1. Decreased blood glucose 2. Observable Symptoms: Neurogenic and Neuroglycopenic 3. Elevated symptoms after glucose administration.

Carbohydrates Flashcards by Gilbert Villegas

Carbohydrates are hydrates of ___________ and __________.

Aldehydes

Ketones

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Major food source of the human body.

Carbohydrates

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Major organ that controls CHO metabolism

Pancreas

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________ and _______ are the major hormones that regulate CHO metabolism.

Insulin

Glucagon

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Major organ consumer of CHO

Brain

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____ of body’s glucose are consumed predominantly by the Brain

2/3

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CHO are stored primarily as _______ and _______ glycogen.

Liver and Muscle

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Simplest CHO

Glycol Aldehyde (2-hydroxyethanal)

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Most common Monosaccharide

Glucose - Blood Sugar (Dextrose)

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Only KETOSE group of monosaccharide sugars

Fructose - Fruit/Semen Sugar

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Give their other names of Disaccharides:

Maltose
Sucrose
Lactose

Maltose - Beer Sugar
Sucrose - Table Sugar
Lactose - Milk Sugar

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Give their components of Disaccharides:

Maltose
Sucrose
Lactose

Maltose - Glucose + Glucose
Sucrose - Glucose + Fructose
Lactose - Glucose + Galactose

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Only non-reducing sugar

Sucrose

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Most common polysaccharide

Starch (plants)

Glycogen (Animals)

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CHO Digestion and Absorption

FOOD - MOUTH —–salivary amylase—– OLIGOSACCHARIDES —— STOMACH ——inactivates amylase —— SMALL INTESTINES —–pancreatic amylase —— DISACCHARIDES —– brush border enzymes (maltase) ——- MONOSACCHARIDE —– MICROVILLI —– SGLT 1/GLUT 5/GLUT 2 —– LIVER (hepatic vein) —– stores as glycogen/circulate in blood —– BLOOD —– ENERGY

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Pancreas is Endocrine - secretes _________, _________, _________.
Pancreas is Exocrine - secretes __________.

Pancreas is Endocrine - secretes INSULIN, GLUCAGON, SOMATOSTATIN

Pancreas is Exocrine - secrets AMS

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Hyperglycemic Pathways

Gluconeogenesis
Glycogenolysis
Lipolysis

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Hypoglycemic Pathway

Insulin

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Islets of Langerhans have ______ different type of cells.

Four (4)
Beta-cells
Alpha-cells
Delta-cells
F-cells

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Blood Glucose Pattern after a meal:

30 mins:
1 hr:
2 hrs:
4 hrs:

30 mins: fastest rise
1 hr: Peak
2 hrs: Normal
4 hrs: Reactive Hypoglycemia/Alimentary

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Glucose normalizes within ______ hours after a meal

2-3 hrs

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Whipple’s Triad

Decreased blood glucose
Observable Symptoms: Neurogenic and Neuroglycopenic
Elevated symptoms after glucose administration.

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Hypoglycemia can be classified as __________ and ____________.

Post-absorptive (fasting) Hypoglycemia

Post-prandial (reactive) Hypoglycemia

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Hyperglycemia

Increase ________, _____, _____ in Urine
Electrolyte Imbalance: Low - ___, ____ ; High - _____

Hyperglycemic State

Increase Glucose, Ketones, SG in Urine
Electrolyte Imbalance: Low - Na, pH, HCO3 ; High - K

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_________ known as deep respiration that occurs in normally sleeping or comatose px.

Kussmaul's Respiration

______________ is a group of metabolic diseases characterized by HYPERglycemia resulting from the defects in insulin _______ and ______, or both.

DM is a group of metabolic diseases characterized by HYPERglycemia resulting from the defects in insulin SECRETION and ACTION, or both.

Diagnostic Criteria for DM: FBS: > 126 mg/dL RBS: > _______ 2hr PP: > _______ Hba1c: > 6.5%

Diagnostic Criteria for DM: FBS: > 126 mg/dL RBS: > 200 mg/dL 2hr PP: > 200 mg/dL Hba1c: > 6.5%

Type I DM vs. Type II DM ``` Pathogenesis: Onset: Symptoms: Incidence: Ketosis: Autoantibodies: C-peptide Test: Dependence: ```

Type I ``` Pathogenesis: Autoimmune B-cell destruction Onset: Juvenile Symptoms: Abrupt Incidence: 5-10% Ketosis: Ketosis prone (common) Autoantibodies: Positive C-peptide Test: Undetectable/Decrease Dependence: Insulin Dependent ``` Type II ``` Pathogenesis: Insulin receptor resistance Onset: Adult Symptoms: Gradual Incidence: 90-95% (Most common) Ketosis: Ketosis resistant (rare) Autoantibodies: Negative C-peptide Test: Detectable/Increase Dependence: Insulin Independent ```

Gestational Diabetes Mellitus is a degree of glucose tolerance with onset of first recognition during ________.

Pregnancy

GDM maybe gone after delivery but may return after ____ years in some cases.

10 years

According to AMA, all adults older than 45 y.o. should have measurement of FBS every __ years.

3 years

PREFFERED test for diagnosing DM is _________.

FBS

Renal Threshold

160-180 mg/dL

CSF Glucose

60-70%

Blood should be separated within ___ mins - __ hour, due to _______ by blood cells.

30 mins - 1 hr Loss of glucose Rationale: This is to prevent loss of glucose by blood cells

_______ is used as an anticoagulant and preservative for glucose id analysis is delayed.

Sodium Fluoride Rationale: Fluoride is antiglycolytic

Standard Specimen for Glucose Determination

Fasting venous plasma

Fasting blood sugar should be ______, but not greater than ______

8-10 hrs, but not > than 16 hrs.

At room temperature, glucose decreases at a rate of _______

7 mg/dL

At ref (4C) glucose decreases approximately to ______

2 mg/dL

Recall: 10% contamination with 5% dextrose will increase glucose by ________

500 mg/dl

Whole blood is lower than ______ glucose level than serum or plasma

10-15%

_________ tests to differentiate Type I DM to Type II, evaluates for Hypoglycemia and this is a biproduct from pro-insulin to insulin.

C-peptide (Directly proportional to Insulin Lvl)

C-peptide conversion factor

0.333

C-peptide to Insulin Ratio

>5-15:1

Screening time for GDM

24th - 28th week of pregnancy

Procedure in OGTT 1. Collect _______ 2. Drink Glucose Load (____) 3. Collect blood after ____, _____.

Procedure in OGTT 1. Collect fasting blood (baseline) 2. Drink Glucose Load (75g) 3. Collect blood after 1 hr, 2 hrs.

Glucose load by WHO standard Adults Kids Obese

Adult: 75g Kids: 1.75g/kg Obese: 100g

Guideline for OGTT 1. Should consume normal to high CHO intake (________) for __ days. 2. Fasting: _____ 3. Should be tested in the ______ due to diurnal variation. 4. Patient should be ______. 5. Test is terminated if FBS is _______. 6. Glucose load for adults is ____ and should drink within __ minutes.

1. Should consume normal to high CHO intake (150g/day) for 3 days. 2. Fasting: 8-10 hrs 3. Should be tested in the MORNING due to diurnal variation. 4. Patient should be AMBULATORY. 5. Test is terminated if FBS is >140 mg/dl. 6. Glucose load for adults is 75g and should drink within 5 minutes.

Recalls (Sept, 19). BMI Obese: Overweight:

Recalls (Sept, 19) BMI Obese: >30 Overweight: 25-29.9

Arterial/Capillary whole blood is higher in venous blood approximately _____.

7 mg/dL

Equilibrium for Plasma and CSF Glucose

1 hr

For every 100 mg/dl rise of Serum glucose, sodium decreases by _______.

1.6 mmol/L

For every 1% change in HbA1c, there is an increase of _____ in plasma glucose.

35 mg/dl

Time intake for GTT OGTT - ______ IVGTT - ______

OGTT - 5 mins | IVGTT - 3 mins

Average fasting for plasma glucose

10 hrs

_____ is requested during emergency, insulin shock, hyperglycemic ketonic coma

RBS

Measure overall glucose hemostasis

FBS

Determine ho well the body metabolizes glucose

OGTT

HbA1c vs. Fructosamine Test ``` Other Names: Monitoring: Reflects: Tested every: Specimen: ```

HbA1c ``` Other Names: Glycated Hb Monitoring: Long Term Reflects: 2-4 months previously Tested every: 3-6 MONTHS Specimen: EDTA Whole Blood ``` Fructosamine ``` Other Names: Glycated albumin Monitoring: Short Term Reflects: Tested every: 3-6 WEEKS Specimen: Serum ```

________ utilizes reducing property of glucose in a HOT ALKALINE SOLN.

Alkaline Copper Reduction

______ and _____ that contain alkaline of cupric ions stabilized by Citrate and Tartrate.

Benedict's (Citrate) and Fehling's (Tartrate)

_________ uses INVERSE colorimetry which reduces YELLOW to COLORLESS ferricyanide by glucose.

Alkaline Ferric Reduction - Hagedorn Jensen

Glucose Oxidase only measure ________ specifically

B- D glucose

_______ used to facilitate conversion of a- D glucose to b- D glucose

Mutaratose

Reference Method in Glucose

Hexokinase Method

Most specific reagent in Hexokinase Method

G6PD

Self-Monitoring of Blood Glucose Type 1: Monitored ____/day Type 2: ________

Type 1: Monitored 3-4x/day | Type 2: Frequency is unknown

GSD: Viagra Pills Causes A Muscle Hardening Tight when Fucked! ``` Type 1 a - Von Gierki; _________ Type 2 - Pompei; ________ Type 3a - _______; _______ Type 4 - ______; Brancher Type 5 - Mcardle; _______ Type 6 - ______ Disease; _____ Phosphorylase Type 7 - Tarui; ______ Type 11 - __________; _______ ```

``` Type 1 a - Von Gierki; G-6 Phosphate Type 2 - Pompei; 1,4 Glucosidase Type 3a - Cori Forbes; De Brancher Type 4 - Andersen; Brancher Type 5 - Mcardle; Muscle Phosphorylase Type 6 - Hers Disease; Liver Phosphorylase Type 7 - Tarui; Phosphofructokinase Type 11 - Fanconi Bickel; Glucose transporter ```

GSD that affects; Muscle - __, __ Liver - __, __, __, __, __, __

Muscle: 5 & 7 Liver: 0. 1, 3, 4, 6, 9

GSD that both affects the Muscle and Liver

Type 3a | Type 9b

Carbohydrates Flashcards

(71 cards)