Lecture 4

Question 1

what is false regarding glucose?
a) is a ketopentose
b) most glucose in the body is beta-D-glucose (64%)
c) is a reducing sugar
d) is a carbohydrate

Answer 1

a) ketopentose bc it is actually a aldohexose

Question 2

what are non-reducing sugars? why are they non reducing?

Answer 2

sucrose, no free ketone or aldehyde to reduce other substances

Question 3

what is benedicts reaction used for?

Answer 3

used to measure reducing substances (if glucose was present, it would be pos)

Question 4

would sucrose be positive using clinitest tablets?

Answer 4

no because it is non reducing and the rxn is not accessible to copper

Question 5

what common condition is linked to a deficiency in one of the enzymes involved in carb metabolism?

Answer 5

lactose intolerance; where you lack the enzyme to breakdown lactose sugar

Question 6

what common condition is linked to a deficiency in one of the hormones involved in carb metabolism?

Answer 6

diabetes mellitus –> insulin

Question 7

which organ helps decide the outcomes from cellular level glucose metabolism

Answer 7

liver

Question 8

glycolysis

Answer 8

breakdown of glucose into pyruvate or lactate for energy production

Question 9

glycogenesis

Answer 9

conversion of glucose to glycogen

Question 10

how does glucose get converted to glycogen

Answer 10

glucose –> G-6-P –> G-1-P –> glycogen synthase by liver + muscle

Question 11

what is the storage form of glucose? where is it stored?

Answer 11

glycogen; liver and muscles

Question 12

glycogenolysis

Answer 12

breakdown of glycogen to glucose

Question 13

gluconeogenesis

Answer 13

formation of G-6-P from non carb sources

Question 14

PC

Answer 14

post cibum; non fasting

Question 15

AC

Answer 15

ante cibum; fasting

Question 16

blood glucose

Answer 16

measurement of glucose in blood

Question 17

T/F serum or whole blood can be used to measure blood glucose

Answer 17

T

Question 18

what is a reducing substance?

Answer 18

any substance capable of reacting in an redox rxn as the oxidized chemical

Question 19

mellituria

Answer 19

presence of any sugar in the urine

Question 20

glucosuria

Answer 20

presence of glucose in the urine (sometimes called dextosuria)

Question 21

FBS

Answer 21

fasting blood sugar, usually 8-12 hr fast

Question 22

FPG

Answer 22

fasting plasma glucose

Question 23

hypoglycemia

Answer 23

condition where blood glucose levels drop too low

Question 24

hyperglycemia

Answer 24

condition where glucose levels are higher than normal

Question 25

T/F symptoms such as thirst, frequent urination, and fatigue are related to hypoglycemia

Answer 25

F, it is from hyperglycemia bc body wants the extra sugar out

Question 26

glucose tolerance

Answer 26

how the body responds to a measured intake of glucose

Question 27

renal threshold

Answer 27

quantity at which the kidneys spill sugar into the urine

Question 28

what is the renal threshold for glucose?

Answer 28

7.7-9.9mmol/L

Question 29

what are factors that affect glucose metabolism?

Answer 29

1. absorption issue 2. hormones 3. liver disease 4. metabolic rate

Question 30

how does insulin work in glucose metabolism?

Answer 30

- hypoglycemic agent - decreases glucose levels - pancreas, B cells! - controls glucose entry into cells

Question 31

how does glucagon work in glucose metabolism?

Answer 31

- hyperglycemic agent - increases glucose levels - alpha cells - #2 player if energy is needed

Question 32

cushings syndrom

Answer 32

- hyperadrenal function - may lead to hyperglycemia

Question 33

addisons syndrome

Answer 33

- hypoadrenal function - may lead to hypoglycemia

Question 34

how do diabetes mellitus and diabetes insipidus differ?

Answer 34

DM: patients insulin is causing it DI: ADH not insulin

Question 35

what are the classifications of DM?

Answer 35

type I - IDDM type II - NIDDM gestational diabetes - GDM

Question 36

which is false regarding type I DM? a) result of beta cell destruction b) prone to ketoacidosis c) ~90% of cases d) onset is usually quick

Answer 36

c) 90% of cases (only 5-10%)

Question 37

why are type I DM prone to ketoacidosis?

Answer 37

body starts to use fat for energy instead of glucose, produces ketones which are acidid and alter blood pH

Question 38

which of the following is false regarding type II DM? a) can deal with for years and not know b) B cells do not work properly c) can be due to insulin resistance or insulin secretion deficiency d) can use lifestyle changes to manage

Answer 38

b) B cells do not work properly B cells DO work

Question 39

which is false regarding GDM? a) it is temporary b) check for it at 20-28weeks c) glucose intolerance associated w/ pregnancy d) only at risk if it is your first pregnancy

Answer 39

d) bc it can happen to anyone at any pregnancy, but a previous diagnosis is a risk factor for future pregnancies

Question 40

what is type 1.5 diabetes?

Answer 40

falls between type I and II, slow production of type I latent onset (bc type I usually acute)

Question 41

what is the reference for FPG and how long is the fast?

Answer 41

>/ 7.0mmol/L & no caloric intake for at least 8 hours

Question 42

what is the reference for A1C?

Answer 42

>/6.5% (in adults)

Question 43

what is the reference for 2hPG in a 75g OGTT?

Answer 43

>/ 11.1mmol/L

Question 44

what is the reference for random PG?

Answer 44

>/ 11.1mmol/L

Question 45

T/F we screen everyone for type I diabetes

Answer 45

F, it is based on history and symptoms

Question 46

what is the critically low glucose for adults?

Answer 46

<3mmol/L

Question 47

what is the critically high glucose for adults?

Answer 47

>20mmmol/L

Question 48

what is the renal threshold?

Answer 48

~ >10mmol/L

Question 49

you have an american tourist visit the ER because he said his glucometer showed a glucose of 42. should this patient be given glucose or insulin?

Answer 49

42mg/dL /18 = 2.3mmol/L give the patient glucose!!! bc it is critically low!

Question 50

you have an american tourist visit the ER because he said his glucometer showed a glucose of 378. should this patient be given glucose or insulin?

Answer 50

378mg/dL /18 =21mmol/L give the patient insulin! critically high glucose!

Question 51

you have an american tourist visit the ER because he said his glucometer showed a glucose of 90. should this patient be given glucose or insulin?

Answer 51

90mg/dL /18 = 5mmol/L neither, their glucose levels are within range :)

Question 52

compare and contrast type I, type II and GDM

Answer 52

type I: - B cell destruction - depends on insulin to live - ketoacidosis risk - acute + genetic mostly type II: - insulin resistance - develops overtime - diet can be managed GDM: - due to pregnancy - temporary usually - affects both baby and mom similar: - increased urination + thirst - all endocrine - high blood sugar urine + blood