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Clinical Chemistry > Module 2- Carbohydrates > Flashcards

Module 2- Carbohydrates Flashcards

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1
Q

What are the 3 classifications of carbohydrates?

A

Monosaccharides, oligosaccharides, polysaccharides

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2
Q

Most common isomer in the human body

A

B-D-glucose

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3
Q

What are polysaccharides?

A

High molecular weight
Glycogen
Starch
Are broken down by specific enzymes secreted by pancreas or intestinal wall

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4
Q

What is anaerobic glycolysis?

A

Not oxygen dependent

Splitting of glucose into 2 pyruvates to produce small amounts of ATP

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5
Q

What is aerobic glycolysis?

A

Oxidation of pyruvate in the mitochondria via the Kreb’s cycle and electron transfer chain to produce large amounts of ATP

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6
Q

Is anaerobic glycolysis reversible?

A

All steps are reversible EXCEPT conversion to G-6-P by hexokinase (liver cells can reverse this step)

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7
Q

What is glycogenesis vs. glycogenolysis?

A

Glycogenesis - excess glucose converted into glycogen

Glycogenolysis - breakdown of glycogen back to G-6-P

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8
Q

What is gluconeogenesis?

A

Synthesis of new glucose from non-carbohydrate sources

Not efficient

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9
Q

What occurs in glucose regulation?

A

Low blood glucose - release of glucagon acts to increase blood glucose levels

High blood glucose - release of insulin acts to decrease blood glucose levels

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10
Q

Other hormones that raise blood glucose levels

A

Cortisol
Epinephrine
Growth hormone

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11
Q

What is the renal threshold?

A

Maximum concentration in the blood that can be completely reabsorbed

All glucose is normally filtered and reabsorbed by kidneys

Blood levels above 10 mmol/L are unable to reabsorb all the glucose

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12
Q

Analysis of glucose specimens

A

Serum or plasma

Whole blood values are about 10% LOWER
Must separate cells within 1-2 hours
Fasting must be 10-12 hourly

Urine - glucose levels in diabetes
CSF - identifying bacterial meningitis

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13
Q

Glucose oxidase method

A

Reacts with B-D-glucose

Converts glucose to gluconic acid and hydrogen peroxide

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14
Q

What are 2 ways glucose oxidase can be measured?

A

Amperometry - uses an oxygen electrode to measure consumption of oxygen

Colormetric - Trinder’s Reaction, add a peroxidase and a chromagen to form an oxidized colored product (subject to interference)

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15
Q

Hexokinase method for measuring glucose

A

Formation of NADPH measured photometrically at 340nm

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16
Q

Glucose dehydrogenase method for measuring glucose

A

NADH formation measured at 340nm

17
Q

What are the collection protocols for glucose?

A

Fasting glucose - at least an 8hr fast
Random glucose - any time
2 hrs glucose tolerance - 2 hours postcibal
Gestational diabetes screen - glucose tolerance test for gestational diabetes mellitus

18
Q

What is the process for the 2 hour PP (glucose tolerance) test?

A

2 hours post pranidal

  1. Standard glucose load administered 75g in 300mL
  2. Measure blood glucose levels after 2 hours (should be less than 6.7mmol/L)
19
Q

What is the process of the gestational diabetes screen?

A
  1. 50g carbohydrate load

2. Blood collected at 1 hour (result should be >11.0 mmol/L)

20
Q

What are the reference ranges for glucose?

A

Fasting: 3.3-6.0 mmol/L
Random: 3.3-11.0 mmol/L
Critical Low: = 25.0 mmol/L

21
Q

What are the reference intervals for arterial and CSF samples?

A

Arterial samples HIGHER by 15%

CSF about 60% of plasma levels

22
Q

What are the criteria for diagnosis of diabetes mellitus (DM)?

A

Must have at least TWO of the following:
Fasting glucose > 7.0 mmol/L
2 hour PP > 11.1 mmol/L
Random glucose > 11.1 mmol/L with symptoms
HbA1C >= 6.5%

23
Q

What is diabetes mellitus?

A 
Disorders of HYPERGLYCEMIA 
Caused by: 
1. Insufficient insulin secretion
2. Defective insulin action
3. Target tissue has insulin resistance
24
Q

Lab findings in diabetes mellitus:

A 
Hyperglycemia 
Glycosuria
Increased serum and urine osmolality 
Ketonemia and ketonuria 
Wight loss
Confusion
25
Q

Complications in diabetes mellitus

A

Hyperlipidemia - increased circulating fatty acids

Damage due to glycation of proteins - vascular, kidneys, retinas, nervous tissue

26
Q

What is Type 1 Diabetes Mellitus?

A

Insulin deficiency due to decreased secretion

10% of cases and insulin dependent

27
Q

What is Type 2 Diabetes Mellitus?

A

Insulin resistance - target tissues not affected or secreted insulin not as effective

90% of cases and not insulin dependent - can be controlled through diet and exercise

28
Q

What is gestational diabetes?

A

Glucose intolerance induced by pregnancy

High blood glucose levels in mother can transfer to fetus

29
Q

How is diabetes mellitus monitored?

A

Glycated hemoglobin

  • reference range 4.0-6.0%
  • can be used to predict average blood glucose levels over time and

Glycated albumin
Urine microalbumin
C-peptide

30
Q

What are ketones and ketosis?

A

Glucose cannot enter cells due to low levels
Lipolysis increases for energy - can cause lipemia
Fatty acids convert to acetyl-CoA, and cannot be converted back into glucose so they are converted to cholesterol and ketones instead

31
Q

What are ketones?

A

Acetone (can show up in breath)
Acetoacetic acid

Increased acid levels in blood leads to acidosis
- hypoxia due to affect on hemoglobin binding affinity for oxygen

32
Q

What is ketoacidosis?

A

Acids are excreted as dissociated anions - don’t take hydrogen so it’s left in the blood to decrease pH
Cations and water follow the excreted anions resulting in dehydration and electrolyte imbalance

33
Q

What is diabetes insipidus?

A

NOT related to glucose levels
Caused by decreased levels of ADH - unable to concentrate urine and lose a lot of water
Large quantities of dilute urine causing excessive thirst and urination

34
Q

What is hypoglycemia?

A

Most commonly associated with insulin overdose

High levels of insulin

35
Q

What are carbohydrates?

A

Organic molecules
Primarily carbon, hydrogen, and oxygen
Contain either an Aldose or ketoses

Clinical Chemistry (2 decks)

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