Podcast
Questions and Answers
What is the primary effect of insulin on carbohydrate metabolism?
What is the primary effect of insulin on carbohydrate metabolism?
Gluconeogenesis becomes the primary source of blood glucose after 18 hours of fasting.
Gluconeogenesis becomes the primary source of blood glucose after 18 hours of fasting.
True
What hormone is secreted from the adrenal medulla?
What hormone is secreted from the adrenal medulla?
Epinephrine & norepinephrine
Glucose levels are considered hyperglycemic when fasting blood glucose is greater than __________ mg/dl.
Glucose levels are considered hyperglycemic when fasting blood glucose is greater than __________ mg/dl.
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Match the hormones with their corresponding effects:
Match the hormones with their corresponding effects:
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Which hormone is primarily responsible for lipolysis inhibition?
Which hormone is primarily responsible for lipolysis inhibition?
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Cushing's syndrome is associated with excess glucocorticoids.
Cushing's syndrome is associated with excess glucocorticoids.
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What are the symptoms of hyperglycemia?
What are the symptoms of hyperglycemia?
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What is the primary reason for increased insulin requirements during the second half of pregnancy?
What is the primary reason for increased insulin requirements during the second half of pregnancy?
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Chemical determination of glucose level in blood can be accurately achieved only through non-specific tests.
Chemical determination of glucose level in blood can be accurately achieved only through non-specific tests.
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What is the definition of a diabetic patient in relation to fasting plasma glucose concentration?
What is the definition of a diabetic patient in relation to fasting plasma glucose concentration?
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Adding sodium fluoride and potassium oxalate to the anticoagulant can prevent the rapid conversion of glucose to ______.
Adding sodium fluoride and potassium oxalate to the anticoagulant can prevent the rapid conversion of glucose to ______.
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Match the glucose testing methods to their type of measurement:
Match the glucose testing methods to their type of measurement:
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Which of the following is NOT a non-specific test for glucose determination?
Which of the following is NOT a non-specific test for glucose determination?
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The apparent glucose level measured by non-specific tests is always lower than the true glucose level.
The apparent glucose level measured by non-specific tests is always lower than the true glucose level.
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What color is produced in the phosphomolybdic acid method when glucose reacts with cuprous ions?
What color is produced in the phosphomolybdic acid method when glucose reacts with cuprous ions?
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Which of the following conditions can result from chronic complications of diabetes?
Which of the following conditions can result from chronic complications of diabetes?
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Ketonuria is defined as the presence of ketone bodies in the urine.
Ketonuria is defined as the presence of ketone bodies in the urine.
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What are the three main types of ketone bodies produced during ketosis?
What are the three main types of ketone bodies produced during ketosis?
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A major risk factor for developing Type II DM after gestational diabetes is __________.
A major risk factor for developing Type II DM after gestational diabetes is __________.
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Which mechanism involves the conversion of glucose into sorbitol and fructose, leading to cell swelling?
Which mechanism involves the conversion of glucose into sorbitol and fructose, leading to cell swelling?
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Match the complications of diabetes to their descriptions:
Match the complications of diabetes to their descriptions:
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Gestational diabetes occurs during pregnancy and can resolve post-delivery for most women.
Gestational diabetes occurs during pregnancy and can resolve post-delivery for most women.
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What vitamin is suggested to help prevent neuropathy in diabetic patients?
What vitamin is suggested to help prevent neuropathy in diabetic patients?
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What is the primary cause of reactive hypoglycemia?
What is the primary cause of reactive hypoglycemia?
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Pheochromocytoma is characterized by a deficiency in epinephrine and norepinephrine production.
Pheochromocytoma is characterized by a deficiency in epinephrine and norepinephrine production.
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What is the enzyme deficiency associated with Classical Galactose Intolerance?
What is the enzyme deficiency associated with Classical Galactose Intolerance?
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Insulinoma results in excessive production of _______ in the pancreas.
Insulinoma results in excessive production of _______ in the pancreas.
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Which condition is characterized by liver glycogen branching enzyme deficiency?
Which condition is characterized by liver glycogen branching enzyme deficiency?
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Match the following conditions with their associated deficiencies:
Match the following conditions with their associated deficiencies:
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Excessive alcohol drinking can lead to hypoglycemia.
Excessive alcohol drinking can lead to hypoglycemia.
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What is the fasting glucose range for a person with normal glucose tolerance?
What is the fasting glucose range for a person with normal glucose tolerance?
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A diabetic curve shows fasting glucose levels greater than the normal range.
A diabetic curve shows fasting glucose levels greater than the normal range.
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What does glucosuria indicate?
What does glucosuria indicate?
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What is the primary component measured in the glucose oxidase method?
What is the primary component measured in the glucose oxidase method?
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The intravenous glucose tolerance test (IGTT) is conducted by administering ________ g/kg of glucose.
The intravenous glucose tolerance test (IGTT) is conducted by administering ________ g/kg of glucose.
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Fasting blood glucose (FBG) levels in non-diabetics should be greater than 110 mg/dl.
Fasting blood glucose (FBG) levels in non-diabetics should be greater than 110 mg/dl.
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Match the following conditions to their typical findings:
Match the following conditions to their typical findings:
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At what blood glucose level does glucose typically start appearing in urine?
At what blood glucose level does glucose typically start appearing in urine?
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What does NADPH measure in the hexokinase method?
What does NADPH measure in the hexokinase method?
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The renal glucose threshold decreases with age and diabetes.
The renal glucose threshold decreases with age and diabetes.
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In a Random Blood Glucose (RBG) test, values higher than _____ mg/dl usually indicate diabetes mellitus.
In a Random Blood Glucose (RBG) test, values higher than _____ mg/dl usually indicate diabetes mellitus.
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What test is used to measure the body's ability to utilize glucose without hyperglycemia?
What test is used to measure the body's ability to utilize glucose without hyperglycemia?
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What condition can ketone levels in plasma suggest besides diabetes?
What condition can ketone levels in plasma suggest besides diabetes?
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Match the glucose tests with their definitions:
Match the glucose tests with their definitions:
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The postprandial test requires fasting for at least 10 hours before measurement.
The postprandial test requires fasting for at least 10 hours before measurement.
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What is the threshold for blood glucose levels to be considered borderline in fasting blood glucose tests?
What is the threshold for blood glucose levels to be considered borderline in fasting blood glucose tests?
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Study Notes
Disorders of Carbohydrate Metabolism
- Carbohydrate metabolism is a complex process involving the digestion, absorption, and utilization of carbohydrates.
- Glucose is a vital energy source, and its homeostasis is crucial for maintaining bodily functions.
- The body regulates blood glucose levels through various mechanisms and hormones.
Glucose Homeostasis
- Blood glucose levels are maintained within a specific range (80-120 mg/dL).
- Normal fasting blood glucose is 65-110 mg/dL.
- Glucose is added to the body through diet (fructose and galactose).
- Glucose is removed through glycogenolysis (breakdown of glycogen), gluconeogenesis (synthesis of glucose), glycolysis, Krebs cycle, and lipogenesis.
Normal Carbohydrate Metabolism
- Intestines absorb glucose after a meal.
- Pancreas responds to high glucose levels by secreting insulin, causing tissues to take up glucose.
- If increasing glucose levels persist, homeostasis is restored, and glucose uptake is increased by the liver and skeletal muscles.
- This is a negative feedback loop to maintain normal glucose levels.
Tissue Regulation
- Gastrointestinal (GI) tract: Slows food evacuation and absorption.
- Liver: Increases tissue glucose uptake, activating glycogenesis, glycolysis, and Krebs cycle during hyperglycemia. In hypoglycemia glycogenolysis and gluconeogenesis occur.
- Muscles: Converts glucose to glycogen (glycogenesis) in hyperglycemia. In hypoglycemia, glycogenolysis occurs.
Adipose Tissues
- Convert glucose to fats (triacylglycerols) via glycerol-3-P.
Kidneys
- Maintain blood glucose by preventing its loss in urine (threshold 180 mg/dL).
- Excrete glucose in urine when levels exceed 180 mg/dL.
Hormonal Regulation
- Hormones regulate carbohydrate, lipid, and protein metabolism.
- Hyperglycemic hormones: Glucagon, thyroid hormone, epinephrine, NE, growth hormone, and glucocorticoids.
- Hypoglycemic hormones: Insulin.
Maintaining Blood Glucose Levels
- After 2-3hrs of fasting, stored glycogen is degraded into glucose.
- After 18hrs of fasting, gluconeogenesis becomes the main source of glucose.
- Triglycerides, amino acids, and lactate are converted to glucose in the liver.
Hyperglycemia
- Fasting blood glucose levels above 150mg/dL or postprandial levels exceeding 200 mg/dL indicate hyperglycemia.
- Causes include defects in the pancreas (diabetes mellitus), heavy diets, stresses (increased E, NE, and thyroxin), pancreatitis, excessive anti-insulin hormones, and pregnancy.
Hypoglycemia
- Low blood glucose levels (below 60 mg/dL).
- Causes include prolonged fasting, excessive insulin secretion after a high-carbohydrate meal, overdose of insulin/antidiabetic drugs, alcohol, insulinoma, hepatic disease, and Addison's disease.
Glycogen Storage Diseases
- Genetic disorders affecting glycogen metabolism.
- Examples: Von Gierke's disease, McArdle disease, Pompe's disease, and Cori's disease.
Galactose Intolerance
- Results from deficiencies in enzymes.
- Symptoms can include cataracts, liver damage, and mental retardation.
Fructose Intolerance
- Genetic disorders affecting fructose metabolism.
- Symptoms vary, including potential liver damage and mental retardation.
Diabetes Mellitus (DM)
- A group of metabolic disorders characterized by elevated blood glucose levels.
- Two main types: Type 1 (insulin deficiency) and Type 2 (insulin resistance).
DM Complications
- Acute: Hyperglycemia, glucosuria, polyuria, polydipsia, polyphagia.
- Chronic: Retinopathy, neuropathy, nephropathy, atherosclerosis, cardiovascular disease, and complications due to glycation and sorbitol.
Chemical Determination of Glucose Levels
- Various methods exist to determine glucose levels (e.g., non-specific tests like Benedict's, and specific tests like glucose oxidase and hexokinase).
Biochemical Tests for DM
- Random Blood Glucose (RBG): Used in emergencies.
- Fasting Blood Glucose (FBG): Measured after an overnight fast.
- Postprandial test: 2 hours after a carbohydrate meal.
- Oral Glucose Tolerance Test (OGTT): Measures body's ability to process glucose.
Other Common Screening Tests
- Glucose in Urine (Glycosuria): Indicates high blood glucose levels but isn’t definitive.
- Ketones in Urine/Plasma: Abnormal levels suggest ketoacidosis.
- Plasma Insulin Level: Assesses insulin production and function.
- Hemoglobin A1c (HbA1c): Reflects average blood glucose levels over several months providing insight into diabetes control.
- Fructosamine: Reflects average blood glucose levels over several weeks.
- Microalbuminuria/Macroalbuminuria: Reflects kidney damage and chronic complications.
- UACR urine Test: Albumin/creatinine ratio in urine assesses for kidney damage.
Case Studies
- Examples of hypoglycemia and diabetes management, highlighting various diagnostic and treatment approaches.
Long-Term Indices of Diabetic Control
- HbA1c (glycated hemoglobin) measures average blood glucose for the past 2-3 months
- Urine Albumin Creatinine ratio (UACR) assesses for kidney damage
- Other indices include fructosamine, and specific tests for long-term indicators of control.
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Description
Test your knowledge on insulin, glucose metabolism, and hormonal effects related to diabetes. This quiz includes questions on fasting blood glucose levels, the role of hormones in carbohydrate metabolism, and the challenges faced during pregnancy. Perfect for students learning about endocrinology and diabetes management.
