Treating proteinuria mainly needs proper diagnosis of the cause. The most common cause is diabetic nephropathy; in this case, proper glycemic control may slow the progression. Medical management consists of angiotensin converting enzyme (ACE) inhibitors, which are typically first-line therapy for proteinuria. In patients whose proteinuria is not controlled with ACE inhibitors, the addition of an aldosterone antagonist or angiotensin receptor blocker may further reduce protein loss. Caution must be used if these agents are added to ACE inhibitor therapy due to the risk of hyperkalemia. Proteinuria secondary to autoimmune disease should be treated with steroids or steroid-sparing agent plus the use of ACE inhibitors.
I. Choose the best answer
1. Measuring glucose levels before the first meal of the day is termedas
(a) Post prandial blood glucose
(b) Fasting blood glucose
(c) Normal blood glucose
2. The catabolic hormone which increases blood glucose level is
(a) Glucagon (b) Insulin
(c) Histamine (d) None
3. The coenzyme acts as blood clotting factor is
(a) Magnesium (b) Iron
(c) Calcium (d) Lead
4. The vitamin D-dependent calcium-binding protein that actively transports calcium into the body
(a) Calbindin (b) Calmodulin
(c) Transferrin (d) Globulin
5. Good cholesterol is termed for
(a) LDL-cholesterol (b) VLDL-cholesterol
(c) HDL-cholesterol (d) Triglycerides
II. Fill in the blanks
6. Excretion of glucose into the urine is called as ……………..
7. …………….. is the by-product of muscle metabolism
8. The protein in the urine is composed mainly of globulins is termed
medically as ……………..
9. The two most common employed enzymes in the blood glucose
measurement are ……………..
10. …………….. increases if glomerular filtration rate and blood volume
III. Match the following
11. Bone formation (a) LDL
12. Bad cholesterol (b) Calcium
13. Glycosuria (c) Diabetes mellitus
14. Bilirubin in the urine (d) Benedict’s qualitative test
15. Metformin (e) Bilirubinuria
1. Glucose is the primary source of energy for the body’s cells. Its level should be between 70 and 100 mg/dL for normal person.
2. Anabolic hormone (insulin) decreases blood glucose andcatabolic hormones (such as glucagon, cortisol and catecholamines) increase blood glucose.
3. More precise blood glucose measurements are performed in a medical laboratory, using hexokinase, glucose oxidase or glucose dehydrogenase enzymes.
4. The liver produces urea in the urea cycle as a waste product of the digestion of protein.
5. Derangements of the calcium mechanism lead to hypercalcemia or hypocalcemia, both of which can have important consequences for health.
6. Calbindin is a vitamin D-dependent calcium-binding protein inside intestinal epithelial cells actively transports calcium into the body.
7. Hyperlipidemia is recognized as a risk factor which leads to cardiovascular disease.
8. HDL-cholesterol is often called good cholesterol and LDL-cholesterol is often called as bad cholesterol.
9. Glycosuria is nearly always caused by elevated blood glucose levels. Glucose in urine can be identified by Benedict’s qualitative test.
10.Serum creatinine is an important indicator of renal health because it is an easily-measured by-product of muscle metabolism. Creatinine is removed from the blood chiefly by the kidneys.
11. Proteinuria means the presence of an excess of serum proteins in the urine.
12. The three main mechanisms that cause proteinuria are disease in glomerulus, increased quantity of proteins in serum, and low reabsorption at proximal tubule (Fanconi syndrome).
1. Write short note on Laboratory tests of Blood glucose
2. Write short note on Lipid profile
3. Write short notes on urine levels of creatinine
Answers to Intext Questions
I. 1. (b) 2. (a) 3. (c) 4. (a) 5. (c)
II. 6. Glycosuria,
8. Bence-Jones proteins,
9. Glucose oxidase and Hexokinase,
10. Blood urea nitrogen,
III. 11. (b) 12. (a) 13 (d) 14. (e) 15. (c)