Endo 8 Flashcards

1
Q

The pancreas

A

Exocrine pancreas - digestive enzymes

Endocrine- alpha cells (10%), beta cells (70-80%), delta cells (3-5%)

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2
Q

Alpha cells

A

secrete glucagon
secreted when glucose levels fall
stimulates glycogenesis by activating enzyme cascade (each step more potent)
stimulates gluconeogenesis in liver (activate enzymes)
also stimulated after meal high in protein AND during exhaustive exercise

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3
Q

Beta cells

A

insulin

only hormone that effectively lowers blood glucose

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4
Q

delta cells

A

somatostatin
depresses secretion of insulin and glucagon
stimulated release by increased blood glucose, amino acids, fatty acids, GI hormones
acts locally to depress secretion of glucagon and insulin

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5
Q

Insulin promotes utilization of _____ for energy and depresses utilization of _______

A

carbs

fats

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6
Q

Other pancreatic hormones

A
somatostatin-14
Islet amyloid polypeptide
-co-secreted with insulin
-cause amyloid deposits in pancreas
Pancreatic polypeptide
-inhibits bicarb and enzyme secretion by exocrine pancreas
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7
Q

Hypoglycemias effect on insulin and glucagon

A

inhibits insulin secretion while stimulating glucagon

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8
Q

Hyperglycemia, leucine, arginine and vagal stimulations effect on insulin and glucagon

A

increase insulin secretion while inhibiting glucagon secretion

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9
Q

Incretins include

A

gastric inhibitory peptide

glicentin, oxyntomodulin,GLP-1&2

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10
Q

Control of insulin secretion

A
  • regulated by blood glucose levels AND blood AA, GI hormones, glucagon, GH, cortisol and progesterone/estrogen
  • blood glucose provides rapid feedback to pancreas for regulating insulin release
  • Rise in blood AA must be accompanied by rise in blood glucose for it be a potent stimulator
  • GI hormones released before the meal actually absorbed
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11
Q

Factors that can impinge on secretion

A

vagus stimulation
diet
exercise

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12
Q

Glucose transporters

A
  • insulin exerts part of its actions by affecting membrane glucose transporters GLUT in target cells
  • insulin stimulates GLUT 1, 3 and 4 recruitment in the membrane of insulin-responsive cells
  • enhances removal of glucose from plasma
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13
Q

Diabetes mellitus

A
  • failure to remove glucose from blood plasma
  • two main tpyes, insulin dependent (type I) and non-insulin dependent (type II)
  • type I diabetes mainly results from an autoimmune disorder which destroys pancreatic beta
  • symptoms appear when 90% or more of beta cells are destroyed
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14
Q

Type II diabestes

A

more common and associated with obesity

-insulin resistance rather than the lack of insulin appears to be the cause

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15
Q

Hyperglycermia of severe injuries

A
  • non-diabetic individuals who sustain extreme injuries such as massive burns
  • stress of injury increases epinephrine and norepinephrine release
  • catecholamines inhibit insulin secretion and increase glucagon secretion
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16
Q

Insulinoma

A
  • insulin secreting tumor of the pancreas
  • high levels of insulin sufficiently suppresses glucagon secretion
  • characterized by persistent hypoglycemia with periods of weakness, apathy, fainting
17
Q

Hyperglycemia leads to accumulation of?

A

fructosamine and glycosylated hemoglobin