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phys > exam 2: glucagon > Flashcards

exam 2: glucagon Flashcards

1
Q

what is 29 amino acid peptide, secreted from pancreatic ____ cells

A

glucagon

alpha cells

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2
Q

glucagon is the hormone of

A

starvation

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3
Q

secretion of glucagon is controlled by ______ levels (inverse relationship)

A

blood glucose

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4
Q

the primary target tissue for glucagon is ______ to increase blood glucose.

does this by
1
2
3

A

liver

1.stimulating glycogenolysis and inhibiting glycogen synthesis (bc inverse relationship)
2. increasing gluconeogenesis (new glucose)
3. increases blood FA and ketoacid levels to provide more substrates for gluconeogenesis

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5
Q

metabolic disorder characterized by HYPERGLYCEMIA due to insufficient insulin or cellular resistance to insulin (or both)

A

diabetes mellitus MI

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6
Q

DM is hyperglycemia due to two things:

A

insufficient insulin or cellular resistance to insulin

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7
Q

with this, it takes longer to reduce blood glucose levels and glucose levels dont reach the control level

A

DM

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8
Q

percent of type 1 and 2

A

type 1 10%
type 2 90%

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9
Q

3 classic symptoms of DM called the 3 P’s

A

polyuria (pee)
polydypsia (thirst)
polyphagia (hunger)

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10
Q

type 1 or 2?

-weight loss even though you are eating more=

-tingling, pain or numbness in the hands or feet=

A

weight loss= type 1

numb= type 2

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11
Q

what functions like a buffer for blood glucose

A

liver

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12
Q

people with severe liver disease have a difficultly maintaining a

A

narrow plasma glucose range

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13
Q

glucagon secretion is stimulated by:
1
2
3

A

hypoglycemia
epinephrine (B2)
vagus nerve

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14
Q

remaining symptoms of diabetes mellitus

A

extreme fatigue
blurry vision
cuts/bruises that are slow to heal

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15
Q

hypoinsulinemia

A

type 1

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16
Q

hyperinsulinemia

A

type 2

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17
Q

25% of patients with type 1 DM initially present in diabetic __________ (bc of high glucagon levels) (hyperglycemia >250mg/dl

A

ketoacidosis

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18
Q

diagnosis of DM glucose levels that show symptoms of HYPERGLYCEMIA: (casual plasma glucose)

what is normal:

A

casual plasma glucose > or equal to 200 miligrams/dl

100 and below normal (like 70-100)

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19
Q

A1c is the measurement of long term blood glucose levels (last 2-3 months)

A1C of DM patient:

normal patient:

A

> =6.5%

(normal patient <5.6%)

20
Q

Diabetes Mellitus Type 1 is autoimmune destruction of

A

pancreatic beta cells

21
Q

what are the risk factors for Diabetes Mellitus Type I

A
  1. genetic predisposition-increased susceptibility
  2. environmental triggers (viral infection)
  3. less than 40, non-obese younger patients
22
Q

what is the fasting plasma glucose level for DM:

normal:

A

126

normal: 100

23
Q

DM 2 hour post-prandial glucose:

normal:

A

DM: 200

normal: 140

24
Q

insulin dependent diabetes:

A

DM type 1

25
Q

when does beta destruction occur slowly

A

in DM type 1

26
Q

when does hyperglycemia occur in DM type1:

A

when 80-90% of cells are destroyed

27
Q

what is DM type 1 triggered by

A

stressor (illness)

28
Q

hyperglycemia in DM type 1 lead to:

A

-3 p’s: polyuria, polydipsia, polyphagia
-glucosuria (glucose in urine)
-weight loss
-malaise and fatigue
-hyperkalemia (due to lack of insulin which normally activates Na/K pump)

29
Q

due to increased lipolysis to fatty acids to produce ketoacids
-most common in type 1

A

diabetic ketoacidosis (DKA)

30
Q

response to cellular starvation brought on by relative insulin deficiency and couterregulatory or catabolic hormone excess:

A

diabetic ketoacidosis (DKA)

hormone excess:
would be glucagon, catecholamines, cortisone and growth hormone

31
Q

causes of DKA

A

-reduced daily insulin injections
-infection
-surgery
-cushing’s
-substance abuse
-steroids

-all have in common that stimulate catechcholamones, cortisone, glucagon, or GH

32
Q

what are the pathophysiology of DKA:

A
  1. osmotic diuresis and dehydration (hyperglycemia)
  2. metabolic acidosis (increase H+=coma)
  3. fluid and electrolyte imbalances (from osmotic diuresis)
33
Q

signs and symptoms of DKA

A

-fruity breath (acetone)
-nausea/abdominal pain
-dehydration
-tachycardia
-lethargy
-coma
-3 p’s
-kussmaul respirations (deep/ blow off CO2 to reverse acidosis)

34
Q

pH and category of individual that will be in coma

A

pH less than 7.0

35
Q

DKA/acidosis depresses neuronal function since it blocks inward current of

so that decreases nerve and muscle excitability

A

Na and Ca

36
Q

fasting hyperglycemia despite availability of insulin=insulin resistance

A

DM type 2

37
Q

insulin dependent:
insulin resistance:

A

dependent: type 1
resistance: type 2

38
Q

risk factors for DM type 2

A

-history of diabetes in parents or siblings!!
-obesity
-physical inactivity
-race
-women
-hypertension and high cholesterol

39
Q

T2DM

early in disease: DMT2 ________ due to insulin resistance

later: ______ dysfunction with impaired insulin secretion-pancreatic exhaustion

A

hyperinsulinemia

beta cell dysfunction

40
Q

we dont really know, but think T2DM caused by:

A

down regulation of insulin receptors in target tissues and insulin resistance

41
Q

insulin resistance is part of a cascade of disorders that are called:

5 of them:
1
2. insulin resistance
3
4
5

A

metabolic syndrome

  1. obesity, especially abdominal deposition
  2. insulin resistance
  3. fasting hyperglycemia
  4. lipid abnormalities (HIGH TG and LOW HDL (cholesterol)
  5. hypertension
42
Q

those with metabolic syndrom have increased risk for CVD (Cardiovascular disease) and insulin resistance is a contributing factor for devloping

A

type 2 DM

43
Q

chronic complications of DM

A

retinopathy
nephropathy
neuropathy
vascular disease
myopathies

44
Q

oral manifestations of DM

A

-burning mouth
-xerostomia
-diminished salivary flow
-periodontal disease
-delayed healing

45
Q

periodontal disease makes diabetic complications worse and someone who has it has:

A

-poor glycemic control
-increased cardiovascular complications

46
Q

therefore, someone who has periodontal disease and DM, taking care of periodontal infection may improve

A

glycemic control

47
Q
A

phys (16 decks)

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