front 1 What it the predominant source to create cellular energy used by mammals? | back 1 Carbon + Water = Carbohydrate |
front 2 What does Dexter mean? | back 2 Right in Latin |
front 3 What does Lævo mean? | back 3 Left in Latin |
front 4 What monosaccharides compose Maltose? | back 4 Glucose and Glucose Note: GG I’m getting a Malt shake |
front 5 What monosaccharides compose Lactose ? | back 5 Glucose and Galactose Lactose like the world eater Galactose |
front 6 What monosaccharides compose Sucrose ? | back 6 Glucose and Fructose Sucrose is Fruit sugar |
front 7 What is a carbonyl group? | back 7 One double bonded Oxygen to a Carbon |
front 8 A Carbonyl group at the beginning or end of the chain is called? | back 8 aldose or aldehyde |
front 9 A Carbonyl group on an internal carbon in the chain is called? | back 9 ketose or ketone Ketone: are in the middle. |
front 10 What do all reducing sugars consist of ? | back 10 all monosaccharides |
front 11 What is Tautomerization? | back 11 is the random binding and releasing of the aldehyde and hydroxyl groups in the carbohydrate ring, which enables a transient reduction capacity of other substances. The end sugar on chain to become a reducing sugar |
front 12 What is Glycogen? | back 12 the storage form of glucose for our bodies |
front 13 What three things do you need to know about the Embden-Meyerhof Pathway? | back 13
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front 14 What is the process of Embden-Meyerhoff Pathway (glycolysis)? | back 14 Breakdown of glucose to pyruvate (with oxygen, aerobic glycolysis) or lactate (without oxygen, anaerobic glycolysis) |
front 15 What is the process of the Krebs Cycle (TCA or Citric Acid Cycle) ? | back 15 Turns acetyl Co-A into ATP for energy, and gives off electrons and H+ |
front 16 What is the process of the Hexose monophosphate (HMP) shunt or pentose phosphate pathway? | back 16 Oxidation of glucose to ribose + CO 2 + NADPH. Ribose for RNA and DNA |
front 17 What is the definition of Glycogenesis? | back 17 - Formation of glycogen for energy storage |
front 18 What is the definition of Glycogenolysis? | back 18 - Destruction of glycogen for energy usage |
front 19 What is the definition of Gluconeogenesis ? | back 19 Formation of glucose from non-carbohydrate sources |
front 20 What is the definition of Glycolysis? | back 20 - Destruction of glucose into pyruvate or lactate |
front 21 What does Insulin do? | back 21 - ↑ glycolysis, glycogenesis, and lipogenesis. Released from the pancreatic |
front 22 What does Glucagon do? | back 22 ↑ glycogenolysis, gluconeogenesis, lipolysis Released from the pancreatic |
front 23 What does Somatostatin do? | back 23 Inhibits secretion of glucagon and insulin Released from the Pancreatic ẟ cells, islets of Langerhans Note: statin for stable. |
front 24 What do most other hormones that affect glucose do in carbohydrate regulation? | back 24 ↑ glycogenolysis, gluconeogenesis (Thyroxine, Growth Hormone, ACTH, Glucocorticoids, Epinephrine) |
front 25 What hormone is principally charged with decreasing blood sugar? | back 25 Insulin |
front 26 What are the 3 P's of diabetes? | back 26
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front 27 What are the ADA(Americans with Disabilities Act ) Diagnostic Criteria values ? | back 27 Fasting Blood Sugar >126 mg/dL Random Blood Sugar >200 mg/dL 2 hour Oral Glucose Tolerance Test "OGTT " >200 mg/dL HbA1c >6.5% |
front 28 What is the collateral damage for diabetes? | back 28 Renal damage - assess microalbumin (more sensitive in assessing glomerular function than Creatinine) Cardiac damage - assess EKG (best screening test for stress on the heart) Retinal damage - yearly ophthalmologist exam (best screening for diabetic retinopathy) Diabetic foot ulcers - weekly/daily self check and prevention by avoiding injuries |
front 29 !!What are the ADA(Americans with Disabilities Act ) Diagnostic Criteria values for gestational Diabetes?!! | back 29 Fasting blood sugar >92 mg/dL 1 hour Oral Glucose Tolerance Test (OGTT) >180 mg/dL 2 hour OGTT >153 mg/dL |
front 30 Diagnosis is more strict for pregnant women than the nonpregnant population, why? | back 30 Elevated blood sugar increases the rate of Intrauterine Fetal Demise (IUFD) Don’t want to birth a dead baby. |
front 31 !!What are the ADA(Americans with Disabilities Act ) Diagnostic Criteria values for Hypoglycemia? !! | back 31 < 60 mg/dL in adults < 45 mg/dL in infants, |
front 32 What is Whipple’s Triad? | back 32 1.Documentation of hypoglycemia when symptomatic 2.Signs and Symptoms of hypoglycemia 3.Alleviation of symptoms after ingestion of glucose |
front 33 What are the Adrenergic Symptoms? | back 33 1.Sweating 2.Shaking 3.Nervousness 4.“Feeling of impending doom” |
front 34 What is the cause of postprandial hypoglycemia? | back 34 Hypersecretion of insulin following the ingestion of food |
front 35 ! What are the Important Values for Fasting Blood Glucose?! | back 35 !Reference Range for Glucose = 70-100 mg/dL! Critical Serum or Plasma Glucose (All ages) Below 40 mg/dL Brain Damage Above 450 mg/dL Diabetic Coma Critical Plasma Glucose (Newborn to 6 Wks) Below 30 mg/dL Brain Damage Above 300 mg/dL Diabetic Coma |
front 36 What is are the signs and symptoms of Galactosemia? | back 36 Cause of ‘failure to thrive’ in infants May lead to irreversible mental retardation, cataracts, and eventually blindness Lab findings: 1. hypoglycemia 2. hyperbilirubinemia 3. accumulation of glycogen |
front 37 What is the cause of hypoglycemia? | back 37 caused by inability to turn glycogen into glucose |
front 38 What is Type I - G6PD Deficiency (von Gierke Disease)? | back 38 Most common enzyme deficiency worldwide. Most people are asymptomatic. Enzyme deficiency for the last step in glycogenolysis, Glycogenolysis cannot occur Episodes of intravascular hemolysis can occur after Plasmodium vivax infection, ingestion of medications that induce oxidative stress (Rifampin, methylene blue, Primaquin, Rasburicase, Sulfa drugs, etc.), fava beans, infections, or ketoacidosis |
front 39 What is the chemical reaction for Glucose oxidase / Peroxidase - GOD / POD Trinder reaction? | back 39 Glucose + O2 + H2O → Gluconic acid + 2 H2O2 H2O2 oxidizes many substrates catalyzed by Horseradish Peroxidase H2O2 + reduced chromogen → Oxidized chromogen + H2O |
front 40 What should you know about Hexokinase? | back 40 Catalyzes G-6-P formation in the presence of Mg ++ |
front 41 What is the oxidizing substance that is produced in the Trinder Reaction? | back 41 H2O2, Hydrogen Peroxide |
front 42 !! What are the values need to know for Hemoglobin A1c? | back 42 Normal range is between 4.8-5.9% Diabetes is diagnosed with a HbA1c >6.5% note:Glucose binds non-enzymatically to all proteins |
front 43 What to know about Glycated Albumin / Fructosamine? | back 43 HbA1c works just fine, until it doesn’t. This can be caused by early red cell destruction like hemolysis, or more commonly dialysis. |
front 44 A physician is wondering what the long-term glucose control has been in one of her patients. What test(s) should she order? | back 44 HbA1c initially, because it looks at the glycosylated hemoglobin molecules still in the blood. Since red cells turn over every 90 days or so, this test is only good to look at the last 90 days of control. If the patient has high red-cell turnover (sickle cell anemia, hemolysis, bleeding, etc.), then the test will not look at the last 90 days, and a fructosamine or glycated albumin test should be ordered. |
front 45 What is an important Ketone to know? | back 45 |
front 46 What to know about the lactate process. | back 46 Lactate is produced in glycolysis when oxygen is NOT present (e.g. exercise, heart attack, etc.) Interferences:
Know that the chromogen creates a color change |
front 47 What is Glycorrhachia ? | back 47 the presence of glucose in the CSF and is a NORMAL finding !CSF glucose should be ⅔ the plasma glucose! |
front 48 For urine glucose what is the renal threshold? | back 48 !The Renal Threshold for glucose is 180 mg/dL! |
front 49 What ketone is measured in our analyzers? | back 49 Acetoacetic acid |
front 50 When testing for insulin what do the these parameters indicate: High Insulin and Low Glucose = | back 50 Hyperinsulinemia, either an insulin-secreting tumor or exogenous insulin administration |
front 51 When testing for insulin what do the these parameters indicate: High Insulin and High Glucose = | back 51 Insulin insensitivity |
front 52 When testing for insulin what do the these parameters indicate: Low Insulin and High Glucose = | back 52 Type I Diabetes |
front 53 When testing for insulin what do the these parameters indicate: Low Insulin and Low Glucose = | back 53 Starvation, ↑ Glucagon |
front 54 What is important to know about the C-Peptide ratio? | back 54
C-Peptide and Insulin are created in a 1:1 ratio
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front 55 What are the reference values for glucose in a separated vs non separated vile of blood? | back 55 These are just example know the principle not the exact numbers.
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front 56 A female athlete is exercising to her max and using all of her
energy. What | back 56 Answer: Anaerobic glycolysis is likely being used in this situation.
Anaerobic |
front 57 What ketone is measured by our machines? | back 57 Acetoacetic acid |
front 58 What hormone is principally in charge of decreasing blood sugar? | back 58 Insulin |
front 59 What is the action and source for the following hormone: Thyroxine? | back 59 Action:↑ gluconeogenesis ↑ glycogenolysis Source:Thyroid gland |
front 60 What is the action and source for the following hormone: Somatostatin? | back 60 Action: Inhibits secretion of insulin and glucagon Source: ẟ cells in the pancreas |
front 61 What is the action and source for the following hormone: Adrenocorticotropic Hormone (ACTH)? | back 61 Action: ↑ gluconeogenesis ↑ glycogenolysis ↑ lipolysis Source: Anterior pituitary gland |
front 62 What is the action and source for the following hormone: Growth Hormone (GH)? | back 62 Action: ↑ gluconeogenesis ↑ glycogenolysis ↑ lipolysis Source: Anterior pituitary gland |
front 63 What is the action and source for the following hormone:Epinephrine? | back 63 Action: ↑ gluconeogenesis ↑ glycogenolysis ↑ lipolysis Source: Adrenal medulla |
front 64 What is the action and source for the following hormone:Glucocorticoids (Cortisol)? | back 64 Action: ↑ gluconeogenesis ↑ glycogenolysis ↑ lipolysis Source: Adrenal cortex |
front 65 What method is recommended to analyze glucose if the patient is on dialysis? | back 65 Hexokinase |
front 66 What is the standard tube to be drawn if you want to make sure that
glycolysis is | back 66 Na fluoride (gray top) |
front 67 A 37-year-old male and well-controlled long term type 1 diabetic,
presents to his physician complaining of vague abdominal pain. He is
also being treated for agammaglobulinemia with intravenous
immunoglobulins (IVIG). His glucose values at his last checkup were
high (155 mg/dL) on the laboratory test, but his home glucose monitor
tells him that his glucose values are usually between 95-120 mg/dL.
What is the most likely reason for this testing discrepancy? | back 67 Answer: (Answer A) The laboratory is in a better controlled environment is a true statement, but doesn’t likely apply in this case. We also know that he is being treated with IVIG, which contains maltose. Maltose cross-reacts in the glucose oxidase method and falsely-elevates the glucose value (Answer C). Maltose does NOT do this with the hexokinase method. This would be a problem (Answer B) IF we were comparing these two test methods. |
front 68 A 57-year-old female with Cushing syndrome is having a difficult time
controlling her blood glucose levels. She has tried diet, exercise,
and even prolonged fasting. Nothing has worked. What is the likely
hormone causing this issue? | back 68 Answer: |
front 69 A 7-year-old female is complaining of abdominal pain. She has
urinated 17 times today and has eaten 12 bowls of Kellogg’s® Frosted
Flakes. Her mother takes her into her pediatrician who quickly makes a
diagnosis of new-onset Type 1 Diabetes with a glucose value of 817
mg/dL! If this patient is in ketoacidosis, then what will likely be
the most prevalent ketone? | back 69 Answer: |
front 70 A physician is wondering what the long-term control of his patient’s glucose has been. What test should she order? | back 70 Answer: |
front 71 What is the cause of postprandial hypoglycemia? | back 71 Hypersecretion of insulin following the ingestion of food |
front 72 Name a deadly long-term complications of diabetes | back 72 Myocardial Infarction, stroke, or renal failure |
front 73 What is the diagnostic value of Diabetes for a patient who just ate
a | back 73 Answer: |
front 74 A 59-year-old male patient comes in for a physical examination. He
has not been to the physician in 15 years because he says, “I can take
care of myself.” The reason why he came in is because he can’t feel
his feet anymore and has this festering wound over his calcaneus. He
thought that he just needed some antibiotics, so he decided that he
needed to go to the physician to get those. He is diagnosed with Type
2 diabetes and he wants to treat it and go home. He is given insulin,
but he doesn’t take it. What is the most likely fatal side effect of
his long-standing diabetes? | back 74 Answer: |
front 75 A 12-year-old girl has been feeling dizzy and sweaty. She is found to
have tachycardia and is very anxious and she comes from an anxious
family. She says that she feels this way each day about an hour after
she eats, but it usually resolves after she eats a box of runts. What
is her likely condition? | back 75 Answer: |
front 76 3. A 38-year-old long-term insulin-dependent diabetic male is having
problems with his eyesight. He says that he’s starting to go blind.
His physician reminds him that Diabetic Retinopathy is a feared
complication of uncontrolled long-term diabetes and asks his patient
if he has been taking his insulin. The patient replied with a “yes”.
What laboratory test would help to assess the sensitivity of insulin
in the peripheral tissues? | back 76 The correct answer is A) 2 Hour OGTT. The 2 hour OGTT is a test in which a standard glucose load is given to the patient. We are interested in seeing how the patient decreases this glucose over the next 2 hours. This is demonstrated in the figure below: |