CC 14-17
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Questions and Answers

What hormone is primarily secreted by alpha cells of the pancreas?

  • Glucagon (correct)
  • Somatostatin
  • Insulin
  • Cortisol

Which condition is characterized by low blood sugar occurring after prolonged fasting?

  • Reactive hypoglycemia
  • Post-absorptive hypoglycemia (correct)
  • Fasting-induced hypoglycemia
  • Hyperinsulinism

Which carbohydrate classification includes sugars with multiple units?

  • Monosaccharides
  • Oligosaccharides
  • Polysaccharides (correct)
  • Disaccharides

What is the primary effect of cortisol on metabolism?

<p>Promotes gluconeogenesis (B)</p> Signup and view all the answers

What distinguishes aldoses from ketoses in carbohydrates?

<p>Location of the carbonyl group (D)</p> Signup and view all the answers

Which of the following hormones antagonizes the effects of insulin?

<p>Epinephrine (B)</p> Signup and view all the answers

Which statement is true regarding the general properties of carbohydrates?

<p>They modify proteins through a process known as glycosylation. (D)</p> Signup and view all the answers

What type of hypoglycemia typically occurs within four hours after eating a meal?

<p>Reactive hypoglycemia (D)</p> Signup and view all the answers

Which of the following is an example of a hexose?

<p>D-Glucose (A)</p> Signup and view all the answers

Which of the following metabolites is not directly involved in glycolysis?

<p>Acetyl CoA (B)</p> Signup and view all the answers

What type of carbohydrate contains exactly three carbon atoms?

<p>Trioses (A)</p> Signup and view all the answers

What hormone is secreted in response to low blood glucose levels?

<p>Glucagon (B)</p> Signup and view all the answers

Which metabolic disorder is characterized by excessive insulin production?

<p>Insulinoma (A)</p> Signup and view all the answers

What is the reference range for serum albumin levels?

<p>165 - 185 Jmol/l (A)</p> Signup and view all the answers

Which condition is indicated by microalbuminuria?

<p>Diabetic nephropathy (C)</p> Signup and view all the answers

What range of albumin-creatinine ratio qualifies as persistent albuminuria?

<p>10 - 500 $ ext{ug/mg}$ (C)</p> Signup and view all the answers

How often should urine collections be performed to assess persistent albuminuria?

<p>Twice in all three collections (B)</p> Signup and view all the answers

What is a common method for preventing glycolysis in glucose measurement specimens?

<p>Use of NaF or SST (A)</p> Signup and view all the answers

Which method is used in the copper reduction test for glucose measurement?

<p>Folin-Wu method (D)</p> Signup and view all the answers

What consequence can dextrose contamination have on glucose assay results?

<p>Increase in glucose levels by 5% (C)</p> Signup and view all the answers

Which of the following is involved in the condensation method for glucose measurement?

<p>Glucose and o-toluidine (A)</p> Signup and view all the answers

What are the common symptoms associated with diabetes mellitus?

<p>Polyuria, polydipsia, and polyphagia (B)</p> Signup and view all the answers

Which of the following is NOT a microvascular complication of diabetes?

<p>Coronary artery disease (CAD) (C)</p> Signup and view all the answers

What is the recommended screening age for diabetes in adults?

<p>25 years old (A)</p> Signup and view all the answers

In the two-step method for screening gestational diabetes mellitus (GDM), what should be done after a 1-h plasma glucose (PG) reading of ≥140 mg/dL?

<p>Proceed to the second step with a higher glucose load (A)</p> Signup and view all the answers

Which of the following represents a normal fasting plasma glucose level?

<p>70 - 99 mg/dL (D)</p> Signup and view all the answers

What should be the fasting duration before conducting a fasting plasma glucose test?

<p>8-12 hours (A)</p> Signup and view all the answers

Which of the following is a diagnostic criterion for gestational diabetes mellitus using the two-step method?

<p>1-h PG ≥ 180 mg/dL after a 75 g load (C)</p> Signup and view all the answers

Which of the following is a characteristic long-term complication of diabetes?

<p>Cerebrovascular accident (CVA) (C)</p> Signup and view all the answers

What is one of the components of Whipple's triad of hypoglycemia?

<p>Symptoms of hypoglycemia (D)</p> Signup and view all the answers

Which of the following is a symptom of neuroglycopenic hypoglycemia?

<p>Dizziness (A)</p> Signup and view all the answers

What type of diabetes mellitus is characterized by absolute insulin deficiency due to immune-mediated destruction of beta cells?

<p>Type 1 diabetes (C)</p> Signup and view all the answers

In the context of insulinoma diagnosis, what is considered a change in glucose level?

<p>Change of 25 mg/dL or greater (C)</p> Signup and view all the answers

Which factor is NOT part of the diagnostic criteria for insulinoma?

<p>Proinsulin level of 2.5 pmol/L (C)</p> Signup and view all the answers

Which of the following describes insulin resistance?

<p>Type 2 diabetes (C)</p> Signup and view all the answers

What is a common symptom of neurogenic hypoglycemia?

<p>Diaphoresis (C)</p> Signup and view all the answers

What is the threshold value for insulin to be considered in the diagnostic criteria for insulinoma?

<p>≥5 pmol/L (C)</p> Signup and view all the answers

What deficiency causes galactosemia?

<p>Galactokinase (A), Uridine diphosphate galactose-4-epimerase (B), Galactose-1-phosphate uridyltransferase (C)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with galactosemia?

<p>Hepatomegaly (B)</p> Signup and view all the answers

Which glycogen storage disease is most commonly associated with hypoglycemia?

<p>Gierke disease (B)</p> Signup and view all the answers

The enzyme deficiency in McArdle disease affects which process?

<p>Glycogen breakdown (D)</p> Signup and view all the answers

Which type of glycogen storage disease primarily presents with muscle cramps and exercise intolerance?

<p>Muscle glycogenoses (D)</p> Signup and view all the answers

Which of the following enzymes is deficient in Gierke disease?

<p>Glucose-6-phosphatase (C)</p> Signup and view all the answers

Which symptom is characteristic of hepatic glycogenoses?

<p>Hypoglycemia (A)</p> Signup and view all the answers

Which enzyme is deficient in Andersen disease?

<p>Glycogen branching enzyme (C)</p> Signup and view all the answers

Flashcards

Carbohydrate Classification

Carbohydrates classified by their type, specifically based on the number of sugar units.

Monosaccharides

Sugar units with a single sugar molecule.

Disaccharides

Sugar units composed of two sugar molecules joined by a glycosidic bond.

Polysaccharides

Sugar units built from multiple sugar units linked by glycosidic bonds.

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Reducing Sugars

Sugars with a hemiacetal group, which can reduce other compounds.

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Glycolysis

The process by which glucose is broken down into pyruvate in the cytoplasm of cells, generating ATP.

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Lactate fermentation

A type of fermentation that occurs in muscle cells during intense exercise, where pyruvate is converted to lactate to regenerate NAD+.

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Pyruvate

A 3-carbon molecule produced by glycolysis, which can be converted to Acetyl CoA for entry into the TCA cycle or used to produce lactate.

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Insulin

A hormone produced by the pancreas that regulates blood glucose levels by promoting glucose uptake and storage in cells.

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Glucagon

A hormone produced by the pancreas that raises blood glucose levels by stimulating glycogen breakdown and glucose production.

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Hypoglycemia

A disorder characterized by abnormally low blood glucose levels, which can be caused by various factors including hyperinsulinism, hormonal deficiencies, or genetic disorders.

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Fasting hypoglycemia

Hypoglycemia that occurs after 10 hours without food, often associated with hyperinsulinism, hormonal deficiencies, or genetic disorders,

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Post-prandial hypoglycemia

Hypoglycemia that occurs within 4 hours of eating a meal, often triggered by a rapid rise in blood sugar followed by an exaggerated insulin response

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Diabetes Mellitus

A condition where the body produces insufficient insulin, leading to high blood sugar levels. There are several types, but the most common are Type 1 and Type 2.

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Type 1 Diabetes

A form of diabetes characterized by the body's inability to produce insulin, typically due to autoimmune destruction of pancreatic beta cells.

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Type 2 Diabetes

A form of diabetes characterized by insulin resistance, where the body's cells don't respond properly to insulin, and eventual decline in insulin production.

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Whipple's Triad

A triad of symptoms, low blood sugar, and relief of symptoms with glucose administration, used to diagnose hypoglycemia.

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Microalbuminuria

A condition where the kidneys excrete abnormally high levels of albumin into the urine. It is an early indicator of diabetic nephropathy, a complication of diabetes that damages the kidneys.

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Serum Albumin Level

A blood test that measures the amount of albumin in the blood. It's used to assess liver function, as low levels can indicate liver disease.

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Copper Reduction Method

A chemical method for measuring glucose levels in blood or urine. It relies on the reduction of copper ions to cuprous ions by glucose in the presence of a reagent.

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Folin-Wu Method

A specific type of copper reduction method where glucose is reduced into cuprous ions in the presence of phosphomolybdic acid. This reduces the reagent to a molybdenum blue, leading to a color change.

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Nelson-Somogyi Method

A specific type of copper reduction method where glucose is reduced into cuprous ions in the presence of arsenomolybdic acid. This reduces the reagent to arsenomolybdenum blue, also causing a color change.

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Neocuproine Method

A specific type of copper reduction method where glucose is reduced into cuprous ions in the presence of neocuproine. This creates a colored complex used to measure glucose levels.

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Ferric Reduction Method

A chemical method for measuring glucose levels in blood or urine that relies on the reduction of ferric ions by glucose. This converts ferricyanide to ferrocyanide, which is measured spectrophotometrically.

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Condensation Method

A chemical method for measuring glucose levels in blood or urine that involves the condensation reaction between glucose and o-toluidine. This reaction creates a Schiff's base, which is colored and directly proportional to the glucose concentration.

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What is Galactosemia?

A genetic disorder caused by a deficiency in an enzyme involved in galactose metabolism, leading to accumulation of galactose in the body.

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What are Glycogen Storage Diseases (Glycogenoses)?

A group of genetic disorders characterized by the accumulation of glycogen in various tissues due to deficiencies in enzymes involved in glycogen metabolism.

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What are Hepatic Glycogenoses?

A type of glycogen storage disease where glycogen accumulates primarily in the liver, leading to symptoms like enlarged liver, low blood sugar, and growth problems.

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What is Von Gierke's Disease?

The most common type of hepatic glycogen storage disease, characterized by low blood sugar, lactic acid build-up, and high uric acid levels.

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What are Muscle Glycogenoses?

A type of glycogen storage disease where glycogen accumulates primarily in muscles, resulting in exercise intolerance, muscle cramps, fatigue, and weakness.

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What is Cori Disease (GSD III)?

A specific type of glycogen storage disease caused by a deficiency in the enzyme glycogen debranching enzyme, resulting in both liver and muscle involvement.

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What is Andersen's Disease (GSD IV)?

A specific type of glycogen storage disease caused by a deficiency in the enzyme glycogen branching enzyme, leading to accumulation of abnormally structured glycogen in the liver, resulting in hepatomegaly and cirrhosis.

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What is McArdle's Disease?

A specific type of muscle glycogen storage disease caused by a deficiency in the enzyme glycogen phosphorylase, leading to exercise intolerance and muscle cramps.

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Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis (DKA) is a serious complication of diabetes characterized by high blood sugar levels, ketone production, and acidosis. It develops when the body can't use glucose for energy and instead starts to break down fat for fuel, producing ketones as a byproduct. Ketones are acidic and can build up in the blood, leading to acidosis.

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Hyperglycemic Hyperosmolar Non-Ketotic Coma (HHNS)

Hyperglycemic hyperosmolar non-ketotic coma (HHNS) is a serious complication of diabetes marked by extremely high blood sugar levels, dehydration, and altered mental state. It occurs when the body produces insufficient insulin to use glucose for energy, leading to a hyperosmolar state due to high glucose in the blood.

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3Ps of Diabetes

Polyuria, polydipsia, and polyphagia (3Ps) refer to excessive urination, thirst, and hunger, respectively. These symptoms are common in uncontrolled diabetes due to the body's inability to use glucose effectively, leading to increased fluid loss and a need for more energy.

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Microvascular Complications of Diabetes

Microvascular complications of diabetes include damage to small blood vessels affecting the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy). This damage is caused by elevated blood sugar levels over time, leading to impaired blood flow and tissue damage.

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Macrovascular Complications of Diabetes

Macrovascular complications of diabetes refer to damage to large blood vessels, leading to increased risk of coronary artery disease (CAD), stroke (CVA), and peripheral artery disease (PAD). This damage is linked to elevated blood sugar, hypertension, and dyslipidemia.

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Diabetes Screening

To screen for diabetes, adults aged 24 years and older should undergo a test. There are three common tests: Fasting Plasma Glucose (FPG), Oral Glucose Tolerance Test (OGTT), and HbA1c. These test help identify high blood sugar levels indicative of diabetes.

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Gestational Diabetes Mellitus (GDM)

Gestational Diabetes Mellitus (GDM) is a condition where diabetes develops during pregnancy. It typically resolves after delivery but increases the risk of future diabetes for both mother and child. Screening for GDM is usually done between 24-28 weeks of gestation using a glucose tolerance test.

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GDM Screening Methods

The one-step method for GDM screening involves a 50g glucose load followed by a 1-hour plasma glucose (1-h PG) test. A result of ≥140 mg/dL indicates a need for further testing. The Two-step method involves a 50g glucose load followed by a 100g glucose load if the 1-h PG result is ≥140 mg/dL. Results of FPG ≥105 mg/dL, 1-h PG ≥180 mg/dL, or 2-h PG ≥155 mg/dL on the 100g glucose load confirm GDM.

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Study Notes

Carbohydrates Classification

  • Carbohydrates are classified by the number of sugar units (monosaccharides, disaccharides, polysaccharides), the number of carbons (trioses, tetroses, pentoses, hexoses), the location of the CO functional group (aldoses, ketoses), and stereochemistry (D and L enantiomers).

Monosaccharides

  • Monosaccharides are simple sugars, the basic building blocks of carbohydrates.
  • Examples include glucose, fructose, and galactose.
  • Glucose is a common monosaccharide, essential for the brain.
  • Fructose is found in fruits and honey.
  • Galactose is a component of lactose.

Types of Carbohydrates

  • Monosaccharides: single sugar units (e.g., glucose, fructose).
  • Disaccharides: two sugar units linked together (e.g., sucrose, lactose).
  • Polysaccharides: many sugar units linked together (e.g., starch, glycogen).

Aldoses and Ketoses

  • Aldoses have an aldehyde group (-CHO) at the end of the carbon chain (e.g., glucose).
  • Ketoses have a ketone group (C=O) within the carbon chain (e.g., fructose).

D and L Enantiomers

  • D and L enantiomers are mirror images of each other.
  • Carbohydrates in living organisms are almost always D-isomers.

D-Isomers

  • D-isomers are the most common type of carbohydrate in living organisms.

Carbohydrate Structure

  • Shown are structural diagrams of various monosaccharides (e.g., D-glyceraldehyde, D-erythrose, L-ribose, D-glucose, D-galactose, D-fructose).

Hormonal Regulation of Glucose Metabolism

  • Insulin and glucagon are key hormones regulating blood glucose levels.
  • Insulin promotes glucose uptake and storage.
  • Glucagon promotes glucose release into the bloodstream.

Disorders of Glucose Metabolism

  • Hypoglycemia: low blood glucose levels.
  • Two types:
    • Post-absorptive/Fasting- occurs after 10 hours without food; secondary to hyperinsulinism, hormonal deficiencies, genetic disorders, autoimmunity or drug-induced.
    • Post-prandial/Alimentary/Reactive- occurs usually within 4 hours after eating a meal.
  • Diabetes mellitus (DM): elevated blood glucose levels.
    • Classified as Type 1 (autoimmune or idiopathic), Type 2 (insulin resistance), and other types.
    • Gestational Diabetes Mellitus (GDM) is glucose intolerance that occurs during pregnancy, usually resolves after delivery but may become type 2 DM.

Diagnostic Criteria for DM

  • Fasting plasma glucose (FPG): levels used in diagnosing or screening for diabetes.
  • Oral glucose tolerance test (OGTT) 2-hour post-load glucose level.
  • Glycated hemoglobin (HbA1c): a measure of average blood glucose levels over several months.

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Description

Test your knowledge on the classification of carbohydrates, including monosaccharides, disaccharides, and polysaccharides. This quiz will also cover the different types based on their structure and functional groups. Challenge yourself to identify key examples and characteristics of each category.

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