Carbs

Question 1

The 4 structural properties to classify carbs:

Answer 1

• Size of base carbon chain
• location of CO function group
• Number of sugar units
• Stereochemistry of the compound

Question 2

Symptoms of diabetes Mellitus

Answer 2

• Polyuria
• Polydipsia
• Unexplained weight loss

Question 3

Diagnostic criteria for diabetes mellitus

Answer 3

1) HbA1c >6.5%
2) Fasting plasma glucose >126 mg/dL
3) 2-h plasma glucose >200 mg/dL
4) Random plasma glucose >200 mg/dL plus symptoms of diabetes

Question 4

D- and L-glucose are ____

Answer 4

Stereoisomers

Question 5

What are the bonds between two monosaccharides?

Answer 5

Glycosidic Linkage

Question 6

What causes hypoglycemia?

Answer 6

Insulin overdose, drugs, alcoholism, inulinemia, galactosemia, glycogen storage diseases

Question 7

Glycolysis

Answer 7

Metabolism of glucose molecule to pyruvate or lactate for production of energy

Glucose —-> CO2 + H2O + ATP

Question 8

Gluconeogenesis

Answer 8

Formation of G6P from non carbohydrate sources

Non-CHO sources —-> glucose

Question 9

Glycogenolysis

Answer 9

Breakdown of glycogen to glucose for use as energy

Glycogen —-> glucose

Question 10

Glycogenesis

Answer 10

Conversion of glucose to glycogen for storage

Glucose —-> glycogen (liver, muscle)

Question 11

Lipogenesis

Answer 11

Conversation of carbohydrates to fatty acids

Question 12

Lipolysis

Answer 12

Decomposition of fat

Question 13

What is the fed state?

Answer 13

Increase in insulin from the pancreatic beta cells (islets of Langerhans). When insulin is increased you have glycogenesis. When insulin is decreased you have glycogenolysis and gluconeogenesis.

Question 14

What happens in the fasting state?

Answer 14

Glucagon from the pancreatic alpha cells are released and glycogen is converted to glucose.

Question 15

What happens during fight or flight?

Answer 15

Similar to glucagon, but epinephrine from the adrenal medulla is released.

Question 16

Where does glycogenolysis and gluconeogenesis occur?

Answer 16

Liver

Question 17

Where does glucose uptake and lipogenesis occur?

Answer 17

Adipose tissue

Question 18

Where foes glucose uptake and glycolysis occur?

Answer 18

Muscle

Question 19

What do alpha pancreatic islet cells do?

Answer 19

Stimulates glucagon which will stimulate glycogenolysis and gluconeogenesis

Question 20

What do beta pancreatic islet cells do?

Answer 20

Stimulates insulin which then stimulates glucose uptake/lipogenesis and glucose uptake/glycolysis. Insulin also inhibits glycogenolysis and gluconeogenesis.

Question 21

Classification of Type 1 diabetes

Answer 21

Type 1a: beta cell destruction from AI process that leads to an absolute insulin deficiency

Type 1b: idiopathic

Question 22

Classification of type 2 diabetes

Answer 22

Insulin resistance in peripheral tissues and an insulin secretory defect of the beta cell. Associated with family history of diabetes, older age, obesity, lack of exercise.

Question 23

Pathogenesis of gestational diabetes

Answer 23

Glucose intolerance during pregnancy diagnosed in the second or third trimester of pregnancy. A frequent but transitory glucose intolerance. Two of the four glucose results need to be abnormal

Question 24

Level 1 glucose alert

Answer 24

Sufficiently low for treatment with fast acting carbohydrate and dose adjustment of glucose lowering therapy

Question 25

Level 2 clinically significant hypoglycemia

Answer 25

Sufficiently low to indicate serious, clinically important hypoglycemia

Question 26

Severe hypoglycemia

Answer 26

Hypoglycemia associated with severe cognitive impairment requiring external assistance for recovery

Question 27

Renal threshold

Answer 27

Proximal convoluted tubule reabsorbs all glucose if <180 mg/dL. The glycolysis results if blood glucose >180 mg/dL

Question 28

Specimens used for glucose determination

Answer 28

WB, Plasma, CSF, Urine

Question 29

What is glycated hgb

Answer 29

Hemoglobin A1C. An irreversible reaction occurring throughout the 120 day life span of an RBC. Gives an idea of average blood sugars over 90 days.

Ref: 3-6% of total hgb

Question 30

For every 1% decrease in HBA1C, it reduces the risk of microvascular complications by ____

Answer 30

35%

Question 31

How do you determine HbA1C for hemolyzed whole blood?

Answer 31

Turbidimetric inhibition immunoassay (TINIA)

Question 32

Approximately how much A1C makes up the estimated average glucose?

Answer 32

36% of the estimated average glucose will be the ICC of HbA1C

Question 33

What is the problem in glycogen storage diseases?

Answer 33

There is a lack of enzymes of glycogen metabolism

Question 34

What is the problem in lactose intolerance?

Answer 34

There is a deficiency in intestinal mucosal lactase. A GTT is done for a baseline and an abnormal result with be a flat curve.

Question 35

Ketones are a result of ____

Answer 35

uncontrolled diabetes mellitus