Carbohydrate Part 2

MAHATHIR ALPHA · 55問 · 2年前

通報

問題一覧

What is the reference value for serum/plasma in Laboratory testing?

74-106 mg/dL

How will it be collected for laboratory testing?

Fasting, random, after a meal

Where do we collect and contain the blood for glucose determination?

Fluoride (Grey top tube)

Why do we contain the blood in the Grey top tube for glucose determination?

Because fluoride inhibits glycolysis

What are the specimens used in the laboratory testing of Carbohydrates?

Whole blood, Serum, Plasma

What is the difference between the result gained from whole blood than the result obtained from serum and plasma?

Results are 11% lower than plasma/serum.

What are other specimen type for the laboratory testing of carbohydrates?

CSF specimens, 24-hour urine

Why is random urine no longer being used in diagnosis?

Because it is not as accurate as the blood tests.

When there is a decreased in the CSF glucose value and increased in WBC, it suggest what condition?

Bactetial meningitis

What are the different methods used for Glucose monitoring?

Chemical method, Condensation method, Enzymatic method

It is an enzyme that will catalyze the reaction of glucose to gluconic acid, with the formation of hydrogen peroxide as a by-product.

Glucose oxidase

It is an enzyme that catalyzes the phosphorylation of glucose.

Hoxokinase

What are the two methods under Enzymatic method?

Glucose oxidase, Hoxokinase

Explain the advantage and disadvantage of Glucose oxidase methodology.

Procedure is good for blood and CSF specimens, but urine has too many interfering substances.

Give the advantage and disadvantage of Hoxokinase method.

Method can be very accurate and precise since the coupling reaction is specific, but it can be time consuming for routine use.

It is the most frequently ordered "screening" test for glucose metabolism.

Fasting blood sugar (FBS)

It is no longer recommended by the new ADA guidelines and is used to screen for gestational diabetes.

Oral glucose tolerance test (GTT)

It is produced by the liver metabolism by products of fatty acids.

Ketones

Why is maintaining blood glucose within normal range important?

It is essential because many cells and tissues depend, largely or entirely, on glucose to meet their ATP demands.

Why is the metabolic pathway Gluconeogenesis important?

•It ensures the maintenance of appropriate blood glucose levels when the liver glycogen is almost depleted, and no carbohydrates are ingested. Maintaining blood glucose within the normal range.

What is the normal range for Blood glucose?

3.3 to 5.5 mmol/L

It occurs in all microorganisms, fungi, plants and animals, and the reactions are essentially the same, leading to the synthesis of one glucose molecule from two pyruvate molecules.

Gluconeogenesis

It is a metabolic pathway that leads to the synthesis of glucose from pyruvate and other non-carbohydrate precursors, even in nonphotosynthetic organisms.

Gluconeogenesis

What is the final product of Anaerobic glycolysis?

Lactate along with the production of 2 ATP molecules.

What is the final product of Aerobic glycolysis?

Pyruvate along with the production of 8 ATP molecules.

The type of glycolysis which occurs when oxygen is plentiful.

Aerobic glycolysis

The type of glycolysis which occurs when oxygen is scarce.

Anaerobic glycolysis

What are the two types of Glycolysis?

Aerobic glycolysis, Anaerobic glycolysis

Where do glycolysis occur?

It occur in the cytoplasm of all cells.

Who described Glycolysis?

Embdem, Meyerhof, Pamas

It can be defined as the sequence of reactions for the breakdown of glucose (6- carbon molecule) to two molecules of pyruvic acid (3-carbon molecule) under aerobic conditions; or lactate under anaerobic conditions along with the production of small amount of energy.

Glycolysis

It is a universal catabolic pathway in the living cells.

Glycolysis

Greek word which means Splitting

Lysis

Greek word which means Sweat

Glykys

How much glycogen can the muscle store before being saturated?

400-500g

It is derived from food and is transported via the blood stream to the peripheral tissues where, under normal circumstances, the hormone insulin enables it to be taken up by the cells and used as an energy source via the glycolysis pathway.

Glucose

What if there is excess glucose after glycogen reserves are saturated?

Excess glucose is converted to fat for longer term storage.

How much glycogen can the liver store?

100g

How is excess glucose stored?

It is initially stored as glycogen in the liver or muscles.

In the process of digestion, it is primarily converted into glucose and stored as glycogen.

Galactose

Why are blood fructose concentrations always low?

Only a small amount of fructose reaches the bloodstream after digestion.

In the process of digestion, It is taken up by the liver and converted to glucose, glycogen and lactate. A fraction may also be oxidized or converted into fatty acids and uric acid.

Fructose

Digestion predominantly occurs in the ________________ with pancreatic amylase hydrolyzing the starch to dextrin and maltose.

Small intestine

What will be removed once in the liver from the blood and converted into other metabolites?

Fructose, Galactose

The digestion process of polysaccharides such as starch will begin in the mouth where it is hydrolyzed by _____________________.

Salivary amylase (Ptyalin)

Where does the digestion process of polysaccharides such as starch begin?

Mouth

It is defined as the process of breaking down large, insoluble molecules of food into smaller, water-soluble molecules which can then be readily absorbed by the body.

Digestion

Explain the process of Digestion.

Digestion works by moving food through the GI tract. Digestion begins in the mouth with chewing and ends in the small intestine. As food passes through the GI tract, it mixes with digestive juices, causing large molecules of food to break down into smaller molecules.

What are the actions/effects of Somatostatin?

•Increase plasma glucose . •Antagonistic to insulin. •Inhibits endocrine hormones including glucagon and growth hormone .

It originates from the delta cells of the islets of Langerhans in the pancreas.

Somatostatin

Where do thyroid hormones originate from?

Thyroid gland

What are the actions/effects of Thyroid hormones?

•Increases absorption of glucose from intestines. •Promotes conversion of liver glycogen to glucose.

What is the advantage of Glycosylated Hemoglobin?

"Time average glucose" not subject to temporary variability due to diet and exercise. Does not require fasting.

It is a long term glycemic control indicator.

Glycosylated Hemoglobin/ Hemoglobin A1c

It assists in the diagnosis of early proteinuria.

Microalbumin

What is the hemoglobin A1C reference range?

4.0 to 6.0%

Explain how is Glycosylated Hemoglobin measured.

It is measured by electrophoresis, enzymatic assays and HPLC.

It is not specific and detects all reducing sugars, used to detect galactosemia in babies and children <3 years old.

Copper reduction clinitest

Lactose malabsorption leads to what?

It often results in diarrhea, cramping, and gas.

What are released from adrenal gland to increase glucose metabolism and inhibit insulin?

Epinephrine, Cortisol, Growth hormone

Glucose intolerance associated with pregnancy’s hormonal and metabolic changes Mothers usually return to normal after pregnancy, but with increased risk for diabetes later on in life. Infants are at increased risk for respiratory complications and hypoglycemia after birth .

Gestational diabetes

Glucose – 6- Phosphatase deficiency

Von Gierke

Non-Insulin dependent diabetes mellitus(NIDDM) falls under what type of diabetes.

Type II Diabetes

1,4-Glucosidase deficiency

Pompe

Muscle phosphorylase

McArdle

It is the most common form of diabetes Demographics.

Non-Insulin dependent diabetes mellitus (NIDDM)

Increased food uptake

Polyphagia

Liver phosphorylase

Hers

Increase thirst

Polydipsia

It is the defect results in failure of hepatic glucose

Fructose -1,6-biphosphate deficiency

Increase urine production at night

Nocturia

It is an autosomal recessive disorder characterized by fructokinase deficiency. Fructokinase catalyzes the conversion of fructose to fructose-1-phosphate.

Fructosuria

Condition wherein plasma levels is > 110 mg/dL

Hyperglycemia

What catalyze the conversion of fructose to fructose-1-phosphate?

Fructokinase

Condition wherein plasma levels is > 180 mg/dL

Glucosuria

Galactose in Blood indicates?

Galactosemia

Medical term for Decreased blood pH

Acidosis

It can lead to mental retardation, cataracts, death check children < 3 yrs for reducing substances.

Galactosemia

What are the symptoms of Hypoglycemia?

Increased hunger, Sweating, Nausea, Vomiting, Dizziness, Shaking, Blurring of speech and sight, Mental confusion

Disease triggered by viral illness or environmental factors that destroys beta cells in pancreas.

Pathology

Defect in secretion, production or action or all Autoimmune destruction of islet beta – cells in pancreas Auto-antibodies are present

Absolute Insulin deficiency

It is the condition wheirein plasma glucose level falls below 60 mg/dl.

Hypoglycemia

Insulin dependent diabetes mellitus (IDDM) falls under what type of diabetes

Type 1 diabetes

Treatment for Hypoglycemia

Varies with cause. Generally, hypoglycemia is treated with small, frequent meals, (5-6 / day) low in carbohydrates, high in protein

5-10% of diabetes cases are what?

Insulin dependent diabetes mellitus (IDDM)

May result If the patient’s cells are not able to take in glucose, they may begin to convert fats to fatty acids, which then become keto acids.

Acidosis

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