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KIN 311 > Metabolic Screening > Flashcards

Metabolic Screening Flashcards

1
Q

Type 1 diabetes:

A

primarily a result of pancreatic beta cell destruction causing impaired insulin secretion

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2
Q

Type 2 diabetes:

A

insulin resistance (insulin less effective at facilitating glucose uptake)

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3
Q

Gestational diabetes:

A

glucose intolerance onset during pregnancy

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4
Q

Glucose measurement is important for…

A
  • diagnosis of diabetes

- monitoring glucose (at rest, during, and following exercise)

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5
Q

Normal blood glucose levels for capillary glucose sampling:

A
  • fasting: 3.9 - 5.5 mmol/L (70-100 mg/dL)

- non-fasting: < 11.1 mmol/L (<200 mg/dL)

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6
Q

4 steps of capillary sampling (WHO guidelines):

A
  • select and clean site with alcohol
  • puncture the skin with 1 quick, deliberate poke (prevent repeated punctures)
  • wipe away first drop of blood (avoid contamination with tissue fluid or debris)
  • avoid squeezing the finger too tightly because this dilutes the sample with tissue fluid (plasma)
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7
Q

The same technique (capillary sampling) is used for…

A
  • blood glucose

- lactate sampling

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8
Q

Where should the site be for capillary sampling?

A
  • lateral aspect (least sensitive)
  • do not use tip: can it bone
  • pad of finger is thicker/harder
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9
Q

Why can capillary sampling be ineffective in some cases?

A
  • 1 value is not relevant all day long

- doesn’t tell you how the body deals with glucose (value can be high or can be going up)

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10
Q

OGTT =

A

oral glucose tolerance test

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11
Q

OGTT:

A
  • standardized test to see how individuals deal with glucose
  • oral glucose tolerance beverage (standard 75g of glucose)
  • need to take in 5 minutes
  • healthy individual should be able to clear quickly
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12
Q

Disadvantage to OGTT:

A

doesn’t tell you anything about the rest of the day

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13
Q

Continuous glucose monitoring:

A
  • patch on abdomen

- measures interstitial glucose (glucose that has exited circulatory system, good representation of what is in it)

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14
Q

Who would use continuous glucose monitoring?

A
  • someone with diabetes (need data often)
  • expensive, not covered
  • some have alerts if it gets too high or too low
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15
Q

HBA1c =

A

glycated hemoglobin

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16
Q

RBC are freely permeable to ______ molecules.

A

glucose

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17
Q

Glucose irreversibly attaches to _______ to form ____ _____.

A
  • hemoglobin

- glycated hemoglobin (HBA1c)

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18
Q

Because RBC has a life span of ____ days, glycated hemoglobin reflects glucose levels over the preceding ____ months.

A
  • 120 days

- 2-3 months

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19
Q

The HBA1c fraction is abnormally _____ in people with chronic hyperglycemia.

A

elevated

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20
Q

A HBA1c > or equal to ____% is diagnostic of diabetes if confirmed by repeat testing.

A

6.5%

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21
Q

FPG =

A

fasting plasma glucose

22
Q

Advantages of FPG:

A
  • established standard
  • fast and easy
  • single sample
  • prevents microvascular complications
23
Q

Disadvantages of FPG:

A
  • sample not stable
  • high day to day variability
  • inconvenient (fasting)
  • reflects glucose homeostasis at a single point in time
24
Q

Advantages of 2hPG in 75g OGTT:

A
  • established standard

- predicts microvascular complications

25
Q

Disadvantages of 2hPG in 75g OGTT:

A
  • sample not stable
  • high day to day variability
  • inconvenient
  • unpalatable
  • cost
26
Q

A1C =

A

glycated hemoglobin

27
Q

Advantages of A1C:

A
  • convenient (measure any time of day)
  • single sample
  • predicts microvascular complications
  • better predictor of macrovascular disease than FPG or 2hPG in a 75g OGTT
  • low day to day variability
  • reflects long-term glucose concentration
28
Q

Disadvantages of A1C:

A
  • cost
  • misleading in various medical conditions
  • altered by ethnicity and aging
  • standardized, validated assay required
  • not for diagnostic use in children, adolescents, pregnant women, or those with suspected type 1 diabetes
29
Q

Diagnosis of diabetes with FPG:

A

> or equal to 7.0 mmol/L

30
Q

Fasting =

A

no caloric intake for at least 8 hours

31
Q

Diagnosis of diabetes with A1C:

A
  • not recommended
  • > or equal to 6.5% (in adults)
  • using a standardized, validated assay in the absence of factors that affect the accuracy of the A1C and not for suspected type 1 diabetes
32
Q

Diagnosis of diabetes with 2hPG in a 75 g OGTT:

A

> or equal to 11.1 mmol/L

33
Q

Diagnosis of diabetes with random PG:

A

> or equal to 11.1 mmol/L

34
Q

Random =

A

any time of the day, without regard to the interval since the last meal

35
Q

IFG =

A

impaired fasting glucose

36
Q

IGT =

A

impaired glucose tolerance

37
Q

Diagnosis of prediabetes with FPG:

A
  • 6.1-6.9 mmol/L

- IFG

38
Q

Diagnosis of prediabetes with 2hPG in a 75g OGTT:

A
  • 7.8-11.0 mmol/L

- IGT

39
Q

Diagnosis of prediabetes with A1C:

A
  • 6.0-6.4%

- prediabetes

40
Q

How to diagnose metabolic syndrome: > or equal to 3 of the following:

A
  • elevated waist circumference
  • elevated TG > or equal to 1.7 mmol/L
  • reduced HDL-C < 1.0 mmol/L (male), < 1.3 mmol/L (female)
  • elevated BP (> or equal to 130/85)
  • elevated FPG > or equal to 5.6 mmol/L
41
Q

What is required for phlebotomy?

A

separate certification

42
Q

Phlebotomy:

A

taking blood

43
Q

Normal range of hematocrit:

A

40-50%

44
Q

Plasma should be ____% of total blood.

A

55%

45
Q

Buffy coat leukocytes and platelets should be ___% of total blood.

A

< 1%

46
Q

Erythrocytes should be ____% of total blood.

A

45%

47
Q

Hemoglobin concentration normal range:

A

13-17 g/dL

48
Q

Hemoglobin consists of:

A
  • alpha chains
  • beta chains
  • O2 binding heme group
49
Q

Hemoglobin oxygen saturation:

A
  • Measures amount of hemoglobin not bound to oxygen
  • Should be high 90s in most individuals
  • Relevant for heart failure, exercise (aerobic power, how much oxygen is used)
50
Q

Hypoxia during exercise:

A
  • Females can’t ventilate enough with exercise
  • Need to extract more from the blood = hypoxic
  • If you give them oxygen, they will perform better
51
Q

Urine tests can be used to show…

A
  • Kidney function (Protein shows up when this fails)

- Ketosis (Protein shows up)

KIN 311 (19 decks)

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