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Clinical Chemistry
Exam 3
| Question | Answer |
|---|---|
| Decrease in osteoid (bone matrix) formation, decrease in mineralization, increase in bone resorption | Osteopenia |
| Measured by bone density scan | Osteoporosis |
| What is the SD that diagnosis osteoporosis | 2.5 SD below the mean |
| Mineralization failure | Osteomalacea |
| Abnormal increase in PTH | Osteitis fibrosis |
| Disorder of bone metabolism, increase in osteoclast resorption | Paget's disease |
| "Brittle bone disease", bones just break | Osteogenesis imperfecta |
| What controls PTH? | Calcitonin |
| Effects of PTH | increases serum Ca, increases calcitriol production, decreases serum phosphorus, Mg levels |
| Alpha cells | glucagon (increase glucose) |
| Beta cells | insulin (decrease glucose) |
| F cells | polypeptides |
| Epsilon cells | Ghrelin |
| Delta cells | somatostatin |
| What does somatostatin do? | Inhibits insulin, inhibits exocrine enzymes, decreases bile flow |
| What do polypeptides do? | Stimulate intestinal enzymes, decrease intestinal motility |
| What do acinar cells do | store digestive enzymes such as proteases |
| Name endocrine disorders | insulinoma, glucoglonoma, diabetes, stomatostatinoma, PPoma, islet disorders (insulin deficiency, glucagon excess) |
| Name exocrine disorders | pancreatitis, ARDS, Pancreatic cancer |
| What is ARDS | Adult Respiratory Distress Syndrome (auto digestion of pulmonary capillaries) |
| Name 3 monosaccharides | glucose, fructose, galactose |
| Name 3 disaccharides | sucrose, maltose, lactose |
| Name 3 polysaccharides | starch, cellulose (cellulose), glycogen (energy storage) |
| Glucose is transported by what to the plasma membrane | glycoprotiens |
| Hexose Monophosphate Shunt | G6P to ribose and CO2 |
| Uronic Acid Pathway | G6P to glucoronic acid |
| Glycogenesis | G6P to glycogen |
| Glycogenesis means | to form glycogen |
| The enzymes important in glycogenesis are: | Glycogen synthetase, protein kinase, cAmp, insulin |
| Active GS is | dephosphorylated |
| Inactive GS is | phosphorylated |
| What does protein kinase do? | phosphorylates GS |
| What does cAmp do? | Activates protein kinase therefore regulating the whole process (glycogenesis) |
| What does insulin do? | Regulates cAMP; insulin = decrease in cAMP |
| What is the key intermediate in gluconeogenesis? | Pyruvate |
| Hyperglycemic agents | increase blood sugar |
| Hypoglycemic agents | decrease blood sugar which inhibits glucose production and stimulates glucose storage |
| Give examples of hyperglycemic agents | glucagon, epinephrine, cortisol, thyroxin |
| What does glucagon do? | Promotes glycogen breakdown |
| What does cortisol do? | increases the rate of gluconeogenesis |
| What does somatostatin do? | Blocks the effects of glucagon and insulin |
| What does insulin do? | Promotes metabolism, Glucose shift (extracellular to intracellular), facilitates glycogen, fat and protein storage |
| Conversion of glucose to glycogen for storage | Glycogenesis |
| Breakdown of glycogen to form glucose and other intermediate products | Glycogenolysis |
| Formation of glucose from noncarbohydrate sources such as AA's, glycerol or lactate | Gluconeogenesis |
| Conversion of glucose or other hexoses into 3-C molecules (lactate or pyruvate) | Glycolysis |
| Glucose increase causing hyperglycemia. Insulin is compromised (decreased cellular response) | Diabetes |
| What percent of diabetes is type 1 | 5-10% |
| What is type 1 diabetes due to | viral infection (antibodies to islet cells), genetic predisposition, autoimmune (antibodies to islet cells) |
| 3 symptoms of type 1 diabetes | polyuria, polydipsia, polyphagia |
| Increased urination | polyuria |
| Increased thirst | polydipsia |
| increased hunger | polyphagia |
| What percent of diabetes is type 2 | 90-95% |
| What is type 2 diabetes caused by | age, diet, exercise |
| Do type 2 and type 1 diabetes have the same symptoms | Yes |
| Receptor site defect where insulin can't dock to cells and glucose can't get in | Type 2 diabetes |
| temporary diabetes during pregnancy | gestational diabetes |
| Functions of bone | support/structure, mineral homeostatis |
| Bone building cells (formation) | osteoblasts |
| Bone breaking cells (resorption) | osteoclasts |
| Mature bone cells | osteocytes |
| Things in the bone matrix | collagen fibers, non-collagenous, minerals, proteins, amino acids, hydroxyapatite crystals, others |
| Remodeling of bone is regulated by what | hormones (calcitropic hormones) |
| Best indicator of future bone health | bone mass in 30's |
| Key minerals in bone | Calcium, phosphorus and magnesium |
| Forms of calcium | ionized (45%), bound to albumin (45%), complexed to anions (10%) |
| What percent of calcium is in the bones | 99% |
| What percent of phosphorus is in the bones | 80-85% |
| What other place can you find phosphorus stored in and to what percent? | muscle 9% |
| What percent of magnesium is stored in the bones? | 50-55% |
| Where else is magnesium stored besides the bones? | Intracellulary, muscle, blood |
| What regulate PTH release | magnesium and calcium |
| What does calcitriol do? | increases osteoclast activity |
| What is the inactive form of digestive enzymes called | zymogens |
| What enzyme activates trypsin by removing the AA chain | enterokinase |
| what are the upper GI tract hormones that help release pancreatic fluid | CCK, secretin and gastrin |
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