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MT 6317: CC1 > Unit 3: Carbohydrates (Part 2) > Flashcards

Unit 3: Carbohydrates (Part 2) Flashcards

1
Q

If we are going to use fat as energy, what is the byproduct present in the blood?

A

Ketone bodies

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2
Q

What are the 3 ketone bodies produced when fat is used as energy?

A

Acetoacetate, Beta-hydroxybutyrate, Acetone

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3
Q

Condition wherein there is too much ketone bodies in the blood

A

Ketoacidosis

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4
Q

What would happen if insulin is not working or malfunctioning?

A

Glucose would stay in the blood (ECF)

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5
Q

T/F: People with Diabetes mellitus does not have insulin.

A

HALF TRUE HALF FALSE LOL. Some conditions don’t produce insulin (Type 1), some conditions produce insulin, but is not enough (Type 2)

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6
Q

Any substance present in the urine will increase its?

A
  • Specific Gravity
  • Osmolality
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7
Q

Why would there be acidosis in hyperglycemia?

A

Because of ketone bodies

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8
Q

Ketones in serum (blood)

A

Ketonemia

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9
Q

Ketones in urine

A

Ketonuria

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10
Q

T/F: Electrolyte imbalance is due to sodium going into the cell.

A

FALSE. Potassium going OUT

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11
Q

This can also be a finding in hyperglycemia if potassium is outside the cell.

A

Hyperkalemia

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12
Q

What is the pH of urine if it is acidic?

A

Lower than 7.30

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13
Q

Insulin is not enough or effect of insulin is
not working, hyperglycemia persists

A

Diabetes mellitus (DM)

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14
Q

A group of metabolic diseases characterized by Hyperglycemia

A

Diabetes Mellitus (DM)

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15
Q

DM is due to:

A
  • Defects in insulin secretion
  • Defects in insulin action
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16
Q

3 classical signs of DM

A
  • Polyuria
  • Polydipsia
  • Polyphagia
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17
Q

Frequent urination

A

Polyuria

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18
Q

Excessive thirst

A

Polydipsia

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19
Q

Excessive hunger/ Increased Appetite

A

Polyphagia

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20
Q

T/F: Involuntary weight loss is also a symptom of DM.

A

TRUE

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21
Q

Other symptoms of DM:

A
  • Hyperventilation
  • Loss of consciousness
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22
Q

Why would there be loss of consciousness if someone has DM?

A
  • Excessive glucose in the brain
  • No glucose (mental confusion)
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23
Q

Glucosuria happens when the glucose exceeds the renal threshold of:

A

more than 180 mg/dL

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24
Q

Complications of DM

A
  • Neuropathy
  • Nephropathy
  • Retinopathy
  • Atherosclerosis
  • Heart disease
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25
Q

Methods of DM Diagnosis

A
  • HbA1c
  • Fasting blood glucose
  • Oral Glucose Tolerance Test (OGTT)
  • Random plasma glucose
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26
Q

HbA1c is based on:

A

National Glycohemoglobin Standardization Program (NGSP)-certified method

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27
Q

T/F: Point-of-care assay methods for either plasma glucose or HbA1c are recommended for diagnosis.

A

FALSE, they are not recommended for diagnosis.

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28
Q

Categories of Fasting Plasma Glucose

Normal fasting glucose

A

FPG 70-99 mg/dL (3.9-5.5 mmol/L)

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29
Q

Categories of Fasting Plasma Glucose

Impaired fasting glucose

A

FPG 100-125 mg/dL (5.6-6.9 mmol/L)

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30
Q

Categories of Fasting Plasma Glucose

Provisional diabetes diagnosis

A

FPG more than or equal to 126 mg/dL (more than or equal to 7.0 mmol/L)

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31
Q

This diagnostic method is a long-term measurement method

A

HbA1c

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32
Q

How many months of RBC are measured in HbA1c for glucose?

A

3 months

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33
Q

What is the value of HbA1c for it to be considered DM?

A

more than or equal to 6.5%

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34
Q

In OGTT, how long should a patient wait for glucose testing?

A

2 hours

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35
Q

T/F: OGTT is a 4 hour post load test.

A

FALSE, 2 hours (usually)

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36
Q

What is the glucose load in OGTT?

A

75 g glucose load

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37
Q

T/F: Fasting is not required for OGTT.

A

FALSE, the patient should have fasted.

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38
Q

Categories of OGTT

Normal glucose tolerance

A

2-h PH less than or equal to 140 mg/dL (less than or equal to 7.8 mmol/L)

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39
Q

Categories of OGTT

Impaired glucose tolerance

A

2-h PH 140-199 mg/dL (7.6-11.1 mmol/L)

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40
Q

Categories of OGTT

Provisional diabetes diagnosis

A

2-h PH more than or equal to 200 mg/dL (more than or equal to 11.1 mmol/L)

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41
Q

T/F: Provisional diabetes diagnosis must be confirmed.

A

TRUE

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42
Q

In Random Blood Sugar, the patient is considered to have DM if they have a test value of:

A

more than 200 mg/dL

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43
Q

T/F: Random Blood Sugar is a confirmatory test.

A

FALSE, it is a screening test.

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44
Q

T/F: To be diagnosed with DM, the patient should meet all the criteria for FBS, OGTT, and HbA1c.

A

FALSE, just one + signs or symptoms

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45
Q

Type 1 is associated with (onset)

A

Genetics, childhood onset

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46
Q

Type 2 is associated with (onset)

A

Lifestyle choices; adult onset

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47
Q

T/F: ALL fat people have DM

A

FUCK U!

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48
Q

Type 1 DM is also known as

A

Insulin-dependent DM (IDDM) and Juvenile onset DM

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49
Q

This is due to pancreatic islet beta-cell destruction

A

Type 1 DM

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50
Q

Type 1 DM is the ____________________ of beta cells

A

autoimmune destruction

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51
Q

Type 1 DM is the ___________ insulin secretion deficiency

A

Absolute

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52
Q

________ of cases of DM are Type 1

A

10%

53
Q

Type 1 DM commonly occurs in

A

Childhood/ adolescence (24 y.o.)

54
Q

Characteristics of Type 1 DM

A
  • Abrupt onset
  • Insulin dependence
  • Ketotic tendencies
55
Q

There would be an excess of this hormone in DM

A

Glucagon

56
Q

Ketotic tendencies can be characterized by

A

Fruity smelling breath

57
Q

This characteristic is only present in Type 1 DM

A

Ketoacidosis

58
Q

T/F: Type 1 DM is genetically related.

A

TRUE

59
Q

Markers of Type 1 DM

A
  • Islet cell autoantibodies
  • Insulin autoantibodies
  • Glutamic acid decarboxylase (GAD) antibodies
  • Tyrosine phosphate IA-2 and IA-2B autoantibodies
  • Zinc transporter 8 antibodies (ZnT8)
60
Q

This is an idiopathic type of DM classified under type 1:

A

Fulminant Type 1 Diabetes (FT1D)

61
Q

Associated with the destruction of beta cells but there are no beta-cell autoantibodies

A

Fulminant Type 1 Diabetes (FT1D)

62
Q

Methods of detecting Type 1 DM autoantibodies

A
  • Immunofluorescence
  • Immunohistologic techniques using GOD (glucose oxidase)
  • Radiobinding Assay (RBA)
  • Enzyme linked immunoabsorbent assay (ELISA)
63
Q

Other names for Type 2 DM

A

Non-insulin dependent DM (NIDDM) and Adult onset DM

64
Q

Type 2 DM is due to _________ resistance to _________ which leads to __________ action of ___________

A

Peripheral; insulin; Decreased; Insulin

65
Q

Type 2 DM is a _______ insulin deficiency

A

Relative

66
Q

_________% of DM are Type 2

A

90%

67
Q

Type 2 DM Risks

A
  • Increase in age
  • Obesity
  • Lack of physical exercise
68
Q

Type 2 DM Characteristics

A
  • Adult onset
  • Milder symptoms
  • Hyperosmolar coma
69
Q

Type 2 DM Complications

A
  • Macrovascular complications
  • Microvascular complications
70
Q

Microvascular complications (Type 2)

A
  • Nephropathy
  • Neuropathy
  • Retinopathy
  • Gangrene
71
Q

RELATIONSHIP

_____ glucose = ______ osmolality

A

High, High

72
Q

Osmolality can affect the brain and induce

A

Hyperosmolar coma

73
Q

Hyperglycemia in Type 2 DM results from 3 major metabolic defects:

A
  • Increased glucose production (liver)
  • Impaired insulin secretion (pancreas)
  • Insulin resistance (in peripheral tissues)
74
Q

This is the intermediate stage between normal and DM status

A

Impaired fasting glucose/ glucose tolerance

75
Q

Impaired FBG/OGTT has glucose levels _______ normal limits but not to the level of _________

A

Above; diabetes

76
Q

T/F: There is a low risk to develop DM if the patient’s result is within the impaired levels.

A

FALSE, there is HIGH RISK

77
Q

Impaired is a __________ condition

A

Pre-diabetes condition

78
Q

Gestational DM onset

A

2nd-3rd trimester of pregnancy

79
Q

T/F: Patients who developed gestational DM normally return to normal conditions post partum

A

TRUE

80
Q

Gestational DM is associated with

A
  • Increased risk of perinatal complications (miscarriage, respiratory distress syndrome in the infant)
  • Development of DM
81
Q

When a mother has gestational DM, the infant may experience

A

Severe hypoglycemia

82
Q

Why would the infant experience hypoglycemia if the mother has gestational DM?

A

Since the mother has excess glucose, the abrupt termination of the umbilical cord on delivery would cause the infant to have low sugar levels.

83
Q

Main cause of Gestational DM

A

Hormonal

84
Q

What hormones produced by the placenta can inhibit the function of insulin?

A
  • Estrogen
  • Cortisol
  • Human placental lactogen
85
Q

High risk group for Gestational DM

A
  • Familial history for DM
  • Race (East Asian, Asian-American)
  • Age older than 25yo
  • Overweight
  • History of poor obstetric outcomes
  • Glycosuria
86
Q

Screening for GDM

A

2 positive FBS results of different instances

87
Q

Two testing approaches for GDM

A
  1. 1 step: 2-hr OGTT (75 g. glucose load)
  2. 2 step: 1-hr post load of 50g glucose, if (+), 3 hr OGTT using 100g glucose.
88
Q

Term for “diagnosis is confirmed”

A

Rendered

89
Q

(2 step) Test value if positive for FBS

A

More than 140 mg/dL (7.8 mmol/L)

90
Q

GDM test results

FBS =
1 hr OGTT =
2 hr OGTT =

A

FBS = >92
1 hr OGTT = >180
2 hr OGTT = >153

91
Q

GDM screening should be performed:

A

between 24-28 weeks of gestation

92
Q

T/F: If results are normal for GDM, the test should be repeated during the third trimester.

A

TRUE

93
Q

To diagnose GDM, how many values should exceed in 2-step testing?

A

2 out of 4 values

94
Q

GDM Diagnosis (100g load)

Fasting =
1 hour =
2 hour =
3 hour =

A

Fasting = 95 mg/dL
1 hour = 180 mg/dL
2 hour = 155 mg/dL
3 hour = 140 mg/dL

95
Q

GDM Diagnosis (75g load)

Fasting =
1 hour =
2 hour =
3 hour =

A

Fasting = 95 mg/dL
1 hour = 180 mg/dL
2 hour =155 mg/dL
3 hour = —-

96
Q

T/F: If 75 g OGTT is employed, it is necessary to get the blood sugar levels on the 3rd hour.

A

FALSE, only until the 2nd hour

97
Q

Patient preparation:

_______ of fasting after at least ___ days of unrestricted diet and unlimited physical activity

A

8-14 (10 hours) hours; 3 days

98
Q

Unrestricted diet carbohydrate per day

A

> 150g carbohydrate per day

99
Q

At _____ y.o.: If results are normal, testing should be done every ______-

A

45 y.o.; 3 years

100
Q

When to test for DM?

A
  • Habitually physically inactive
  • Family history (first-degree relative)
  • High-risk minority group
  • History of GDM or delivering a baby weighing more than 9lb.
  • Hypertension
  • Low HDL concentrations
  • Elevated triglyceride concentrations
  • History of impaired FBG/OGTT
  • Women with PCOS
  • Presence of clinical conditions associated with insulin resistance (severe obesity and acanthosis nigricans)
  • History of cardiovascular disease
101
Q

When to test for Type 2 DM?

A
  • Testing at 10 y.o or at onset of puberty
  • Overweight
  • Family history of type 2 DM (first or second degree)
  • Race/ ethnicity
  • Signs of insulin resistance or conditions associated
  • Maternal history of diabetes or GDM
102
Q

Every how many years is the follow up for Type 2 DM testing?

A

Every 2 years

103
Q

Dominantly inherited disorder of NIDDM before 25 y.o

A

Maturity-Onset Diabetes of the Young (MODY)

104
Q

MODY occurs when there are mutations in which genes

A
  • Glucokinase (GCK)
  • HNF1A
105
Q

This gene is like a sensory of glucose

A

Glucokinase

106
Q

This gene produces a gene that helps insulin

A

HNF1A

107
Q

MODY is often misdiagnosed as:

A

Type 1 or Type 2 DM

108
Q

T/F: MODY is polygenic.

A

FALSE, it is monogenic

109
Q

T/F: MODY is a “type 1” DM patient with autoantibodies.

A

FALSE, no autoantibodies

110
Q

T/F: MODY is a “type 1” DM patient with insulin secretion years beyond diagnosis.

A

TRUE

111
Q

T/F: MODY is a “type 2” DM patient with normal weight or significantly overweight with signs of insulin resistance.

A

FALSE, there are no signs of insulin resistance

112
Q

T/F: MODY is a diabetes patient who is part of a family in which three or more consecutive generations who has not been diagnosed with diabetes.

A

FALSE, diagnosed with diabetes

113
Q

T/F: MODY is a diabetes patient with abnormally high blood sugars, often found incidentally during a check-up.

A

FALSE; stable, mildly elevated blood sugars

114
Q

T/F: Patients with MODY usually have autoantibodies against the islets of Langerhans.

A

FALSE

115
Q

LADA is a disease of

A

Adults (adult onset)

116
Q

LADA

A

Latent autoimmune diabetes of adults

117
Q

LADA does not need insulin for glycemic control at least in how many months after diagnosis:

A

first six months

118
Q

LADA is also known as

A

Type 1.5 DM (Type 1a DM)

119
Q

T/F: LADA shares genetic, immunologic, and metabolic features with type 1 diabetes

A

FALSE, BOTH type 1 and type 2

120
Q

Criteria for the diagnosis of LADA

A
  • Age greater than 35 years
  • Positive autoantibodies to islet beta cells
  • Insulin independence for at least the initial 6 months after diagnosis
121
Q

T/F: There are autoantibodies in LADA.

A

TRUE

122
Q

Autoantibody for LADA

A

GAD (glutamate decarboxylase) autoantibodies

123
Q

This organization set the criteria for LADA diagnosis

A

Immunology for Diabetes Society (IDS)

124
Q

Develops as an outcome of a pancreatic disease such as chronic pancreatitis or carcinoma.

A

Pancreatogenic DM (PDM)

125
Q

PDM is also known as

A

Type 3C

126
Q

NDM is also known as

A

Infantile diabetes/ congenital diabetes

127
Q

NDM is a form of monogenic diabetes that occurs in an infant _________

A

<6 mos. of age

128
Q

Insulin-dependent hyperglycemia that persists longer than a week should raise suspicion for this and prompt genetic testing

A

Neonatal Diabetes Mellitus (NDM)

129
Q

Most common cause of permanent NDM

A

Genetic mutations in KCNJ11 and ABCC8

MT 6317: CC1 (2 decks)

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