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CCHM LAB (2) > Glucose > Flashcards

Glucose Flashcards

(89 cards)

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1
Q

Specimen Collection and Storage: normal hematocrit

A

whole blood glucose is 10-12% lower than plasma glucose

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2
Q

Specimen Collection and Storage: Capillary blood glucose

A

2-5 mg/dl higher than venous blood

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3
Q

Possible samples glucose method

A

Serum
CSF
Whole Blood
Synovial Fluid
Urine

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4
Q

Standard specimen glucose method

A

Fasting venous sample

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5
Q

Specimen Consideration

A

Uncentrifuged coagulated blood

Prolonged standing: 7 mg/dL per hour (RT)

Separated nonhemolyzed sterile serum

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6
Q

Specimen consideration: Uncentrifuged coagulated blood

A

Lower 5-7 % in 1 hour

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7
Q

Specimen Consideration: Prolonged
standing

A
  • 7 mg/dL per hour (RT)
  • 40C - 1-2 mg/dL per hour
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8
Q

Specimen Consideration: Separated nonhemolyzed sterile serum (25oC)

A

8 hrs

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9
Q

Specimen Consideration: Separated nonhemolyzed sterile serum (40oC)

A

72 hrs

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10
Q

CHOICE OF SAMPLE:

A

Serum should be separated from the clot within 0.5 to 1 hour

NaF: 2mg/ml of blood or iodoacetate

NaF - 2 mg for up to 48 hrs

Binds with Ca and Mg

inhibition of enolase

Precautions in sample collection to prevent glucose utilization by leukocytes (WBC)

RBC have all the enzymes necessary to metabolize glucose

The sample should be kept cool

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11
Q

Other samples for glucose testing urine sample reagent

A

5 mL glacial acetic acid
5g sodium benzoate (24 hr specimen)
Chlorhexedine
0.1% sodium nitrate w/ 0.01% benzethonium chloride

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12
Q

Tests for Glucose
Measurement

A

Random Blood Sugar
Fasting Blood Sugar (FBS)
Two-hour post prandial test (PPBS)
Glucose Tolerance Test
Oral glucose tolerance test

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13
Q

Requested during insulin shock and hyperglycemic ketonic coma.

A

Random blood sugar

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14
Q

The test should be performed after an 8 hour fast

A

Fasting blood sugar

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15
Q

The test is performed two hours after meal

A

2 hrs post prandial test

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16
Q

Used to determine how well the body metabolizes glucose over a required period of time

A

Glucose tolerance test

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17
Q

Used for diagnosis of gestational diabetes

A

Glucose tolerance test

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18
Q

Glucose tolerance test is used to diagnose

A

Gestational diabetes

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19
Q

Not generally recommended for routine clinical use for diagnosis of DM

A

Glucose tolerance test

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20
Q

Kinds of Glucose Tolerance
Tests

A

Oral Glucose Tolerance Test

Intravenous Glucose Tolerance Test

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21
Q

Oral glucose tolerance test 2 types

A

Janney-isaacson method
Exton rose method

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22
Q

Most common single dose method oral glucose tolerance test

A

Janney-isaacson method

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23
Q

Divided oral dose or double dose method oral glucose tolerance test

A

Exton rose method

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24
Q

Janney-isaacson method AKA

A

Single dose method

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25
Exton rose method AKA
Divided oral dose Double dose method
26
Used for DM patients with gastrointestinal disorders
Intravenous glucose tolerance test
27
Intravenous glucose tolerance test used for dm patient with
Gastrointestinal disorder
28
Intravenous glucose tolerance test body weight
0.5 g of glucose/kg of body weight
29
Oral glucose tolerance test Requirements:
• Patient must be ambulatory • Patient to be tested should ingest at least 150 g of CHO 3 days prior to testing • Patient should not eat food, drink tea, coffee or alcohol, vigorously exercise, or smoke cigarettes during the test • Patient must fast the night before the testing is performed
30
Procedure for OGTT
Collect the fasting blood sample Instruct the patient to drink the glucose load Collect blood sample after 1°, 2° and 3°
31
Categories of Oral Glucose Tolerance
Normal glucose tolerance Impaired glucose tolerance Provisional diabetes diagnosis
32
Normal glucose tolerance value
2-h PG < 140 mg/dl
33
Impaired glucose tolerance value
2-h PG 140-199 mg/dl
34
Provisional diabetes diagnosis value
2-h PG > 200 mg/dl
35
If the 1 hour postload glucose level is 140 mg/dL (7.8 mmol/L), a complete _______ three-hour oral glucose tolerance test should be performed
100g
36
TEST USED TO DIAGNOSE GESTATIONAL DIABETES a _______ oral glucose load is recommended as basis of initial diagnosis.
50 g
37
CRITERIA USED TO DIAGNOSE DIABETES: FBS level that is greater than or equal to ____________ (7.0 mmol/L) on at least 2 occasions
126 mg/dL
38
CRITERIA USED TO DIAGNOSE DIABETES : Two-hour postprandial glucose greater than __________ (7.8 mmol/L).
140 mg/dL
39
CRITERIA USED TO DIAGNOSE DIABETES: Symptoms of hyperglycemia which include
polyuria (increased urine) , polyphagia (extreme hunger), polydipsia (extreme thirst)
40
CRITERIA USED TO DIAGNOSE DIABETES: A two-hour postload glucose of _______________ in an OGTT.
200 mg/dL or greater than
41
CRITERIA USED TO DIAGNOSE DIABETES : HbA1C of _________ or equal to 6.5%
greater than or equal to 6.5%
42
CRITERIA USED TO DIAGNOSE DIABETES
FBS is greater than (126mg/dl) 2 hour postprandial is greater than (140mg/dl) Symptoms of hyperglycemia 2 hour postload glucose 200mg/dl HbA1C is greater than or equal 6.5%
43
Monitoring Test for Diabetes Mellitus
Glycosylated hemoglobin Fructosamine
44
Determined for DM once in 3 months
Glycosylated hemoglobin
45
ideal HbA1C valu
<7%
46
Factors affecting HBA1c
• Average glucose concentration • RBC life span
47
Hemoglobinopathies, increased red cell turnover
pregnancy recent blood loss transfusion erythropoietin therapy/hemolysis
48
Laboratory Testing of HbA1c: Specimen requirement
Ethylenediaminetetraacetid acid whole blood samples (hemolysate)
49
2 Categories of HbA1c
Charge difference Structural characteristics of glycogroups on hemoglobin
50
Categories under Charge differences
cation exchange chromatography, electrophoresis, isoelectric focusing
51
preferred method for HbA1c
Affinity chromatography
52
HbA1c attaches to the ________ group of the resin and is selectively eluted from the resin bed using a buffe
boronate group
53
HbA1c attaches to the boronate group of the_______ and is selectively eluted from the resin bed using a buffe
resin
54
Point of care HbA1c
latex immunoagglutination inhibition methodology
55
Monitor test for DM Once in 3 weeks
Fructosamine
56
Affected by albumin levels or hypoalbuminemia
• Liver disease • Malabsorption • Burns • Nephrotic syndrome
57
Glucometer aka
Point of care blood glucose meter
58
Glucometer factor
1.11 concentration
59
Glucometer reaction
Glucose oxidase/peroxidase chromogen reaction
60
Glucometer factor
1.11 concentration
61
Factors affecting accuracy and reproducibility: glucometer
User variability Hematocrit → the presence of anemia (false increase); polycythemia (false decrease) Defective reagent strips and instrument malfunction Other variables: altitude, temperature, humidity, hypotension, hypoxia, high triglyceride concentrations
62
Ketones specimen
Fresh serum/urine
63
Ketones method or test used
Gerhardt’s test
64
Copper Reduction Methods
Folin wu method Nelson-somogyi method Neocupreine method Benedict’s method/fehlings method
65
Method that uses PMA
Folin wu method
66
Accurate but labor intensive and difficult to automate
Nelson-somogyi method
67
Cu+ reduces AMA to molybdenum blue
Nelson-somogyi method
68
Cu + neocupreine → yellow to yellow orange
Neocupreine method
69
Inverse colorimetry method
Ferric reduction (hagedorn jensen)
70
Ferric reduction Yellow → colorless measured at
400nm
71
Most sensitive method glucose
Dubowski method - o-toluidine method
72
Uses acetic acid
Dubowski method
73
Dubowski method that is used but carcinogenic and poisonous
O-toluidine
74
Wavelengths used dubowski method
630nm
75
Method that very specific to a substrate
Enzymatic method
76
first enzymatic reaction used
Glucose oxidase method
77
H2O2 measurement:
Trinders method Peroxidase method
78
O2 is measured by:
Clark electrode Ortho-dianisidine method
79
Disadvantage of Glucose Oxidase Reaction
Glucose oxidase can only measure beta glucose
80
2 types of glucose
Alpha glucose Beta glucose
81
Type of glucose 35% cannot be oxidized
Alpha glucose
82
Type of glucose 65% the only type which can be oxidized
Beta glucose
83
Generally accepted method for measuring glucose
Hexokinase method
84
Uses alkaline ferricyanide reagent
Autoanalyzer method
85
Gave falsely high results because several compounds in serum alse were oxidized by ferricyanide
Ferricyanide method
86
Ferricyanide method wavelength
400 nm
87
Used in establishing correct insulin amount for next dose
Dextrostics
88
Widely used as a method of screening for hypoglycemia of the newborn
Dextrostic
89
Employs a paper strip impregnated with an enzyme-chromogen system
Dextrostic

CCHM LAB (2) (5 decks)

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