Carbohydrates

what condition is described below:

• autoimmune beta cell destruction

• insulin in 5-10% cases

• often in children

• insulin-dependent

type I DM

what condition is described below:

• progressive insulin resistance

• most common form

• often in adulthood

• usually non-insulin-dependent

type II DM

the following are laboratory findings of _____:

• increased U and S glucose

• increased urine SG

• increased U and S osmolality

• increased ketones in U and S (ketonuria, ketonemia)

• acidosis in U and S

• electrolyte imbalance

hyperglycemia

acute diabetic ketoacidosis (DKA) is a form of metabolic acidosis found in _____ patients.

type I DM

chronic complications of _____ includes:

• retinopathy

• nephropathy

• neuropathy

• CAD, CVA

hyperglycemia

screening tests for pre-diabetes and diabetes should be performed on all adults, 45 years, every _____ years.

3

screening tests for pre-diabetes and diabetes should happen every year if there is at least ____ of these risk factor(s):

• inactive

• family history

• hypertension

• low HDL

• high TG

• HbA1C >/= 5.7%

• history of CVD

1

the HbA1C value of greater than or equal to _____% is diagnostic for diabetes.

6.5%

the fasting plasma glucose (FPG) value of greater than or equal to _____ is diagnostic for diabetes.

126 mg/dL

the OGTT 2-hour plasma glucose value of greater than or equal to _____ is diagnostic for diabetes.

200 mg/dL

the random plasma glucose (RPG) value of greater than or equal to _____ is diagnostic for diabetes.

200 mg/dL

the ____ test should be performed in a laboratory using a method certified by NGSP and traceable to the DCCT reference assay.

HbA1C

POCT A1C assays are adequate for diagnosing diabetes. true or false?

false

for a FPG, patients should fast with no calorie intake for at least ____ hours.

8

for the OGTT, it is based on a ____g oral glucose load.

75 g

a patient’s result for the _____ test may reach diabetic, diagnostic values if the patient has classic symptoms of diabetes or in hyperglycemic crisis.

RPG

the value range for pre-diabetic/intermediate patients for impaired glucose tolerance (IGT) is _____ at 2 hours.

140-200 mg/dL

the value range for pre-diabetic/intermediate patients for impaired fasting glucose (IFG) is _____.

110-126 mg/dL

the value range for pre-diabetic/intermediate patients for HbA1C is _____%.

5.7-6.4%

based on ADA recommendations, women with risk factors are to be tested prenatally for ____.

type II DM

women with no history of diabetes should be screened for GDM by which test?

OGTT

the diagnostic fasting criteria for GDM is greater than or equal to _____.

92 mg/dL

the diagnostic 1 hour criteria for GDM is greater than or equal to _____.

180 mg/dL

the diagnostic 2 hours criteria for GDM is greater than or equal to _____.

153 mg/dL

what long term monitoring test in DM is described below:

• at least twice a year

• great correlation with glucose level over the past 2-3 months

• <6% optimal, 10% fair, 13-20% poor control

HbA1C

what long term monitoring test in DM is described below:

• to monitor kidney function (eGFR required)

• marker of CVD mortality

• annual test

microalbumin

what is the preferred anticoagulant for glucose testing?

sodium fluoride

glucose specimens must be separated from the cell within ____ hour(s) of collection if it is not collected in a sodium fluoride tube.

1

what refers to any nitrogen-containing compound which is not a protein?

NPN

NPNs are often waste products from _____ metabolism.

protein

what term refers to an increase in NPNs (usually urea and creatinine)?

azotemia

____ include the following:

• amino acids

• ammonia

• urea

• creatinine

• uric acid

NPN

which NPN is described below:

• major NPN end product of protein catabolism

• synthesized in the liver from deamination of amino acids via urea cycle

• generates ammonia

• >90% excreted in urine

urea

serum ____ levels may vary with the following:

• diet

• synthesis in liver

• amount excreted by the kidneys

urea

what is reference range for BUN?

6-20 mg/dL

what form of azotemia is described below:

• high protein diet

• increased protein catabolism, tissue breakdown (increased amino acid metabolism in the liver)

• reabsorption of blood proteins after GI hemorrhage

• dehydration

pre-renal

what form of azotemia is treated with cortisol and analogues?

pre-renal

what form of azotemia is described below:

• wide variety of diseases will cause an increase in plasma urea concentration

• usefulness of urea as an independent indicator of renal function

  • limited by variability of non-renal factors

renal

what form of azotemia is described below:

• obstruction of the urinary system

  • malignancy, nephrolithiasis (renal calculi or stones), prostatism

post-renal

what post-renal azotemia syndrome is associated with outlet obstruction at the bladder neck and the most common cause of benign prostatic hypertrophy?

prostatism

what NPN is usually reported as units of urea nitrogen (BUN) in mg/dL.

urea

how can one calculate urea from BUN?

urea = BUN x 2.14

these are the following specimen collection and handling requirements for ____:

• serum or heparinized plasma: specimen of choice

• no sodium fluoride (NaF)

• stability: 24 hours at RT or several days in fridge

• very high in urine, should be diluted

urea

loss of urea in urine is contaminated with (____+) bacteria.

urease

____ is synthesized in the liver and pancreas from amino acids (arginine, glycine, methionine).

creatine

creatine is phosphorylated to creatine phosphate by the catalytic activity of the enzyme ____.

creatine kinase

____ functions to provide a high energy source to muscles and brain.

creatine

____ is increased in muscle wasting diseases and trauma.

creatine

creatine is not part of the routine metabolic panel. true or false?

true

what NPN refers to a nitrogenous waste product derived (spontaneously) from creatine in muscle tissue?

creatinine

what % is the approximate daily conversion of creatinine?

2%

the amount of ____ is proportional to muscle mass.

creatinine

the excretion rate of _____ is relatively constant but will be increased in impaired renal function.

creatinine

what NPN is filtered by the kidney at a constant rate with very minimal tubular reabsorption and secretion?

creatinine

what NPN is used to assess azotemia with BUN?

creatinine

what refers to a good endogenous measure of glomerular filtration rate (GFR)?

creatinine

what is the equation for creatinine clearance?

[(U Crea x Vol (mL/min) ) / P Crea ] x (1.73m² / BSA)

what is the range for male creatinine clearance?

94-140 mL/min/1.73m²

what is the range for female creatinine clearance?

72-110 mL/min/1.73m²

what is the male creatinine reference range?

0.6-1.2 mg/dL

what is the female creatinine reference range?

0.5-1.1 mg/dL

ammonium heparin cannot be used for the iminohydrolyse method to test for ____.

creatinine

serum should be removed from RBCs immediately for creatinine testing to avoid in vitro ____ production.

ammonia

creatinine is stable for up to ____ days when refrigerated.

7

creatinine urine samples should be ____ before analysis.

diluted

what NPN is described below:

• 2,6,8 - trihydroxypurine

• final breakdown of purine metabolism

uric acid

breakdown products (e.g., adenine and guanine) of nucleic acids or tissue destruction converted to ____ in the liver.

uric acid

what NPN is filtered by glomerulus in the kidney with 98% reaborption in proximal tubules?

uric acid

____ in plasma appears as monosodium urate (MSU).

uric acid

what NPN is found in the following clinical situations:

• gout

• increased catabolism of nucleic acids

  • chemotherapy

  • myeloproliferative disorders

• renal disease

• toxemia of pregnancy (pre-eclampsia)

• poisons: lead and alcohol

• lesch-nyhan syndrome

uric acid

uric acid is stable in urine for ____ days when refrigerated.

3-7

uric acid is stable several days at RT but should be refrigerated to avoid _____.

bacterial growth