4. Diagnosis

Almira Coleen · 28問 · 1年前

通報

問題一覧

WB glucose conc. is 11% lower than?

Plasma

Obtain Serum/plasma within?

1 hr

Obtain FPG? in the morning after 8-10 hrs. fasting (not >16 hours)

Fasting Blood Glucose

Obtain FPG? in the morning after how many hrs. of fasting (not >16 hours)

8-10 hours

Nelson Somogyi Hagedorn Jensen Ortho-toluidine (Dubowski)

Non-Enzymatic

Glucose oxidase (Saifer Gernstenfield) Hexokinase (Reference method)

Enzymatic

Copper reduction method Glucose + arsenomolybdic acid → arsenomolybdenum blue

Nelson Somogyi

Ferric reduction method (inverse colorimetry)

Hagedorn Jensen

Condensation of carbo. w/ aromatic amines to Schiff base

Ortho-toluidine (Dubowski)

Glucose + ferricyanide = ?

yellow

Ferrocyanide

colorless

Β-D-glucose + O2 + H2O = ?

Glucose oxidase

H2O2 + reduce chromogen = ?

Peroxidase

Couple reaction is known as

Trinder’s reaction

Trinder's reaction: False ↓ results due to ↑ uric acid, bilirubin & ascorbic acid

True

Glucose + ATP –? 6-PO4 + ADP G6-PO4 + NADP+ –G-6-PD NADPH + H++ 6-phosphogluconate

Hexokinase (reference method)

Measure O2 depletion

O2 consumption electrode (polarographic glucose)

Hexokinase result: False ↓ results due to gross hemolysis and ↑ bilirubin

True

Glucose load (75 g solution) is administered. Blood glucose is determined in the 2nd hr.

Oral Glucose Tolerance Test

Ambulatory and in a normal carbohydrate intake for 3 days Fasting for 8 - 10 hours

Oral Glucose Tolerance Test (OGTT)

Categories of FPG : Normal fasting glucose Impaired fasting glucose 100-125 (5.6-6.9) Provisional diabetes diagnosis ≥126 (≥7.0) Categories of FPG: Normal fasting glucose

70-99 (3.9-5.5)

Categories of FPG: Impaired fasting glucose

100-125 (5.6-6.9)

Categories of FPG: Provisional diabetes diagnosis

≥126 (≥7.0)

Categories of Oral glucose tolerance: Normal glucose tolerance

<140 (<7.8)

Categories of Oral glucose tolerance: Impaired glucose tolerance

140-199 (7.8-11.1)

Categories of Oral glucose tolerance: Provisional diabetes diagnosis

≥200 (≥11.1)

Diagnostic Criteria for Gestational Diabetes: Fasting plasma glucose

≥92 mg/dL

Diagnostic Criteria for Gestational Diabetes: One-hour plasma glucose

≥180 mg/dL

Diagnostic Criteria for Gestational Diabetes: Two-hour plasma glucose

≥153 mg/dL

Index for long term plasma glucose control (2-3 month period)

HbA1C Measurement

Represents glucose attached to the N-terminal valine of the hemoglobin molecule HbA1c measurement is an EDTA whole blood sample. No fasting needed prior to collection. Normal Value: 4 % to 6%

HbA1C

Produced by the liver through metabolism of stored lipid

Ketone

Acetone (2%) Acetoacetic acid(20%) 3-β-hydroxybutyric acid (78%)

Ketones

accumulation of ketones in blood

Ketonemia

accumulation of ketones in urine

Ketonuria

Acetoacetic acid + Ferric chloride → Red color

Gerhardt’s Test

• Acetoacetic acid + Na nitroprusside –alkaline pH = Purple color

Nitroprusside (Acetest tablet & Reagent Strip

Acetoacetic acid + Ferric chloride = ?

Red color

Acetoacetic acid + Na nitroprusside –alkaline pH = ?

Purple color

Acetoacetic acid (pH 7) + NADH + H+ + ←β-HBD→ NAD + β-hydroxybutyric acid (8.5-9.5)

Enzymatic

Early stage diabetic renal nephropathy

Albuminuria

Persistent albuminuria

30-299 mg/24 hr

Albumin-creatinine ratio

30-300 µg/mg

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