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Clinical Chemistry 1 > 8. Carbohydrates > Flashcards

8. Carbohydrates Flashcards

1
Q

Which ketone body is not measured using routine urinalysis reagent strips?

A

Beta-hydroxybutyric acid (BHB)

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2
Q

What is glycolysis

A

Conversion of glucose to pyruvate/lactate

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3
Q

What reagent is used to detect ketones?

A

Sodium nitroprusside

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4
Q

What is gluconeogenesis

A

Production of glucose from non-carbohydrate sources (glycerol, FAs, AAs)

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5
Q

What is acetest

A

Semi-quantitative test that determines ketones in urine and serum

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6
Q

What happens to lyte levels during diabetic ketoacidosis?

A

Na+ and K+ are usually decreased due to polyuria and excretion of salts of the acids produced by the utilization of lipids for energy

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7
Q

Why should grey top tubes be cautiously used for other tests?

A

Enzymes inhibited by additives in it

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8
Q

Equation for calculated osmolality?

A

2*(Na+) + BUN + glucose

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9
Q

What is glycogenesis

A

Formation of glycogen from glucose

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10
Q

What does acetest detect? Doesn’t detect?

A

Detects: acetoacetate, lesser extent acetone

Does NOT detect BHB

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11
Q

Clinical significance of elevated HgbA1C?

A

Indicates poor glucose control over the past 6-12 weeks

Values >= 7 mmol/L = poor diabetic control

Therapeutic goal is <6.5%

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12
Q

What would cause an elevated anion gap in a ketoacidosis patient?

A

Increased ketones (unmeasured anion)

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13
Q

Source of cortisol?

A

Adrenal cortex

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14
Q

What is glycogenolysis

A

Breakdown of glycogen to G6P to enter glycolysis cycle

Production of glucose from glycogen

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15
Q

2 enzymatic methods for glucose determination

A
  • Glucose oxidase

- Hexokinase

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16
Q

Equation for osmolar gap?

A

Osmolar gap = measured osmol - calculated osmol

17
Q

What are the most common causes of hypoglycemia?

A
  • inappropriate insulin production
  • insulin injection
  • ingestion of oral hypoglycemic agents
18
Q

Source of epinephrine?

A

Adrenal medulla

19
Q

4 diagnostic tests to determine enzyme deficiencies in carb malabsorption?

A
  1. BC New Born Screening Program
  2. Confirmatory tests
  3. Tolerance testing
  4. Genetic testing
20
Q

What is microalbuminuria?

A

Excretion of urinary albumin at a rate of 20-200 ug/min or 20-300 mg/24 hr

Highly predictive of diabetic nephropathy in type 1 diabetes

21
Q

5 hormones that affect [glucose] and their effect on it

A
  1. Insulin - lowers
  2. Glucagon - increase
  3. Cortisol - increase
  4. Epinephrine - increase
  5. Growth hormone - increase
22
Q

2 additives in grey top tubes and their functions

A

Potassium oxalate - anticoagulant

Sodium fluoride - glycolytic inhibitor

23
Q

How do glucose levels differ in venous and capillary specimens? How do they differ if the patient is fasting?

A

Fasting: all 3 (arterial, capillary, venous) comparable

After meal: venous levels lower than capillary/arterial (common estimate = 10%)

24
Q

When are ketones present in the blood?

A

When there is impaired carb metabolism w/ breakdown of FA:

  • uncontrolled diabetes mellitus
  • starvation
  • vomiting
  • low carb diet
25
Q

Renal threshold?

A

10 mmol/L

26
Q

Hormone that has the greatest effect on increase glucose levels

A

Glucagon

27
Q

What is glycated hemoglobin?

A

Hemoglobin A w/ glucose attached to the beta chains (hemoglobin A1)

28
Q

3 major ketone bodies?

A
  • Acetone
  • Acetoacetic acid
  • Beta-hydroxybutyric acid (BHB)
29
Q

Source of growth hormone?

A

Anterior pituitary

30
Q

Define renal threshold

A

Blood concentration of a substance that can be reabsorbed by the renal tubules

Once blood level > threshold: glucose excreted in urine

31
Q

How is gestational diabetes diagnosed?

A

Screening test = O’Sullivan test

Woman given 50g load og glucose

1 hr plasma glucose >= 7.9 mmol/L = abnormal; risk of fetal death/neonatal complications

32
Q

Most common method for glycated hemoglobin?

A

Affinity chromatography

Glycate Hgb binds to column; non-glycated Hgb do not

33
Q

What specimen is required for glycated hemoglobin?

A

Whole blood

Fasting not required

Clinical Chemistry 1 (13 decks)

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