40 Questions
Which of the following is NOT a characteristic of Type 1 diabetes mellitus?
Insulin resistance
What is the primary purpose of gluconeogenesis?
Synthesis of glucose from non-carbohydrate sources
Which of the following is a characteristic of hyperglycemia?
Increased urine specific gravity
What is the reference method for glucose measurement?
Hexokinase method
Which type of hyperlipoproteinemia is characterized by increased chylomicrons?
Type I
What is the primary function of glucagon?
Increases glycogenolysis
Which of the following is a characteristic of glucose?
Constituent of all living cells
What is the purpose of fasting before glucose measurement?
To allow for accurate measurement of glucose levels
At which level is impaired glucose tolerance determined?
200 mg/dL, random plasma glucose
What is the unit of measurement for a 2-hr OGTT in a provisional diagnosis of diabetes?
mmol/L
What is the principle involved in measuring HbA1c using cation exchange chromatography?
The negatively charged hemoglobin attaches to the positively charged resin bed
Which of the following is a characteristic that differentiates LDL from Lp(a)?
Kringles
What is the waste product of purine catabolism?
Uric acid
What is the cut-off point for desirable total cholesterol?
199 mg/dL
What is the purpose of the oxidase enzyme in the enzymatic method of cholesterol determination?
To oxidize free cholesterol to peroxide
What is the majority of the NPN waste excreted daily?
Urea
Which hormone increases glycogenolysis and gluconeogenesis?
Glucagon
Which hormone is produced by the alpha cells and increases plasma glucose?
Glucagon
What is the primary function of creatinine in the body?
Waste product of muscle metabolism
What is the primary diagnostic test for diabetes mellitus?
Fasting plasma glucose (FPG) test
What is a characteristic of type 1 diabetes mellitus?
Absolute insulin deficiency
What is the recommended age for diabetes screening according to the American Diabetes Association (ADA)?
40 years old
What is the primary criterion for gestational diabetes mellitus (GDM)?
Two-hour OGTT ≥ 8.5 mmol/L
What is the primary function of glucocorticoids in the body?
Anti-inflammatory response
What is the approximate amount of bilirubin formed daily?
500-600 mg
What is the primary form of bilirubin found in serum?
Unconjugated bilirubin
What type of bilirubin is found in urine?
Indirect bilirubin
What is the likely cause of increased bilirubin production?
Hemolysis
What is the likely diagnosis in a patient with impaired bilirubin conjugation?
Unconjugated hyperbilirubinemia
What is the likely cause of increased unconjugated bilirubin in serum?
Impaired bilirubin conjugation
What is the likely diagnosis in a patient with increased conjugated bilirubin in serum?
Obstruction to the bile flow
What is the likely cause of increased BUN in a patient?
Dehydration
What is the molecular weight of creatinine?
113 Da
Which of the following statements is true about urobilinogen?
It is reduced to a colorless compound by intestinal bacteria
What is the primary site of creatinine synthesis?
Liver
Which type of kidney injury is characterized by increased protein catabolism?
Pre-renal
What is the primary function of horseradish peroxidase in the glucose hexokinase method?
To catalyze the second reaction
What is the recommended frequency of HbA1c testing for patients not meeting treatment goals for diabetes?
Quarterly
What is the primary form of uric acid in plasma?
Soluble monosodium urate
Which of the following conditions is an example of post-renal kidney injury?
Obstruction
Study Notes
Energy Storage and Diabetes
- Excess calories can be stored as energy in various forms, including glycogen, fat, and protein.
- Hyperglycemia is characterized by increased glucose in plasma and urine, and may also involve increased urine ketones and specific gravity.
Diabetes Mellitus
- Type 1 diabetes mellitus is characterized by:
- Absolute deficiency in insulin secretion
- Cell-mediated autoimmune destruction of pancreatic beta cells
- Often initiated by viral infection or environmental factors
- Type 1 diabetes mellitus is not associated with obesity or increased body fat.
Glucose Measurement
- Glucose can be measured in serum, plasma, urine, or whole blood.
- Testing should be done in the morning after an 8-10 hour fast.
- The hexokinase method is the reference method for glucose measurement.
Hyperlipoproteinemia
- Frederickson-Levy classification system is used to categorize hyperlipoproteinemia based on the type of lipoprotein elevated.
- Types of hyperlipoproteinemia include:
- Type I: Elevated chylomicrons
- Type II: Elevated LDL and VLDL
- Type III: Elevated IDL
- Type IV: Elevated VLDL
- Type V: Elevated chylomicrons and VLDL
Gluconeogenesis and Glucagon
- Gluconeogenesis is the synthesis of glucose from non-carbohydrate sources, such as amino acids.
- Glucagon is a hormone produced by the alpha cells of the pancreas that:
- Increases glycogenolysis
- Increases gluconeogenesis
- Increases plasma glucose
Plasma Glucose and Hormones
- Hormones that increase plasma glucose include:
- Epinephrine
- Glucocorticoids
- Glucagon
- Insulin decreases plasma glucose.
Creatinine and Renal Function
- Creatinine is a waste product of protein catabolism.
- Creatinine has a molecular weight of 113 Da and is produced in the body at a constant rate.
- Excretion of creatinine depends on renal function.
Diabetes Diagnosis and Testing
- Tests used to diagnose diabetes mellitus include:
- Fasting plasma glucose (FPG)
- Oral glucose tolerance test (OGTT)
- Hemoglobin A1c (HbA1c)
- Criteria for diagnosing diabetes mellitus include:
- FPG ≥ 126 mg/dL
- OGTT ≥ 200 mg/dL
- HbA1c ≥ 6.5%
Lipoproteins and Cholesterol
- LDL (low-density lipoprotein) is the primary lipoprotein that carries cholesterol from the liver to peripheral tissues.
- Lp(a) is a lipoprotein that is similar to LDL but has a different density and composition.
- Cholesterol is a lipid that is an essential component of cell membranes.
Waste Products and Metabolism
- BUN (blood urea nitrogen) is a waste product of protein catabolism.
- Creatinine is a waste product of protein catabolism.
- Uric acid is a waste product of purine catabolism.
- Bilirubin is a waste product of heme catabolism.
Kidney Injury and Function
- Pre-renal kidney injury is caused by decreased blood flow to the kidneys.
- Renal kidney injury is caused by damage to the kidney tissue itself.
- Post-renal kidney injury is caused by obstruction to the urinary tract.
- Kidney function can be assessed by measuring creatinine, BUN, and other waste products.
A short quiz on biology and physiology, covering topics such as energy storage, hyperglycemia, and cell characteristics.
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