MLS 2211 Exam 3

Explain the clinical rationale for performing serum Osmolality assay

What is the normal range for a serum osmo

What is the normal range of a urine osmo

How does freezing-point depression osmo work

How does vapor pressure(dew-point) osmo work 

How does colloid osmo pressure osmo work 

Describe how alterations in blood osmotic pressure can cause dehydration, edema, or hypertension.

describe the conditions under which non-electrolytes can contribute significantly to the
serum's osmolality

What is the cOsmol equation

(mmol Na * 1.86) + (Glucose mg/dL/18) + (BUN mg/dL/2.8)

Explain what is meant by the Osmolal Gap

What is the osmolal equation

Explain why patients with Hereditary Galactosemia or Hereditary Fructosemia would have galactose or

fructose in their fasting blood and urine

What effect do the hormones Insulin and Glucagon have on glucose?

Define glycolysis

Define glycogenolysis

define glycogensis

define glyconeogenesis

define lipogensis

define lypolysis 

Differentiate between Diabetes Mellitus and Diabetes Insipidus

What blood/urine glucose would you see in DM I

What blood/urine ketone level would you see in DM I

What blood pH would you see in DM I

What blood insulin and C-peptide level would you see in DM I 

What blood/urine glucose would you see in DM II

What blood/urine ketone level would you see in DM II

What blood pH would you see in DM II

What blood insulin and C-peptide level would you see in DM II 

Where in the body is Insulin made

Where in the body is C-Peptide made

How is C-peptide useful in diagnostic testing 

What is DMII

What causes DMII

What is DMI

What causes DMI

What is gestational diabetes mellitus

What causes gestational diabetes

What is an impaired glucose tolerance 

What is pheochromocytoma and how is glucose impacted 

What is cushing’s disease and how is glucose impacted

What is hyperthyroid disease (Graves disease or Toxic goiter) and how is glucose impacted 

What is hashimotos disease and how is glucose impacted 

What is myxedema and how is glucose impacted

What is addisons disease and how is glucose impacted

What is von Gierkes disease and how is glucose impacted 

What are insulin producing tumors and how do they impact glucose 

What is the glucose load for a GTT for a child

What is the glucose load for a GTT for non-pregnant adults 

What is the glucose load for a GTT for a pregnant adult 

When would a random urine glucose test be done

When would a fasting blood glucose test be done

When would a 5 hours GTT test be done

When would a GDM screen be done

When would a GDM confirmatory test be done

When would a 2 hour GTT test be done 

When would a 2 hour postprandial blood glucose test be done 

When would a 2 hour post challenge blood glucose test be done 

When would a glycosylated hemoglobin test be done

What is a normal A1C

<5.7%

What is a pre diatbetic A1C 

5.7-6.5%

What is a diabetic A1C

>6.5%

When would a serum fructosamine test be ran

What is the diagnostic criteria for DM

a. Random Glucose equal to 200 mg/dL or greater, with patient symptoms.
b. Fasting blood glucose of 126 mg/dL or greater documented on two occasions.
b. 2-Hour Post-Challenge Tolerance Test, equal to or greater than 200 mg/dL at 2 hours

Why would a xylose tolerance test be done

Why would a lactose tolerance test be done

Why would an epinephrine tolerance test be done

Explain the rationale for performing CSF glucose and CSF Lactate assays on patients suspected of having spinal meningitis.

How does CSF glucose compare to blood glucose?

Explain the proper specimen collection techniques and storage requirements for glucose assays, and explain why the specimen of choice for most glucose and lactate methods is plasma which contains fluoride

Explain the relationship between whole blood glucose levels and serum (plasma) glucose levels

Explain the relationship between arterial (capillary) and venous glucose levels.

What is Glucose Oxidase method (Trinder)

What is Hexokinase method (Glucokinase):

What is Glucose Dehydrogenase method

What is the reference range for adult fasting plasma glucose 

70-110mg/dL

What is a critical high adult fasting plasma glucose

>450mg/dL

What is a critical low adult fasting plasma glucose

< 40 mg/dL

Sodium Chloride is often used by highway departments to prevent the roads from freezing in the winter, why

D5W (5% Dextrose in Water) has an osmolality of 275 mOsm/kg, while Normal Saline (0.9% NaCl) has an osmolality of 286 mOsm/kg. Which solution would exert the higher osmotic pressure and why?

Using a patient’s CMP results, calculate their serum osmolality:

Test Result Reference Range

Sodium 137 mMol/dL 133 - 147

Potassium 4.2 mMol/dL 3.5 – 5.1

Chloride 108 mMol/dL 94 – 112

CO2 24 mMol/dL 18 – 32

BUN 14 mg/dL 7 – 25

Creatinine 0.8 mg/dL 0.5 – 1.5

eGFR 93 mL/Min/1.73M2 >60

Glucose 85 mg/dL 79 – 106

Total Protein 6.5 g/dL 6.0 – 8.9

Albumin 4.1 g/dL 3.5 – 5.7

Calcium 9.3 mg/dL 8.4 – 10.5

Total Bili 0.4 mg/dL 0.1 – 1.5

AST 16 U/L 12- 41

ALT 26 U/L 0 – 50

ALP 79 U/L 30 – 138

A toddler is taken to the ED because their parents believed that they got into the family liquor cabinet and drank some vodka. What type of osmometer would you want to test this patient’s serum with?

An ER patient is suspected of having meningitis. The patient's blood glucose is 186 mg/dL, while the CSF glucose is 65 mg/dL. This patient most likely has?

Which of the following are hypoglycemic conditions?  

How can we use C-Peptide and Insulin to distinguish between Type I and Type II DM?

What is the pre-diabetic range for Hemoglobin A1c?

I am a GTT test that is recommended by the ADA/WHO to screen for Diabetes Mellitus. After a fasting sample is taken, the patient ingests 75g of glucose. A follow-up Blood Glucose is drawn at the 2-hour mark. What GGT am I?

Which is the most accurate statement regarding Diabetes Mellitus versus Diabetes Insipidus:

You have two adult patients who come in for a Glucose Tolerance test at the same time. Patient A is there for a Gestational DM Screening and Patient B is there for a Gestational DM Confirmatory test. You grab a 50g and 100g glucose drink from the storage room and head back to the draw room to draw the fasting samples.

After fasting samples are taken, which glucose drink should you give to each patient?

Which of the following are hyperglycemic conditions?  

The Glucose Dehdrogenase glucose method converts Glucose and NAD+ into  ___________ and __________. 

What is the process called in which fat is synthesized from glucose?

A random urine glucose test is a cheap and easy screen for diabetes mellitus. What does the serum glucose level need to be for there to be glucose present in the urine?

You have just performed a venous Whole Blood Glucose on yourself, and it was 90 mg/dL. What would be his venous Serum glucose level at the same time?

You are a process in which glucose is broken down for energy. What's your name?

The Hexokinase glucose method converts Glucose and ATP into ________ and ___________. 

What it is called when glycogen is broken down into glucose? 

What is the Fasting Blood Glucose cutoff value that indicates Diabetes Mellitus?

True or False: Sodium has the greatest effect on osmotic pressure:

Your patient has a Serum Osmolality of 291 mOsm/Kg. She also has a serum Sodium of 135 mMol/L, a Glucose of 110 mg/dL, and a BUN of 13 mg/dL.

What is the Osmolal Gap?

A serum and urine osmolality is ordered on a patient. The serum osmo comes back at 282 mOsm/kg and the urine came back at 943 mOsm/kg. 

Is the serum to urine osmolality ratio within normal range