Endocien Pancreas And Glucose Metobolism Flashcards
What tube could you used to collect blood for measurement of blood glucose, that will inhibit glycolysis?
Grey top
Sodium fluoride
What are the sources of blood glucose?
Intestinal absorption
Hepatic production (gluconeogenesis and glycogenolysis)
Kidney production
Glucocorticoids have what effect on blood glucose?
Increase
Common cause for hyperglycemia
- promote hepatic gluconeogenesis
- inhibit insulin binding/action
What effects do catecholamines have on blood glucose
Increase
- increase hepatic glycogenolysis
- inhibit insulin secretion
- stimulate glucagon secretion
- inhibit insulin action
What effect with glucagon have on blood glucose?
Increase
- increase gluconeogenesis
- increase glycogenolysis
- inhibit insulin binding
- inhibit insulin action
What effect does growth hormone have on blood glucose?
Increase
- inhibits cellular glucose uptake
- inhibits insulin action
- increases hepatic gluconeogenesis
An apparent hypoglycemia can be caused by?
Glycolysis by erythrocytes
-failure to remove serum from clot within 30mins
B cell tumors or insulin overdose cause what condition?
Hypoglycemia
What causes hypoglycemia due to a negative energy balance and decreased glycogen
Ketosis/pregnancy toxemia
Does hepatic failure lead to hyper or hypo- glycemia?
Hypoglycemia
What causes an hypoglycemia through insulin release in an idiosyncratic reaction in some dogs?
Xylitol -artificial sweetener
What is Jamaican vomiting sickness?
Caused by Ackee fruit
- hypoglycemia inhibits b-oxidation of fatty acids
- glucose stores are consequently depleted leading to hypoglycemia
What type of neoplasms have been associated with hypoglycemia?
Lymphocytic leukemia
Lymphoma
Plasma cell tumors
Hepatocellular Mammary Pulmonary Salivary carcinoma Hepatoma
Leiomyosarcoma
Leiomyoma
How is serum insulin measured?
Immunoassay - anti-insulin Ab
If your blood glucose is <60mg/dL, what should your insulin levels be?
Decreased
-decreased glucose utilization and increased glucose synthesis
If BG <60mg/dL and insulin levels are high, what does this indicate?
Inappropriate insulin release
Insulin-producing tumor (insulinoma)
What are the most common causes of hyperglycemia ??
Glucocorticoids
Catecholamines (exertion/fear/pain)
Diabetes mellitus
Post-prandial
Does pancreatitis lead to hyper or hypo- glycemia??
Hyperglycemia
Increased glucagon production
Damage to B cells –> diabetes mellitus
What important toxicosis will cause a hyperglycemia and can induce renal failure?
Ethylene glycol toxicosis
What drugs will cause a hyperglycemia?
Glucocorticoids
Megestrol acetate in cats (progestin and glucocorticoids activity)
When blood glucose > renal threshold you have?
Glucosuria
If you have a normal blood glucose and a glucosuria, what does this infer?
Renal tubular disorder
Transient stress
Obstruction
T/F: glucocorticoid excess can lead to prolonged excess insulin release and result in Bcell exhaustion and atrophy
True
T/F: A proximal duodenal obstruction can cause incredibly high blood glucose (600-1000 mg/dL)
True
Type 1 diabetes mellitus is an immune mediated destruction of what cells?
B cells
Decreased insulin production and tissue insulin resistance is found in what type of diabetes?
Type 2 diabetes mellitus
What glycated protein is increased with hyperglycemia and is useful for monitoring BG levels during the previous 2-3weeks ?
Fructosamine
- > rule out transient hyperglycemia
- > monitor therapy
What can be used to detect hyperglycemia over a longer period of time than can fructosamine?
Glycated hemoglobin
Formed in erythrocytes as a result of a reaction between glucose and hemoglobin
T/F: the urine dipstick detects all the ketones?
False
Only acetone and acetoacentte
Ketones can indicate what conditons?
Diabetes mellitus
Disorders with negative energy balance (starvation, pregnancy toxemia, and bovine ketosis)
What effect do Ketones have on pH and on the anion gap?
Keatones -> metabolic acidosis
Increase anion gap by contributing to cation loss in urine
An a lack of insulin shifts K+ from inside the cells t the ECF, acidosis causes K+ to be exchanged for H+, making the serum K+ appear normal. What will occur if your treat with fluids and insulin???
Dramatic hypokalemia
Will drive K+ back into the cells –> life threatening
If you have pancreatitis associated with diabetes mellitus, what enzymes would be increased?
Amylase and lipase
A common complication of diabetes can be hyperlipidema and hepatic lipidosis. What would you except to see on a biochem indicating this?
Cell swelling -> cholestasis
Increased ALP GGT and T.Bili
Increased ALT and AST (if there is hepatocellular damage)
T/F: fasted dogs with insulinomas will not decrease insulin concentration and glucose concentration decreases
True
A low baseline serum insulin with little to no increase with hyperglycemia indicates??
Insulin dependent diabetes mellitus
A normal to increased baseline serum insulin with variable response to glucose will suggest?
Non insulin dependent diabetes mellitus
