Chemistry Internship Study Questions Section 1

List the reference ranges for glucose in the following:

Plasma, Adults

70-110 mg/dL
List the reference ranges for glucose in the following:

Plasma, Newborns

50-100 mg/dL
List the reference ranges for glucose in the following:

CSF

40-70 mg/dL
List the reference ranges for glucose in the following:

Whole Blood

65-95 mg/dL
What are the Glucose Critical Values for an adult?
<50 mg/dL
>450 mg/dL
What are the Glucose Critical Values for a Newborn?
<45 mg/dL
>180 mg/dL
Why do plasma and whole blood glucose levels differ slightly?
Whole blood is ~10% less DUE to the Dilutional Effect of RBC
If given a plasma glucose level, how can you estimate the CSF level?
CSF Level ~ 60-70% Plasma Level
If a sample cannot be tested right away, what is the preferred collection tube/preservative?
Gray Top
If a sample cannot be tested right away, why would a Gray Top be used?
NaFl slows Glycolysis
How will a glucose level be affected if an unpreserved whole blood sample is allowed to sit at room temperature for 1 hour?
Decreases by 10% or more per hour
Name the ONE HORMONE that will DECREASE a Plasma Glucose Level
Insulin
Name 3 Primary Hormones that can INCREASE a Plasma Glucose Level
Glucagon, Epinephrine, Cortisol
According to the American Diabetes Association Criteria, what FASTING GLUCOSE level is DIAGNOSTIC for DIABETES?
>126 mg/dL
What 2 Hour Post-Pradial Glucose Level is Consistent with Diabetes?
>200 mg/dL
Following the start of an oral glucose tolerance test, at what time should values return to normal levels in NON-DIABETIC?
2 Hours
What are the MOST common causes of Hypoglycemia?
Insulin Overdose
Insulin Shock
What are ketones?
Products of faulty or excessive fat metabolism
In what conditions can you detect ketones in serum or urine?
Diabetes Mellitus Type I, Vomiting, Starvation, Carb-Free Diets
What is the purpose of performing a glycosylated hemoglobin (HBA1C) assay?
Estimate Average concentration blood glucose for the preceding 2-3 months; can help determine patient compliance with treatment.
What is the specimen requirement for a HBA1C assay?
EDTA Whole Blood;
Prepare a hemolysate
List diseases or conditions that can cause a Falsely decreased HBA1C assay
Hemoglobinopathies, Diseases with INCREASED RBC Turnover, Acute or Chronic Blood Loss, Alcohol, Lead (Pb), Drugs
State the 2 MOST frequently used methodologies for Glucose determination
Hexokinase & Glucose Oxidase
What is/are the MOST common interfering factors in the following for glucose determination:

Hexokinase

Bilirubin
Hemolysis
What is/are the MOST common interfering factors in the following for glucose determination:

Glucose Oxidase

Abscorbic acid
Uric acid
Bilirubin
What may the following common interfering factors of Glucose Oxidase for glucose determination cause:
Ascorbic acid
Uric acid
Bilirubin
False Negative
Of what significance is a positive urine microalbumin in a diabetic?
Indicator of early renal disease in the absence of a Positive urine protein dipstick
Describe Type I Diabetes in regards to typical age, major symptoms, and insulin dependence.
Juvenile on set
Absolute Insulin dependent
Sudden
Weight loss
Ketosis common
Autoimmune
Etiology may be viral
Describe Type II Diabetes in regards to typical age, major symptoms, and insulin dependence.
Adult on set
Obesity
Sedentary lifestyle
Strong genetic link
What condition is a MAJOR Immediate Risk to new babies born to Diabetic Mothers?
Insulin shock causing hypoglycemia/seizures
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