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Clinical Chemistry
Carbs
| Question | Answer |
|---|---|
| -Major source of energy (glucose metabolism) -Part of cell membrane structure | Carbohydrates |
| basic building blocks of carbs | monosaccharides |
| 2 examples of a pentose sugar | Ribose (RNA) and deoxyribose (DNA) |
| glucose, fructose and galactose are all ____ kind of monosaccharides | hexose |
| most glucose in humans are ____ form of isomer | beta-D |
| disaccharides linked by an _____ bond | alpha 1,4 glycosidic bond |
| glucose + fructose= | sucrose |
| glucose + galactose= | Lactose |
| glucose + glucose = | maltose |
| 10 or more monosacchariides linked together | polysaccharide |
| Starch: primary carb in diet; storage form of glucose in _______; digested by _______ | plants// amylase |
| Glycogen: _____ form of glucose in animals; short-term energy reserve stored in ___ and ____ muscles | storage// liver & skeletal |
| Cellulose: in plant ___; cannot be digested by man (we lack ____), so generally provides fiber/bulk in diet | cell walls/ cellulase |
| Insulin is made in ____ cells in ____ | beta cells/ pancreas |
| -Stimulates glucose uptake by cells, so lowers blood glucose levels -Stimulates production of fat from carbs and conversion of amino acids to proteins | insulin |
| Insulin receptors: -Found on ______ -Binding of insulin to functional receptors allows ____ to enter cells to be metabolized | outside of cell membranes// glucose |
| Glucose catabolized to pyruvate + 2 ATP | Anaerobic Glycolysis |
| Gluc catabolized to pyruvate, converted to acetyl CoA, which then enters the Kreb’s cycle Net production of 38 ATP per molecule of gluc | Aerobic Glycolysis |
| Excess gluc converted to glycogen & stored in liver & skeletal muscle | Glycogenesis |
| -Glycogen hydrolyzed (breakdown) to glucose for energy needs -Uses different enzyme than glycogenesis | Glycogenolysis |
| Glucose formed from non-carbo sources (amino acids, fatty acids) when carbs not available | GlucoNEOgenesis |
| ___________ from _______ increases glycogenolysis to increase blood glucose levels | Glucoagon from the pancrease |
| __________ from ______ increases gluconeogenesis to increase blood glucose levels | cortisol from the adrenal cortex |
| ______ & ________ increase glycogenolysis to increase blood glucose levels | epinephrine and Thyroid hormones (T3, T4) |
| _____ from the ______ inhibts insulin to increase blood glucose levels | growth hormones from the anterior pituitary |
| Glucose Reference Ranges: Fasting serum/ plasma | 70-100 mg/ dL |
| Glucose Reference Ranges: Fasting whole blood ____ lower than serum | 15% |
| Glucose Reference Ranges: CSF`// ___ lower tahn serum | 40-70mg/dL // 60-70% |
| Renal Threshold of glucose | 180mg/dL |
| More than ___mg/dL of glucose in the kidney than it will spill over into ___ | 180// urine |
| Fasting Blood Glucose: greater or equal ___ is diabetes mellitus for Fasting Blood Glucose test | >126 |
| 3 types of glucose tests | -fasting blood glucose -2 hour post prandial glucose -oral glucose tolerance test |
| ____ or greater mg/dL is consistent with diabetes mellitus for the 2-Hour Post Prandial Glucose | greater or equal to 200 |
| -Draw blood 2 hours after eating meal containing 75-100 mg carbohydrates (done after lunch) >200 mg/dL consistent with diabetes mellitus | 2- hour post prandial glucose (2oPP) |
| -No longer recommended for diabetes screening -Can be used to detect hypoglycemia | Oral Glucose Tolerance Test |
| If serum cannot be seperated from the cells by a centrifuge immediately after a glucose test ___ should be used | gray tube with NaF |
| whloe blood glucose for a finger stick is ___-___% lower than serum or plasma value | 11-15% |
| also called benedict's rxn | copper reduction by glucose |
| color change for copper reduction test | blue -negative::: Positive= green, yellow , orange. red -semiquantitative |
| ___ & ___ can interfere with a copper reduction reaction | vitamin C and creatinine |
| The reference method for glucose lab assay | Hexokinase |
| The hexokinase lab assay for glucose measures the amount of reduced ___ at _____ | NADPH// 340nm |
| The more ___ the more ____ in a hexokinase assay | NADPH// Glucose |
| Glucose Oxidase (Trinder) assay for glucose: glucose is porportional to ___. | oxygen consumption |
| the glucose oxidase assay produces a ___ result and is specific for ___ | colored// beta-D glucose |
| Glucose Tolerance Test: ____ is normal// _____is impaired and _____ is diabetes | <140mg/dL/// 140-200mg/dL //// >200mg/dL |
| diabetes symptoms | hyperglycemia, polyuria, thirst, fatigue, irritability, change in weight, ketonuria |
| Type 1 diabetes is caused by insulin deficiancy due to damage to the ___ cells in the ___ | beta cells // pancreas |
| complications of type 1 diabetes | hyperlipidemia (CVD), kidney dis, microvascular damage, peripheral neuropathy, ketoacidosis, hypertension |
| insulin dependent diabetes | type 1 |
| non- insulin dependent diabetes | type 2 |
| type 2 diabetes is caused by | deficient or non-function insulin receptors |
| ___ is rare in type 2 diabetes | ketoacidosis |
| Pre-diabetes have a fasting glucose of | between 99 and 126 mg/dL |
| ____ are by-products of lipid metabolism | ketoacids (ketones) |
| Causes acidosis, decreased enzyme activity, ketones in serum & urine, electrolyte imbalance | ketoacidosis |
| metaboic syndrome is being diagnosed with 3 or more of the following: | -Abdominal obesity - waist > 35(F) or 40(M) in. -High triglycerides or low HDL cholesterol -Hypertension (BP > 130/80) -Hyperglycemia (gluc > 110 mg/dL) |
| metabolic syndrome increase risk of | developing cardiovascular disease, stroke, type II diabetes, arthritis |
| Symptoms: dizziness, fainting, shakiness due to low blood glucose levels | hypoglycemia |
| causes of hypoglycemia: | -insulinoma (tumor produciing excess insulin) -liver & GI disorders |
| how to diagnose hypoglycemia | blood glucose levels below norma after 4-5 hours after glucose tolerance test |
| Symptoms: cramps, diarrhea, failure to thrive in newborns | lactose intolerance |
| how to diagnose lactose intolerance | - fasting lactose intolerance test -fast, give lactose drink = -if glucose goes up, not intolerance// glucose goes down, intolerant to lactose |
| Symptoms: hypoglycemia, diarrhea,vomiting, failure to thrive, cataracts, mental retard | galactosemia |
| cause of galactosemia | lack of galactose-1-phosphate uridyltransferase, which converts gal --> glu |
| how to diagnose galactosemia | clinitest +// dipstick - |
| Abbreviation for glycosylated hemoglobin | A1C |
| A1C levels assess glucose control for the past | 8-12 weeks |
| normal range for HV A1C levels | 4-6% |
| Factors that affect HbA1c value | ++Altered RBC turnover -Hemolytic anemia, aplastic anemia, splenectomy ++Abnormal Hb A levels |
Created by:
lindsayburch