General chemistry: Carbohydrates

All of the following are possible medical complications for an individual diagnosed with metabolic syndrome, EXCEPT:

Brain tumor

When evaluating a 2-hour glucose tolerance test report performed on a pregnant woman, Which of the following results is considered NORMAL (within range for the test)?

A 2 hour glucose level is less than 140 mg/dL

Beta-hydroxybutyric is formed as the result of an accumulation of which of the following?

Acetyl-CoA

A 3-year old girl brought to the ER with a temperture of 103 degree F, lethargt, and cervical rigidity. Three tubes of cloudy CSF were delivered to the lab, and preliminary test results showed: WBC= 4,500/ul Differential= 88% neutrophils 12% lymps Glucose= 15 mg/dL Protein= 140mg/dL Gram stain= No organisms observed What should the physician consider?

Bacterial meningitis

A test for microalbuminuria is used most often to monitor patients with which of the following diseases or conditions?

Diabetes

HB A1c percent can be used as an assay to diagnose which of the following conditions?

Diabetes

In which of the following conditions would an increased serum osmolality be an expected finding?

Diabetes insipidus

Which of the following conditions is associated with a positive ketone test on the urine test strip?

Diabetes mellitus

At medical examination, a 50 year old caucasian male expressed concerns regarding diabetes. There is a history of type 2 diabetes, hypertension, and cardiovascular disease in his family. He has gained a few pounds each year and his physician notes abdominal obesity. His physician orders lab tests to evaluate his risk of cardiovascular disease. Blood pressure: 128/82 mm Hg Weight: 230 lbs Height: 5' 11'' Calculated BMI: 32.1 Waist Circumference: 45 inches Fasting Glucose Blood: 120 mg/dL Trig: 170 mg/dL HDL-C: 42 mg/dL Which statement is true based on the results?

Diagnosis of metabolic syndrome; waist circumference, Triglycerides level, and fasting blood glucose meet the criteria

maltose, sucrose, lactose

Disaccharides

A patient has a fasting plasma glucose performed at an outpatient lab. He has fasted as instructed: FPG= 135 mg/dL What does this result indicate?

Elevated FPG; needs further evaluation by a repeat or alternative test

WHICH OF THE FOLLOWING METHODS FOR LONG-TERM DIABETIC MONITORING IS RECOMMENDED FOR PATIENTS WITH SICKLE CELL ANEMIA?

Fructosamine

A renal function panel consists of the following tests?

GLucose BUN Creatinine Sodium Potassium Chloride CO2 Calcium Albumin Phosphorus

Which analyte may be falsely decreased due to a delay in transport time to the laboratory?

Glucose

Which of the following serum constituents is unstable if a blood specimen is left standing at room temperature for eight hours before centrifugation and processing?

Glucose

Which of the following is a liver enzyme that is instrumental in allowing glucose to enter the blood stream?

Glucose 6 phosphatase

A basic Metabolic Panel (BMP) consists of which group of tests?

Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, calcium

Which anaylyte is MOST useful for monitoring long-term (~12 weeks) stability of blood glucose?

Glycosylated HbA1C

Six months ago, a 55-year old female had a fasting plasma glucose (FPG) greater than 200 mg/dl on two occasions. She was diagnosed as having type 2 diabetes and treatment was started. Along with rountine FPG's which of the following tests would most likely be used to monitor glycemic control?

HbA1C

A variety of additives are used in blood collection tubes. Which of the following additives inhibits glycolysis?

Sodium fluoride

All of the following carbohydrates are considered reducing sugars except? Lactose Sucrose Glucose Ribose

Sucrose

Whole blood glucose values are _________________________ plasma glucose values

about 11% lower

Which test is performed to assess the average plasma glucose level that an individual maintained during the previous 10 week to 12 week period?

gLYCOSYLATED HEMOGLOBIN

A blood specimen is recieved in the laboratory for testing five hours after collection. Which of the following test results may be falsely decreased?

serum/plasma glucose

You are working in a clinical chemistry lab and are analyzing a plasma glucose sample. The sample is flagged BY THE ANALYZER FOR BEING " OUTSIDE LINEAR RANGE" ALERT. you DECIDE TO PERFORM A DIFFERENT MANUAL DILUTION. this TIME YOU MANUALLY DILUTE THE original SAMPLE AGAIN; THIS TIME USING A 1:3 DILUTION. THE INSTRUMENT GIVES YOU A GLUCOSE RESULT OF 150MG/DL FROM THE DILUTED SAMPLE WHAT IS THE ACTUAL PATIENT GLUCOSE RESULT THAT YOU SHOULD REPORT TO THE PHYSICIAN?

450MG/Dl

Which of the following would be considered a normal value for a glucose level in cerebrospinal fluid?

60 mg/dL

When three tubes of CSF are recieved in the lab, they should be distritubed to the various lab sections as followed.

#1 Chemistry #2 Microbiolgy #3 Hematology

After experiencing extreme fatigue and polyuria, a patient's basic metabolic panel is analyzed in the laboratory. The result of the glucose is too high for the instrument to read. The lab performs a dilution using 0.25 mL of patient sample to 750 microliter of diluent. The results now reads 325 mg/dl. how should the technologist report this patients glucose result?

1300

The formula for conversion of HbA1C to glucose in mg/dL is eAG= (28.7 x A1c)-46.7 The HbA1C measured on a patient is reported 7.5%. What would be reported as the estimated average glucose (eAG) for this % A1C?

169 mg/dL

A CSF glucose value is 62 mg/dL. What would you estimate the serum glucose?

93 mg/dL

What is a hemiacetyl?

A compound with both a carbonyl and alcohol group

Which of the following satements best describes hemoglobin A1C?

A glycated protein that is an index of carbohydrate managment over 2-3 months

Which of the following would be considered a normal CSF glucose level if the serum is 70 mg/dL?

About 45 mg/dL

Which adipokine is decreased in obesity, is anti-inflammatory, and increases insulin sensitivity?

Adiponectin

A comprehensive Metabolic Panel (CMP) consists of which group of tests?

Albumin, Glucose, BUN, Creatinine, Sodium, Potassium, Chloride, CO2, AST, ALT, ALP, Total Protein, TOtal Bilirubin, Calcium

Which of the following is the most commonly abused substance in the US?

Alcohol

Which of the following statements about diagnosing gestational diabetes is true?

All non-diabetic pregnant women should be screened at 24 to 28 weeks of gestation

All of the following hormones increase or decrease plasma glucose concentration by regulating glycogenolysis ( converting glycogen to glucose) except:

Cortisol

Recently the American Diabetes Association (ADA) recommended reporting which of these values to correlate with hemoglobin A1C as a further indicator of glycemic control?

Estimated average Glucose

The NHLBI and AHA have created a set of parameters to define the presence of metabolic syndrome. Select the set of lab assays that are utilized in the NHLBI and AHA criteria for metabolic syndrome diagnosis

Fasting blood glucose Triglycerides HDL-C

Which test is considered a more reliable method of monitoring long-term diabetes control?

Hgb A1c

A low CSF glucose level is associated with all the following EXCEPT:

Hyperglycemia

Sodium fluoride is an excellent preservative for collecting glucose specimens because it does which of the following?

Inhibits glycolysis

A 56 year old female was taken to the emergency room in a coma by her employers nurse. She had lost 35 pounds in 3 months; She was always thirsty; drinking a lot of water and running to the bathroom. The following are her lab results: pH: 7.11 (7.35-7.45) pCO2: 21 mm Hg (35-45) Glucose: 950 mg/dL (60-110) Serum osmo: 365 (275-295) Urine Ketone: Strongly positive (negative) Urine Glucose: Strongly positive (negative) What is the most likely cause of the patients symptoms?

Insulin dependant diabetes mellitus

Glucose is considered an aldose because

It contains a terminal carbonyl group, called aldehyde group

From the groups of analytes below, Which set would most likely be increased in a type 1 diabetic patient in crisis?

Ketone bodies and blood glucose

Which of the following conditions would make a sample unsuitable for lactic acid testing?

Movement of hand or arm during specimen collection

The measurement of total glycosylated HbA1C is an effective means of assessing the average blood glucose levels:

Over the past 2-3 months

A physician is evaluating a 45 year old obese male for diabetes and orders a plasma glucose test at time of evaluation and a HbA1C one week later. The patient has a family history of diabetes AND CURRENTLY EXHIBITS SYMPTOMS OF DIABETES. What would be the best course of action if these are the blood glucose test results? Casual Plasma Glucose: 208 mg/dl HbA1C one week later: 7.2%

Patient meets criteria for diagnosis of diabetes

When in the fisher projection, Which carbon is used to determine if the molecule is in D or L formation?

Penultimate carbon

All of the following are characteristics of type 2 diabetes mellitus Except:

Requires insulin therapy to control hyperglycemia

A 14 year old male was taken to the emergency room in a coma by his school nurse. He had lost 15 pounds in 3 months. His teacher said he was always thirsty and that was he spent a lot of time running between the water fountain and the bathroom. Considering the patient's results and symptoms, what could be the cause for the osmolality result, and increased thirst? Results: pH= 7.11 (7.35-7.45) pCO2= 20mm Hg (35-45 mm Hg) Glucose= 1050 mg/dl (60-110 mg/dl) Serum osmolality= 385 mOsm/Kg (275-295 mOsm/Kg) Urine ketone= strongly positive (negative) Urine glucose= strongly positive (negative)

The increased glucose level causes a more concentrated extracellular solution, stimulating the thirst center of the hypothalamus

A HbA1C result for a diabetic patient is 6.0%. What conclusion can be made regarding this patient's carbohydrates management?

The patient is compliant with diet and medication

A ccording to the American Diabetes Association recommendations, Which of the following statements is TRUE with regards to the following findings? Fasting glucose= 130 mg/dL 2 hour post prandial glucose= 210 mg/dL

The patient may be diagnosed as having diabetes mellitus

The ADA guidelines recommend screening all asymptomatic in individuals age 45 and older for diabetes. If the screen is negative:

The screening should be reported every 3 years

Height: 5' 7' Weight 192: pounds Waist circumference: 37 inches Clood pressure: 108/70 FBG: 92 Total Cholesterol: 172 LDL: 112 HDL: 46 Triglycerides: 70 hs-CRP: <1.0

This patient does not meet the criteria for the diagnosis of metabolic syndrome

A clinical lab scientist is reviewing the results of comparison studies between lab plasma glucose results and patients self-monitoring (whole-blood) blood glucose (SMBG) results. Which SMBG results are expected?

Whole blood result is 11 % lower

Below are the laboratory results on a 20-year old overweight male. His waist circumference is 41 inches and blood pressure is 105/70. FBG= 130mg/dL Trig= 190mg/dL HDL= 50mg/dL Does this patient meet criteria for metabolic syndrome?

Yes

Which of the following patients is most at risk for hyperosmolar nonketotic coma?

a 70 year old type 2 diabetic patient