Glucose Lecture

Question 1

Ketones

Answer 1

by products of fats that are used to make energy instead of glucose

Question 2

Ketoacidosis

Answer 2

when the body has a pH less than 7.35 due to the abundance of ketones

Question 3

ketoniemia

Answer 3

ketones present in the blood

Question 4

Ketonuria

Answer 4

ketones in the urine

Question 5

OGTT

Answer 5

oral glucose tolerance test

Question 6

GDM

Answer 6

gestational diabetes mellatius

Question 7

Carbohydrates

Answer 7

carbon, hydrogen, oxygen w/ either an aldehyde or ketone configuration
major energy supply
monosaccharides- glucose, fructose, galactos
disaccharides - sucrose (glucose & fructose), lactose (glucose & galactose), maltose (2 glucose)
polysaccharides- glycogen, starch

Question 8

Amylase

Answer 8

gland in saliva that helps break down starches

stomach acids denature the salivary enzymes

Question 9

Metabolism of CHO

Answer 9

begins w/ salivary amylase -> stomach acids -> disaccharides in the intestines (lactase, maltase, sucrase bc GI only absorbs monosaccharides) -> monos absorbed-> glucose stored in fat cells or utilized in other cells

Question 10

Glucose pathways

Answer 10

glucose-6-phosphate :
embden-myerhof pathway (glycolysis)
hexose monophosphate pathway
convert moiety to glycogen

Question 11

Glycogenesis

Answer 11

conversion of glucose to glycogen

Question 12

Glycogenolysis

Answer 12

conversion of glycogen to glucose

Question 13

Gluconeogensis

Answer 13

glucose from non-CHO sources : amino acids etc

Question 14

Glycolysis

Answer 14

breakdown of glucose to pyruvate or lactate

Question 15

Glucose clinical reference

Answer 15

ranges : ~80-100 mg/dL
>125 mg/dL during fasting -> suspect diabetes
hemolyzed specimen can alter lab results

Question 16

insulin

Answer 16

decreases blood glucose (hypoglycemic agent) via aiding in the uptake of glucose into the cells

Question 17

glucagon

Answer 17

increases blood glucose (hyperglycemic agent)

uses glycogenolysis & gluconeogenesis to increase blood glucose levels

Question 18

Epinephrine effect on blood glucose

Answer 18

glucose will increase

Question 19

glucocorticoids (cortisol) effect on blood glucose

Answer 19

stimulates gluconeogenesis particularly to increase blood glucose levels
cortisol breaks down protein so the amino acids will be converted to glucose

Question 20

growth hormone effect on blood glucose

Answer 20

pituitary hormones

increases blood glucose

Question 21

ACTH effect on blood glucose

Answer 21

pituitary hormone

stimulates cortisol release (increases)

Question 22

Thyroxine (T4) effect on blood glucose

Answer 22

increases blood glucose

can speed up metabolism & a loss of T4 can decrease metabolism & can also aid in absorption of glucose in GI tract

Question 23

Somatostatin effect on blood glucose

Answer 23

can influence growth hormone (ergo increase blood glucose); also known as IGF
protein produced from the liver

Question 24

Insulin-dependent diabetes mellitus

Answer 24

insulin deficiency, often autoimmune destruction of beta cells of pancreas
affects about 10% of diabetic population

Question 25

chronic disease effects of diabetes

Answer 25

eyes- retinopathy: optic nerve is especially susceptible to excess glucose kidneys- renal disease & nephropathy blood vessels - peripheral neuropathy ketoacidosis- not enough insulin to utilize glucose & cells start to break down fats

Question 26

general diabetic symptoms

Answer 26

``` polydipsia - thirst polyphagia- increased food consumption polyuria - increased urine production rapid weight loss hyperventilation mental confusion ( brain is only getting ketones) ```

Question 27

Lab testing for diabetes

Answer 27

``` fasting glucose >100 mg/dL urine sp. gravity serum & urine osmolalities ketones present blood & urine pH from ketoacidosis electrolyte imbalance hemoglobin A1c ```

Question 28

Diabetes type 2

Answer 28

non-insulin dependent diabetes mellitus may be obesity related affects 90% of diabetic population often lack of adequate insulin-receptors on cells or lack of adequate insulin synthesis

Question 29

Glucose analyzer methods

Answer 29

2 major reactions B-D-glucose + O2 -(glucose oxidase)-> D-glucono-&-lactone ---> gluconic acid + H2O2 use perxoide produced in 2nd reaction: H2O2 + chromogen --(peroxidase)-->ox-chromogen +H2O2

Question 30

glucose peroxidase

Answer 30

enzyme used in 1st reaction for glucose analyzing | specifically breaks down specifically beta-D glucose

Question 31

Perioxidase enzyme

Answer 31

used in many reactions although many things can inhibit the reactions

Question 32

Hexokinase method for analyzing glucose

Answer 32

glucose + ATP --(hexokinase enzyme)--> Gluc-6-PO4 + ADP Gluc-6-PO4 + NADP --(G-6-PD enzyme)--> 6-phosgluc + NADPH + H+ most often method used on automated systems amount of product formed NADPH relates to the amount of glucose in patietn sample this reaction doesn't differentiate between beta & alpha glucose orientations

Question 33

Poloragraphic glucose analyzer method

Answer 33

electrode method that measures O2 consumption by using reaction : B-D glucose + O2 --(glucose oxidase)--> D-glucono-&-lactone --> gluconic acid + H2O2 eliminates H2O2

Question 34

Renal glucose limits

Answer 34

>180 mg/dL in blood glucose will show up in the urine

Question 35

testing for suspected diabetics

Answer 35

symptoms + random glucose >200 mg/dL fasting glucose >126 mg/dL oral glucose tolerance test (OGTT) - where 75g glucose given & wait 2 hours to draw blood-> if value is >200 mg/dL is diabetic (if ~180 mg/dL impaired function not completely diabetic) must have 2 positive on separate days to diagnose

Question 36

Hemoglobin A1c

Answer 36

will show glucose control over the last 2 -3 months based on RBC survival of 120 days >5.5-6% are out of control 6-7% are acceptable when monitoring diabetics normal is <5.5% glucose attachment to the RBC

Question 37

Monitoring diabetics

Answer 37

monitor for ketoacidosis, acute illness, stress, pregnancy, glucose >300 mg/dL microalbumin

Question 38

Microalbumin

Answer 38

increases in urine when kidney glomerulus is damaged chronic diabetic: 30-299 mg/24hr or albumin/creatinine ratio of 30-300 ug/ml creatine may see microalbumin increases w/ exercise, infection, fever, increased BP, increased glucose, congestive heart

Question 39

macroalbuminemia

Answer 39

seen when >300 mg/24 hr or >300 ug/mg creatinine

Question 40

Hypoglycemia

Answer 40

<60 mg/dL blood glucose | may be due to insulin producing tumor or medications

Question 41

inborn errors of metabolism leading to hypoglycemia

Answer 41

galactosemia fructosuria von Gierke's

Question 42

Galactosemia

Answer 42

inborn error of metabolism that may lead to hypoglycemia | decreased galactose-1-phosphatase & cannot utilize galatose as effectively

Question 43

Fructosuria

Answer 43

inborn error of metabolism that may lead to hypoglycemia -'fructose in the urine' decreased fructo-1-phophatase adolase

Question 44

Von Gierke's

Answer 44

inborn error of metabolism that may lead to hypoglycemia - affects children glycogen builds up in the liver decreased glucose-6-phosphatase : liver enzyme used for moving glycogen-glucose into the blood

Question 45

hellloo

Answer 45

meow