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glucose is a major blood carbohydrate used for what?
used for energy by cells of the body
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excess glucose is stored as what?
glycogen
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where is glycogen stored?
muscles and liver for later use
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what produces insulin?
beta cells of pancreas
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what is the purpose of insulin?
lower glucose by increasing intake of glucose to cells (increases rate of glycolysis/changes glucose to lactic acid)
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what is the normal range for a fasting adult plasma glucose?
70-99 mg/dL
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what is hyperglycemia?
increased glucose in the blood (>99)
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what is hypoglycemia?
low glucose in the blood (<70)
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what is a check strip?
used to calibrate the glucometer (like a standard)
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what is Hemoglobin A1C?
(also called glycosylated hemoglobin) measures glucose control over 3 months - diabetics should be &5 or less if they're in control.
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2 hour post prandial tests are used for what?
screen for gestational diabetes and monitor insulin dose
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>140 mg/dL
abnormal result from post prandial
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four reasons to use home glucometers
- 1. convenient
- 2. can check glucose immediately when having symptoms
- 3. can decide insulin dosage quickly
- 4. keeps glucose at a more desirable level so disease complications are minimized
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Performing a GTT (glucose tolerance test)
- 1. patient must be fast
- 2. get a urine sample and draw blood
- 3. if FBS is <160, have patient drink glucose solution.
- 4. if FBS is >160, contact physician before performing test.
- 5. draw blood and get a urine sample at 30, 60, 120, and 180 minutes after the solution has been drank.
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During GTT
- 1. nothing but H2O to eat/drink
- 2. no smoking (raises metabolism)
- 3. no activity (raises metabolism)
- 4. watch patient for reaction (light headed, nauseated, etc.)
- 5. obtain each urine sample before drawing the blood sample
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chemistry sample uses what?
serum or plasma (can be urine or CSF)
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chemical levels are used for what?
to diagnose and treat disease by comparing the patients results to normal ranges
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define quantitatively
reported as a number, not pos. or neg.
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Chemistry tests can be ordered as..
- 1. single tests
- 2. groups of chemical types
- 3. by organ system
- 4. by insurance/medicare grouping
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define standards
substances with an exact known value or concentration
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you should calibrate instruments how often?
every 6 months or less
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The range of this control is very similar to the normal range of the chemical in healthy people
normal control
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range is higher than patient's normal range
abnormal high control
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range is lower than that of values found in healthy patients
abnormal low control
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CLIA requirements for POL
- 1. calibrate every 6 months or less and document results in instrument manual
- 2. run 2 levels of controls everyday
- 3. action logs must be kept
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written documentation of problems with instruments and how they are corrected
action log
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Fasting
only water 12 hours before blood draw
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nonfasting
random sample, drawn at any time
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Trough
right before next dose
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peak
right after dose is given
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timed
a certain number of hours after a dose (check lab directory for number of hours/varies by medication)
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postprandial
- 1. usually glucose
- 2. after a meal is completed
- 3. usually 2 hours (2hr.pp)
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lipids
- fats
- (elevations add to risk of obesity and heart attack)
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cholesterol
white waxy fat that your body does need
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2 sources of cholesterol
- 1. made by the liver and controlled by genetics (endogenous)
- 2. from the foods you eat (exogenous)
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elevated cholesterol leads to:
- 1. inc. risk of coronary heart disease
- 2. white waxy fat lines on the walls of arteries
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