Endocien Pancreas And Glucose Metobolism

Question 1

What tube could you used to collect blood for measurement of blood glucose, that will inhibit glycolysis?

Answer 1

Grey top

Sodium fluoride

Question 2

What are the sources of blood glucose?

Answer 2

Intestinal absorption

Hepatic production (gluconeogenesis and glycogenolysis)

Kidney production

Question 3

Glucocorticoids have what effect on blood glucose?

Answer 3

Increase

Common cause for hyperglycemia

• promote hepatic gluconeogenesis
• inhibit insulin binding/action

Question 4

What effects do catecholamines have on blood glucose

Answer 4

Increase

• increase hepatic glycogenolysis
• inhibit insulin secretion
• stimulate glucagon secretion
• inhibit insulin action

Question 5

What effect with glucagon have on blood glucose?

Answer 5

Increase

• increase gluconeogenesis
• increase glycogenolysis
• inhibit insulin binding
• inhibit insulin action

Question 6

What effect does growth hormone have on blood glucose?

Answer 6

Increase

• inhibits cellular glucose uptake
• inhibits insulin action
• increases hepatic gluconeogenesis

Question 7

An apparent hypoglycemia can be caused by?

Answer 7

Glycolysis by erythrocytes

-failure to remove serum from clot within 30mins

Question 8

B cell tumors or insulin overdose cause what condition?

Answer 8

Hypoglycemia

Question 9

What causes hypoglycemia due to a negative energy balance and decreased glycogen

Answer 9

Ketosis/pregnancy toxemia

Question 10

Does hepatic failure lead to hyper or hypo- glycemia?

Answer 10

Hypoglycemia

Question 11

What causes an hypoglycemia through insulin release in an idiosyncratic reaction in some dogs?

Answer 11

Xylitol -artificial sweetener

Question 12

What is Jamaican vomiting sickness?

Answer 12

Caused by Ackee fruit

• hypoglycemia inhibits b-oxidation of fatty acids
• glucose stores are consequently depleted leading to hypoglycemia

Question 13

What type of neoplasms have been associated with hypoglycemia?

Answer 13

Lymphocytic leukemia
Lymphoma
Plasma cell tumors

Hepatocellular 
Mammary 
Pulmonary 
Salivary carcinoma 
Hepatoma 

Leiomyosarcoma
Leiomyoma

Question 14

How is serum insulin measured?

Answer 14

Immunoassay - anti-insulin Ab

Question 15

If your blood glucose is <60mg/dL, what should your insulin levels be?

Answer 15

Decreased

-decreased glucose utilization and increased glucose synthesis

Question 16

If BG <60mg/dL and insulin levels are high, what does this indicate?

Answer 16

Inappropriate insulin release

Insulin-producing tumor (insulinoma)

Question 17

What are the most common causes of hyperglycemia ??

Answer 17

Glucocorticoids
Catecholamines (exertion/fear/pain)
Diabetes mellitus
Post-prandial

Question 18

Does pancreatitis lead to hyper or hypo- glycemia??

Answer 18

Hyperglycemia

Increased glucagon production
Damage to B cells –> diabetes mellitus

Question 19

What important toxicosis will cause a hyperglycemia and can induce renal failure?

Answer 19

Ethylene glycol toxicosis

Question 20

What drugs will cause a hyperglycemia?

Answer 20

Glucocorticoids

Megestrol acetate in cats (progestin and glucocorticoids activity)

Question 21

When blood glucose > renal threshold you have?

Answer 21

Glucosuria

Question 22

If you have a normal blood glucose and a glucosuria, what does this infer?

Answer 22

Renal tubular disorder
Transient stress
Obstruction

Question 23

T/F: glucocorticoid excess can lead to prolonged excess insulin release and result in Bcell exhaustion and atrophy

Answer 23

True

Question 24

T/F: A proximal duodenal obstruction can cause incredibly high blood glucose (600-1000 mg/dL)

Answer 24

True

Question 25

Type 1 diabetes mellitus is an immune mediated destruction of what cells?

Answer 25

B cells

Question 26

Decreased insulin production and tissue insulin resistance is found in what type of diabetes?

Answer 26

Type 2 diabetes mellitus

Question 27

What glycated protein is increased with hyperglycemia and is useful for monitoring BG levels during the previous 2-3weeks ?

Answer 27

Fructosamine

• > rule out transient hyperglycemia
• > monitor therapy

Question 28

What can be used to detect hyperglycemia over a longer period of time than can fructosamine?

Answer 28

Glycated hemoglobin

Formed in erythrocytes as a result of a reaction between glucose and hemoglobin

Question 29

T/F: the urine dipstick detects all the ketones?

Answer 29

False

Only acetone and acetoacentte

Question 30

Ketones can indicate what conditons?

Answer 30

Diabetes mellitus

Disorders with negative energy balance (starvation, pregnancy toxemia, and bovine ketosis)

Question 31

What effect do Ketones have on pH and on the anion gap?

Answer 31

Keatones -> metabolic acidosis

Increase anion gap by contributing to cation loss in urine

Question 32

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???

Answer 32

Dramatic hypokalemia

Will drive K+ back into the cells –> life threatening

Question 33

If you have pancreatitis associated with diabetes mellitus, what enzymes would be increased?

Answer 33

Amylase and lipase

Question 34

A common complication of diabetes can be hyperlipidema and hepatic lipidosis. What would you except to see on a biochem indicating this?

Answer 34

Cell swelling -> cholestasis
Increased ALP GGT and T.Bili

Increased ALT and AST (if there is hepatocellular damage)

Question 35

T/F: fasted dogs with insulinomas will not decrease insulin concentration and glucose concentration decreases

Answer 35

True

Question 36

A low baseline serum insulin with little to no increase with hyperglycemia indicates??

Answer 36

Insulin dependent diabetes mellitus

Question 37

A normal to increased baseline serum insulin with variable response to glucose will suggest?

Answer 37

Non insulin dependent diabetes mellitus