Explain the discrepancy between the whole blood glucose concentration and the plasma glucose concentration in the neonate.
Explain the discrepancy between the whole blood glucose concentration and the plasma glucose concentration in the neonate.
Biochemistry
9th Edition
ISBN:9781319114671
Author:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.
Publisher:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.
Chapter1: Biochemistry: An Evolving Science
Section: Chapter Questions
Problem 1P
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Explain the discrepancy between the whole blood glucose concentration and the plasma glucose concentration in the neonate.

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only in thos
(1) hypoglycemic syn
concentration is low (<50 mg/
toms are present; and (3) symptoms
by correction of the hypoglycemia when admini
tered glucose or glucagon. Symptoms of hypogly-
cemia include increased hunger, sweating, nausea
and vomiting, dizziness, nervousness and shaking,
blurring of speech and sight, and mental confusion.
When hypoglycemia symptoms present in individu-
als in a postabsorptive (fasting) state, an insulinoma
(pancreatic B-cell tumor) might be suspected. Lab-
oratory findings include decreased plasma glucose
levels during a hypoglycemic episode and extremely
elevated insulin levels in patients with an insuli-
noma. To investigate an insulinoma, the patient
is required to fast under controlled conditions.
Men and women have different metabolic patterns
in prolonged fasts. The healthy male will main-
tain plasma glucose of 55 to 60 mg/dL for several
days. Healthy females will produce ketones more
readily and permit plasma glucose to decrease to
40 mg/dL or lower. Diagnostic criteria for an insuli-
noma include a change in glucose level ≥25 mg/dL
omonone
of glyc
ital form of glycogen storage disease is glucos
phosphatase deficiency type 1, also called von Ge
cose by way of hepatic glycogenolysis,
growth
disease, which is an autosomal recessive disease
disease is characterized by severe hypoglycemia
elevated lactate and alanine. Hypoglycemia
because glycogen cannot be converted back u
buildup is found in the liver, causing hepat
aly. The patients usually have severe hypogly
A liver biopsy will show a positive glycogen p
Although the glycogen accumulation is irreve
the disease can be kept under control by a
the development of hypoglycemia. Liver
tation corrects the hypoglycemic condition
enzyme defects or deficiencies that cause
glycemia include glycogen synthase, fru
hyperlipidemia, uricemia, and
CASE STUDY 9.6, PART 2
Recall Jo Ann, a 28-year-old woman who delivered her daughter, Martha, early this morning.
The mother's history was incomplete; she claimed to have had no medical care through her
pregnancy. Several hours after birth, Martha became lethargic and flaccid. A whole blood glu-
cose and ionized calcium were ordered and performed in the nursery with the following results:
25 mg/dL
4.9 mg/dL
Whole blood glucose
lonized calcium
Plasma glucose was drawn and analyzed in the main laboratory to confirm the whole blood
findings.
Plasma glucose
33 mg/dL
An intravenous glucose solution was started, and whole blood glucose was measured hourly.
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Getty Images
1. Give the possible explanation for the Martha's large birth weight and size.
2. If Jo Ann has gestational diabetes, why is her baby hypoglycemic?
3. Explain the discrepancy between the whole blood glucose concentration and the plasma glucose concentra
the neonate.
4. If Jo Ann had received appropriate prenatal care, what laboratory tests should have been performed, and
criteria would have indicated that she had gestational diabetes?
Galactoser
in infants, is a
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will develop
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cyte galactos
Laboratory
irubinemia,
tissue, and
enzyme de
deficiency,
fructose ing
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and long-ch
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insulin in
after a mea
gastric fact
CASE
Recall Em
tion. Her p
history of
results we
Laborato
Fasting b
Choleste
HDL
Triglycer
1. What
2. Desc
3. Wha
4. Wha
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