Glucose & Lipids Flashcards
what is insuli stimulated by and what does it do
stimulated by an increase in blood glucose, as well as an increase in growth hormone, glucagon, or amino acid levels
actions: lowers blood glucose by promoting glucose uptake and use in metabolism, inhibits gluconeogenesis, increases fatty acid and TG stores, promote glycogen synthesis
**pro fat storage and pro glucose usage
glucagon is stimulated by what and does what
stimulated by a decrease in blood glucose concntrations
actions: increases blood glucose by stimulating gluconegenesis, help maintain glood glucose under fasting or food deprived states
what do catecholamines do in regards to glucose?
net effect is it increases blood glucose concentrations
what does growth hormone do?
released from pituitaru during hypoglycemia or epinephrine stim
action: increases glood glucose concentrations by inhibiting glucose update by cells
what do corticosteroids do regarding glucose and lipids?
they act to increase blood glucose concentrations, inhibit gucose uptake by cells, and promote storage of glycogen
what happens to glucose cocnentration for each:
- insulin
- glucagon
- catecholamines
- GH
- corticosteroids
- decrease
- increase
- increase
- increase
- increase
what are the two “types” of hyperglycemia, and birelfy describe them
- physiologic: after eating, excitement or fright
- pathologic: diabetes mellitus, either beta cell destruction or insulin resistance, could be pancreatitis, or an endocrine disorder???
what is the hallmark of diabetes mellitus
persistent fasting hyperglycemia with concurrent glucosuria
what does a fructosamine test tell you
it can prove chronicity of high sugars in the blood, reflects the glucose over the past 2-3 weeks
why can you see ketoneuria with diabetes mellitus?
because there s diabetic ketoacidosis, because there is lots of fatty acid available for ketone formation and not a lot of glucose getting into cells
up to 40% of diabetes patients have _______
a positive culture with an inactive urine sediment
what is acromegaly?
happens in cats, excessive GH secretion from a functional somatotropic ademona or hyperplasia of the pituitary gland. you should suspect this when DM is not controlled with climbing insulin doses
list some examples of drugs that can cause hyperglycemia
dextrose, steroids, thyroxine, ethylene glycol, xylazine, etc
give 2 examples of a transient hyperglycemia
- sepsis (if acute; chronic will be hypoglycemia)
- proximal duodenal obstruction like an LDAor RDA in cows
WHAT IS THE NUMBER ONE THING YOU SHOULD RULE OUT WHEN YOU SEE A HYPOGLYCEMIA??????
improper handling/how long was that sample sitting on the bocnh before being analyzed–>remember you might also see a hyperkalemia from delayed sampling too
besides improper handling, what are some other reasons you might get a hypoglycemia?
- insulinoma: functional beta pancreatic cells making insulin
- xylitol toxicity: stimulant for insulin release and happens really fast
- hypoadrenocorticism: due to no cortisol to tell insulin to stop
- decreased gluconeogenesis, like if the liver isn’t working, decreased hepatic function
- lactational, using up all the glucose
what is amanita toxicity and what does it cause?
essentially an isulin overdose and severe hypoglycemia, from a mushroom usually seen in late summer/fall
why does sepsis cause a hypoglycemia?
not sure, but it could be the cells are using lots of glucose and glucose is also not being produced. bacteria are NOT eating it
what is exocrine pancreatic insufficinecy?
pancreas can’t produce and secrete digestive enzymes and bicarbonate, usually due to pancreatic acinar atrophy, most commonly seen in german shepherds
what are some clinical signs of EPI?
weight loss, polyphagia, loose, pale, frappucino poop
how do you diagnose EPI?
trypsin like immunoreactivity (TLI)
a low TLI=EPI
why would amalyase and lipase be increased?
- decreased GFR
- pancreatitis
- medications like steroids
why would have you have a hypertriclyceridemia and milk hypercholesterolemia with pancreatitis?
- there is a decrease or defect in lipoprotein lipase activity, which normally catalyzes hydrolysis of triglycerides in the plasma
which mineral can be decreased in patients with acute pancreatitis?
calcium, due to the saponification of the pancreas
the Spec Pli and SNAP Pli tests detect only ____. How should you interpret these tests?
pancreatic lipase
increased PLI supports pancreatitis but does not 100% prove it, they are better negative predictors to rule out pancreatitis than to confirm it
true or false: you can diagnose pancreatitis based soley on amalyase and lipase elevations
FALSE!!!! NEVER DIAGNOSE PANCREATITIS BASED SOLEY ON AMALYASE AND LIPASE ELEVATIONS
which causes the milkly appearance of plasma: high triclycerides or high cholesterol
high triglycerides!
lipoprotein lipase is activated by _____. what does it do?
insulin
it converts CM and VLDL to free fatty acids and glycerol for tissue use
hormone-sensitive triglyceride lipase is inhibited by ____. what does it do?
inhibited by insulin
responsible for lipolysis
what are 3 causes of hypertriglyceridemia?
- physiologic, like they just ate
- iatrogenic: giving steroids
- pathophysiologic: diabetes, cushings, pancreatits, etc
true or false: hypotriglyceridemia is not considered clinically significant
what are some reasons for a hypercholesterolemia ?
- after eating, diabetes, hypothyroidism, pancreatitis, nephrotic syndrome, cholestasis/obstructive
what are some reasons for a hypocholesterolemia?
- decreased hepatic function
- protein losing enteropathy, esp lymphangiectasia
- hydroadrenocorticism
- select neoplasia like lymphoma (rare)
a horse with a marked hypertriglyceridemia you are worried about
equine hyperlipiemia–>negative energy balance, excessive mobilization of fat from adipose tissue
