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carbohydrates Flashcards

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1
Q

All carbohydrates have…

A

C-H-O and aldehyde or ketone group

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2
Q

Reducing sugars

A

Reduce other compounds, useful in copper reaction, Benedict’s reaction

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3
Q

Nonreducing sugars

A

Sucrose

No active ketone or aldehyde group

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4
Q

Monosaccharides

A

Glucose
Fructose
Galactose

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5
Q

Disaccharides

A

Maltose (glu + glu)
Lactose (glu + gal)
Sucrose (fru + glu)

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6
Q

Polysaccharides

A

Starch (broken down by amylase)

Glycogen (glucose-6-phosphatase for breakdown; only created in liver)

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7
Q

What kind of bonds connect simple sugars?

A

Glycoside

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8
Q

glycogen

A

polysaccharide (chains of glucose)

storage form of glucose found in the liver

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9
Q

Glycogenesis

A

Formation of glycogen from glucose

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10
Q

Glycogenolysis

A

Breakdown of glycogen in liver. Glycogen is converted back to glu-6-phos for entry into the glycolytic pathway.

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11
Q

Gluconeogenesis

A

Creation of glucose from amino acids (non-carb sources). Utilization of amino acids for energy.

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12
Q

Ketone bodies

A

Formed from breakdown of triglycerides.
Brain can use ketone bodies as source of energy.
Very acidic- can cause ketoacidosis.

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13
Q

action of insulin

A

allows entry of glucose into cell for utilization. Decreases glucose levels

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14
Q

insulin is made by…

A

beta-cells of islets of Langerhans in pancreas

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15
Q

Insulin causes…

A

glycogenesis, glycolysis, and inhibits glycogenolysis

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16
Q

Insulin is released when…

A

Glucose levels are high

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17
Q

Insulin is secreted as ______ and then cleaved into ______ and _______

A

Proinsulin
Insulin
C-peptide

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18
Q

Glucagon action

A

Increased glucose levels, causes glycogenolysis and gluconeogenesis.

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19
Q

Glucagon released due to….

A

decreased plasma glucose

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20
Q

glucagon released by ….

A

alpha-cells of islets of langerhans (pancreas)

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21
Q

somatostatin action

A

Inhibits insulin, glucagon, growth hormone and other endocrine hormones.
Net effect: increase glucose levels

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22
Q

Somatostatin released by,,,

A

d-cells of islets of langerhans

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23
Q

Pancreatic hormones for glucose regulation

A
  1. Insulin (decrease)
  2. Glucagon (increase)
  3. somatostatin (increase)
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24
Q

growth hormone action regarding glucose

A

Increases glucose by decreasing entry into cell and increasing glycolysis.

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25
Growth hormone released by
pituitary (stimulated by low glu levels)
26
Adrenal hormones that regulate glucose
1. Glucocorticoids | 2. Catecholamines
27
Glucocorticoid action on glucose
Increases glu by decreasing entry into cells | increases gluconeogenesis, glycogenolysis and lipolysis
28
main glucocorticoid
Cortisol
29
Cortisol release controlled by...
ACTH
30
Catecholamines action on glucose
Increase glu by inhibiting insulin, | increasing glycogenolysis
31
Cortisol released by ...
adrenal glands
32
catecholamines released by...
adrenal glands
33
catecholamine released due to ....
stress
34
Thyroid hormone (thyroxin) action on glucose
increases glucose levels by glycogenolysis, gluconeogenesis, intestinal absorption
35
Glucose levels only decreased by this hormone
insulin
36
Type 1 diabetes cause
beta-cell destruction of islet of langerhans, can't produce insulin. Usually damage from autoimmune response. Combo of genes & environment.
37
Type 2 diabetes cause
Resistance to insulin and insulin secretory defect | Genetics + age + lifestyle
38
Most NIDDM meds work to:
help body use insulin, make insulin receptors more sensitive to the insulin the body produces
39
Impaired glucose tolerance
"gray zone," prediabetic. glucose levels between normal & diabetic.
40
IDDM
Insulin dependend DM (type 1)
41
NIDDM
Non-insulin dependent DM (type 2)
42
DKA
diabetic ketoacidosis
43
Gestational diabetes is:
any degree of glucose intolerance with onset during pregnancy due to hormones and metabolic changes
44
Neonatal complications from Gestational diabetes:
respiratory distress, hypocalcemia, hyperbilirubinemia, hypoglycemia (from fetal insulin secretion and overabundance of maternal glucose)
45
ketoacidosis
usually seen in Type 1 diabetes, metabolic acidosis
46
Mechanism of ketoacidosis
Acetoacetate, acetone & beta-hydroxybutyric acid produced from fatty acids, cause decrease in pH.
47
Signs & symptoms of DKA
patient will breathe deeply or hyperventilate to blow off CO2, increased serum and urine osmolality, electrolyte imbalance (increased K+)
48
Hypoglycemia
Decreased glucose levels, nonspecific term. Observable signs will appear around 50 to 55 mg/dL. symptoms: lightheadedness, dizziness, loss of consciousness
49
When do we use Whipple's Triad?
When a pt with diabetes presents with possible hypoglycemia
50
What 3 things are in Whipple's triad?
1. symptoms of hypoglycemia 2. glucose concentration is low at the time of symptoms 3. symptoms resolve when the glucose level is corrected
51
postparandial syndrome
hypoglycemic symptoms that occur after eating without actually being hypoglycemic (>55 mg/dL)
52
Insulinoma
beta-cell tumor | leads to increased insulin production and decreased glucose levels
53
Glycogen storage diseases
Deficiency of enzyme(s) that alters glucose metabolism. More than 1 enzyme can be deficient, usually only one is. Congenital disorder. Example- von Gierke disease: pt lacking G6. decreased glucose, metabolic acidosis, ketones, increased lactate. Need liver transplant. Also see increased lipids and abnormal response to epinephrine in these patients.
54
Galactosemia
Congenital disorder. Lack of enzymes in galactose pathway. Increased serum galactose and decreased glucose. Screen for in newborns. Causes failure to thrive, need diet modifications to treat.
55
Normal serum glucose range
70-100 mg/dL
56
Normal CSF glucose
40-70 mg/dL
57
best sample for serum glucose testing
``` sodium fluoride (gray top) tube stops glycolysis, can store sample ```
58
Copper reduction test
Benedict's reaction. In an alkaline medium, cupric ions change to cuprous ions, forming a red precipitate. Measures reducing substances.
59
Glucose oxidase test
Double enzyme reaction; more interferences than hexokinase Glu --(glu oxidase)--> gluconic acid + H2O2 H2O2 --(peroidase)--> color formation, H2O + O2
60
Hexokinase reaction
Reference method, coupled enzymatic reaction glu --(hexokinase)--> Glu-6-phosphate glu-6-phos --(G6PD)--> 6-phosphogluconate + NAPDH
61
Normal 2 hour OGTT
<140 mg/dL
62
increased risk 2 hour OGTT
140-199 mg/dL
63
abnormal OGTT 2 hour
200 or above
64
OGTT for pregnant women screen
24-28 weeks of pregnancy 50 gram glucose load, test at 1 hour cutoff= 140 mg/dL
65
complete OGTT for pregnant women
If screening >140 mg/dL 100 gram load, 3 hour test (draw at fasting, 1, 2 and 3 hours). If over level at any draw can diagnose as GDM. Cutoff = 140 or above
66
New 2-hour OGTT for pregnant women ranges
(75 gram load; not a national standard) 0-hour: 92 or above 1-hour: 180 or above 2-hour: 153 or above
67
fasting glucose normal
<100 mg/dL
68
Fasting glucose increased risk (impaired/prediabetic)
100 to 125 mg/dl
69
fasting glucose abnormal
126 or above (diagnostic for DM)
70
Random/casual abnormal glucose level
200 or above, diagnostic for DM
71
2 HRPP
2-hour post parandial | not standardized, carb load unknown, pt drawn 2 hours after eating
72
A1C test methods
HPLC, electrophoresis, ion exchange, immunoassay
73
What can interfere with A1C results?
abnormal hemoglobin, hematologic disorders
74
A1C normal range
<5.7% (equal to or less than 5.6%)
75
A1C impaired range
5.7-6.4%
76
A1C for DM Dx
6.5% or above
77
In A1C, glucose reacts with amino group of Hgb to form ____
ketoamine
78
Diabetes diagnosis criteria:
Results proven on subsequent day with any of the 4: 1) fasting plasma glucose 126 mg/dL or above 2) Random plasma glucose 200 or above with diabetic symptoms 3) 2 hour plasma glucose >200 mg/dL during OGTT using 75 g glucose load 4) Hgb A1C 6.5% or greater
79
Urine albumin test
small albumin filtration as nephropathy begins. Can't be caught with normal dipstick (not sensitive enough. Run in conjunction with A1C.
80
Urine albumin test method
nephelometry
81
fructosamine
back up test to A1C if that cannot be used Glycation of amines on proteins, similar to A1C but protein turnover 1-3 weeks
82
LTT
Lactose tolerance test; test for lactase deficiency. 50 grams of lactose given to fasting pt, glucose concentrations measured to test for lactase activity. Historical test- replaced with other tests for lactose intolerance.
83
XTT
Xylose tolerance test. 5 carbon sugar not normally found in blood. Used to evaluate intestinal malabsorption (ex Sprue). Xylose given, then urine and serum xylose levels measured
84
Lactate
Used to test anaerobic metabolism, tissue oxygenation, ketoacidosis, and (mostly) sepsis
85
Autoimmune tests for DM
islet cell Abs (B-cells in pancrease. Cause of Type 1?) insulin antibodies others
86
C-peptide
Used for evaluating hypoglycemia. Helps diagnose B-cell tumors and assess B-cell activity

Chem (Clinicals) (4 decks)

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