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56 Cards in this Set
- Front
- Back
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These are hydrated of aldehyde or ketone derivates -It is combination of carbon, hydrogen-oxygen |
Carbohydrates |
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Disease states involved |
hyperglycemia and hypoglycemia |
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-Sugar that cannot be hydrolyzed to a simpler form -Sugar that contain 3, 4, 5, 6 carbon atoms (triose, tetroses, pentoses and hexoses, etc.) -Examples include fructose, glucose, galactose |
Monosaccharides or simple sugars |
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Formed by interaction of two monosaccharides Examples Maltose = glucose + glucose Lactose = glucose + galactose Sucrose = glucose + fructose |
Disaccharides |
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Linkage of many monosaccharide units Include starch, glycogen and cellulose |
Polysaccharides |
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Pathways of Glucose Metabolism |
Glycolysis Gluconeogenesis Glycogenolysis Glycogenesis Lipogenesis Lipolysis |
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Metabolism of glucose to lactate or pyruvate for production of energy |
Glycolysis |
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-Formation of glucose-6-phosphate from non carbohydrate source |
Gluconeogenesis |
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Breakdown of glycogen to glucose for use as energy |
Glycogenolysis |
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Conversion of glucose to glycogen for storage |
Glycogenesis |
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Conversion of carbohydrates to fatty acids |
Lipogenesis |
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Decomposition of fat |
Lipolysis |
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Regulation of Glucose Metabolism |
1.Insulin 2.Glucagon 3.Epinephrine 4.Cortisol 5.Growth hormone 6.Thyroxine 7.Somatostatin
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-Primary hormone responsible for decreasing blood glucose -Synthesized by the β cells of the islets of Langerhan (pancreas) - Regulates blood glucose by ↑ glycogenesis, glycolysis and lipogenesis; and ↓ glycogenolysis. |
Insulin (Hypoglycemic agent) |
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-Primary hormone responsible increasing blood glucose -Synthesized by the α cells of the islets of Langerhan (pancreas) - Regulates blood glucose by ↑ glycogenolysis and gluconeogenesis. |
Glucagon (hyperglycemic agent) |
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1. Produced by the adrenal medulla, ↑ blood glucose 2. Released during times of physical and emotional stress 3. Inhibits insulin secretion, ↑ glycogenolysis and lipolysis |
Epinephrine |
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1.Produced by the adrenal cortex, in response to ACTH, ↑ plasma glucose 2. ↓ intestinal entry of glucose into the cell, ↑ gluconeogenesis, glycogenolysis and lipolysis |
Cortisol (Glucocorticoids) |
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1. Produced by the anterior pituitary gland; ↑ plasma glucose 2. ↓ glucose entry to cells, ↑ glycolysis |
Growth hormone |
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1. Produced by the thyroid gland; ↑ plasma glucose 2. ↑ glycogenolysis, gluconeogenesis and glucose intestinal absorption |
Thyroxine |
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1. Produced by the Delta cells of the islet of Langerhans in the pancreasand hypothalamus 2. Increases plasma glucose by inhibition of insulin, glucagon, GH, etc.s |
Somastostatin |
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Disease states in Glucose Metabolism |
Hyperglycemia Hypoglycemia |
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Increase in plasma glucose
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Hyperglycemia |
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Metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both |
Diabetes mellitus |
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Diabetes Mellitus Classification |
1. Type 1 (IDDM) 2. Type 2 (NIDDM) 3. Other 4. Gestational |
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-10-20% of all cases of diabetes -Occurs in childhood and adolescence -Absence of Insulin with excess in glucagon |
Type 1 |
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Type 1.Sign and Symptoms
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• Polydipsia (excessive thirst) • Polyphagia (↑ food intake) • Polyuria (excessive urine production) •Rapid weight loss •Hyperventilation •Confusion and possible loss of consciousness |
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-90% of all cases of diabetesAdult onset -Non Insulin dependendent |
Type 2 |
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Type 2 Milder symptoms than type 1
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• Polydipsia (excessive thirst) • Polyphagia (↑ food intake) • Polyuria (excessive urine production) |
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HyperglycemiaLaboratory Findings
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1.increase glucose in plasma and urine 2. Increase urine specific gravity 3. Ketones in serum and urine 4. Decrease oid and urine pH 5. Electrolyte imbalance |
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Result imbalance between glucose utilization and production |
Hypoglycemia |
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HypoglycemiaLaboratory Findings |
↓ glucose in plasma ↑↑↑ in patients with pancreatic β-cell tumors (insulinoma |
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-Glycogen build up in the liverdue to inhibition of hepatic glycogenolysis |
Von Gierke Disease (glucose-6-phosphatase deficiency type 1) |
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Inhibition of glycogenolysis |
Galactosemia (galactose-1-phosphate uridyl transferase dificiency) |
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Diagnosis of Glucose Metabolic Alterations |
1. WB glucose concentration 11% lower than plasma 2. Serum or plasma must be refrigerated and separated from the cells within 1 hr 3. Sodium flouride (gray-top) can be used to inhibit glycolyticenzymes 4. FBG should be obtained in the morning after 8 to 10 hours fasting(not longer than 16 hours |
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-Copper reduction method (uses BaSO4 to remove saccharoids) Glucose + arsenomolybdic acid arsenomolybdenum blue |
Nelson Somogyi |
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-ferric reducion method (inverse colorimetry) -Glucose + Ferricyanide (yellow) Ferrocyanide (colorless) |
Hagedorn jensen |
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-Condensation of carbohydrates with aromatic amines producing Schiff bases (green) |
Ortho-toluidine (Dubowski) |
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Enzymatic Methods of Glucose Measurement
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1. Glucose oxidase (Saifer Gernstenfield) 2. Hexokinase (reference method) 3. Clinitest |
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Self-Monitoring of Blood Glucose
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1. Type 1 diabetes – 3 to 4 times/day |
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Polyclonal or monoclonal antibodies toward the glycated N-terminal group of the β chain of Hb |
Immunoassays |
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Separated based on chemical structure using boronate group to bind glycosylated protein |
Affinity Chromatography |
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Methods of HbA1C Measurement based on charge differences |
-Cation-exchange Chromatography -Electrophoresis -Isoelectri fucosing -HPLC |
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Positive-charge resin bed attaches to negatively charged hemoglobin |
Cation-exchangechromatography |
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Separation is based on differences in charge |
Electrophoresis |
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Type of electrophoresis using isoelectric point to separate |
Isoelectric focusing |
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A form of ion-exchange chromatography Separates all forms of HbA1C (A1a, A1b, A1 c) |
HPLC |
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Produced by the liver through metabolism of stored lipids |
Ketone |
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3 ketone bodies
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• Acetone (2%) • Acetoacetic acid(20%) • 3-β-hydroxybutyric acid (78%) |
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accumulation of ketones in blood |
Ketonemia |
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accumulation of ketones in urine |
Ketonuria |
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Mtds. of Ketone Measurement
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-Gerhardt’s Test -Nitroprusside -Enzymatic |
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Acetoacetic acid + Ferric chloride Red color |
Gerhardt’s Test
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Acetoacetic acid + nitroprusside–alkaline pH Purple color |
Nitroprusside
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NADH + H+ + acetoacetic acid β-HBD NAD + β-hydroxybutyric |
Enzymatic |
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Diagnosis at an early stage diabetic renal nephropathy and before the development of proteinuria |
Microalbuminuria
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Thank you 😊 |
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