Chapter 24: The endocrine system

Question 1

The cells of the langerhans sislands:

Answer 1

1) alpha = glucagon
2) beta = insulin
3) delta = somatostatin
4) PP = pancreatic polypeptide

RARE:

5) Enterocromaffin cells (serotonin)
6) D1-cells (VIP vasoactive protein)

Question 2

Name the diagnostic criteria for diabetes:

Answer 2

1) Fasting plasma glucose > 126 mg/dL
2) A random blood glucose of > 200 mg/dL
3) 2 hour plasma glucose test (OGTT oral glucose tol test) > 200 mg/dL
4) glycnoated hemoglobin (Hb_AIC) >= 6.5 %

Question 3

Name the types of diabetes:

Answer 3

1) Type 1 = beta cell destruction = autoimmune
2) Type 2 = insulin resistance and inadequate response by beta cells
3) MODY = Monogenic forms of diabetes
4) Pregestational and gestational diabetes = The hormone milleu in pregnant women is pro-insulin resistance

Question 4

What is C-peptide?

Answer 4

A peptide released when the pro-form of insulin is cleaved.

Question 5

Name some important molecules which induce insulin production:

Answer 5

1) Glucose

2) The increntins (GIP andd GLP-1)

Question 6

Pathogenesis type 1 diabetes:

Answer 6

1) Failure of self antigen acceptance in regulatory T-cell subset
2) activation of T1 and CTL
3) killing of Beta-cells.

Question 7

The most common effects of insulin resistance:

Answer 7

1) Failure to inhibit endogenous glucose production.
2) Failure of glucose uptake resulting in hyperglycemia
3) Failure to inhibit lipases in fatty tissue resulting in FFAs in the blood.

Question 8

Why does obesity lead to Type 2 diabetes?

Answer 8

1) High levels of FFA lead to high insulin resistance
2) Adipokines (the adipose tissue works as endocrine tissue)
3) Inflammation can correlate with a lot of nutrients

Question 9

The classiac triad of diabetes:

Answer 9

1) Polyuria
2) polydipsia (thirst)
3) Polyphagia

(+ diabetic ketoacidosis)

Question 10

Acute metabolic complications:

Answer 10

1) Diabetic ketoacidosis
2) Activation of ketogenic machinery = acetyal CoA processing in liver creates ketone bodies
3) Hypoglycemia

Question 11

Chronic complications of diabetes:

Answer 11

Injuries to the vessels - both bigger macro vessels and smaller ones.

Question 12

Chronic complications of diabetes pathogenesis:

Answer 12

1) Glycotoxcicity - this causes:
- Formation of advanced glycation end products which binds RAGE (inflammatory receptor)
- PKC activation (calcium dependent)