DIABETES LAB WORK-UP (CARBOHYDRATES)

Question 1

Anabolic hormone

Answer 1

Insulin

Question 2

Glucagon is stimulated by:

Answer 2

Cortisol
AA
Exercise
Infection

Question 3

Epinephrine ____ glucose level

Answer 3

Increase

Question 4

activate adenylate cyclase

Answer 4

Epinephrine

Question 5

Inhibits lipogenesis, glycogenesis

Answer 5

GH/ACTH

Question 6

accelerate degradation of insulin

Answer 6

Thyroid hormone

Question 7

Defect: Muscle phosphorylase

Answer 7

V (McArdle disease)

Question 8

Defect: Phosphofructokinase

Answer 8

VII (Tarui disease)

Question 9

Phosphoglycerate kinase

Answer 9

Phosphoglycerate kinase deficiency

Question 10

Phosphoglycerate mutase M subunit

Answer 10

Phosphoglycerate mutase deficiency

Question 11

Lysosomal acid alpha glucosidase (GAA) (acid maltase)

Answer 11

II/Pompe disease

Question 12

standard clinical specimen

Answer 12

plasma (glucose)

Question 13

appropriate if separated from cells within 30 minutes

Answer 13

serum (glucose)

Question 14

levels are generally lower than plasma glucose levels by 10-15%

Answer 14

whole blood (HbA1c)

Question 15

Whole blood (HbA1c) percentage varies

Answer 15

1. Hematocrit
2. Analysis technique
3. Sample timing

Question 16

Ways to slow down glycolysis:

Answer 16

1. add an enzyme inhibitor (sodium fluoride / lithium iodoacetate)
2. cooling of blood sample
3. serum separation

Question 17

Screening test for hyperglycemia and hypoglycemia:

Answer 17

Random blood sugar (RBS)

Question 18

Criteria for hypoglycemia in adults

Answer 18

<55 mg/dl (3.0 mmol/L)

Question 19

Criteria for hypoglycemia in infants:

Answer 19

<50 mg/dL (2.8 mmol)

Question 20

American Diabetes Associations recommendation for

hyperglycemia:

Answer 20

If RBS is >160 mg/dL

Question 21

gold standard for DM diagnosis

Answer 21

FBS

Question 22

Normal values:

Answer 22

< 100 mg/dL (<5.6 mmol/L)

Question 23

Diabetes mellitus

Answer 23

≥ 126 mg/dL (7.0 mmol/L)

2 or more occasions

Question 24

Impaired FBS

Answer 24

100-125 mg/dL (5.6-6.9 mg/dL)

Question 25

standardized glucose test

Answer 25

Oral glucose tolerance test

Question 26

not recommended for routine clinical use

Answer 26

Oral glucose tolerance test

Question 27

sensitive but not specific

Answer 27

Oral glucose tolerance test

Question 28

Normal value for Oral Glucose Challenge | Test (OGCT)

Answer 28

< 140 mg/dL

Question 29

If >140 mg/dL

Answer 29

proceed with OGTT

Question 30

Risk factors for GDM:

Answer 30

1. Previous pregnancy with GDM 2. LGA >8.8 lbs (4 kg) 3. Overweight (BMI = >30) 4. <25 years old

Question 31

Patients given 3 days 150 gram/day CHO diet

Answer 31

Preparatory phase

Question 32

What to avoid:

Answer 32

1. inactivity 2. illness/infection 3. coffee/tea/alcohol 4. smoking 5. drugs: * salicylates * diuretics * anticonvulsants * oral contraceptives

Question 33

dextrose/glucose

Answer 33

100-300 mL

Question 34

adult/non-pregnant

Answer 34

75 gm

Question 35

pregnant

Answer 35

100 gm/75 gm

Question 36

children

Answer 36

1.75 gm/kg BW

Question 37

time period:

Answer 37

7-9 am

Question 38

baseline glucose after ________ of rest

Answer 38

30 minutes

Question 39

glucose load ingestion within _________

Answer 39

5 minutes

Question 40

impaired fasting glucose

Answer 40

FBS: 100-125 mg/dL

Question 41

impaired glucose tolerance

Answer 41

2 hr – 140-199 mg/dL (7.8-11.0 mmol/L)

Question 42

diabetes FPG

Answer 42

≥ 126 mg/dL (≥ 7.0 mmol/L)

Question 43

diabetes 2 hr

Answer 43

≥ 200 mg/dL (≥ 11.1 mmol/L)

Question 44

FPG (NIH consensus)

Answer 44

> 95 mg/dL (5.3 mmol/L)

Question 45

1 hr (NIH consensus)

Answer 45

> 180 mg/dL (10.0 mmol/L)

Question 46

2 hr (NIH consensus)

Answer 46

> 155 mg/dL (8.6 mmol/L)

Question 47

3 hr (NIH consensus)

Answer 47

> 140 mg/dL (7.8 mmol/L)

Question 48

2 or more abnormal values for GDM performed after OGCT

Answer 48

(two step method)

Question 49

FPG (IADPSG consensus)

Answer 49

> 92 mg/dL (5.1 mmol/L)

Question 50

1 hr (IADPSG consensus)

Answer 50

> 180 mg/dL (10.0 mmol/L)

Question 51

2 hr (IADPSG consensus)

Answer 51

> 153 mg/dL (8.5 mmol/L)

Question 52

one step method

Answer 52

75 gm OGTT

Question 53

screen and diagnose DM

Answer 53

2-hour postprandial glucose

Question 54

monitor glucose control

Answer 54

2-hour postprandial glucose

Question 55

performed following a meal

Answer 55

2-hour postprandial glucose

Question 56

maximum glucose values

Answer 56

60-90 mins after load

Question 57

2-hour postprandial glucose for adults

Answer 57

≤ 140 mg/dL (7.8 mmol/L)

Question 58

2-hour postprandial glucose for pregnant adults

Answer 58

100-129 mg/dL (5.6 mmol/L)

Question 59

Limitations for 2-hour postprandial glucose:

Answer 59

1. Carbohydrate load 2. Patient preparation 3. Intercurrent infection 4. Age of patient

Question 60

3-6% of total hemoglobin

Answer 60

Hemoglobin A1c

Question 61

increases 1-4 weeks after ↑ in blood glucose

Answer 61

Hemoglobin A1c

Question 62

HBA1C represents average blood glucose past ________.

Answer 62

2-4 months

Question 63

monitor patient compliance

Answer 63

Hemoglobin A1c

Question 64

differentiate short term stress related GT abnormality from DM

Answer 64

Hemoglobin A1c

Question 65

Normal

Answer 65

<5.7%

Question 66

Prediabetes

Answer 66

5.7 – 6.4%

Question 67

Diabetes

Answer 67

> 6.4%

Question 68

Good glycemic control

Answer 68

< 7.0%

Question 69

Source or error:

Answer 69

RBC survival

Question 70

Decrease values:

Answer 70

Hemolytic anemia | Phlebotomy pregnancy

Question 71

Increase values:

Answer 71

G6PD | Glycogen storage disease