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Clinical Chem > Chem Unit 2 > Flashcards

Chem Unit 2 Flashcards

1
Q
A

D-Glucose

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2
Q
A

L-Glucose

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3
Q

Most clinically significant Monosaccharides?

A

Hexose
Pentose

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4
Q

What is a disaccharide?

A

Two monosaccharides joined together with a loss of a water molecule

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5
Q

What are the most common disaccharides?

A

Maltose
Lactose
Sucrose

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6
Q

What is Maltose made of?

A

Glucose + Glucose

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7
Q

What is Lactose made of?

A

Glucose + Galactose

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8
Q

What is Sucrose made of?

A

Glucose + Fructose

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9
Q

What is a Polysaccharide?

A

Numerous monosaccharides joined together by glycosidic linkages

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10
Q

What are the most common Polysaccharide?

A

Starch
Glycogen
Cellulose

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11
Q

How many glucose are in a Polysaccharide?

A

20 or more

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12
Q

How many glucose are in an oligosaccharide?

A

<20

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13
Q
A

Aldehyde

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14
Q

If the carbonyl group is at the end/beginning of the carbon chain it is?

A

An aldehyde
**more reactive

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15
Q
A

Ketone

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16
Q

If the carbonyl group is on an internal Carbon it is?

A

A ketone

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17
Q

What is Tautomerization?

A

Random binding and releasing of the aldehyde and hydroxyl group in the carbohydrate ring

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18
Q

What do reducing sugars consist of?

A

All Monosaccharides
Disaccharides: Lactose, Maltose

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19
Q

What is glycogen?

A

The storage form of glucose in our bodies

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20
Q

What does the Hexose monophosphate shunt produce?

A

Oxidation of glucose to ribose
+ CO2
+ NADPH

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21
Q

What is glycogenesis

A

Formation of glycogen for energy storage

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22
Q

What is glycogenolysis

A

Destruction of glycogen for energy usage

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23
Q

What is gluconeogenesis

A

Formation of glucose from non-carbohydrate sources

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24
Q

What is glycolysis

A

Destruction of glucose into pyruvate or lactate

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25
Q

Where is insulin released from?

A

Pancreatic B cells
*Islets of Langerhans

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26
Q

Where is glucagon released from?

A

Pancreatic A cells
*Islets of Langerhans

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27
Q

What does Insulin do?

A

Increase Glycolysis
Increase glycogenesis
Increase lipogenesis

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28
Q

What does Glucagon do?

A

Increase glycogenolysis
Increase gluconeogenesis
Increase lipolysis

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29
Q

What does somatostatin do?

A

Inhibits secretion of glucagon and insulin

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30
Q

What is Type 1 diabetes?

A

Cell-mediated autoimmune response which destroys Beta cells of the pancreas

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31
Q

Risk factors that can increase the likelihood of getting Type 2 diabetes?

A

Age
Obesity
Calorie and animal rich diet
Lack of activity

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32
Q

What is the happening in Type 2 diabetes?

A

Beta cells are producing insulin but the peripheral cells are insensitive to it

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33
Q

The 3 P diabetes symptoms

A

Polyuria
Polydipsia
Polyphagia

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34
Q

Diabetes Diagnostic Criteria

A

Fasting Blood sugar >126
Random Blood sugar >200
2 hour OGTT >200
HbA1c >6.5

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35
Q

What do we access to see if Diabetes has caused renal damage?

A

Microalbumin

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36
Q

Long term consequences of diabetes

A

Renal Damage
Cardiac Damage
Retinal Damage
Diabetic foot ulcers

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37
Q

Gestational diabetes symptoms

A

Fasting blood sugar >92
1 hour glucose >180
2 hour glucose >153

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38
Q

Hypoglycemia criteria

A

Adults <60
Infants <45

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39
Q

What is it called when our body releases an excess of insulin after a carbohydrate meal?

A

Postprandial hypoglycemia

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40
Q

What is Whipple’s Triad

A
  1. Documentation of hypoglycemia when symptomatic
  2. Signs & symptoms of hypoglycemia
  3. Alleviation of symptoms after ingestion of glucose
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41
Q

What are the adrenergic symptoms of hypoglycemia?

A
  1. sweating
  2. shaking
  3. nervousness
  4. feeling of impending doom
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42
Q

What is the reference range for glucose?

A

70-100

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43
Q

Critical levels for glucose

A

<40 drain damage
>450 diabetic coma

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44
Q

What is Type 1 glycogen storage disease?

A

von Gierke Disease
**problem with the final stage of glycolysis

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45
Q

What is Type 2 glycogen storage disease?

A

Pompe Disease
**GAA deficiency; can’t break down glycogen

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46
Q

What is Type 3 glycogen storage disease?

A

Cori Disease
**creates structurally abnormal glycogen

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47
Q

What is Type 4 glycogen storage disease?

A

Anderson Disease
**glycogen branching enzyme deficiency

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48
Q

What can lead to irreversible mental retardation, cataracts, and eventually blindness?

A

Galactosemia

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49
Q

Lab findings for Galactosemia

A
  1. hypoglycemia
  2. hyperbilirubinemia
  3. accumulation of glycogen
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50
Q

Common enzyme deficiency in Galactosemia

A

galactose-1-phosphate uridyltransferase

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51
Q

What is von Gierke Disease deficient in?

A

G6P

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52
Q

Most is the most common enzyme deficiency worldwide?

A

G6PD deficiency
*von Gierke Disease

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53
Q

What is the consequence of Type 1 von Gierke disease?

A

Glycogenolysis can’t occur which can result in hypoglycemia
*glycogen can’t turn into glucose

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54
Q

What is Type 2 Pompe disease deficient in?

A

Lysosomal deficiency

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55
Q

What is Type 2 Pompe disease also known as?

A

Acid Maltase Deficiency

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56
Q

What is the result of Type 2 Pompe disease?

A

cardiac failure
death usually before age 2

57
Q

What happens in Type 3 Cori disease?

A

There is an inability to breakdown glycosidic (1,6) bonds

58
Q

What are the consequences of Type 3 Cori disease?

A

Cardiomyopathy
hepatomegaly
hypoglycemia

59
Q

What is Type 3 Cori disease also known as

A

Glycogen debranching enzyme deficiency

60
Q

What is the result of Type 4 Andersen disease?

A

failure to thrive in early infancy
hepatosplenomegaly

61
Q

What happens in Type 4 Andersen disease?

A

There is an inability to form glycosidic (1,6) bonds

62
Q

What is Type 4 Andersen disease also known as?

A

Glycogen branching enzyme deficiency

63
Q

What is more expensive than glucose oxidase but more accurate?

A

Hexokinase

64
Q

Hexokinase catalyzes what in the presence of Mg?

A

G-6-P formation

65
Q

Hexokinsase secondary reaction is catalyzed by?

A

glucose-6-phosphate dehydrogenase

66
Q

What are the medically important ketones?

A

beta-hydroxybutyrate
acetone
acetoacetic acid

67
Q

The most common ketone?

A

beta-hydroxybutyrate

68
Q

What can stop ketone formation?

A

Very low levels of insulin

69
Q

Interferences of Lactate?

A

Bilirubin >274
Hemolysis >5.0
Lipemia
Ascorbate >568

70
Q

What should CSF glucose be at?

A

2/3 the plasma glucose

71
Q

What is the renal threshold for glucose?

A

180 mg/dL

72
Q

What does high insulin and low glucose indicate?

A

Hyperinsulinemia
*insulin-secreting tumor
*exogenous insulin admin

73
Q

What does high insulin and high glucose indicate?

A

Type 2 diabetes
Insulin insensitivity

74
Q

What does low insulin and high glucose indicate?

A

Type 1 diabetes

75
Q

What does low insulin and low glucose indicate?

A

Starvation
*increase in glucagon

76
Q

What is created in a 1:1 ratio with insulin?

A

C-Peptide

77
Q

What are ketones produced from?

A

Breakdown of fats in the liver

78
Q

What does A1c test measure?

A

non-enzymatic glycosylation of hemoglobin

79
Q

What hormones are released when blood glucose levels drop?

A

cortisol
epinephrine
glucagon
growth hormone

80
Q

Lipids serve as?

A

Energy storage
Membrane structure
Cell signaling molecules

81
Q

Clinically significant lipids

A
  1. Glycerol esters
  2. Sphingosine derivatives
  3. Terpenes
82
Q

What are glycerol esters?

A

Triglycerides
Phospholipids

83
Q

What are the Sphingosine derivatives?

A

Sphinghomyelin
Glycosphingolipids

84
Q

What are the Terpenes

A

Vitamins:
A
E
K

85
Q

What do chylomicrons do?

A

Transport dietary fatty acids, cholesterol, and monoglycerides to the liver from the small intestine.

86
Q

What has the highest percent of lipids of any lipoprotein molecule?

A

Chylomicron

87
Q

What does lipase do?

A

Cuts off lipid residues from glycerol backbone

88
Q

What is a monoglyceride?

A

1 fatty acid + glycerol backbone

89
Q

What is a diglyceride?

A

2 fatty acids + glycerol backbone

90
Q

What is a triglyceride?

A

3 fatty acids + glycerol backbone

91
Q

What is a saturated fatty acid?

A

Alkyl chain WITHOUT a double bond

92
Q

What is an unsaturated fatty acid?

A

alkul chain WITH a double bond

93
Q

Clinically significant sterols?

A

Cholesterol
Steroid hormones
Bile acids
Vitamin D

94
Q

What is the smallest lipoprotein?

A

albumin/fatty acid

95
Q

What is the largest lipoprotein?

A

chylomicron

96
Q

Apolipoproteins on chylomicrons

A

A-I
A-II
A-III
B-48
C-I
C-II
C-III
E

97
Q

What is the source of chylomicrons?

A

intestine

98
Q

What is the source of albumin/fatty acid?

A

adipose tissue

99
Q

What is the source of VLDL?

A

liver

100
Q

Apolipoproteins on VLDL?

A

B-100
C-I
C-II
C-III

101
Q

Apoplipoproteins on IDL?

A

B-100

102
Q

What is the source of IDL?

A

VLDL

103
Q

What is the source of LDL?

A

IDL

104
Q

Apolipoproteins on LDL?

A

B-100

105
Q

Source of HDL?

A

Liver

106
Q

Apolipoproteins on HDL?

A

A-I
A-II
A-III
C-I
C-II
C-III
E

107
Q

What apolipoproteins get lipids into the blood?

A

A-I
A-II

108
Q

What apolipoproteins get fats from intestine to the liver?

A

B-48

109
Q

What apo gets fats from periphery and deposits them in blood vessels, liver, and muscles?

A

B-100

110
Q

What apo are involved in the endogenous cholesterol pathway?

A

C-I
C-II
C-III

111
Q

What apo is involved with the exogenous cholesterol pathway and the exit of fats from our body?

A

E

112
Q

What lipoprotein is used to maintain equilibrium of cholesterol?

A

HDL

113
Q

What can cause Xanthomas?

A

Primary hypercholesterolemia

114
Q

Causes of secondary hypercholesterolemia?

A

Hypothyroidism
Diabetes
Nephrotic syndrome
Bile duct obstruction
Postmenopause

115
Q

Causes of hypocholesterolemia

A

Hyperthyroidism
Hepatic failure
Malnutrition/anemia
Starvation

116
Q

What is a significant risk factor for CAD?

A

Lipoprotein (a)

117
Q

CAD risk factors

A

smoking
BP > 140/90
HDL <40
Family history
Age men > 45
women >55

118
Q

What is atherosclerosis?

A

hardening of the arteries

119
Q

What is deficient in Gauchers disease?

A

Glucocerebrosidase

120
Q

What happens in Gauchers disease?

A

Fat collects in the spleen, liver, kidneys, lungs, brains, and bone marrow

121
Q

Symptoms of Gauchers disease

A

Splenomegaly
anemia
thrombocytopenia
occasionally seizures

122
Q

What disease causes this cell?

A

Gauchers Disease

123
Q

Characteristic of Niemann-Pick Disease

A

cherry-red spot on retina

124
Q

Sphingomyelinase deficiency causes?

A

Niemann-Pick disease

125
Q

Symptoms of Niemann-Pick disease

A

accumulation of lipids in:
liver
spleen
bone marrow
lungs
brain

126
Q

Neurological complications of Niemann-Pick disease

A

Ataxia
eye paralysis
brain degeneration
hypersensitivity to touch

127
Q

What does Alpha galactosidase A deficiency cause?

A

Fabry disease

128
Q

Fabry disease deposits fat where?

A

autonomic nervous system
eyes
kidneys
cardiovascular system

129
Q

What lipid storage disease is X linked and primarily affects males?

A

Fabry Disease

130
Q

What stores fats in nervous tissues?

A

Tay-Sachs disease

131
Q

Tay-Sachs disease is deficient in?

A

Hexoseaminidase

132
Q

Symptoms of Tay-Sachs

A

progressive loss of mentation
dementia
sensorineural hearing loss
blindness
cherry spot on macula

133
Q

Total Cholesterol equation

A

LDL + HDL + (triglycerides/5)

134
Q

LDL equation

A

Total cholesterol - [HDL+(trig/5)]

135
Q

Reference range for Total Cholesterol

A

140-200

136
Q

RR for HDL

A

40-75

137
Q

RR for LDL

A

50-130

138
Q

RR for Triglycerides

A

60-150

Clinical Chem (5 decks)

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