech and sight
• mental confusion

A

Hypoglycemia

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5
Q

Normal glucose concentration range

A

60–110 mg/dL

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6
Q

<60 mg/dL

A

Hypoglycemia

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7
Q

> 110 mg/dL

A

Hyperglycemia

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8
Q

Describe insulinoma

A

Excess production of insulin

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9
Q

Type ___ diabetic patient:
• rely on insulin from outside sources
• pancreas can’t produce insulin

A

Type 1 diabetic patient

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10
Q

Type ___ diabetic patient:
• has insulin but deficient
• most common in seniors
- insulin ran out due to old age

A

Type 2 diabetic patient

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11
Q

Alcohol-induced Hypoglycemia
Effects of alcohol

A

• increase NADH/NAD ratio
- more NADH instead of NAD
• decrease gluconeogenesis
• increase glycolysis
• increase conversion of pyruvate to lactate
• decrease fat breakdown
• increase fat synthesis

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12
Q

What happens to the babies of diabetic mothers?

A

• develops hypoglycemia due to exposure to maternal hyperglycemia.

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13
Q

Why do small for date babies have inadequate glycogen stores?

A

• due to Prematurity
- glycogen stores are laid in the last months of pregnancy.

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14
Q

6 Endocrine Disorders associated with Hypoglycemia

A

• Hypothyroidism
• Hypopituitarism
• Hypocorticism
• Liver disorders
• glycogen storage disease
• heavy exercise

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15
Q

Clinical Manifestations of Hypoglycemia

A

1. Neuroglycopenic
• deprivation of glucose to brain cells.
—> confusion, headache, convulsion, syncopal attacks, coma & death.

2. Adrenergic
• release of catecholamines, especially adrenaline.
—> palpitations, tremors, excessive sweating

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16
Q

Healthy males maintain plasma glucose of _____ for several days.

Healthy females permit plasma glucose to decrease to ____.

A

• 55–60 mg/dL (3.1–3.3 mmol/L)

• 40 mg/dL (2.2 mmol/L) or lower

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17
Q
  1. _____ administration if person is alert.
  2. _____ administration for unconscious patients.
A
  1. Oral glucose
  2. Intravenous glucose
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18
Q

Symptoms:
• increased thirstiness
• dry skin
• blurring vision
• poor wound healing
• sleepiness
• increased appetite
• frequent urination

A

Hyperglycemia

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19
Q

It is characterized by deficiency of insulin secretion or action resulting in hyperglycemia. The presence of insulin is usually deficient in the patients.

A

Diabetes Mellitus

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20
Q

Genetic predisposition + viral infection + environmental factor = ___

A

Diabetes Mellitus

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21
Q

• causes immune destruction of the b-cells of pancreas —> decrease insulin production
• abrupt onset
• insulin dependence
• genetically-related

A

Type 1 Diabetes Mellitus

22
Q

Symptoms:
• Polydipsia
• Polyphagia
• Polyuria
• Rapid weight loss
• Mental confusion
• possible loss of consciousness

A

Type 1 Diabetes Mellitus

23
Q

Complications included in Type 1 Diabetes Mellitus.

A
  1. Cardiovascular/Heart disease
  2. Microvascular problems
    • Nephropathy: kidney problems
    • Neuropathy: affects small blood vessels in brain
    • Retinopathy: affects blood vessels in eyes
24
Q

• strongly inherited
• no b-cell autoimmunity
• no known etiology
• no visible autoantibodies present
• doesn’t rely on insulin

A

Idiopathic Type 1 Diabetes

25
Q

• result of an individual’s resistance to insulin with an insulin secretory defect.
• results in a relative insulin deficiency.
- no absolute absence of insulin
• associated with strong genetic predisposition.
• patients are more likely to go into a hyperosmolar coma
• increased risk of developing macrovascular & microvascular complications.
- involving bigger blood vessels

A

Type 2 Diabetes Mellitus

26
Q
  1. Describe Pancreatitis.
  2. In what type of diabetes Mellitus does it occur?
A
  1. Inflammation of the pancreas
  2. Type 2 Diabetes Mellitus
27
Q

Rare form of diabetes that is inherited in an autosomal dominant fashion.

A

Maturity-onset Diabetes

28
Q

Drugs that increase blood glucose.

A

• corticosteroid
• thiazide diuretic
• niacin & phenytoin (high dose)
• rubella

29
Q
  1. Defined as any degree of glucose intolerance with onset or first recognition during pregnancy.
  2. The condition in #1 is identified through ___.
A
  1. Gestational Diabetes Mellitus
  2. Oral Glucose Tolerance Test
30
Q

Presence of glucose in the urine due to glucose concentration of plasma exceeding 180 mg/dL.

A

Glucosuria

31
Q

The process of oxidizing glucose to make carbon dioxide, water, and energy.

A

Glycolysis

32
Q

Blood glucose converted to fats

A

Lipogenesis

33
Q

Storage form of glucose

A

Glycogen

34
Q

Glucose to glycogen

A

Glycogenesis

35
Q

The primary source of energy for humans.

A

Glucose

36
Q

Three pathways of glucose

A

1. Hexose Monophosphate Pathway
- glycolysis
- produces ribose 5 PO4 & NADPH

2. Glycolytic pathway / Embden Meyerhof Parnas pathway
- pyruvate —> acetyl coenzyme A
- production of ATP & NADH

3. Glycogenesis pathway

37
Q
  1. In this pathway, glucose is broken down into pyruvic acid, then converted to acetyl coenzyme A that can enter the tricarboxylic acid cycle.
  2. The pathway in #1 requires oxygen. What kind of pathway is it?
A
  1. Embden Meyerhof Parnas pathway / Glycolytic pathway
  2. Aerobic pathway
38
Q

The conversion of amino acids into substrates that can be converted to glucose.

A

Gluconeogenesis

39
Q

Breakdown of glycogen to glucose

A

Glycogenolysis

40
Q

• inhibits pouring of glucose into blood
• promotes utilization of glucose
• primary hormone responsible for entry of glucose into the muscle and adipose

A

Insulin

41
Q

• released during stress & fasting states
• main hyperglycemic agent
• primary hormone responsible for increasing glucose levels
• promotes glycogenolysis & gluconeogenesis

A

Glucagon

42
Q

In cases of Hypoglycemia:
(Enumerate the 4 lines of defense in order)

A
  1. Inhibit insulin
  2. Increase glucagon
  3. Release of catecholamines, anterior pituitary hormones, ACTH
  4. Thyroid & GH (carbohydrate metabolism)
43
Q

6 hormones that affect carbohydrate metabolism and increase glucose levels.

A

Epinephrine
- promotes glycogenolysis & lipolysis
- inhibits insulin
- released when stress

Glucocorticoids
- promotes glycogenolysis & lipolysis

Growth hormone
- decreases cell entry of glucose

ACTH
- triggers adrenal cortex to produce glucocorticoids

Thyroxine & Somatostatin

44
Q

Laboratory findings

Plasma glucose: >1000 mg/dL

Plasma sodium & potassium: Normal or Elevated

Bicarbonate: slightly decreased

BUN & Creatinine: Elevated

Osmolality: Elevated

A

Nonketotic Hyperosmolar State

45
Q

Diagnostic of Gestational Diabetes Mellitus

Fasting plasma glucose:

1 hour value:

2 hour value:

A

Fasting plasma glucose: 92 mg/dL or more

1 hour value: 180 mg/dL or more

2 hour value: 153 mg/dL or more

46
Q

Oral Glucose Tolerance Test

Normal:
Impaired:
Provisional diabetes diagnosis:

A

(2 hours)
Normal: 140 mg/dL or less
Impaired: 140–199 mg/dL
Provisional diabetes diagnosis: 200 or more

47
Q

Diabetes Mellitus Treatment

A

Insulin supplementation, oral hypoglycemic drugs

48
Q
  • preferred method for diagnosis of diabetes
  • 8-10 hour fasting without any caloric intake
  • more than 126 mg/dL = diagnosis DM
  • serum: 70 to 100
  • WB: 60 to 100
A

Fasting Blood Sugar

49
Q
  • a screening test for diabetes (not diagnostic)
  • check response of glucose level post meals
  • 200 mg/dL = Diabetes
  • normal: 85 to 125
A

Random blood sugar

50
Q

Criteria for Diagnosing Diabetes using OGTT

  • Diabetes: ___mg/dL
  • Impaired glucose tolerance: __mg/dL for 2 hours, and other value of ___ mg/dL
A

Diabetes: more than 140
Impaired: 140 to 200, more than 200

51
Q

The following are procedures of what method of glucose tolerance test?

  • 2 to 3 days CHO diet
  • 12 hours fasting
  • after 12 hours fasting, blood sample collected.
  • high CHO meal
  • 2 hours rest
  • then, venous blood collected

✓ normal: 120 mg/dL

A

Exton Rose / Divided Dose method (2 hour postprandial)

CC1 (16 decks)

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