Chemistry Test 2 (Chapter 6)
Terms in this set (98)
Conversion of glucose into lactate or pyruvate is referred to as:
Which one of the following statements is correct concerning the oral glucose tolerance test (OGTT)?
A fasting blood glucose concentration of 100 mg/dL and a 2 hour glucose value of 60 mg/dL are indicative of impaired glucose tolerance
Which anticoagulant is the best anticoagulant for serum glucose analysis because it inhibits glycolysis?
Which one of the following statements concerning whole blood glucose values is correct?
They are approximately 15% lower than plasma glucose values
Which one of the following statements concerning carbohydrates is incorrect?
The process of glycogen formation occurring in the liver and skeletal muscle is referred to as glycogenolysis
All of the following results are confirmatory of diabetes mellitus except:
Urine glucose >250 mg/dL
The specimen of choice for glycated hemoglobin ion-exchange chromatography analysis is:
EDTA whole blood
Is associated with resistance to the action of insulin
In uncontrolled diabetes mellitus, ketones are present in the blood and urine because of:
Increased free fatty acids
Which of the following hormones promotes decreased blood glucose?
Factors identified as associated with (and possibly causing) type 1 diabetes mellitus include all of the following except?
Dysfunctional insulin receptors
A patient visits her physician with a complaint of polyuria and polydipsia. Based on family history, he suspects she is a candidate for diabetes mellitus. He orders a glucose analysis, which is performed using the glucose oxidase method. The physician does not know, however, that the patient also has gout. How will this affect the glucose value obtained by using the mentioned methodology?
It will be falsely decreased
When glucose in blood becomes elevated, the renal threshold for glucose will be reached and _______ can be observed.
Glycated hemoglobin (GHb) is an indicator of a diabetic's compliance with their insulin taking regimen. It time averages the glucose in the blood over a _______ time period.
6 to 8 week (3 months)
An individual visits the free clinic stating that she if feeling "sort of woozy" and confused. Upon checking her records, the physician at the clinic notes that she is a diabetic and is supposed to take insulin twice a day. It is also noted that she is a chronic alcoholic. The doctor chooses to assess her glycated hemoglobin (GHb) to determine whether she is following her prescribed insulin therapy. Your laboratory uses an ion- exchange procedure to test GHb. How will these results be affected by the preanalytical variables?
The GHb value will be falsely decreased
Which of the following oral glucose tolerance test (OGTT) results would be classified as diagnostic for diabetes mellitus (normal glucose is 60 to 110 mg/dL) if an individual's fasting blood glucose value is 125 mg/dL?
30 minute serum glucose: 145 mg/dL; 2 hour plasma glucose: 210 mg/dL
By what mechanism does glucagon promote hyperglycemia?
Glucagon stimulates glucose synthesis by gluconeogenesis
Which of the following is characteristic of type 1A diabetes mellitus?
Autoantibodies formed against islet cell cytoplasm
The formation of glucose from amino acids occurs in the liver and is referred to as:
An example of a reducing disaccharide would be?
The breakdown of glycogen stores in the liver to increase serum glucose is referred to as:
Which form of diabetes mellitus is manifested in individuals with first degree relatives who have diabetes, associated with obesity and glycosuria?
A patient with a severe, uncontrolled case of type 1 diabetes mellitus will exhibit all of the following conditions except:
Glycated hemoglobins are formed by the addition of glucose to the ________ residue.
A diabetic patient with a glycated hemoglobin value of 5.4% would be considered to have _______ control of his/her diabetes?
As a regulator of glucose metabolism in a healthy individual, thyroxine has the effect of:
Stimulates glycogenolysis to increase blood glucose
Microalbuminuria is a(n)
Urinary excretion rate of albumin that is higher than normal but less than overt proteinuria
Insulin regulates blood glucose levels by
Stimulating the translocation of a glucose transporter and promoting glucose uptake into skeletal muscle and fat
What is the classic test to analyze hypoglycemic symptoms?
A 72 hour fast
Recognized abnormalities of lipid metabolism associated with uncontrolled diabetes mellitus include
Insulin deficiency in diabetes mellitus will cause
Decreased reesterification of fatty acids into triglycerides
A 75 year old diabetic man was brought by his daughter to a hospital emergency department. He was in a confused state, complaining of lightheadedness, trembling, sweating, and nausea. His daughter claims that he does not drink alcohol and that he takes oral hypoglycemic agents to control his diabetes. What is the likely cause of his symptoms?
He has likely taken too much of his medication and is suffering from hypoglycemia
A polarographic oxygen electrode method is used in a laboratory analyzer to assess glucose. An individual who is unfamiliar with the protocol places several anticoagulated whole blood samples on the analyzer to be analyzed. What effect will this have on the glucose values of these specimens?
They will be falsely decreased
A fingerstick glucose value was 120 mg/dL. If unhemolyzed serum or plasma were tested from the same individual at the same time, what might the glucose value be?
Approximately 132 mg/dL
Retinopathy, neuropathy, microvascular, and macrovascular changes are all chronic complications of both type 1 and type 2 diabetes mellitus. One theory as to the cause of these chronic problems is the presence of advance glycation end (AGE) products. These AGE products consist of:l
Proteins that have been irreversibly modified by nonenzymatic attachment of glucose
The development of metabolic acidosis (blood pH becoming more acidic) in an uncontrolled diabetic is caused by the:
The increased formation of B-hydroxybutyric acid
An EDTA anticoagulated blood tube is received in your laboratory. The specimen has come from an individual with known hereditary spherocytosis, which produces a hemolytic anemia. How might this affect the GHb values from this individual?
There would e a decreased value for GHb
Blood is obtained in a plain red top tube containing no serum separator and is transported to the laboratory from an outpatient clinic. Transport time at room temperature, accessioning, and sample prep time equal approximately three hours. If a glucose level is requested on this tube of blood, how might the results be affected by the timing?
The glucose value would be decreased by ~15%
The role of the clinical laboratory in diagnosis of diabetes mellitus involves an initial diagnostic criterion. What is this sole determination upon which a diagnosis rests?
Demonstration of hyperglycemia in more than one fasting plasma glucose test
An isomer of glucose with the -OH group of the anomeric carbon C1 that is below the plane of the ring or on the right hand side is:
a-glucose.... so alpha glucose
Which of the following carbohydrates is a polysaccharide?
The formation of glucose from non carbohydrate sources, for example, amino acids, glycerol, and lactate
The conversion of glucose into lactate or pyruvate and then CO2 and H20.
Glycogen is stored in the:
Which of the following is the primary hypoglycemic hormone?
Which of the following hormones does not stimulate glycogenolysis?
A patient low glucose, increased insulin, and increased C-peptide is caused by:
The only hormone that causes a decrease in blood glucose levels is:
Which of the following is characteristic of type 2 diabetes mellitus?
Obesity and physical inactivity
Which form of diabetes usually manifests itself early in life, and is associated with ketosis, low insulin levels, and autoantibodies to islet cells?
All of the following are associated with gestational diabetes EXCEPT:
Is diagnosed using the same glucose tolerance criteria as in nonpregnant women
All of the following are confirmatory of diabetes mellitus EXCEPT:
Urine glucose greater than 300 mg/dL
Complications of diabetes mellitus include all of the following EXCEPT:
Instructions for patients preparing for a glucose tolerance tests include all of the following EXCEPT:
Caffeine and smoking are permitted before and during the test
A patient with an insulinoma may exhibit dizziness and fainting attributable to:
What type of hypoglycemia is exhibited 8 hours after a meal?
All of the following statements about clinical hypoglycemia are true EXCEPT:
High fasting insulin levels must be present to make a diagnosis
Select the enzyme that is most specific for B-D glucose
The enzyme that catalyzes the reaction ATP + D-glucose -> ADP + D-glucose-6-phosphate is:
In the Hexokinase method for glucose determinations, the actual end product measured is the:
NADPH + H+ produced from the reduction of NADP
Glucose concentration in serum is:
Higher than the concentration in whole blood
In a specimen collected for plasma glucose analysis, sodium fluoride:
Which of the following 2 hour glucose results would be classified as impaired glucose tolerance?
The glucose concentration in normal cerebrospinal fluid is:
60-75% of the plasma glucose concentration
If a patient's serum glucose is 100 mg/dL, what would you expect the cerebrospinal fluid glucose to read?
A sneaky diabetic tried to lower her glucose by working out and watching her diet 1 or 2 days before her appointment. The rest of the time she spent the day in front of the television and eating chocolates. What test could the doctor order to detect this type of behavior?
A glycosylated hemoglobin
Which statement regarding glycosylated hemoglobin is true?
It has a sugar attached to the N-terminal valine of the B-chain of the hemoglobin molecule, Is dependent upon the time averaged blood glucose over the lifespan of the RBC, Levels below 7% indicate adequate regulation for 8-12 weeks prior to sampling. (ALL CORRECT)
Of the following blood glucose levels, which would you expect to result in glucose in the urine?
The following glucose tolerance test values are indicative of what state?
1 hour 139
2 hour 130
Which glucose method is subject to falsely low results caused by such compounds as ascorbate, urate, or bilirubin?
Trinder glucose oxidase
Which of the following is a glucose molecule with the hydroxyl group on the right side on C1?
Formation of glucose from non carbohydrate sources describes which of the following?
In what form is glucose stored in the liver?
Which of the following OGTT results indicates impaired glucose tolerance?
One hour- 120 mg/dL
Two hour- 190 mg/dL
Which test may be performed to assess the average blood glucose level that an individual maintained during the previous 2 to 3 month period?
Breakdown of glycogen to form glucose and other intermediate products is called:
The conversion of glucose into lactate or pyruvate and then CO2 and H20 is called:
Which of the following inhibits glycolysis and glucose uptake by muscle cells and causes a rise in blood glucose levels?
Which of the following hormones has the ability to decrease blood glucose concentration?
Decreased blood glucose, increased insulin and low C-peptide is seen in:
Injection of exogenous insulin
Which of the following is the primary hyperglycemic hormone?
Which form of diabetes usually manifests itself later in life and is associated with obesity, physical inactivity, and glucosuria?
Which of the following is characteristic of type 1 diabetes?
Low insulin levels, Ketosis often accompanied by hyperglycemia, high frequency of autoantibodies to islet cells (ALL CORRECT)
Which statement regarding glycosylated hemoglobin is true?
It has a sugar attached to the n terminal valine of the B-chain, It is dependent on the time averaged blood glucose over the RBC life, Levels below 7% indicate adequate regulation for 8 to 12 weeks prior to sampling (ALL CORRECT)
What is cutoff value for HbA1c recommended by the American diabetes association for adequate control of blood glucose?
What enzyme is responsible for von Gierke disease (type 1 glycogen storage disease)?
All of the following are confirmatory of diabetes mellitus except:
Urine glucose in excess of 300 mg/dL
In preparing a patient for an oral glucose tolerance test (OGTT), all of the following are done except:
Carbohydrate intake must be below 150 g/day prior to the test
Which of the following may result in hypoglycemia?
Insulinoma, early type 2 diabetes, ethanol (ALL CORRECT)
What type of hypoglycemia follows a meal?
All of the following statements about clinical hypoglycemia are true except:
High fasting insulin levels must be present to make a diagnosis
In the glucose oxidase/peroxide methodology, which product reacts with the chromagen?
The hexokinase reaction for serum glucose:
Uses a glucose-6-phosphate dehydrogenase (G-6-PD) catalyzed indicator reaction
In the glucose oxidase methods, a mutarotase is added to:
convert a-glucose to B-glucose
Glucose concentration in whole blood is:
less than the concentration in plasma or serum
If a patient's serum glucose is 85 mg/dL, what would you expect the cerebrospinal fluid glucose to read?
A patient with an isulinoma may exhibit dizziness and faiting attributable to:
The following glucose tolerance test results are indicative of what state? Glucose values are assayed by the glucose oxidase method.
1 hour- 225
2 hour- 150
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