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54 Cards in this Set

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CHO
aldehyde and ketone derivatives of polyhydroxyl alcohols or cmpds that yield these derivatives upon hydroysis
maltose
glucose + glucose
lactose
glucose + galactose
sucrose
glucose + fructose
polysaccharide
greater than ten molecules (starch)
starch
type of polysaccharide (amylose and amylopectin)
D-configuration
configuration of sugar in our bodies; alpha and beta forms are in equilibrium in aqueous soln.
glucose oxidase
method for glucose determination; doesn't react with alpha-D-glucose and is negative for reducing sugars; important for infants who are lactose or sucrose intolerant
mutarotase
added to convert all glucose to the beta-D-glucose steroisomer
copper reduction test
test that is positive for all reducing sugars; (negative for sucrose)
galactosemia
neonatal disorder; due to enzyme deficiency; D & V; mental retardation, cataracts, and liver damage
fructosuria
deficiency of fructokinase enzyme; causes ketosis, lactic acidosis, and liver failure when fruits, honey, or syrup are large part of intake
glycolysis
metabolism of glucose molecule to pyruvate or lactate for production of ATP
gluconeogenesis
formation of G-6-P for AA and fat sources
glycogenesis
conversion of glucose to glycogen for storage
lipogenesis
conversion of glucose to fat
lipolysis
decomposition of fat
insulin
hormone produced by beta cells of pancreas; two chain polypeptide; LOWERS blood glucose; stimulates glycolysis, glycogenesis, and lipogenesis
glucagon
hormone produced by alpha cells of the pancreas; INCREASES blood glucose; stimulates glycogenolysis, gluconeogenesis, and lipolysis
ACTH
hormone from anterior pituitary; controls glucocorticoic secretion; indirectly increases blood glucose
Glucocorticoid (cortisol)
hormone from adrenal cortex; increases blood glucose; stimulates glucose adding processes
Epinephrine
hormone from adrenal medulla; increases blood glucose; stimulate glucose adding processes
growth hormone
hormone from anterior pituitary; increases blood glucose; stimulates glucose adding processes
Thyroxine (T4) and Thyronine (T3)
hormones from thyroid gland; increases blood glucose; stimulates glucose adding processes
diabetes mellitus; pancreatitis/pancreatectomy
reduced insulin secretion leads to these disorders
Type 1
diabetes due to lack of insulin
Type 2
diabetes due to insulin resistance or insulin deficiency
gestational
diabetes due to insulin resistance during gestation
other causes
diabetes due to endocrine/exocrine or specific drugs
ketoacidosis
happens when glucose can't get into cell, so fat (FFA) is broken down and lipogenesis is stimulated; causes a decrease in blood pH
Type II
NIDDM; adult onset (>40); variable insulin secretion; insulin independent; not prone to ketoacidosis or complications
gestational diabetes
occurs during pregnancy (1-14%); tx with diet or insulin; becomes normal after pregnancy
@ low risk for gestational diabetes
<25; normal wt. before pregnancy; no known diabetes in 1st degree relatinve; no hx of abnormal glucose tolerance or poor obstetric outcome
<126 mg/dl
normal fasting blood glucose
>200 mg/dL
random blood glucose level; polyuria, polyphagia, polydipisa
CHO diet or 300 g/day for 3 days prior to test; overnight fasting; may drink water; no meds
OGTT; pt prep
draw fasting blood; 75g CHO (glucose drink); draw blood after 30 min, 1 hr, and 2 hr.
OGTT; procedure
OGTT
this test is rarely necessary for dx of diabetes; suffers from poor reproducibilty and should be performed 2 x's before diagnosis of DM is given
IGTT
give this test when patient has malabsorption due to GI surgery or gastric problems; patient prep similar to OGTT
IGTT
give pt 0.5g glucose/kg bw/IV over 30 minutes
hyperglycemia/glucosuria; ketonuria; acidosis (pH<7.35); anionic gap increased; hyperosmolarity (>350, BUN and glucose); BUN increased (due to protein catabolism)
DM lab findings
acidosis
nitroprusside test positive (reacts with ketoacids);
blood gas analysis with acidosis
Low pH; low bicarbonate, high anion gap; high glucose
glycated hgb
normal=<6%
goal=<7%
glycated hgb testing guideline
if unstbale perform quarterly; if stable perform twice a yr; do lipid profile and microalbumin yearly
glycated hgb
this concentration representss the integrated values of glucose over the preceding 6 to 8 wks;
glycation
process of non-enzymatic addition of a sugar molecule to the amino group of a protein; glycation is an irreversible process
glycosylated hgb
normal = 5-7%
uncontrolled diabetes = 11-15%
glycosylated hgb methodology
ion-exchange chromatography; HPLC (GOLD STANDARD); and immunoassay
hypoglycemia
blood glucose conc. below the fasting level; weakness/trembling, headache/lightheaded, epigastric discomfort, hunger, & rapid pulse
postprandial hypoglycemia
clinical disorder in which the pt has postprandial symptoms that occur in everyday life and are accompanied by glucose level <45-50 mg/dL
fasting hypoglycemia
hypoglycemia that may be due to a decreased rate of hepatic glucose production or an in creased rate of glucose utilization
insulin overdose hypoglycemia
caused by insulin secreting tumor or deficiency or hyperglycemic hormone
drug induced hypoglycemia
due to ethanol, propanol, or salicylate