glucose methodologies Flashcards

1
Q

in a normal hematocrit, whole blood glucose level is ___ % lower than the plasma glucose

A

10-12%

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2
Q

Plasma glucose is __% lower than Serum glucose

A

5%

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3
Q

Capillary blood glucose: ___ higher than venous blood

A

2-5 mg/dL

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4
Q

possible samples we can use to check for glucose level

A

Serum, CSF, Whole Blood, Synovial Fluid, Urine

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5
Q

Standard specimen

A

Fasting Venous Sample

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6
Q

csf sample has how many percent of glucose

A

60%

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7
Q

Uncentrifuged coagulated blood
-can lower the glucose level for how many percent in 1 hr?

A

↓5-7% in 1 hour

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8
Q

Prolonged standing:___ lower
without refrigerator

A

7 mg/dL per hour (RT)

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9
Q

if the sample is refrigerated in 4*C, the glucose level will only lower down for ___ every hhr

A

1-2 mg/dl

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10
Q

Separated nonhemolyzed sterile serum
can last in 25*C for how many hrs?

A

8 hrs

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11
Q

Separated nonhemolyzed sterile serum
can last in 4*C for how many hrs?

A

72 hrs

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12
Q

serum should be separated from the clot within ___

A

.5 to 1 hr

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13
Q

a composition of sodium fluoride or a gray top

A

2mg/ml of blood or iodoacetate

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14
Q

a composition of sodium fluoride or a gray top - 2mg/ml of blood or iodoacetate

functions to __

A

inhibit glycolysis and prevent most glucose consumption by RBC (good for 24 hours up to 48 hrs)

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15
Q

the function of sodium fluoride is the

chelation thus the binding of ca and mg which inhibits ____

A

inhibition of enolase

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16
Q

Precautions in sample collection to prevent glucose utilization by leukocytes (WBC)

true or faslse

A

true

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17
Q

The sample should be kept cool; loss on standing in a warm room maybe as high as ___

A

10 mg/dL (0.6 mmol/L)/ hr

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18
Q

in OGTT, we can use what type of samples>

A

urine and serum

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19
Q

what are the substances we can add in urine to detect glucose?

A

5 mL glacial acetic acid
5g sodium benzoate for 24 hr specimen
Chlorhexedine –inhibit bacterial decomposition
0.1% sodium nitrate w/ 0.01% benzethonium chloride - antibacterial

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20
Q

Requested during insulin shock and hyperglycemic ketonic coma (type 1 DM)

A

Random Blood Sugar

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21
Q

increase glucose plus increase ketone bodies

A

hyperglycemic ketonic coma

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22
Q

The test should be performed after an 8 hour fast

A

Fasting Blood Sugar (FBS)

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23
Q

the most common test for glucose

A

Fasting Blood Sugar (FBS)

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24
Q

Common for detecting diabetes mellitus

A

Fasting Blood Sugar (FBS)

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25
Q

normal fasting glucose level

A

70-99 mg/dl or 3.9-5.5 mmol/L

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26
Q

impaired fasting glucose level

A

100-125 mg/dl or 5.6 - 6.9 mmol/l

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27
Q

impaired fasting glucose level

A

> 126 mg/dl or >7mmol/L

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28
Q

The test is performed two hours after meal

A

Two-hour post prandial test (PPBS)

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29
Q

how well the body will metabolized glucose

A

Two-hour post prandial test (PPBS)

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30
Q

Used to determine how well the body metabolizes glucose over a required period of time

A

Glucose
Tolerance Test/ OGTT

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31
Q

Used for diagnosis of gestational diabetes

A

Glucose
Tolerance Test/ OGTT

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32
Q

Not generally recommended for routine clinical use for diagnosis of DM

A

Glucose
Tolerance Test/ OGTT

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33
Q

the recommended dose for OFTT based from WHO

A

75 mg/dl

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34
Q

2 types of GTT

A

Oral Glucose Tolerance Test
Intravenous Glucose Tolerance Test

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35
Q

the most common oral glucose tolerance test

A

Janney-Isaacson Method (Single Dose Method)

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36
Q

a gtt that are usually for admitted patients

A

Intravenous Glucose Tolerance Test

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37
Q

Used for DM patients with gastrointestinal disorders

A

Intravenous Glucose Tolerance Test

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38
Q

in intravenous glucose tolerance test,
how many gram of glucose are given per kg of body weight?

A

0.5 g

0.5 g of glucose/kg of body weight

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39
Q

an oral glucose tolerance test that is
Divided Oral Dose or Double Dose Method)

A

Exton Rose Method

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40
Q

Requirements for OGTT

A

Patient must be ambulatory

Patient to be tested should ingest at least 150g of CHO 3 days prior to testing

Patient should not eat food, drink tea, coffee or alcohol, vigorously exercise, or smoke cigarettes during the test

Patient must fast the night before the testing is performed

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41
Q

Procedure for OGTT

A

Collect the fasting blood sample
Instruct the patient to drink the glucose load
Collect blood sample after 1˚, 2˚ and 3˚

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42
Q

categories of OGTT

A

NORMAL GLUCOSE TOLERANCE - < 140 mg/dl
IMAPARED GLUCOSE TOLERANCE - 140 - 199
PROVISIONAL DIABETES - > 200

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43
Q

criteria used to diagnose diabetes

A

fbs level
2 hr postprandial
symptoms of hyperglycemia
hbA1c greater than 6.5%

44
Q

FBS level that is greater than or equal to ___ on at least 2 occasions is an indication of diabetes mellitus

A

126 mg/dL (7.0 mmol/L)

45
Q

Two-hour postprandial glucose greater than ___

A

140 mg/dL (7.8 mmol/L).

46
Q

Symptoms of hyperglycemia which include: ___

A

polyuria, polyphagia, polydipsia, unexplained weight loss plus a casual or RBS level of greater than or equal to 200 mg/dL (11.1 mmol/L)

47
Q

A two-hour postload glucose of___ or greater than in an OGTT

A

200 mg/dL

48
Q

HbA1C of greater than or equal to __

A

6.5%

49
Q

a monitoring test for diabetes mellits that is Determined once in 3 months

A

Glycosylated Hemoglobin

50
Q

1% increase in HgbA1C  means

A

35mg/dL (2 mmol/L) change in plasma glucose

51
Q

ideal value for hba1c

A

<7% 

52
Q

Factors affecting HBA1c

A

Average glucose concentration
RBC life span

53
Q

7% in hba1c estimated average glucose

A

154 mg/dl

54
Q

Specimen requirement: for hba1c

A

EDTA whole blood sample - hemolysate

55
Q

hba1 will measure the hemoglobin of our blood for a span of 3 months through the concept of ___ which is about lysing the rbc

A

hemolysate

56
Q

2 Categories of HbA1c

A

Charge differences
Structural characteristics of glycogroups on hemoglobin

57
Q

a category of HbA1C that is about the cation exchange chromatography, electrophoresis,
isoelectric focusing

A

Charge differences

58
Q

a category of HbA1c that is about the affinity
chromatography and immunoassay

A

Structural characteristics of glycogroups on hemoglobin

59
Q

preferred method for hba1c

A

Affinity chromatography

60
Q

HbA1c attaches to the boronate group of the resin and is selectively eluted
from the resin bed using a buffer

A

Affinity chromatography

61
Q

the reference method for hba1c

A

hplc - high performance liquid chromatography

62
Q

HbA1c attaches to the boronate group of the resin and is selectively eluted from the resin bed using a buffer

A

Affinity chromatography

63
Q

a monitoring test for diabetic mellitus that is conducted Once in 3 weeks

A

Fructosamine

64
Q

Fructosamine is also known as

A

Glycosylated albumin

65
Q

Affected by albumin levels

A

hypoalbuminemia > decreased glycated albumin

66
Q

Fructosamine can’t be conducted with patient wth what diseases

A

Liver disease
Malabsorption
Burns
Nephrotic syndrome

67
Q

Glucometer’s principle

A

Glucose oxidase-peroxidase chromogenic reaction

68
Q

factor of glucometer

A

Factor: 1.11

69
Q

Factors affecting accuracy and reproducibility of glucometer

A

User variability

hematocrit
- the presence of anemia (false increase); polycythemia (false decrease

Defective reagent strips and instrument malfunction

Other variables: altitude, temperature, humidity, hypotension, hypoxia, high triglyceride concentrations

70
Q

intermediates of glucose

A

ketones

71
Q

Specimen for ketones

A

fresh serum/urine

72
Q

test for ketone

A

gerhardt’s test

73
Q

end color of gerhardt’s test

A

red solution

74
Q

in ketones

Gerhardt’s Test = _____ + ____ acid –> red solution

A

ferric chloride + acetoacetic

75
Q

Copper Reduction Methods for blood glucose

A

folin wu method
nelson-somogyi method
neocupreine method
benedict’s method/fehling’s reagent

76
Q

a copper reduction method that uses PMA

A

Folin Wu Method

77
Q

a copper reduction method that is Accurate but labor intensive and difficult to automate

A

Nelson-Somogyi Method

78
Q

in Nelson-Somogyi Method, Cu+ reduces AMA to ___

A

molybdenum blue

79
Q

a copper reduction method that will result to a yellow orange end product

A

Neocupreine Method

80
Q

Ferric Reduction is also called as

A

hagedorn jensen

81
Q

Inverse colorimetry

A

ferric reduction

82
Q

Ferric Reduction (Hagedorn Jensen) is from color ___ to ___ at what nm

A

yellow to colorless measured at 400 nm

83
Q

Dubowski Method - ___ method

A

o-toluidine method

84
Q

Most sensitive
method

A

Dubowski Method

85
Q

Uses acetic
acid

A

Dubowski Method – o-toluidine method

86
Q

___ is
carcinogenic
and poisonous

A

O-toluidine

87
Q

Dubowski Method – o-toluidine method is measured at ___

A

630 nm

88
Q

In dubowski method

Glucose + O-toluidine -> ____

A

Glycosylamine (colored green)

89
Q

a method that is very specific to a substrate

A

enzymatic method

90
Q

____ – first enzymatic reaction used

A

Glucose oxidase method

91
Q

H2O2 measurement

A

a. Trinder’s method
b. peroxidase method

92
Q

O2 is measured by:

A

a. Clark electrode
b. Ortho-dianisidine method

93
Q

an O2 method that is initially colorless but when exposed to O2
becomes orange-brow

A

Ortho-dianisidine method

94
Q

Disadvantage of Glucose
Oxidase Reaction

A

Glucose oxidase can only measure beta
glucose

95
Q

2 types of glucose

A

Alpha-glucose
Beta glucose

96
Q

Alpha-glucose
Beta glucose

give the percentage of both

A
  • Alpha-glucose = 35% cannot be oxidized
  • Beta glucose = 65% the only type which
    can be oxidized
97
Q

enzymatic method that can interfere than other methods

A

HEXOKINASE METHOD

98
Q

Generally accepted method for measuring glucose

A

hexokinase method

99
Q

disadvantage of hexokinase method

A

hemolyzed samples can pose problem because contents from
RBCs may interfere with the stoichiometric relationship between glucose and
NAD(P)H accumulation

100
Q

Uses alkaline ferricyanide
reagent

A

Autoanalyzer method

101
Q

Gave falsely high results because
several compounds in serum alse
were oxidized by ferricyanide

A

FERRICYANIDE METHOD

102
Q

FERRICYANIDE METHOD is read at

A

400 nm

103
Q

Cellular Strip

A

Dextrostics

104
Q

Used in establishing correct insulin
amount for next dose

A

dextrostics

105
Q

Widely used as a method of
screening for hypoglycemia of the
newborn

A

dextrostics

106
Q

Employs a paper strip impregnated
with an enzyme-chromogen system

A

dextrostics