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B8 - Reproductive and Endocrine Systems > Exocrine and Endocrine Pancreas > Flashcards

Exocrine and Endocrine Pancreas Flashcards

1
Q

What 3 molecules does the exocrine pancreas produce?

A

Bicarbonate
Zymogens
Enzymes

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2
Q

Where do you find intercalated ducts in the pancreas and what is their role?

A

Found in exocrine glands.

It drains enzymes etc. from the acinus to the intralobular duct which then feeds into the pancreatic duct

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3
Q

What 4 substances does the endocrine pancreas produce?

A

Insulin
Glucagon
Somatostatin
Pancreatic polypeptide

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4
Q

What stimulates secretion of bicarbonate from a duct cell?

A

Secretin

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5
Q

What ion channels does Secretin activate via generation of intracellular cAMP?

A

K+ and Cl- channels

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6
Q

How is bicarbonate ultimately released into duodenum?

A

Secretin causes Cl- to be effluxed from cell and when it enters cell again it exchanges with bicarbonate ions from within the cell so bicarbonate ends up in lumen of duodenum

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7
Q

What hormone is produced by I cells in duodenum in response to fat and what does this hormone do?

A

Cholecystokinin (CCK) which stimulates acini cells to secrete enzymes needed for fat and protein digestion

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8
Q

What hormone is responsible for neutralising acidic contents coming from stomach?

A

Secretin - produced by S cells in duodenum

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9
Q

What gene is mutated in people with CF and what type of mutation is it?

A

Frameshift mutation in CFTR gene

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10
Q

What cells produce glucagon and where do you tend to find them in the islet?

A

Alpha cells - tend to be on ouside of islet

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11
Q

What cells produce insulin and roughly what percentage of cells do they make up in islets?

A

Beta cells - 70-75%

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12
Q

What do delta cells produce in islets?

A

Somatostatin

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13
Q

Where does C-peptide come from and what is the significance of it?

A

Released from insulin as insulin matures.

Levels can be measured to give an indication of beta cell activity

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14
Q

What receptors do beta cells express which allow the uptake of glucose?

A

GLUT2

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15
Q

What does the uptake of glucose into beta cells cause a rise in?

A

ATP

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16
Q

What channels does ATP act on in beta cells and what is the result of this activation?

A

Activates ATP-sensitive potassium channels (K-ATP) causing depolarisation

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17
Q

What does depolarisation of beta cells cause?

A

influx of calcium ions whcih triggers insulin release from vesicles

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18
Q

What type of receptor is the insulin receptor and what reaction can they undergo?

A

Tyrosine kinase - can undergo phosphorylation

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19
Q

What glucose channel do you find on fat and muscle cells?

A

GLUT4

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20
Q

Phosphorylation of what triggers movement of GLUT4 to cell surface of fat and muscle cells?

A

IRS-1

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21
Q

What is a obligatory glucose consuming tissue?

A

Tissue where glucose levels are NOT controlled by insulin e.g. brain

22
Q

What is meant by facultative glucose consumers?

A

Tissues that take up glucose when they need it e.g. muscles

23
Q

What is glycogenesis?

A

Glycogen synthesis

24
Q

What happens in glycogenolysis

A

Liver glycogen converted to glucose

25
Q

How many amino acids make up glucagon?

A

29

26
Q

What is the structure of insulin

A

Alpha chain with 21aa’s and beta chain with 30 aa’s. Alpha and beta chains linked by disulphide bonds

27
Q

What is the role of somatostatin and when is it released?

A

Inhibits release of insulin and glucagon as well as exocrine pancreatic solution.
It is produced after a meal has been digested.

28
Q

Name a few symptoms of diabetes

A

Thirst (polydipsia)
Polyuria
Fatigue

29
Q

Rougley what percentage of NHS resources does diabetes care consume?

A

10%

30
Q

What immune cells are the main killers of beta cells in type 1 diabetes?

A

CD8+ T-cells (cytotoxic T-cells)

31
Q

What is the key target antigen for autoimmune attack in type 1 diabetes?

A

Pro-insulin

32
Q

Outline the natural cause theory of type 1 diabetes

A

That as children grow, their pancreas remodels (like everything else in body) but too much remodelling means lots of beta cells getting destroyed. immune cells clear cells which causes inflammation making immune system think there is an infection and immune system attacks beta cells

33
Q

Outline the infection induced theory of type 1 diabetes

A

Coxsackievirus infection - molecules within this virus are similar to molecules made by beta cells so immune system will accidentally target beta cells when trying to kill virus

34
Q

What are some of the genetic associations with type 1 diabetes?

A

Major histocompatability complex (MHC)
Immunoregulatory genes e.g. PTPN22 (a phosphatase that regulates T and B cells.
CD25 (IL-2alpha receptor) and IL-2

35
Q

What is bystander activation and how is it liked to type 1 diabetes?

A

Immune response to infection causing damage to healthy tissue (e.g. islets) leading to release of islet antigens (beta cell antigens then get recognised as harmful)

36
Q

What is the term used to describe viral proteins that resemble beta cell proteins causing the immune system to attack both?

A

Molecular mimicry

37
Q

What type of infection is thought to trigger type 1 diabetes in children?

A

Enterovirus infections

38
Q

What does LADA stand for?

A

Late Autoimmune Diabetes in Adults

39
Q

Elevated levels of what helps diagnose LADA?

A

Pancreatic autoantibodies

40
Q

What is the incidence of LADA in the UK as a percentage?

A

6-10%

41
Q

Increased signalling of what is thought to be linked to type 2 diabetes?

A

Free fatty acid signalling due to increased uptake of FFAs

42
Q

Where do ceramides come from and what pathway do they inhibit? What is the effect of this?

A

Ceramides are produced from FFA signalling and they inhibit kinase pathway PKB/Akt whcih is responsible for movement of GLUT4 channels to plasma membrane and glycogen synthesis

43
Q

Are high ketone levels more diagnostic of type 1 or type 2 diabetes?

A

Type 1 - due to breakdown of fat

44
Q

What produces ketones and what affect do large amounts of ketones have on the body?

A

Produced by breakdown of fat (attempt of body to get glucose).
Large amounts cause acidosis of blood which is life-threatening

45
Q

Name Macrovascular complications of diabetes

A

Stroke
Heart disease and hypertension
Peripheral vascular disease
Foot problems

46
Q

Name Microvascular complications of diabetes

A 
Retinopathy and cataracts
Renal disease
Neuropathy
Foot problems
Erectile dysfunction
47
Q

What is claudication?

A

cramping due to blockage of blood vessels

48
Q

What affect does high glucose levels have on the immune system?

A

Suppresses it

49
Q

What is HbA1c?

A

Glycated haemoglobin

50
Q

What is high HbA1c a sign of?

A

Diabetes - Sign that there is extra glucose in blood that is not being taken up by cells so something is wrong.
RBCs last 120 days so allows you to look at glucose levels over a long period of time

B8 - Reproductive and Endocrine Systems (9 decks)

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