Flashcards
Glucose
Cards in this deck (47)
- 1What hormones are components of the glucose counter regulatory response system:1. glucagon
2. epinephrine
3. ACTH (cortisol)
4. growth hormone (GH) - 2What is the brain's role in the glucose counter regulatory response:Glucose concentration in ventromedial hypothalamus mediate release of pituitary hormones.
- 3What is the pancreatic islets role in the glucose counter regulatory response:Senses and responds to decreased glucose and regulates insulin and glucagon release appropriately.
- 4What is the liver's role in the glucose counter regulatory response:Responds to hormone signals and alters metabolism
- 5Which rapid acting hormones are released in early phase of hypoglycemia and how do they act:1. glucagon: increases glucose production through stimulation of gluconeogenesis and glycogenolysis in the liver
2. epinephrine:
a. stimulates glycogenolysis in both liver and muscle
b. has some effect on gluconeogenesis in both liver and kidney
c. inhibits peripheral glucose use
d. stimulates lipolysis - 6Which slow acting hormones are released that take effect in 3 to 4 hours after onset of drop in glucose and how do they act:1. GH: promotes lipolysis
2. cortisol:
a. mainly stimulates gluconeogenesis
b. increases lipolysis and protein catabolism - 7What are the consequences of slow acting hormones:Reduced utilization of glucose by peripheral tissues, saved for brain function.
- 8What are the three enzymatic methods for glucose analysis:1. hexokinase
2. glucose oxidase
3. glucose dehydrogenase - 9What is the difference between whole blood glucose and plasma/serum glucose:10-20% less in whole blood
- 10How soon should a specimen be spun after collection to prevent glycolysis:Within 1 hour after collection
- 11What are the classifications of diabetes mellitus:1. type I (beta cell destruction)
a. autoimmune
b. idiopathic
2. type 2 (insulin resistance)
3. genetic syndromes
4. gestational diabetes mellitus
5. impaired fasting glucose or IGT - 12What are the signs/symptoms of DM:1. persistent thirst
2. frequent urination
3. weight gain or loss
4. extreme fatigue or lack of energy
5. blurred vision
6. frequent or recurring infections
7. cuts and bruises slow to heal
8. tingling or numbness of hands and feet - 13What is the diagnostic criteria for diabetes mellitus in non-pregnant patients:1. symptoms plus FPG >7.0 mmol/L or
2. symptoms plus random glucose > 11.1 mmol/L or
3. symptoms plus 2h post 75g GGT >11.1 mmol/L - 14What is the diagnostic criteria for impaired fasting glucose or impaired glucose tolerance:1. FPG between 6.1 and 6.9 mmol/L
2. two hour value in GTT between 7.8 and 11.1 mmol/L - 15What is the protocol for the glucose tolerance test:1. patients should be fasting between 8-12 hours
2. patients given 75g glucola
3. plasma glucose measured at 0h and 2h
4. gestational measured at 0h, 1h and 2h - 16What is the criteria for screening for DM in asymptomatic individuals:1. test all individuals at age 40 and above
2. repeat at 3 year intervals if normal - 17For asymptomatic individuals under the age 40, when should they be screened for DM:1. obese
2. family history
3. high risk ethnic group
4. previous history of GDM
5. hypertensive
6. low HDL and/or high trigs
7. previous IFG or IGT
8. polycystic ovary syndrome, schizophrenia - 18What is the preferred screening test for glucose:Fasting blood glucose
- 19When would a glucose tolerance test be done:If the FBG is between 5.7 and 6.9
- 20What are the acute complications of diabetes mellitus:1. diabetic ketoacidosis, hyperglycemic hyperosmolar state, hypoglycemia
2. myocardial infarction
3. infections
4. stroke - 21What are the clinical features of DKA (diabetic ketoacidosis)1. thirst
2. polyuria
3. dehydration
4. hypotension, tachycardia
5. ketosis
6. hyperventilation
7. vomiting and abdominal pain
8. drowsiness and coma - 22What are the metabolic features of DKA:1. hyperglycemia
2. glycosuria
3. metabolic acidosis
4. ketonemia and ketonuria
5. acute pre-renal failure
6. hyperkalemia
7. hemoconcentration - 23Main elements of treatment of DKA:1. fluid replacement
2. insulin
3. potassium
4. alkali (bicarbonate) only if pH < 7.0 - 24What are the chronic complications of diabetes mellitus:1. leading cause of visual impairement
2. diabetic nephropathy
3. diabetic neuropathy
4. diabetic dermopathy
5. cardiovascular disease
6. gangrene
7. infection - 25What are the tests used for monitoring patients with diabetes mellitus:1. glucose control: A1C
2. diabetic nephropathy: albumin excretion rate, serum creatinine
3. physical examination: blood pressure, opthalmological, cardiovascular neurological exam
4. lipids - 26What is the reference interval for A1C:4-6%
- 27What does a 1% rise in A1C reflects an average glucose concentration:an increase of 1.6 mmol/L
- 28What are the advantages of using A1C for diagnosis of diabetes:1. indicates chronic hyperglycemia
2. low intra-indiviual variability
3. single test for diagnosis and monitoring is attractive
4. evidence suggests that diagnostic accuracy similar to FPG
5. fasting not necessary
6. stable analyte - 29What are the disdvantages of using A1C for diagnosis of diabetes:1. hemoglobin variants may interfere with some methods
2. patients with reduced red cell life span will result in falsely low results - 30How soon can renal failure occur once proteinuria develops:Within 5 years
- 31What test can be used to screen for albuminuria:Albumin to creatinine ratio in random urines
- 32Normal values for albumin creatinine ratio:Males <2.0 mg/mmol
Females <2.8 mg/mmol - 33What measures can be used to prevent progression of diabetic nephropathy:1. achieve glycemic control (A1C < 7%)
2. aggressively manage BP (<130/80)
3. stop smoking
4. angiotensin II receptor blockers - 34What are the most common clinical situations where hypoglycemia is seen:1. the immediate neonatal period
2. insulin treated diabetics - 35What are the consequences of prolonged hypoglycemia:1. coma
2. seizures
3. brain injury
4. death - 36What are the two types of symptoms associated with hypoglycemia:1. adrenergic symptoms
2. neuroglycopenic symptoms - 37How is pseudohypoglycemia caused:By delayed analysis. glucose drops 5-7% / hour when in contact with wbc and rbc
- 38How can pseudohypoglycemia be prevented:Blood should be collected in tube containing NaF, an inhibitor of glycolysis.
- 39How is hypoglycemia classified:1. reactive versus fasting
2. hyperinsulinemic versus non-hyperinsulinemic
3. ill looking versus not ill looking
4. drug or toxin induced versus fasting or postprandial - 40What is thought to cause postprandial/reactive/function hypoglycemia:Due to excessive insulin response or delayed counter-regulatory response resulting in transient hypoglycemia 2-4 hours after a meal.
- 41What was the test used to diagnose postprandial/reactive/functional hypoglycemia:Formally diagnosed in the past with 5 hour glucose tolerance test.
- 42Why is the 5 hour GTT not used any more:10% of normals show an abnormal response.
- 43List some of the drugs and toxins that can cause hypoglycemia:1. insulin (overdose)
2. oral hypoglycemic drugs
3. alcohol (inhibits gluconeogenesis)
4. salicylates - 44List non drug causes of fasting hypoglycemia:1. hyperinsulinism (insulinoma)
2. endorine disorders
3. adrenal failures
4. pituitary failure
5. hepatic disease - 45List some of the tests used for diagnosis of hypoglycemia in adults:1. obtaining glucose measurement at time of symptoms
2. insulin
3. c-peptide
4. ketone - 46What are the minimum glucose requirements:CNS: 125mg/min
RBC and kidney: 25mg/min - 47—
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- Biochemistry Flashcards on Glucose, created by Angela Haché on 03/10/2016.
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- Angela Haché
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