Carbohydrates

Question 1

What are carbs?

Answer 1

compounds containing C,H,O
all contain C=O groups and -OH groups

Question 2

What are the 4 classifications of Carbs?

Answer 2

size of base of carbon chain
location of CO functional group
# of sugar units
stereochemistry of compound

Question 3

What are the two forms of carbohydrates?

Answer 3

aldose and ketose -> carb group in the middle ketone

Question 4

What is the primary energy source of the Brain?

Answer 4

Carbs, natural are the best like grains

Question 5

What is the smallest carb?

Answer 5

glyceraldyhede (3 carbs)

Question 6

What is a fisher projection?

Answer 6

aldehyde group at top, straight chain or link for circular function

Question 7

Is a fisher projection more accurate than a Haworth projection?

Answer 7

No, Haworth is more accurate

Question 8

Describe a stereoisomer

Answer 8

same bonds, different spacial arrangement, assigned as D or L by height of highest carbon
D - natural, metabolize
L - version body can’t handle

Question 9

Describe a monosaccharide

Answer 9

simple sugars that can’t be hydrolyzed to simpler forms
(hydrolysis splits sugar via water release
when two carbs join it uses water)

Question 10

What are most common monosaccharides?

Answer 10

Glucose, fructose and galactose

Question 11

T/F: we use D-glucose and need D-galactose to convert to glucose

Answer 11

true

Question 12

Describe Disaccharides
common forms?

Answer 12

two monosaccharide units joined by glycosdic linkage
common forms: maltose/sucrose

Question 13

Describe polysaccharides
Common forms?

Answer 13

formed by linkages of monosaccharides or oligosaccharides (3-10 units)
Common forms: starch (plant) and glycogen (animal)

Question 14

What are some chemical properties of carbs?

Answer 14

some are reducing substances
most commonly are NON reducing - sucrose
can reduce other compounds when oxidized
MONO/DISACCHARIDES ARE REDUCERS

Question 15

Metabolism of glucose and carbs are primary energy source for what? what cannot store carbs?

Answer 15

primary energy source for CNS
Nervous tissues can’t store carbs

Question 16

Describe Glycogen

Answer 16

create or synthesize
increased glucose = don’t need glycogen
usage/storage/can be converted to fats
(glucose energy)

Question 17

T/F Intestinal absorption is via jejunum villi/microvili and increases surface area/energy absorbed

Answer 17

True

Question 18

T/F: Monosaccharides are easier to absorb

Answer 18

true

Question 19

What uses the most glucose, then what else?

Answer 19

brain uses the most glucose, then rbc/wbc, then muscle or its conv to fat cells

Question 20

T/F 3/4th of glucose comes from glycogen stored in the kindey

Answer 20

false, 3/4th glucose comes from glycogen stored in the liver

Question 21

What is glycogenesis

Answer 21

glucose to glycogen (liver/muscle)

Question 22

What is glycogenoisis

Answer 22

glycogen - glucose

Question 23

What is gluconeogenesis

Answer 23

non CHO source (fatty acid) - glucose

Question 24

What is glycolysis

Answer 24

glucose - CO2+H20+ATP

Question 25

What is the renal threshold

Answer 25

proximal convoluted tubule 180mg/dl >180mg spill over into urine

Question 26

What is lipogenesis

Answer 26

carbs - fatty acids

Question 27

What is lipolysis

Answer 27

decomposition of fats

Question 28

Describe the "Fed State" what kind of synthesis what cells uptake of ? increased insulin = decreased insulin =

Answer 28

insulin from pancreatic Beta cells anabolic synthesis Promotes cellular uptake of glucose Increased insulin = lipogenesis glycogenesis Decreased insulin = lipolysis ketone formation gluconeogenesis glucogenosis

Question 29

Describe the "Fasting state"

Answer 29

glucagon release from pancreatic alpha cells catabolic synthesis liver: glycogen - glucose --> blood Muscle: glycogen conv. to G6PO4 in muscle for energy

Question 30

Describe "Fight or flight" state

Answer 30

epinephrine from adrenal medulla action similar to glucagon

Question 31

Action of Hormones: Insulin increases what, decreases

Answer 31

increases : glycogenesis/glycolysis lipogenesis Decrease: glycogenolysis

Question 32

Action of hormones: Glucagon increases what?

Answer 32

increases glycogenolysis gluconeogenesis

Question 33

Describe Hyperglycemia

Answer 33

diabetes mellitus, endocrine disorders, untreated leads to type 2 diabetes (acromegaly, Cushing syndrome) Drugs: anesthetics steroids

Question 34

What are some symptoms of diabetes? Hgb A1C Fasting plasma glucose 2hr plasma glucose random plasma glucose

Answer 34

polyuria polydipsia unexplained weight loss Hbg A1C >6.5% fasting plasma glucose >126 2hr plasma glucose >200 random plasma glucose >200

Question 35

Describe T1D: Type 1A: Type 1B:

Answer 35

Juvenile onset 5-10yrs Type 1A: beta cell destruction by autoimmune absolute insulin decreases pt must take insulin acute onset/days to weeks islet cell Ab Type 1B: Idiopathic adults

Question 36

Describe T2D:

Answer 36

insulin resistant in peripheral tissues, secretory deficiency of B cells variable insulin associated w family hxt >40 obesity/lack of exercise

Question 37

Describe Gestational diabetes:

Answer 37

glucose intolerance during pregnancy in 2/3rd trimester of pregnancy

Question 38

Lab findings of hyperglycemia

Answer 38

decrease or absent insulin increase glucose in plasma/urine increase urine spec. gravity/serum osmolality Ketones in serum/urine decreased blood/urine pH

Question 39

Ref ranges: normal fasting glucose Impaired fasting glucose Provisional diabetes diagnosis

Answer 39

N fasting glucose: 70-99 Impaired fasting: 100-125 Provis diabetes: >126

Question 40

Describe gestational diabetes: 1hr 2hr 3hr

Answer 40

frequent but transitory greater risk of prenatal complication Human placental lactogen >140 on hour after 50g glucose 1hr: >180 2hr: >155 3hr: >140

Question 41

Describe the glucose tolerance test: pt prep

Answer 41

pt prep normal diet 3 days prior no food after reg evening meal on day before blood/urine allow water but not gum

Question 42

describe Hypoglycemia: caused by what disease states?

Answer 42

insulin overdose drugs: sulfon/antihistamines alcoholism insulinoma galactosemia glycogen storage disease

Question 43

Glucose tolerence test Normal 2hr impaired provisional diabetes

Answer 43

2hr <140 impaired 140-199 provisional >200

Question 44

Glucose Tolerence test, describe level 1, 2 and 3

Answer 44

1: glucose alert value <70 2: clinical significance hypoglycemia <54 3: severe hypoglycemia no specific threshold

Question 45

T/F if serum/plasma are not separated from cells, glucose will continue to increase

Answer 45

false, glucose will be used and will cause a false decreased glucose result

Question 46

What is the renal threshold for reabsorbance of glucose what does glycosuria look like?

Answer 46

threshold is <180 glycosuria looks like >180

Question 47

Determination of glucose uses what decrease per hour? what preserves?

Answer 47

whole blood, examples glucose monitors or at home 7% decrease/hr sodium fluoride preserves 24hr at RT

Question 48

T/F lithium iodoacetate preserves glucose with no interference w urease

Answer 48

true

Question 49

T/F plasma and serum are 10-15% higher level than whole blood glucose

Answer 49

true

Question 50

CSF glucose Urine glucose levels

Answer 50

CSF 40-70 Urine <500/24hr

Question 51

Briefly describe these measurements Glucose oxidase glucose hexokinase Clinitst

Answer 51

GO: cheap GHex: we use, end point reaction Clinitst: least specific reducing in urine

Question 52

T/F you usually use glucose to measure/treat diabetes

Answer 52

false

Question 53

Describe Glycated hgb A

Answer 53

non enzymatic process of conversion of HgbA to HgbA1

Question 54

T/F alb can bind to proteins/glucose in cells that get glycolated and stays for whole time of your life

Answer 54

True it tis forever

Question 55

Describe Glycated Hgb

Answer 55

irreversible, reflects glucose levels 4-8wks HgbA1c = 80% total glycogen 3-6% total hgb

Question 56

T/F HgbA1c decrease by 1% = microvascular complications being reduced by 40%

Answer 56

false, reduced by 35%

Question 57

Describe the Roche diagnostics briefly Glycated serum Pt:

Answer 57

automated, doesn't have risk w hgb variants whole blood tests avg blood glucose Glycated serum Pt: alb turn over 2-3 wks fructosanin?

Question 58

Describe carb. inborn errors of metabolism

Answer 58

glycogen storage disorders lack of enzymes increase tissue glycogen limited lifespan

Question 59

Describe lactose intolerence

Answer 59

deficient intestinal mucosal lactase GTT baseline non flat curve (pain)