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CARBOHYDRATES
MLT 212: CLINCAL CHEMISTRY
| Question | Answer |
|---|---|
| The total number of carbon molecules determines the (blank) of carbohydrates | grouping |
| D/right stereoisomers are commonly associated with humans, but what is a stereoisomer | two molecules with identical molecular formulas, but flipped and reverse. the left and right side is denoted by the lowest OH (hydroxide) grouping present |
| Describe the liver's role in carb absorption | Liver absorbs fructose sugar, converts it to galactose, then further breaks it down to glucose. when glucose is released into the bloodstream, it converts into glycogen |
| Define Glycolysis | conversion of glucose or glycogen back into glucose-6-phosphate to generate energy in a glycolytic pathway (ie. Embden-Myerhof and Hexose Monophosphate shunt) |
| Define Glyconeogenesis | conversion of glycogen stores into glucose |
| Define Gluconeogenesis | the utilization of non-carb sources like fats and proteins to create glucose |
| Define Glycogenesis | the conversion of glucose into glycogen storage in the liver and muscles, once the glucose requirement is met |
| What area(s) store glycogen in the body? | liver and skeletal muscles |
| Which glycolytic pathway utilizes NADP as a cofactor to enzymatically oxidize glucose-6-monophosphate and form pentose sugars | Hexose Monophosphate Shunt |
| Which glycolytic pathway uses glucose-6-monophosphate to produce 2 three carbon pyruvate acid molecules and participate in aerobic TCA glycolysis or anaerobic glycolysis | Embden-Myerhof |
| WHAT IS THE NORMAL FASTING GLUCOSE? | 70-99mg/dL |
| What hormone can increase blood sugar | glucagon |
| What hormone can decrease blood sugar | insulin |
| Describe insulin | a hormone produced by the beta cells in the islet of the langerhans of the pancreas. it increases cell wall permeability, allowing the glucose cells in plasma to enter the cell and lower blood sugar levels (MORE INSULIN=LESS BLOOD SUGAR) |
| Which pancreatic hormone produced by the alpha cells in the islets of langerhans stimulates the generation of glucose from non-carb sources (gluconeogenesis) and stores any un-used excess as glycogen in the liver and muscles (glycogenesis) | Glucagon (MORE GLUCAGON, HIGHER BLOOD SUGAR) |
| Describe Epinephrine | a hormone produced by the adrenal medulla that stimulates glycogenolysis, promotes, lipolysis, and inhibits the release of insulin to increase blood sugar |
| Which hormone is a glucocorticoid triggered by ACTH activity that lessens cell wall entry of glucose, inhibits insulin release, and causes gluconeogenesis, glycolysis, and lipolysis to increase blood sugar | Cortisol |
| How do Growth Hormone and ACTH affect blood sugar? | they inhibit insulin secretion, DECREASES CELL ENTRY, and increase glycolysis to increase blood sugar |
| Which thyroid hormone can increase blood sugar by stimulating gluconeogenesis, glycogenolysis, and increase intestinal absorption of glucose? | Thyroxine |
| Describe Somatostatin | a pancreatic hormone produce by the delta cells of the islets of langerhan that decrease blood sugar by inhibiting insulin secretion and reducing intestinal absorption of glucose |
| What type of Diabetes Mellitus is often referred to as "insulin-resistant" diabetes? | Type 2 (patient is not insulin-dependent) |
| True or False: Hyperglycemia is inherently unhealthy | False; hyperglycemia present in unhealthy patients is due to impaired insulin function or production |
| Which form of Diabetes Mellitus is the most common? Describe it | Type 2; it is insulin resistance due to a receptor deficiency. either there are an increase in ineffective insulin receptors, or a decrease in insulin receptor sites - targets obese people - higher susceptibility based on ethnic background |
| People who once had Gestational Diabetes Mellitus are susceptible to developing (blank) | Type 1 DM |
| Describe the pathophysiology of Type 1 DM | Type 1 DM causes intracellular hypoglycemia, triggering lipolysis and acid build-up in the form of ketones (diabetic ketoacidosis) |
| Describe the pathophysiology of Type 2 DM | Type 2 DM is a reversible, extracellular hyperinsulinemia that results in the blood glucose exceeding the renal threshold. the body can either go through cell dehydration, causing a diabetic coma, OR excessive glucosuria |
| What kind of condition causes sever hypoglycemia and irreversible liver damage? | Glycogen Storage Diseases |
| Describe Hypoglycemia | a glucose level of 50-55mg/dL or less of glucose, which then triggers gluconeogenesis and glycolysis due to the release of epinephrine and glucagon |
| What condition is screened on children to determine whether or not they metabolize galactose? | Galactosemia (deficiency of one of the three enzymes) |
| What carb examination measures the reduction of sugar based on the conversion of cupric ions to cuprous ions to produce a final color product (akin to the clinitest) | Benedict's reagent |
| Describe the O-toludine carb measurement method | a non-specific method that causes carbs to form Schiff bases and aromatic amines once O-toludine is added into hot acid. the colored product is measured at 630nm |
| Describe the Glucose Oxidase test | most specific test that reacts with Beta-D glucose to determine glucose concentration based on the formation of hydrogen peroxide coupled with the Trinder reaction, causing a colored product. |
| Describe the Glucose Hexokinase test | most accurate test that involves converting glucose into G-6-PO4 then to 6 phosphogluconate. it then measures enzymatic formation of NADPH from NADP at 340nm. increased NADPH conversion = increased glycolysis to make more glucose |
| What are some interfering substances in the Glucose Oxidase test | uric acid, bilirubin, ascorbic acid |
| What are some interfering substance(s) in the Glucose Hexokinase test? | RBCs from the G-6-P04 |
| Patients with an impaired fasting glucose/are pre-diabetic will have a fasting glucose of | 100-125mg/dL |
| What result in a 1 hour glucose challenge would require additional testing to confirm Gestational Diabetes? | 180mg/dL< |
| What result in a 2hr Postload Glucose exam would indicate impaired glucose tolerance? | 140-199mg/dL |
| Describe the glycosolated HbA1C test | it assesses 2-3 months of glucose intake to monitor diabetic treatment plans. the rate that glucose reacts to an amino group of hemoglobin is directly proportional to concentration of glucose |
| What abnormality in urine is an early sign of renal neuropathy | microalbumin (protein in urine) |
| Describe Proinsulin | it is substance secreted by Beta cells in the pancreas as an inactive precursor to insulin. when insulin is required, the Beta cells activate it and forms into insulin alongside C peptide (connecting peptide) |
| True or False: C-peptide is contained in exogenous insulin, so it does not increase | false; it is not contained in exogenous insulin, so it does not increase |
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