M1 CARBOHYDRATES Flashcards
Considered as the simplest
carbohydrate.
GLYCOALDEHYDE
the most commonly ingested
polysaccharide by humans.
starch and glycogen
Enzyme that hydrolyzes starch to disaccharide in
duodenum
amylase
products of salivary amylase
dectrins and disaccharides
converts Glucose to Glucose-6-phosphate.
glucokinase
When Glucose-6-phosphate is converted to become Glucose-1- phosphate, it will be converted to Glycogen if it is acted upon by ?
glycogen synthase
Glycogen will be converted to Glucose-1-phosphate if it is acted upon by?
glycogen phosphorylase
In muscles, enzymes are not synthesized but glucose is being released by the muscle
true or falze
true
Glucose to pyruvate/lactate
glycolysis
Formation of G6P
gluconeogenesis
Glycogen to Glucose
glycogenolysis
Glucose to Glycogen
glycogenesis
Carbohydrates to fats
lipogenesis
Decomposition of fats
lipolysis
Conversion of lipids and amino acids to become glucose.
It is the formation of glucose from a
non-carbohydrate source.
GLUCONEOGENESIS
In case of brief fasting, the _____is the source of glucose
LIVER
Tests for glucose requirehow many hours of fasting
6-8 hrs
In case of longer than 1 day fasting, _______________ becomes the source of glucose
Gluconeogenesis
major hormones controlling blood pressire
insulin & glucagon
Responsible for the exocrine function of pancreas.
acinar & duct cells
what cell in the pancreatic islet secretes somatostatin
delta cells
● Produced by beta cells of the islet of Langerhans.
● Main hypoglycemic agent.
insulin
● Causes: Glucose to enter the cell
● Increases:
○ Glycogenesis
○ Lipogenesis
○ Glycolysis
● Decreases:
○ Glycogenolysis
insulin
the only hormone responsible for entry of glucose into the cell.
insulin
Responsible for increasing the
blood sugar level of the body by increasing the process of
glycogenolysis and gluconeogenesis.
main HYPERGLYCEMIC agent (glucagon)
● Produced by alpha cells of the islets of Langerhans.
● Released during stress & fasting state
glucagon
● Causes: Liver breakdown glycogen to release glucose
● Increases:
○ Glycogenolysis
○ Gluconeogenesis
glucagon
Main promoter of gluconeogenesis
cortisol
the process of producing sugar
from amino acids/fatty acids, or other
non-carbohydrate sources.
glucoNEOgenesis
● Produced by Chromaffin cells in Adrenal medulla
● Inhibits insulin
● Increases: Glycogenolysis, Lipolysis
● Released with stress
catecholamines
● Cortisol and corticosteroids
● Produced by Adrenal cortex
It counteract the effects of insulin by
decreasing the entry of glucose into the cell.
glucocorticoids
➔ It causes decreased entry of glucose to the cell;
counteracting the action of insulin.
Growth Hormone: Somatotrophic hormone
It increases blood glucose by stimulating the release of cortisol from adrenal gland (Adrenal cortex).
adrenocorticotropic hormone (ACTH)
Thyroid hormone promoting glycogenolysis and gluconeogenesis.
➔ It promotes intestinal absorption of glucose, increasing glucose level in the blood.
THYROXINE
○ Increase urine specific gravity
○ Ketones in serum and urine
are the laboratory findings in?
hyperglycemia
● Imbalance between glucose utilization and production
● Decreased glucose levels
● Warning signs and symptoms: CNS related
● Whipple’s triad
hypoglycemia
Used as an indicator for diagnosis of
hypoglycemia in a normal healthy individual.
whipple’’s triad
Diagnostic value for hypoglycemia.
<50 mg/dL level of glucose:
● Group of metabolic disorders (Hyperglycemia)
● Cause: Defects in insulin secretion, insulin receptor or
both
diabetes mellitus
Glucose Renal Threshold is?
160-180 mg/dL
due to excess synthesis of Acetyl CoA
as the body attempts to require energy from stored
fat
ketosis
Rare form of DM that are commonly present in adolescents who love
to eat junk foods.
Maturity Onset Diabetes of the Youth (MODY)
Also known as: Insulin dependent DM, Juvenile Onset DM, Brittle Diabetes, Ketosis-prone Diabetes
type 1 DM
● Cause: Cellular mediated autoimmune destruction of B cells of the pancreas
● Insulin dependent to sustain life and prevent ketosis
● Genetic association with HLA DR3 and DR4 (loc at Chromosome 6)
TYPE I DM
○ Strongly inherited, no B cell autoantibodies, episodic insulin requirements
○ Ketosis may also develop
idiopathic type 1 DM
Absolute insulin deficiency due to the loss of pancreatic B-cell.
INSULINOPENIA
Also known as:
Non-Insulin Dependent DM,
Adult Type/Maturity Onset DM,
Stable Diabetes,
Ketosis-Resistant DM,
Receptor-deficient DM
TYPE II DM
● Cause: Resistance to insulin (cell’s receptor deficient with insulin)
● “Geneticist nightmare”
TYPE II DM
Absolute insulin deficiency; has presence of ketoacidosis
what type of DM
TYPE 1
➔ 3P’s: Polyuria, Polydipsia, Polyphagia
➔ Rapid weight loss, Hyperventilation, Mental confusion,
Loss of consciousness, Increased heart disease
ARE SIGNS AND SYMPTOMS OF WHAT TYPE OF DM
TYPE 1 AND 2
: The B-cell of the pancreas has a problem; the pancreas fails to produce insulin
WHAT TYPE OF DM
TYPE 1 NGA
There is no problem with glucose or insulin; rather there is a deficiency with ADH hormone
DIABETES INSIPIDUS
Both DM and DI have an increased urine volume
T OR F
TRU! POLYURIA SILA
High SG due to presence of glucose in urine
DM OR DI
DM
The C-peptide levels of this DM is DECREASED or UNDETECTABLE
TYPE I DM
● Any degree of glucose intolerance with onset or first
recognition during pregnancy.
● Impaired ability to metabolize carbohydrates.
GESTATIONAL DM
It is used to check if the pregnant
woman is having Gestational DM.
GLUCOSE TOLERANCE TEST
In IMPAIRED FASTING GLUCOSE, the normal blood glucose is
70-100 mg/dL
best specimen of choice for glucose
measurement.
serum
It is used to prevent losses of the glucose or the false decrease result of glucose
gray top
Px: Cupric ions to cuprous ions in an alkaline solution
alkaline copper reduction
Cupric ions (+1) are
converted to cuprous ions (+2) in an alkaline solution
through the action of the glucose.
what principle
oxidation-reduction
the reagent used through the
action of glucose and then subjecting it into heat → it will be
converted to become a cuprous ion (+2).
alkaline copper tartrate
Phosphomolybdic is a reagent used in what method
folin-wu
modification of Folin-Wu method
benedict’s test
Uses chromogen. When the end
product was being measured
using chromogen.
colorimetric glucose oxidase method
Oxygen sensing electrode to
measure oxygen consumption.
polarographic glucose oxidase
An enzyme that converts Alpha D-glucose to Beta D-glucose.
mutarotase
● It only measures B-D glucose
● Coupled Enzyme Test (uses two enzymes)
● Product: Gluconic acid and Hydrogen peroxide
glucose oxidase method
Px: Yellow ferricyanide converted to a colorless ferrocyanide by glucose
alkaline ferric reduction
It is mainly used for the detection of
glucose but not any other sugar. It could either be used for
the detection of other reducing sugars.
hagedorn jensen
● Px: Glucose has the ability to form Schiff bases with aromatic amines
● Reagent: Hot acidic solution (Glacial acetic acid)
● Colored compound
● Interference: Galactose and Mannose
ortho-toluidine (dubowski method)
what causes a false negative in glucose oxidase method
bilirubin
uric acd
ascorbic acid
*** BLEACH lng ang false posi
It is a non-glucose reducing substance, it could affect the measurement of glucose when glucose oxidase method is used.
ascorbic acid
● Most specific glucose method
● Reference/Standard method
● Specimen: Serum or plasma collected using Heparin,EDTA, Fluoride, Oxalate, Citrate
● False Decrease: Hemoglobin, Bilirubin
hexokinase
__________________________________ Method: The enzyme that acts on
glucose uses NADH as its coenzyme.
Glucose Dehydrogenase
● Important for establishing correct insulin amount
● Strip with glucose oxidase, peroxidase, and chromogen
● Measures B-D glucose
dextrostics
This test is Useful in: Insulin shock, Hyperglycemic ketonic coma.
random blood sugar
Random Blood Sugar Normal Result:
<140 mg/dL
Hyperglycemia: RBS result is
> 200 mg/dL
Test the blood sugar of the patient
anytime of the day.
➔ Useful in emergency cases
random blood sugar
● 8-10 hours fasting, commonly used for diagnosis of DM.
● Measure of Glucose homeostasis
fasting blood sugar
In FBS, Normal Value is
70-100 mg/dL
● Useful for monitoring glycemic control; blood glucose
is determined 2 hours AFTER a meal.
2 hour post prandial blood sugar
In PPBS, Good Glycemic Control value is
<130 mg/dL
● Multiple blood sugar test.
● Determines how well the body metabolizes glucose
over a given time required.
glucose tolerance test
If the blood sugar of the patient is ≥300 mg/dL, that is the value of glucose where ___________ is felt by the patient
severe polydipsia
○ Patient should be ambulatory (most important)
○ 8-10 hours fasting
○ Unrestricted diet of 150g carbohydrate/day for 3
days
are requirements for what test
glucose tolerance test
what is the glucose load To
be given to an adult or pregnant patient.
75 grams
In collecting FBS:
➔ First Hour: Expect that the glucose level will ?
increase shempre uminom ng glucose load ih
● Diabetes patients with GIT disorders
● 0.5 g of glucose/kg body weight given thru IV
● Requires Fasting sample
● 1st blood collected after 5 minutes of IV glucose
intravenous glucose tolerance test
● Glycated Hemoglobin
● Rate of formation is directly proportional to plasma
glucose levels.
● Monitors long term glucose control.
glycosylated hemoglobin HbA1c
● Purpose: Reflects average blood glucose level for the
previous 2-3 months.
● Specimen: EDTA whole blood
● Reference Range: 4-6% HbA1c = normal
glycosylated hemoglobin
● Glycosylated or glycated albumin (plasma protein
ketoamine).
● Dependent on albumin lifespan (19 days).
● Reflection of short term glucose control (2-3 weeks).
fructosamine
● Indicators for pancreatic and insulin secretions (B cell
function)
● Used to monitor response to “Pancreatic surgery”
c-peptide test
Normal ratio of C peptide: Insulin =
5:1 to 15:1
● Produce in the liver through metabolism of fatty acid.
● B-hydroxybutyrate to acetoacetic acid ratio = 1:1
● Increase serum acetone = defect in CHO metabolism
● Increases: Diabetes (Type I), High fat diets, Starvation
● Specimen: Urine or Fresh Serum
ketones
● Reagent: Ferric Chloride
● Mostly reacts with the acetoacetate
ketone body; it produces red color
whenever present.
Gerhardt’s Ferric Chloride Test
○ Most common GSD
○ Hyperlipidemia (increased lipid level in blood)
○ Severe hypoglycemia (decreased blood glucose)
○ Increase in: Ketones, Lactate, Alanine, Lipids, Uric
acid
○ Glycogen build in the liver (Hepatomegaly)
von gierke disease
● Reagent: Sodium Nitroprusside
● Measuring or detecting acetoacetic
acid and acetone produces a purple
color in this method.
acetest tablets
● First sign of diabetic renal nephropathy.
● Result of albumin:creatinine ratio of 30-299 mg/g
creatinine.
● Measured by: Micral test, Dipstick test for urine.
albuminuria
(Increased galactose in blood)
● Deficiency on one of 3 enzymes involved in galactose
metabolism.
galactosemia
In Type Ia & Type Ib, we can use the IVGTT to measure the
glucose to detect if there is _________________
hypoglycemia
In Type IIIa, Type IIIb, & Type IV, there is no ___________
but there is a positive liver enlargement
hypoglycemia
Type V & Type VII are characterized by having
muscular defects
