Clinical Chem 3&quot;

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問題一覧

What process breaks down glycogen during starvation when there is not enough glucose for metabolism?

Glycogenolysis

Hormone that regulates insulin and glucagon

Somatostatin

Hormones that are produced in the pancreas in regulation to glucose metabolism

Insulin, Glucagon, Somatostatin

Cortisol is a hyperglycemic hormone produced in the

Adrenal cortex

Epinephrine is a hyperglycemic hormone produced in the

Adrenal medulla

Hyperglycemic hormone that are produced in the Anterior Pituitary

ACTH, GH

Thyroxine is a hypoglycemic hormone produced in the thyroid; hPL is a hyperglycemic hormone produced in the placenta

Only the second statement is true

A hypoglycemic disorder that occurs after 10 hours without food; secondary to hyperinsulinism, hormonal deficiencies, genetic disorders, autoimmunity or drug-induced

Post-absorptive/Fasting

A hypoglycemic disorder that occurs usually within 4 hours after eating a meal

Post-prandial/Alimentary/Reactive

Symptoms of hypoglycemia begins to appear at

pgL of 52 mg/dL

Indicated by dizziness, tingling, blurred vision, behavioral changes, seizure, and coma

Post-absorptive/Fasting

Indicative of tremulousness, palpitations, anxiety, diaphoresis, hunger, and paresthesias

Post-prandial/Alimentary/Reactive

Panic value for Hypoglycemia

< or = 40mg/dL

Whipples triad of hypoglycemia

Symptoms of hypoglycemia, Low plasma glucose level, Relief of symptoms with correction of hypoglycemia

Diagnostic criteria for Insulinoma

Greater than or equal to 25mg/dL glucose level change

C-peptide is a marker for Type 2 Diabetes

False

Most abundant ketone form in the body

B-hydroxybutyrate

Beta cell destruction leading to absolute insulin deficiency

Type 1 DM

Insulin resistant with progressive insulin deficiency

Type 2 DM

Type 3a/3.1 DM

Genetic defects of beta cell function

Type 3b/3.2 DM

Genetic defects in insulin action

Type 3c/3.3 DM

Diseases of the exocrine pancreas

Type 3d/3.4 DM

Endocrinopathies

Type 3e/3.5 DM

Drug or chemical-induced

Type 3f/3.6 DM

Infections

Type 3g/3.7 DM

Uncommon forms of immune-mediated diabetes

Type 3h/3.8 DM

Other genetic syndromes

This type may convert to type 2 DM in 30-40% of cases within 10 years due to metabolic and hormonal changes

Type 4

Age of onset is childhood/juvenile; <10% of total frequency

Type 1

Acute complication/s of Type 1 DM I. DKA II. Neuropathy III. Nephropathy IV. Hyperglycemic hyperosmolar non-ketotic coma HHNC

I only

Insulin, pro insulin, C-peptide and b-hydroxybutyrate corresponds to diagnosing Insulinoma in which all are increased, except?

b-hydroxybutyrate

Risk factor for Type 1 DM includes the genetic predisposition of the

HLA-DR3/DR4

Hypertension is a risk factor for Type 2 DM

True

This may require insulin injection

Type 2

Acute complication/s of Type 2 DM I. DKA II. Neuropathy III. Nephropathy IV. Hyperglycemic hyperosmolar non-ketotic coma HHNC

IV only

Panic value for hyperglycemia

>/= 500 mg/dL

Symptoms of DM I. Polyuria II. Polydypsia III. Polyphagia IV. Pruritus V. Poor wound healing

I, II, III, IV, V

Long term microvascular complications of DM I. Nephropathy II. Neuropathy III. Retinopathy IV. CAD V. CVA

I, II, III

Long term macrovascular complications of DM I. Nephropathy II. Neuropathy III. Retinopathy IV. CAD V. CVA

IV, V

Adult age of 45 and above is subjected to screening ____ for diagnosis of DM; while individuals with >/= 1 risk factor is _____

every 3 years; annually

Impaired Fasting plasma glucose level

100-125 mg/dL

Specimen for HbA1c determination

EDTA whole blood

6% HbA1c level is considered

Pre-diabetes

All nondiabetic pregnant women should be screened for GDM at

late 2nd to early 3rd trimester

In One-Step Method for diagnosing GDM, what is the minimum value of test result/s to meet or exceed in order for a GDM diagnosis?

One only

In Two-Step Method for diagnosing GDM, what is the minimum value of test result/s to meet or exceed in order for a GDM diagnosis?

glucose is

10-15% lower in WB

Glycosylated hemoglobin is___

irreversibly attached to one or both N-terminal valines of the beta-chains

Primarily represents glycosylated albumin

Fructuosamine

ADA glycemic goal for HbA1c

<7%

Poor control for HbA1c

>12%

Fructosamine is unreliable when albumin level is

</=3 g/dL

Reference range for fructosamine

205-285 umol/L

Early indicator of diabetic nephropathy

Microalbuminuria

All are used for monitoring glycemic control except?

None of the choices

If specimen is delayed for glucose measurement, use NaF/Iodoacetate or SST to prevent glycolysis

True

Rate of glycolysis if specimen is delayed for glucose determination

7 mg/dL per h (RT) ; 2 mg/dL per h (4°C)

Effect of dextrose contamination

10% contamination with 5% dextrose = increase PG of 500 mg/dL

Chemical methods for glucose measurement I. Glucose oxidase II. Ferric reduction III. Hexokinase IV. Copper reduction V. Condensation VI. Glucose dehydrogenase

II, IV, V

Enzymatic methods for glucose measurement I. Glucose oxidase II. Ferric reduction III. Hexokinase IV. Copper reduction V. Condensation VI. Glucose dehydrogenase

I, III, VI

Limitations of Copper reduction method I. Specific II. Non-specific III. Subject to false increase result due to presence of other reducing agent

II, III

Folin - Wu method

Cu+phosphomolybdic acid - - - >phosphomolybdenum

Nelson-Somogyi method

Cu+arsenomolybdic acid - - >arsenomolybdenun

Neocuprione method

Cu+ neocuprione - - - >Cu-neocrupione complex

Phosphomolybdenum is characteristically

Blue

Arsenomolybdenum is characteristically

Blue

Neocuprione complex is characteristically

Yellow-orange

Reducing agent in Ferric Reduction

Glucose

Ferricyanide is characteristically

Yellow-orange

Ferrocyanide is characteristically

Colorless

glucose + o-toluidine ——> schiff's base

Dubowski mtd

The Dubowski method is more specific than Copper Reduction

True

Schiff's base

Green

Converts a-D-glucose to b-D-glucose

Mutarolase

In the initial reaction of glucose oxidase method for glucose determination, b-D-glucose is oxides to gluconic acid in the presence of?

Glucose oxidase

Chromogens in the POD-coupled/Trinder reaction I. H2O2 II. 4-aminophenazole III. 4-aminoantipyrine IV. Quinoneimine

II, III

Color of quinoneimine

Red/red purple

Polaropgraphic determination for Glucose oxidase method requires addition of _________ to prevent reformation of oxygen

molybdate and iodide or catalase and ethanol

Reference method for glucose measurement

Hexokinase

This may be used to enable colorimetric spectrophotometric measurement in the glucose dehydrogenase method of glucose measurement

Tetrazolium dye

NADH + tetrazolium dye ——> NAD + formazan blue Tetrazolium dye is subsequently converted to formazan blue in the presence of

Diaphorase

Enzyme/s involved in galactose metabolism I. Galactose-1-phosphate uridyl transfers (GALT) II. Galaktokinase (GALK) III. Uridine diphosphate galactose-4-epimerase (GALE)

I, II, III

Manifestation of Hepatic glycogenoses

Hepatomegaly

Enzyme deficient in GSD Type 0

Glycogen synthase

Enzyme deficient in GSD Type 1a

Glucose-6-phosphatase

Enzyme deficient in GSD Type 1b

Glucose-6-phosphatase translocase

Enzyme deficient in GSD Type II

Lysosomal acid alpha glucosidase

Enzyme deficient in GSD Type IIIa

Glycogen debranching enzyme

Enzyme deficient in GSD Type IIIb

Glycogen debranching enzyme

Enzyme deficient in GSD Type IV

Glycogen branching enzyme

Enzyme deficient in GSD Type V

Phosphorylase

Enzyme deficient in GSD Type VI

Glycogen phosphorylase

Enzyme deficient in GSD Type VII

Phosphofructokinase

Enzyme deficient in GSD Type IX

Phosphorylase kinase

Enzyme deficient in GSD Type IXb

Phosphorylase

Enzyme deficient in GSD Type XI

Glucose transporter 2

Hepatic and Muscle glycogenoses includes

Cori-Forbes and Type IXb

Muscle glycogenoses includes

Mc Ardle and Tarui

Hepatic glycogenoses includes

von Gierke disease, Pompe, Andersen, Her's, Fanconi-Bickel

100

GSD Type IIIa

Cori-Forbes

Microbiology

Microbiology

Clinical Chem part 1

Clinical Chem part 1

Clinical Chem part 2

Clinical Chem part 2

CC part 4

CC part 4