Clinical Chemistry : Carbohydrates

Fruits are the primary source of fructose.

Meat is not a good source for any carbohydrate.

Dairy products, such as milk and cheese, are good sources of galactose.

The preservation capacity of Sodium Fluoride for glucose is indeed 48 hours or 2 days. HOWEVER, a case of suspected diabetic ketoacidosis is considered an emergency, thus requiring STAT measurements that must be released in less than an hour.

The measurement of NADH formed in Pyruvate to Lactate Reactions is done at 340 nm. This is because NADH has a characteristic absorbance peak at this wavelength, allowing for its quantification. By measuring the absorbance at 340 nm, the concentration of NADH can be determined, providing insight into the activity of the Pyruvate to Lactate Reactions.

The product of glycolysis is LACTATE and pyruvate, not lactose.

Insulinemia is a general term for increased plasma concentrations of insulin. Insulinoma is a tumor of the Beta Cells of the Pancreatic Islets of Langerhans.

Specifically the brain, the central nervous system unfortunately lacks fuel stores, thus constantly needing glucose for its efficiency. Lack of glucose may lead to decreased cognitive function, and studies have shown that it is a factor for triggering Alzheimer's Disease.

Glucose oxidase is the correct answer because it is an enzyme that specifically acts on β-D-glucose. It catalyzes the oxidation of glucose to produce gluconic acid and hydrogen peroxide. This enzymatic test is commonly used to measure glucose levels in various biological samples. Glucose dehydrogenase, glucose isomerase, and hexokinase are not specific for β-D-glucose and have different functions in glucose metabolism.

An addition to the list is Insulin Autoantibodies. All of these directly destroy the Beta Cells of the Pancreatic Islets of Langerhans, thus a complete deficiency of Insulin, which is the case with Type I Diabetes Mellitus.

The Tolbutamide Tolerance Test is a diagnostic test used to investigate fasting hypoglycemia, a condition characterized by low blood sugar levels. It involves administering tolbutamide, a drug that stimulates insulin secretion, to evaluate the insulin response and subsequent changes in blood glucose levels. The usual route for taking tolbutamide in this test is orally. By monitoring the patient's blood glucose levels over a period of time after administering the tolbutamide, healthcare professionals can assess insulin sensitivity and diagnose underlying causes of hypoglycemia. This test is valuable for investigating conditions like insulinoma or other disorders impacting glucose metabolism.

Glucose is a monosaccharide, the simplest form of carbohydrates, consisting of just one sugar unit. It is a primary source of energy for cells. In contrast, sucrose, lactose, and maltose are disaccharides, made up of two monosaccharide molecules bonded together. Sucrose is composed of glucose and fructose, lactose is made of glucose and galactose, and maltose is two glucose units. Monosaccharides like glucose are the building blocks of more complex carbohydrates.

All of the options mentioned - inulin, lignin, and dextrin - are components of dietary fiber that are indigestible polymers of glucose found in food. Inulin is a type of soluble fiber found in many plants, lignin is a complex polymer found in the cell walls of plants, and dextrin is a type of soluble fiber produced from starch. Therefore, all of these options are correct as they are examples of indigestible glucose polymers found in food.

Also known as the Ortho-Toluidine Method, the Dubowski Method has this reaction:

In clinical terminology, "level nadir" is the lowest level in any numerical range. 30-300 µg/mg of creatinine denotes microalbuminuria, and in that range, 30 is defined as the level nadir for microalbuminuria. There is no medical term for the highest level, but in ordinary linguistics, the opposite of nadir is zenith.

In the Hexokinase Method for glucose, the metabolite being directly measured depends on the source of G6PD. If a bacterium, Leuconostoc mesenteroides, is the source, NADPH production is measured. If yeast is the source, NADH production is measured.

The primary gluconeogenetic hormone is GLUCAGON, not Thyroxine.

Glycol aldehyde is the simplest carbohydrate because it is the smallest molecule that can be classified as a carbohydrate. It consists of a carbon chain with a carbonyl group (aldehyde) and two hydroxyl groups (alcohol). This structure meets the criteria for a carbohydrate, which is a compound composed of carbon, hydrogen, and oxygen in a ratio of 1:2:1. Formaldehyde and glutaraldehyde are not carbohydrates as they do not have the required carbon, hydrogen, and oxygen ratio. Glucose is a more complex carbohydrate compared to glycol aldehyde.

Dextran is an endogenous polysaccharide used to treat post-surgical hypovolemia. // Disaccharidases (e.g. Maltase, Sucrase, and Lactase) exist in the brush border of the small intestines and, as the term denotes, degrades disaccharides (e.g. Maltose, Sucrose, and Lactose, respectively), into glucose. // Amylopsin is also known as Pancreatic Amylase, which degrades remaining polymers of glucose not degenerated by Salivary Amylase.

Maltose and other reducing sugars can be determined by the Clinitest. However, Clinitest cannot detect Sucrose, a non-reducing sugar.

Type I GSD is characterized by hypoglycemic seizures.



Type IV GSD is characterized by findings of amylopectin-like material in tissues, thus its other name, Amylopectinosis.



Type VI GSD is the only GSD with a specific genetic marker: the PYGL gene, detected by sequence analysis.

 

Jizan is experiencing alcohol-induced hypoglycemia, usually seen in the setting of a history of drinking alcohol of 50-300 grams without food intake for the preceding 6 to 36 hours.

Gamma-Glutamyl Transferase levels are increased ONLY in CHRONIC active alcoholism.

Alcoholism was also shown to cause an increase triglyceride levels, particularly beer.

The conversion of glucose to lactate and vice versa is known as the Cori Cycle. This cycle occurs in the liver and muscles during anaerobic conditions when there is a lack of oxygen. Glucose is converted to lactate in the muscles, which is then transported to the liver. In the liver, lactate is converted back to glucose through a series of reactions. This cycle allows for the regeneration of glucose and the removal of lactate, maintaining energy production during anaerobic conditions.

Essential Fructosuria is caused by a deficiency of the enzyme Fructokinase.

F16D in Option #2 is Fructose-1,6-Diphosphatase.

The actual FBS level of patient 556969 is 169 mg/dL IF the specimen was unpreserved. Note that any delay of glucose will lead to a decrease of 7 mg/dL per hour if unpreserved.

It is noted, however, that the specimen in question, among others, was refrigerated by Dan. Therefore, the decrease in glucose per hour is only 2 mg/dL. When the glucose level was finally determined, 7 hours have passed since its collection time. Therefore, the net reduction of glucose level is 14 mg/dL, hence the 120 mg/dL result in the analyzer.

≥ 200 mg/dL ( ≥ 11.1 mmol/L ) in Random Blood Sugar and 2-Hour OGTT is a diagnostic criterion for Diabetes Mellitus.

The screening test for Gestational Diabetes Mellitus is the 1-hour OGTT.

Pancreatic Amylase is secreted by the Acinar Cells of the Pancreas. // Somatostatin, also known as the Growth Hormone Inhibiting Hormone, and Insulin, the primary AND ONLY hypoglycemic hormone, are secreted by the Pancreatic Islets of Langerhans (specifically and respectively the Delta and Beta Cells).

Basically, if the HBA_1c level of an individual is, say, 6.5%, it means that HBA_1c comprises 6.5% of total hemoglobin levels in the blood. This level (and above) is a diagnostic marker of Diabetes Mellitus.

Vancomycin is an antibiotic for serious staphylococcal infections when the penicillins and cephalosporins cannot be used.



In Seliwanoff's Test for Fructose Determination, Resorcinol is the reagent added to hydroxymethyl furfural, the product from fructose and hydrochloric acid. After such addition, a red compound is produced.



Theophylline is a methylxanthine drug used in therapy for respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma.

Pyruvate Kinase is an enzyme that catalyzes the final step of glycolysis.



Pyruvate Carboxylase is the enzyme that shunts excess pyruvate from glycolysis (Embden-Meyerhoff) to gluconeogenesis. Pyruvate is converted into oxaloacetate, which is then converted to glucose. A deficiency of this enzyme can cause lactic acidosis, because the excess pyruvate will be converted into lactate instead.