Test 3 Flashcards
________ is the only carb that can be used or stored for energy.
Glucose
What is the main energy source for cellular metabolism?
Glucose
What depends exclusively on glucose?
Nerve Tissue - Brain
What doesn’t store glucose?
The brain
What is glycolysis?
Breakdown of glucose for energy production
What is glycogenesis?
Excess glucose is converted and stored as glycogen.
What is glycogenolysis?
Breakdown of glycogen into glucose.
What is gluconeogenesis?
Conversion of amino acids into glucose
What is lipogenesis?
Conversion of carbs into fatty acids
What organ synthesizes insulin and glucagon?
Pancreas
What is the only hormone that decreases plasma glucose?
Insulin
What part of the pancreas sythesizes insulin?
Beta-cells of the Islets of Langerhans
What part of the pancreas synthesizes glucagon?
Alpha cells
What is the most important glucose regulator?
Insulin
What are the 3 effects of insulin?
- Promotes cellular uptake of glucose from plasma
- Increases glycogenesis, lipogenesis, and glycolysis
- Inhibits glycogenolysis
What is the effect of glucagon?
- Increases glycogeneolysis and gluconeogenesis and lipolysis
What is hyperglycemia?
Increased plasma glucose greater than 110 mg/dl
Normal glucose range
70 - 110 mg/dl
What is Type 1 diabetes called?
Insulin Dependent, Juvenille Onset
What is Type 2 diabetes called?
Non-Insulin Dependent, Adult Onset
What is gestational diabetes?
Gluocse intolerance during pregnancy
Symptoms associated with Type 1 diabetes?
Thirst, polyuria, hunger, weight loss
Type 1 diabetes is most common in what races?
Anglos, African - Americans, and Hispanics
What do patients need to take for Type 1 diabetes?
Insulin
What can cause a sudden onset of Type 1 diabetes?
Viral illness such as CMV or EBV
What are two causes of Type 1 diabetes as to why they can’t produce insulin?
Autoimmune destruction of beta-cells or autoantibodies are present
Glucose (fasting) normal range
70 - 110 mg/dL
Glycosylated hemoglobin (A1C)
3.0 - 6.0 %
CSF glucose normal range
40 - 70 mg/dL
Plasma ketones normal range
Negative
Triglycerides normal range
60 - 150 mg/dL
Total cholesterol normal range
< 200 mg/dL
High density lipoprotein (HDL) normal range
> 45 mg/dL
Low density lipoprotein (LDL) normal range
< 130 mg/dL
Sodium normal range
135 - 145 meq/l
Potassium normal range
3.5 - 5.0 meq/L
Chloride normal range
100 - 110 meq/l
Bicarbonate normal range
20 - 30 meq/l
Anion gap normal range
10 - 20 meq/l
What is CAD?
Coronary Artery Disease
What are lipoproteins?
Group of related but different molecules that interact with water insoluble fat molecules and transports those fats in the plasma
What are the 4 types of lipoproteins?
Chylomicrons, VLDL (Very Low Density Lipoproteins), LDL (Low Density Lipoproteins), and HDL (High Density Lipoproteins)
What do chylomicrons do?
Transport of dietary triglycerides from GI tract to the liver.
What do VLDLs do?
Transport triglycerides from liver to tissues for storage of energy.
What do LDLs do?
Transports cholesterol to peripheral tissue
What do HDLs do?
Transports cholesterol away from peripheral tissues to the liver
Lipids include what four things?
Cholesterol
Triglycerides
Phospholipids
Glycolipids
What type of bond does saturated fatty acids have?
No double bonds between Carbons
Are saturated fatty acids liquid or solid at room temp?
Solid
Where can you find saturated fatty acids?
Animal sources
What type of bond does unsaturated fatty acids have?
Double bonds between Carbon bonds
Are unsaturated fatty acids liquid or solid at room temp?
Liquid
Where can you find unsaturated fatty acids?
Plant sources
What are transfats?
Artificial modifications of unsaturated fats
Saturated fat is fat that consists of ________ containing only ________ ______ ______.
Triglycerides
Saturated fatty acids
Saturated fatty acids have no ________ _______ between the carbon atoms.
Double bonds
A fat molecule is __________ if it contains one double bond.
Monosaturated
A fat molecule is __________ if it contains more than one double bond.
Polysaturated
What are triglycerides?
Glycerol with 3 attached fatty acids
What is the exogenesis source of triglycerides?
Dietary
Where can you find triglycerides?
Liver and tissue storage
___% of body fat is triglycerides.
95
What is the energy source when plasma glucose is decreased?
Triglycerides
Triglyceride catabolism is regulated by ________,_______, and _______.
Lipase, epinephrine, and cortisol.
Triglycerides are transported by __________ and ______.
Chylomicrons and VLDL
________ is found only in animals.
Cholesterol
_________ is an important component of membranes, steroid hormones, bile, and Vitamin D.
Cholesterol
Exogenous cholesterol comes from _____.
Diet
Endogenous cholesterol is synthesized by the ______.
Liver
___% of cholesterol is associated with cellular components.
70
___% of cholesterol is in the plasma.
30
Cholesterol is transported by _____ and _____.
HDL and LDL
________ and _________ are utilized to determine fetal lung maturity from amniotic fluid (L/S ratio).
Lecithin and sphingomyelin
What are glycolipids?
Lipids with a carbohydrate component
Examples of a glycolipid?
ABO antigens
The _____________ is responsible for the interactions with cell membranes and enzymes to transport lipids to specific locations.
Apolipoproteins
Lipoproteins are classified according to?
Density and Electrophoresis migration
Chylomicrons are removed from the plasma within ___ hours by the liver.
Six
LDL are synthesized in the ______.
Liver
What is the “bad” cholesterol?
LDL
What is the “good” cholesterol?
HDL
H=HEALTHY ;)
HDL is synthesized in the ______ and _________.
Liver and intestines
HDL is ___% phospholipids, ___% cholesterol, and ___% apoprotein.
30, 20, and 50
_______ is the main component of bile.
Cholesterol
What is the exogenous pathway?
Transport of dietary lipids, mostly the chylomicrons transportation of triglycerides to liver
What is the endogenous pathway?
Transportation of lipids from the liver to the tissues (VLDL AND LDL)
Insulin helps make ____.
Fat
Insulin decrease ______ _______.
Plasma glucose
Insulin inactivates ______ and stimulates _________.
Lipase
Lipogenesis
In diabetes mellitus, insulin deficiency promotes the release of _____ _____ and their conversion to __________ by the liver.
Fatty acids
Triglycerides
What specimen do you need for lipid testing?
10-12 hour fasting specimen, serum
If you don’t use fasting specimen for lipid testing, what could happen?
Falsely increased levels from recent dietary intake
Glycerol + 3 fatty acids = ?
Triglycerides
What is proportional to the initial triglyceride concentration?
Free glycerol
What is a double blank?
Reagent without lipase
What can a double blank be used to measure?
Free plasma glycerol
What is the CV for plasma triglycerides?
25-30 %
Triglyceride methodology includes the measurement of what?
Trigylcerides and naturally occurring free glycerol in the plasma
What precipitating reagent is added to patient plasma when you’re doing HDL testing?
Dextran sulfate
What do you need to do to specimen when doing HDL testing?
Precipitate non-HDL from the plasma
Elevated __________ (>400 mg/dl) may interfere with the separation of what?
Non-HDL
What is the Friedwald estimation?
LDL = CHOL - (HDL+VLDL) VLDL = Trig/5
Plaque formation is associated with?
Increased plasma cholesterol and LDL
Decreased plasma HDL
What are statin drugs used for?
People with elevated cholesterols
Trade names of common statin drugs
Lipitor, crestor, zocor
What are three major contributory factors of CAD?
Diet exercise and diabetes
What is apolipoprotein?
Protein shells that interact with lipids and allow them to be water soluble
Where is intracellular water?
Inside cells (2/3 of body water)
Where is extracellular water?
Outside cells (1/3 of body water)
Plasma is __% water.
93
Osmolarity = what?
of osmoles per liter solvent
Osmolality = ?
of osmoles per kilogram of solvent
Osmole = what?
1 mole of a dissolved substance
What is the osmolar gap?
Difference between the measured osmolality and calculated osmolality
Osmolar gap = what?
Measured osmolality - calculated osmolality
What stimulates the sensation of thirst?
Hypothalamus
What secretes ADH?
Posterior pituitary
What increases h2o reabsorption by renal collection ducts?
ADH
What does the renin angiotensin aldosterone system do?
Regulates blood volume via plasma sodium
What stimulates renin secretion by the renal glomeruli?
Decreased blood pressure
What is the most abundant extracellular cation?
Sodium 90%
Na-K ATPase pumps out what out of cells and what into cells?
Sodium out, potassium in
Without the active transport pump, what would happen?
Cells would fill with sodium and osmotic pressure would rupture the cells.
Sodium is regulated what?
Water intake/output and aldosterone
What is the formation of glycosylsted hemoglobin proportional to?
Average plasma glucose concentration over 8-12 week time
What is the most commonly measured glycosylated hemoglobin?
A1C
What specimen is used for glycosylated hemoglobin test?
EDTA whole blood that doesn’t need to be fasted
What is the main hormone that increases plasma glucose?
Glucagon
Ketone production indicates what?
Fat metabolism
Why does people with type 2 diabetes have insulin resistance?
Plasma glucose is unable to enter the cells
Factors that contribute to type 2 diabetes?
Obesity lack of exercise and poor diet
Criteria for dignifying diabetes
- random glucose > 200 mg/dL
- fasting glucose > 126 mg/dL
- glucose tolerance testing > 200 mg/dL
What are ketones?
Byproduct of lipolysis
What are ketones associated with?
Type 1 diabetes
What is the major intracellular cation?
Potassium
Only __% is in the plasma
2
RBCs have high concentrations of?
Plasma
Increased potassium promotes?
Muscular excitability
Regulation of potassium is performed by?
Renal secretion/retention in response to various factors
Aldosterone promotes what?
Sodium reabsorption
Hydrogen moved out of RBCs and into the plasma to balance what?
pH
What moves into the RBCs to preserve electrical balance?
Potassium
What is the main extracellular anion?
Chloride
Chloride moved passively with what or against HCO3 to maintain neutral electrical charge?
Sodium
Chloride is reabsorbed where?
Renal proximal tubes
What is the 2nd most important anion?
Bicarbonate
What accounts for 90% of total plasma co2?
HCO3
What is the most important plasma buffer?
Bicarbonate
What is the 2nd most abundant intracellular cation?
Magnesium
PTH increases regulation of what electrolyte?
Calcium magnesium and phosphate
Calcitonin decreases regulation of what
Calcium
Vitamin increases regulation of what?
Calcium and phosphate
