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Pathoma - Endocrine Pathology > Endocrine Pancreas > Flashcards

Endocrine Pancreas Flashcards

1
Q

What is the Endocrine Pancreas composed of?

A

Clusters of cells termed islets of Langerhans

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2
Q

What makes up a single islet?

A

It contains multiple cell types, with each cell producing one type of hormone.

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3
Q

What lies in the center of islets? What do they secrete?

A

Beta cells

-Secrete insulin

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4
Q

What is insulin?

A

Major anabolic hormone

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5
Q

What function does insulin do?

A

Increases glucose uptake by tissues and leads to increased glycogen synthesis, protein synthesis and lipogenesis.

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6
Q

What does insulin upregulate?

A

Insulin-dependent glucose transporter protein (GLUT4) on skeletal muscle and adipose tissue (glucose uptake by GLUT4 decreases serum glucose)

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7
Q

What secretes glucagon?

A

Alpha cells

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8
Q

How does glucagon function?

A

It opposes insulin in order to increase blood glucose levels (e.g. in states of fasting) via glycogenolysis and lipolysis

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9
Q

What is Type I Diabetes Mellitus?

A

Insulin deficiency leading to a metabolic disorder characterized by hyperglycemia.

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10
Q

What is the cause of Type I Diabetes Mellitus?

A

Autoimmune destruction of beta cells by T lymphocytes

Type IV hypersensitivity

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11
Q

What are three microbiological characteristics of Type I Diabetes Mellitus?

A
  1. Characterized by inflammation of islets
  2. Associated with HLA-DR3 and HLA-DR4
  3. Autoantibodies against insulin are often present (sign of damage) and may be seen years before clinical disease develops
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12
Q

When does Type I Diabetes manifest?

A

In childhood

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13
Q

What is a clinical feature of Type I Diabetes?

A

Insulin deficiency

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14
Q

What is seen in the serum of Type I Diabetics?

A

High serum glucose

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15
Q

What causes high serum glucose in Type I Diabetics?

A

Lack of insulin leads to decreased glucose uptake by fat and skeletal muscle

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16
Q

What are three symptoms of Type I Diabetes related to weight?

A
  1. Weight loss
  2. Low muscle mass
  3. Polyphagia (eat a lot)
17
Q

What does unopposed glucagon lead to in Type I Diabetics?

A

Gluconeogenesis (break down of muscle), Glycogenolysis (break down of glycogen) and Lipolysis (break down of fat) —> These further exacerbate hyperglycemia

18
Q

What are three Type I diabetes symptoms related to urine output?

A

Polyuria (large urine volume), polydipsia (excessive thirst) and glycosuria (secretion of glucose in the urine)

19
Q

What causes glycosuria in Type I diabetes?

A

-Hyperglycemia exceeds renal ability to resorb glucose

20
Q

What does excess filtered glucose lead to in Type I diabetes?

A

Osmotic diuresis

21
Q

What is the treatment for Type I diabetes?

A

Lifelong insulin

22
Q

What condition are Type I diabetics at risk for?

A

Diabetic ketoacidosis

23
Q

What is diabetic ketoacidosis characterized by?

A

Excessive serum ketones

24
Q

When does Diabetic Ketoacidosis often arise?

A

With stress (e.g. infection)

25
Q

How does stress (e.g. infection) contribute to DKA?

A

Epinephrine stimulates glucagon secretion increasing lipolysis (along with gluconeogenesis and glycogenolysis)

26
Q

What does increased lipolysis cause?

A

Leads to increased free fatty acids (FFAs)

27
Q

What does the liver do with the FFAs in Diabetic Ketoacidosis?

A

It converts FFAs into ketone bodies

e.g. beta-hydroxybutyric acid and acetoacetic acid

28
Q

What are two common ketone bodies?

A

Beta-hydroxybutyric acid

Acetoacetic acid

29
Q

What altered labs does DKA present with?

A

Hyperglycemia (>300 mg/dL), anion gap metabolic acidosis, and hyperkalemia

30
Q

Why is the hyperkalemia in DKA deceiving?

A

Hyperkalemia in serum is lost in urine over time.

–> So over time K+ becomes low in the body

31
Q

What symptoms does DKA present with?

A
  • Kussmaul respirations
  • Dehydration
  • Nausea
  • Vomiting
  • Mental status changes
  • Fruity smelling breath (due to acetone)
32
Q

What is the treatment for DKA?

A
  • Fluids (corrects dehydration from polyuria)
  • Insulin
  • Replacement of electrolytes (e.g. potassium)

Pathoma - Endocrine Pathology (1 decks)

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