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Physiology Exam 2 > Endo 5 > Flashcards

Endo 5 Flashcards

1
Q

What cells secrete glucagon?

A

Alpha cells

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2
Q

What cells secrete insulin?

A

Beta cells

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3
Q

The pancreas contains ~1-2 million ______

A

islets of Langerhans

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4
Q

α cells and β constitute about ___ of the cells in the islets.

A

85% of the cells

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5
Q

____ secretion is associated with energy abundance. •Composed of two amino acid chains, connected by disulfide linkages.

A

Insulin

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6
Q

___ is a hormone of plenty of nutrients

A

Insulin

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7
Q

T/F: The proinsulin and C peptide have virtually no insulin activity.

A

True

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8
Q

Does insulin circulate bound or unbound?

A

Unbound

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9
Q

Does insulin hang around in circulation long?

A

No

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10
Q

____ is the key regulator of insulin secretion

A

Glucose

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11
Q

_____ are hormones produced by the digestive system that work to stimulate insulin secretion BEFORE plasma glucose is elevated. Includes: Glucagon-like Peptide-1 (GLP-1) and Glucose-dependent Insulinotropic Polypeptide (GIP).

A

Incretins

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12
Q

What brings glucose into the Beta cell from blood?

A

GLUT-1 and GLUT-2

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13
Q

____ secretion rises when blood glucose rises above 100 mg/100ml

A

Insulin

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14
Q

What type of receptor is the insulin receptor?

A

Tyrosine kinase

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15
Q

In the ___ response of target cells to insulin, Increased glucose uptake, especially by muscle cells and adipocytes due to translocation of vesicles containing GLUT-4 to the membrane.

A

Fast (seconds)

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16
Q

T/F: In response to insulin, The membrane also becomes more permeable to many amino acids along with potassium and phosphate ions.

A

True

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17
Q

In the ___ response of target cells to insulin, Change in enzyme activity leading to changes in metabolism.

A

Slower (10-15 minutes)

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18
Q

In the ___ response of target cells to insulin, Changes in gene expression and growth.

A

Slowest (hours-days)

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19
Q

Insulin promotes muscle glucose _____ and glycogen _____

A

Glucose uptake; glycogen synthesis

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20
Q

_____ increases glucose transport –Increases glycogen storage in skeletal muscle–Increases protein synthesis and inhibits protein degradation

A

Insulin

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21
Q

____ promotes Promotes Protein Synthesis and Storage Inhibits Protein Degradation

A

Insulin

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22
Q

Insulin and Growth Hormone Interact _____ to Promote Growth

A

Synergistically

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23
Q

Lack of insulin causes protein _____ and _______ plasma amino acids

A

protein depletion & increased plasma amino acids.

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24
Q

______ promotes the uptake and storage of glucose (as glycogen) by the liver; increases glucose uptake (glucokinase)•Increased glycogen synthase leads to increased glycogen synthesis• decreased breakdown of glycogen by inhibiting liver phosphorylase

A

Insulin

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25
Q

____ promotes conversion of excess glucose into fatty acids; Inhibits gluconeogenesis

A

Insulin

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26
Q

_____ Promotes Fat Synthesis and Storage

A

Insulin

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27
Q

Lack of insulin causes ____ and release of ____ and increases plasma cholesterol and phospholipids conc.

A

lipolysis; FFA

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28
Q

Decreased blood glucose, Fasting, Somatostatin)α-Adrenergic activity, and Leptin ______ insulin secretion

A

Decrease insulin

29
Q

Increased blood glucose, Increased blood free fatty acids, Increased blood amino acids, Gastrointestinal hormones (gastrin, cholecystokinin, secretin, GIP, Glucagon-like peptide-GLP-1), Glucagon, growth hormone, cortisol, Parasympathetic stimulation; acetylcholine, β-Adrenergic stimulation, Insulin resistance; obesity, Sulfonylurea drugs (glyburide, tolbutamide _____ insulin secretion

A

Increase insulin

30
Q

29 amino acid peptide, secreted from pancreatic alpha cells •Hormone of “starvation”•Secretion controlled by blood glucose levels (inverse relationship)

A

Glucagon

31
Q

What is the primary target tissue of glucagon?

A

Liver

32
Q

Stimulating glycogenolysis & inhibiting glycogen synthesis, 2.Increasing gluconeogenesis, 3.Increases blood fatty acid & ketoacid levels to provide more substrates for gluconeogenesis

A

Glucagon

33
Q

The ___ functions like a buffer for blood glucose. Individuals with severe disease have difficulty maintaining a narrow plasma glucose range.

A

liver

34
Q

Metabolic disorder characterized by hyperglycemia due to insufficient insulin or cellular resistance to insulin (or both)

A

Diabetes mellius

35
Q

T/F: With DM, it takes longer to reduce blood glucose levels and glucose levels don’t reach the control level.

A

True

36
Q

10% of cases-hypoinsulinemia (DM)

A

Type 1 Diabetes

37
Q

90% of cases-hyperinsulinemia (DM)

A

Type 2 Diabetes

38
Q

What are the 3 p’s seen in DM?

A

Polyuria, polydypsia, and polyphagia

39
Q

Urinating often (Polyuria)•Feeling thirsty (Polydypsia)•Feeling hungry (Polyphagia)•Extreme fatigue•Blurry vision•Cuts/bruises that are slow to heal are symptoms of ____

A

Diabetes mellitus

40
Q

Which type of DM shows Weight loss – even though you are eating more

A

(type I DM)

41
Q

Which type of DM shows Tingling, pain or numbness in the hands/feet

A

(type 2 DM)

42
Q

What is the normal fasting plasma glucose level?

A

100 mg/dL

43
Q

What is the normal 2 hour post prandial glucose?

A

140 mg/dL

44
Q

What is the normal A1C percentage?

A

<5.6%

45
Q

Autoimmune destruction of pancreatic beta cells 2.Accounts for 5-10% of diabetes cases3.Formerly called juvenile onset diabetes or insulin dependent diabetes (IDDM)

A

T1DM

46
Q

Risk Factors of ____ include: 1.Genetic predisposition-increased susceptibility 2.Environmental triggers stimulate autoimmune response a. Viral infections (mumps, rubella)b. Chemical toxins 3.Usually develops < age 40, non-obese younger patients

A

T1DM

47
Q

Beta cell destruction occurs slowly•Hyperglycemia occurs when 80 – 90% of cells destroyed•Often triggered by stressor (e.g. illness)

A

T1DM

48
Q

_____ leads to:1.Polyuria (hyperglycemia acts as osmotic diuretic)2.Polydipsia (thirst from dehydration from polyuria)3.Polyphagia (hunger and eats more since cell cannot utilize glucose)4.Glycosuria (renal threshold for glucose exceeded)5.Weight loss (body breaking down fat and protein to restore energy source6.Malaise and fatigue (due to muscle & electrolyte loss) 7.Hyperkalemia-K+ (due to lack of insulin which normally activates the Na+/K+ pump

A

Hyperglycemia

49
Q

Due to increased lipolysis to fatty acids to produce ketoacids; a response to cellular starvation brought on by relative insulin deficiency and counterregulatory or catabolic hormone excess (glucagon, catecholamines, cortisone and growth hormone); dehydration (hyperglycemia)2.Metabolic acidosis (accumulation of ketones)3.Fluid and electrolyte imbalances (from osmotic diuresis)

A

Diabetic ketoacidosis (DKA)

50
Q

___ occurs predominantly in patients with type 1 (insulin-dependent) diabetes mellitus, but 10% to 30% of cases occur in newly diagnosed type 2 (non–insulin-dependent) diabetes mellitus, especially in African Americans and Hispanics

A

DKA

51
Q

Omission or reduced daily insulin injections, dislodgement/occlusion of insulin pump catheter, injection, major surgery, and trauma are all important causes of _____

A

DKA

52
Q

Fruity breath (due to acetone)–Nausea/ abdominal pain–Dehydration–Tachycardia–Lethargy–Coma–Polydipsia, Polyuria, Polyphagia–Kussmaul respirations (deep, labored breathing) are signs and symptoms of ____

A

DKA

53
Q

acidosis ______ neuronal function since it blocks inward current of Na+ and Ca2+.

A

depresses

54
Q

Fasting hyperglycemia despite availability of insulin-Insulin resistance•WAS called non-insulin dependent diabetes or adult onset diabetes. Both misnomers, type II DM may require insulin and occurs in children

A

T2DM

55
Q

Risk factors of ____ include: History of diabetes in parents or siblings•Obesity (especially of upper body)•Physical inactivity•Race/ethnicity: African American, Hispanic, or American Indian origin•Women: history of gestational diabetes, polycystic ovarian syndrome, delivered baby with birth weight > 9 pounds•Patients with hypertension; HDL cholesterol < 35 mg/dL, and/or triglyceride level > 250 mg/dl.

A

T2DM

56
Q

The concordance of ______ in identical twins is between 70 and 90%. Individuals with a parent with type 2 DM have an increased risk of diabetes; if both parents have it, the risk approaches 40%

A

type 2 DM

57
Q

Hyperinsulinemia due to insulin resistance (early)•Beta cell dysfunction with impaired insulin secretion-pancreatic exhaustion? (late); Due to downregulation of insulin receptors in target tissues & insulin resistance

A

Type 2 DM

58
Q

Insulin resistance is part of a cascade of disorders that are called _____; includes Obesity, especially abdominal deposition 2.Insulin resistance 3.Fasting Hyperglycemia 4.Lipid Abnormalities (High TG and Low HDL) 5.Hypertension

A

METABOLIC SYNDROME

59
Q

Individuals with ______ have increased risk for cardiovascular disease (CVD), particularly atherosclerosis and insulin resistance is a contributing factor for development of type

A

metabolic syndrome

60
Q

leading causes of blindness in the United States

A

Retinopathy:

61
Q

Retinopathy, Nephropathy, Neuropathy, Vascular disease, Myopathies are chronic complications of _____

A

DM

62
Q

progressive renal dysfunction that can lead to end-stage renal disease.

A

Nephropathy:

63
Q

peripheral loss of sensation and dysesthesias

A

Neuropathy:

64
Q

accelerated atherosclerotic cerebrovascular and peripheral vascular diseasesmay occur due to abnormal lipid metabolism

A

Vascular disease:

65
Q

progressive weakness and diminished exercise tolerance.

A

Myopathies:

66
Q

The oral manifestations of ____ include: Periodontal Disease•Salivary and taste dysfunction•Oral bacterial and fungal infections (ex. candidiasis)•Oral mucosa lesions (geographic tongue, lichen planus, etc.)•Diminished salivary flow and burning mouth syndrome (with poor glycemic control)•Delayed mucosal wound healing•Xerostomia in patients on oral hypoglycemic

A

DM

67
Q

_____ disease exacerbates diabetic complications–poor glycemic control–cardiovascular complications (stroke, ischemia, infarction)

A

Periodontal disease

68
Q

T/F: Control of periodontal infection may improve glycemic control

A

True

Physiology Exam 2 (6 decks)

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