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Clinical Chemistry

Exam 3

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