Carbohydrates & Glucose Testing
Hyperglycemia
Hypoglycemia & Other Disorders
Amino Acids & Intro to Proteins
Trace Metals
100

What is the reference method for Glucose?

Hexokinase method

100

High levels of insulin can cause darkening of the neck known as what?

Acanthosis Nigricans

100

What glucose level is considered to be hypoglycemic?

<50 mg/dl

100

A chain of amino acids linked by peptide bonds is known as:

Polypeptide
100

What trace metal is most commonly deficient in alcoholics/alcoholism?

Zinc

200

The glucose oxidase method is the most specific for what type of glucose?

B-D-Glucose

200

What is the most common type of Hyperglycemia? Define it.

Type 2 diabetes 

•Hyperglycemia as a result of an individual’s resistance to insulin with an insulin secretory defect

200

In a rapid fall of glucose level to <50, what hormone is released in response?

Epinephrine

200

What is the isoelectric point?

positively charged groups = negatively charged groups (no net charge)

200

1. Define/describe Hemochromatosis.

2. What is a distinct dermatological symptom seen with classical hemochromatosis?

•Progressive disease that results from iron overload

•Body iron accumulates and excess iron deposits in liver, pancreas, heart, joints, and endocrine glands

-Bronze color of skin

300

Name at least 2 hormones that promotes or cause the increase of glucose levels?

Glucagon

Epinephrine

Glucocorticoids (cortisol)

Growth hormone (somatotropin)

ACTH

Thyroxine

300

1. Type 1 Diabetes is a form of inappropriate hyperglycemia commonly caused by:

2. What age group is commonly affected?

-cellular-mediated autoimmune B-islet cell destruction

-Genetics, viral, environmental factors

-Idiopathic

-Age: Children & Adolescence

300

Within Galactosemia, a common symptom is failure to thrive syndrome among infants. What is the lacking enzyme? 

galactose-1-phosphate uridyltransferase

300

1. What is the formula for the A/G ratio?

2. If the total protein of a sample is 7 g/dl and the albumin level is 2 g/dl, what is the globulin level in the sample?

Total protein – Albumin = Globulin

7-2 = 5 g/dl of globulin

300

1. What two disorders/diseases are associated with copper?

2. What are their distinct findings?

Menke's Disease and Wilson's Disease

Menke's disease - Kinky hair, retardation, early death

Wilson's disease - Kayser-Fleischer Rings (green-brown discoloration) in the cornea caused by copper deposition

400

1. If a doctor wants to monitor a patient's glucose levels for the past 2-3 months, what test would be the most useful?

2.What is the normal values for this test?

Glycosylated hemoglobin (HbA1c)

Normal value: 4.0%-6.0% (Ideally <5.7%)

400

Testing Criteria for Type 2 Diabetes is one required plus 2 others. What are they?

Overweight (required)

Two others:

-family history

-race/ethnicity 

-signs of insulin resistance 

-maternal history of GDM or diabetes 

400

A patient comes in complaining of experiencing cramps while exercising often. After some lab work, you recognize the patient has glycogen buildup within their muscles. What is the condition the patient has and what is lacking?

•McArdle’s Disease

•Lack in muscle phosphorylase

400

List and describe the 4 basic protein structures.

Primary - Number and type of amino acids in specific sequence

Secondary - Structure stabilized by hydrogen bonds, makes 3 forms: alpha helix, beta-pleated sheets, random coil

Tertiary - Conformation is a fold, stabilized by hydrogen and disulfide bonds

Quaternary - Shape or structure made from interaction of more than one protein molecule held together by convalescent forces

400

1. Lead has no known role in normal human physiology. 99% of lead is taken up by ________ affecting ______ synthesis.

2. Lead exposure commonly occurs, how?

RBCs, heme

children - paint chips, cribs

adults- occupational exposure

500

1.What is the Glucose value in fasting serum/plasma and CSF?

2. What are the panic values and their significance?

Serum/plasma - 70-99 mg/dl

CSF - 2/3 of venous value (40-80 mg/dl)

Critical values:

<40 mg/dl - brain damage

>400 mg/dl - possible coma

500

1. Name at least 2 tests that can be used to determine diabetes and what are the values?

2. Can a one-time test diagnose diabetes?

-HbA1c: > or equal to 6.5%

-Fasting plasma glucose: > or equal to 126 mg/dl

-OGTT-2 hour post prandial: > or equal to 200 mg/dl

-Random glucose plasma: > or equal to 200 mg/dl + symptoms of diabetes

500

Describe the Tolbutamide Tolerance test and the results in normal and abnormal findings.

AKA Insulin Tolerance Test

•Differentiates insulinomas from other hyperinsulinemia states

•Tolbutamide – stimulates pancreas to produce insulin

Procedure:

•Inject Tolbutamide IV and collect glucose level for 2 hours

Results:

•Normal: rapid fall in glucose to 50% of fasting level, and returns to normal in 2 hours

•Peak insulin conc. usually does not exceed 150 uIU/mL at 2 min.

•Insulinoma suspected – exaggerated plasma insulin response with persistent hypoglycemia, does not return to normal levels

•>150 uIU/Ml at 60 min. consistent with insulinoma

500

1. What is the normal range of protein within the CSF?

2. Name at least 1 cause of Increased and Decreased levels of CSF protein.

3. What is indicative when the CSF IgG Albumin index is >.70?

14-45 mg/dl

Increased:

-bacterial, viral, fungal meningitis, traumatic lumbar puncture, Multiple Sclerosis, obstruction, neoplasms, disk herniation, and cerebral infarction

Decreased: Hyperthyroidism & fluid leaking from CNS 

-CNS production of IgG (Multiple Sclerosis)

500

Determine the condition for the following:

1. Fe (Increased), TIBC (Decreased), % Sat. (Increased), Ferritin (Increased)

2. Fe (Decreased), TIBC (Increased), % Sat. (Decreased), Ferritin (Decreased)

3. Fe (Decreased), TIBC (Decreased), % Sat. (Normal/Decreased), Ferritin (Increased)

1. Thalassemia or Hemochromatosis

2. Iron Deficiency

3. Chronic disease

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