Chem 1 midterm

what are the 4 main causes of Hypoglycemia

insulinoma, malabsorption, liver disease, Hypoactive adrenal glands

What are the symptoms of hypoglycemia? (6)

hunger, dizziness, nervousness, shaking, confusion, blurred vision

what fasting glucose level must be measured on 2 separate occasions for a diagnosis of hypoglycemia?

less than 50 mg/dL

______ is the only hormone that lowers glucose

insulin

what seven hormones raise glucose

growth hormone, ACTH, Glucocorticosteroids, Epinepherine, Glucagon, Thyoxine, somatostatin

Plasma glucose values are _____than whole blood values

higher

a normal adult fasting glucose range is _____ to _____

70-100 mg/dL in serum/ plasma 60-90 mg/dL in whole blood

critical high glucose is over ______mg/dL

700

critical low glucose is less than _____ mg/dL

40

The hexokinase glucose testing method combines what four things?

Hexokinase, Glucose 6 phosphate, NADP, G-6-PD

why must RBC’s be removed from plasma within 30 minutes?

RBC’s will continue to consume glucose in the sample

gluconeogenesis makes ____ from ____

glucose from glycerol, lactate, pyruvate, propionate, or glucogenic amino acids

The glucose-oxidase test is a ______ reaction and uses ______, _______, and ______

color change, glucose oxidase, reduced chromatin, peroxidase

NADH is used to fund ____ and produces _____ ATP

Electron transport chain, 32

Glycogenolysis turns _____ into ______ and _____

glycogen, glucose-1-phosphate and glucose

Glycolysis takes _____ ATP to run and produces ________, __________, and ________

pyruvate, 4 ATP, 4 NADH

what metabolic process breaks down glycogen into glucose?

Glycogenolysis

What 4 conditions can effect A1C interpretation

sickle cell anemia, polycythemia, hemolytic anemia, splenectomy

how do we test foe ketone bodies?

Nitroprusside test, purple dipstick

what are ketone bodies made of?

Acetoacetate, beta-hydroxybutyrate, acetone

what are ketone bodies formed from?

free fatty acids

what are common complications of diabetes/ what are diabetes associated disease states? (9)

Atherosclerosis, coronary artery disease, stroke, gangrene, high blood pressure, retinopathy, nephropathy, neuropathy, ketoacidosis

what are the criteria for diagnosis of gestational diabetes?

a 3 hour glucose tolerance test with 2 of any of the following values: 95 mg/dL fasting, 180 1 hour, 155 2 hour, 140 3 hour

what are the criteria for diagnosing pre-diabetes?

on two separate occasions either a fasting glucose tolerance test of between 100-125 or a two hour glucose tolerance test between 140-200

what is a normal fasting glucose tolerance score

70-100

what is a normal 2 hour glucose tolerance test score?

less than 140

what is a pre-diabetic fasting glucose tolerance test score?

101-125

what is a prediabetic 2 hour glucose tolerance test score?

140-199

what is a fasting diabetic glucose tolerance test score?

126+

what is a 2 hour diabetic glucose tolerance test score?

200+

what are the associated findings of prediabetes?

increased risk of atherosclerosis, electrocardiographic abnormalities, hypertension, hyperlipidemia, obesity

what are the requirements for a diagnosis of diabetes?

a 2 hour glucose tolerance test of 200+ or any of the following met on 2 separate occasions: fasting glucose 125+, random glucose 200+ with diabetes symptoms, Hgb A1C 6.5+

what are the common type 2 diabetes symptoms?

frequent infections, blurred vision, tingly/numb hands/feet, obesity

what are the lab findings of type 2 diabetes? (5)

fasting glucose 126+, abnormal glucose tolerance test, glycosuria, elevated glycated hemoglobin, decreased number of insulin receptors on tissues

What is the root cause of diabetes?

no insulin production due to autoimmune destruction of beta cells of the pancreas

what percentage of diabetes cases are type 1

5%

what percentage of diabetes cases are type 2

95%

what is the root cause of type 2 diabetes?

normal-high insulin production with insulin resistant cells

type 2 diabetes is often diagnosed in what demographic?

adults 40+

what are the common symptoms of type 1 diabetes?

polyuria, polydipsia, polyphagia, unusual weight loss, extremewh fatigue, irritability

What is A1C?

glycosylated hemoglobin

what does A1C tell us?

glucose levels over the last 6-8 weeks

what is a normal A1C range?

3.8-6.3%

what is a slightly elevated A1C range?

6.3-8.3%

what is an elevated A1C range?

8.3-12.3%

what is an extremely elevated A1C range?

12.3%+

what is proteinuria an indicator of?

kidney damage

carbohydrates are composed of what 3 elements?

C,H,O

what term refers specifically to blood glucose concentration

glycemia

Glucose of best classified as what type of carbohydrate?

monosaccharide

a fasting plasma glucose value of 110 mg/dL is most consistent with what condition?

impaired fasting glucose

which specimen tube is preferred to prevent glycolysis during glucose testing?

gray top

a small wavelength corresponds with _____ energy light where as a large wavelength corresponds with a ______ energy light

high, low

what is Beer’s law in words

when a monochromatic beam of light is shone through a solution the amount of light absorbed is directly proportional to the number of particles in solution

what is lambert’s law in words?

when a monochromatic beam of light is shone through a solution the amount of light absorbed is proportional to the distance the light traveled

what is Beer’s law equation?

A= l e c

what is the equation relating absorbance and percent transmittance

Absorbance = 2- log(percent transmittance)

how is beer’s law rearranged to relate concentrations and absorbance for knowns and unknowns?

unknown concentration= (absorbance unknown/absorbance standard) * standard concentration

in spectrophotometry what does absorbance represent?

amount of light absorbed by sample

according to Beer’s law, absorbance is directly proportional to ______

analyte concentration

which factor is controlled by using standard cuvettes in spectrophotometric assays

path length

as the concentration of an analyte in solution increases the amount of transmitted light _____

decreases

percent transmittance is calculated by comparing ______ to _______

transmitted light to incident light

what kind of sugar is this?

aldose

what kind of sugar is this?

ketose

glucose is only able to be metabolized in the ______ conformation

open

starch and glycogen form highly ______ chains

branched

cellulose is also known as _____

fiber

pyruvate made via glycolysis is turned into ______ before entering the Krebs cycle

acetyl-CoA

the Krebs cycle produces 4 products ________, ________, __________, and _______

1 ATP, 3 NADH, 1 FADH, 2 CO₂

in a test tube glucose decreases at a rate of ______% per hour

7%

why are oxalate and sodium fluoride added to chemistry blood samples?

prevents clotting and stops glycolysis

why is a glucose test carried out on CSF?

to diagnose bacterial meningitis

POC glucometers consistently measure _________ than serum glucose tests

lower

what is the most common cause of hyperglycemia?

diabetes

in the US _____% of the population has diabetes, _____ out of _____ people have prediabetes, and ______ out of _____ people have gestational diabetes

8%, 1/3, 6-8%

what is the second largest organ in the body?

liver

what do bile ducts do?

remove waste from liver, pancreas, and gull bladder into the duodenum

what are the two physiologic functions of the liver?

circulation and hematopoietic (formation of blood cells in developing embryo)

all venous blood from the stomach, pancreas, and intestines first stops at ______

the liver

arteries carry blood _______ the heart

away from

what vein sends blood through the liver?

hepatic portal vein

what does the liver being part of the first pass metabolism mean?

the liver gets first dibs on nutrients and intercepts any bacteria

what are liver lobules

hexagonal liver tissues

what are bile cannaliculi?

the space between two rows of hepatocytes where hepatocytes dump toxins, ends at a bile duct

what are hepatic stellate cells?

liver cells that store fat soluble vitamins

what are Kupffer cells?

liver cells that remove foreign debris and particles that came from the hepatic portal system

what are liver sinusoidal endothelial cells?

cells that maintain immune function in the liver

what are the six roles of hepatocytes?

protein synthesis, protein storage, metabolism and storage of carbohydrates, synthesis of cholesterol bile salts and phospholipids, detox modification and excretion of substances, initiation of formation and secretion of bile

what cells convers ammonia to urea?

hepatocytes

hemoglobin is made out of 2 _____ chains, two ______ chains, and 4 heme molecules. each heme molecule contains ______ iron molecule(s)

alpha, beta, 1

what cells destroy old erythrocytes to recycle the iron inside?

macrophages

the first step of recycling iron is to breakdown heme into ______ using _______ and ______

biliverdin, oxygenase, molecular oxygen

the second step in recycling heme is to turn _______ into _________ using the enzyme _______ and _______

biliverdin, bilirubin, bilirubin reductase, NADPH

the final step in recycling heme is to convert ________ into _______ using the enzyme _______ to add 2 molecules of _________ creating ________

unconjugated bilirubin, conjugated bilirubin, uridine glucouranyl transferase, glucuronic acid, soluble bilirubin

how can bacteria unconjugate bilirubin?

via fermentation

what is bilirubin turned into for excretion via pee?

urobilin

what is bilirubin turned into for excretion via poop?

stercobolin

what three non-hemoglobin proteins use heme?

myoglobin, catalases, cytochrome P450 enzymes

what eight items are on a standard hepatic pannel?

AST, ALP, ALT, GGT, albumin, total protein, bilirubin total, bilirubin direct