Week 4 - Integration of Metabolism

Question 1

What happens when you eat a high carbohydrate meal?

Question 2

What does your body want to do with those carbohydrates?

Question 3

Describe the oral glucose tolerance test and contrast the results of a healthy person with those of a diabetic. Describe the pathophysiology of diabetic ketoacidosis

Question 4

clinical case

clickers posted

Answer 4

13 y/o female, neruo symptoms, FHx of diebetes, urine pos for reducing sugars

Oral glucose tolerance test… KNOW WHAT THIS IS.

Fast. then drink glucose. measuere blood glucose at invervals. start at fasted level then should incrase, then insulin response should lower blood glucose levels (pulls it into cells)

if give injection of insulin and bllood sugar drops - type 1

if give insulin and blod sugar dose not drop - type 2

So this pt has a problem with insulin.

tyep I - insulin dependent - pt has to take insulin (body is not pruding insulin - immune distructino of pancreatic beta cells - autoimmune)

type II - insulin resistant

hemoglobin glycosylation is result of long tern hyperglycemia..

low blood pH could be from hypoventilation (resp acidosis) or form ketone body or lactate acidosis… but this pt is hyperventilation which is bodies response to low blood pH

can also look at anion gap.. difference between measured anions and differenc betwen measured cations - a high anion gap suggests metabolic acidosis..

resp acidosis is buffered by bicarb (HCO3), anion gap wont change… not brining in any lactate or ketones or any other anions.. that is why there are more unknown anions in metabolic acisdosis

SO pt had ketoacidosis, huge amount of glucose in blood so brain was dehydrated causing neruological effects (dehydration of cells) (hyperosmolar choma)