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Physiology II > L13/14 > Flashcards

L13/14 Flashcards

1
Q

True or False: For a person of normal weight, insulin secretion is normal. However, as they become obese and develop T2DM, there will have a moderate increase of insulin secretion until, finally, they will be obese and have BELOW NORMAL insulin secretion

A

True

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2
Q

True or False: In T1DM, there is decrease in glucose uptake by cells and increase in glycogenolysis and gluconeogenesis

A

True

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3
Q

True or False: In DM, there is decrease in effective insulin and increase in glucagon. As a result, ketone synthesis in liver + glycogenolysis/gluconeogenesis will increase (leading to elevated glucose)

A

True

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4
Q

Ineffectiveness of intraislet insulin to inhibit glucagon secretion from alpha cells is characteristic of:
A. Early T2DM
B. Late T2DM

A

A. Early T2DM

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5
Q

Severe hyperglycemia and HHS is characteristic of:
A. Early T2DM
B. Late T2DM

A

B. Late T2DM

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6
Q

Which type of DM is associated with:
- Decreased insulin-stimulate glucose intake
- Increased hepatic gluconeogenesis

A

T2DM

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7
Q

Diabetic ketoacidosis is a serious complication of which DM?

A

T1DM

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8
Q

If pancreatic beta-cells are functioning properly, insulin resistance always results in ____ but does not always result in ____

A

hyperinsulinemia; hyperglycemia

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9
Q

True or False: Hyperglycemia is most patients diagnosed with T2DM is the result of both insulin resistance and pancreatic beta cell dysfunction

A

True

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10
Q

True or False: If pancreatic beta cell function is impaired, plasma glucose CAN be normal, as long as target tissues efficiently utilized glucose

A

True

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11
Q

True or False: In impaired insulin secretion, there may be decrease responsiveness (decrease beta cell mass) and increased sensitivity (of beta cells to plasma glucose)

A

False -
There will be DECREASED responsiveness and sensitivity!

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12
Q

Glucose sensitivity, synthesis of pre-pro-insulin, processing of pro-insulin, and reduced beta cell mass are characteristic of:
are characteristic of impaired ___ secretion

A

insulin

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13
Q

If target cells are insulin resistant, it means that insulin cannot inhibit what two processes?

A

1) Hepatic gluconeogenesis
2) Glucagon secretion

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14
Q

Result of excessive adipokine secretion on insulin receptor signaling?

A

Decrease adipokine TNF-a, which decrease RTK activity

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15
Q

Three effects of excessive FA oxidation?

A

1) Serine kinase activated
2) IRS-1 phosphorylated by serine
3) Tyrosine kinase unable to phosphorylate IRS-1

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16
Q

True or False: Excessive FA oxidation by cells results in:
- Serine kinase activation
- Phosphorylation of IRS-1 by serine
- Accumulation of DAG

A

True

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17
Q

What two molecules are elevated in obese individuals? Decreased?

A

Increased = leptin (food intake) and adipokine (insulin/glucose sensitivity)
Decrease = adiponectin (beta cell prol)

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18
Q

True or False: Cortisol and GH will only work if hypoglycemia is severe and persists for hours

A

True

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19
Q

What are the four counter-regulatory hormones?

A

1) Glucagon
2) Epi
3) Cortisol
4) GH

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20
Q

What is the function of counter-regulatory hormones?

A

Prevent hypoglycemia

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21
Q

With short-term fasting, ___ stores are used first

A

glycogen

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22
Q

True or False: With continued fasting, gluconeogenesis and lipolysis increase and low plasma insulin facilitates protein/TG breakdown

A

True

23
Q

In what state are ketones made in liver?

A. Absorptive State
B. Fasting State

A

B. Fasting State

24
Q

Insulin stimulates __ in adipose tissue capillaries

Insulin enhances glucose uptake by and TG synthesis in ___

A

LPL; adipocytes

25
Q

Hydrolysis of glycogen, fat, and proteins (plus: gluconeogenesis and ketogenesis) are associated with:
A. low insulin to glucagon ratio
B. high insulin to glucagon ratio

A

A. low insulin to glucagon ratio

26
Q

Negative feedback loops regulate plasma glucose not plasma ___ or ____

A

insulin; glucagon

27
Q

What inhibits glucagon secretion?

A

Elevated plasma glucose, low plasma amino acids

28
Q

True or False: Plasma amino acids have the same effect on secretion of both insulin and glucagon

A

True

29
Q

True or False: Ach leads to secretion of glucagon

A

False - NE/Epi (SNS) + elevated plasma cortisol lead to glucagon secretion

30
Q

What is the threshold for glucagon secretion?

A

65-70

31
Q

As plasma glucose decreases, plasma glucagon ____

A

increases

32
Q

Absorptive phase is dominated by ___ while fasting phase is dominated by ___

A

insulin; glucagon

33
Q

What molecule is not removed via first pass metabolism and, therefore, is a good indicator of pancreatic function and initial insulin secretion?

A

C-peptide

34
Q

True or False: Parasympathetic stimulation inhibits insulin secretion

A

False - NE/EPI INHIBITS insulin secretion

35
Q

What molecule increases insulin secretion during absorptive phase?

A

GLP-1

36
Q

What are three drugs that treat T2DM and targets GLP-1/DPP-IV?

A

1) DPP-IV resistant GLP-1 analog
2) Albumin based GLP-1
3) Antagonists of DPP-IV (slow breakdown og GLP-1)

37
Q

GLP-1 can be converted to ___, which is biologically inactive

A

GLP-1 fragment

38
Q

Three stimuli that activates insulin secretions?

A

1) GLP-1/GIP
2) Increase glucose, AA/FA
3) Ach/parasympathetic stimulation

39
Q

Plasma glucose of ____ mg/dl is threshold for insulin secretion

A

80

40
Q

What is the most important stimulus for insulin secretion?

A

Plasma glucose

41
Q

Insulin secretion by beta cells involves:
A. Insulin dependent glucose transporter
B. Insulin independent glucose transporter (GLUT4)

A

B. Insulin independent glucose transporter (GLUT4)

42
Q

True or False: Insulin contains C-peptide + a/b chain + insulin

A

True

43
Q

Where in the beta cell does insulin synthesis occur?

A

Vesicle

44
Q

While fasting, plasma glucose should remain stable and ~ ______

A

70 to 100 mg/dl

45
Q

After a meal, plasma glucose should not be greater than ___

A

180 mg/dl

46
Q

True or False: In glucose-dependent tissues, glucose transport is regulated by insulin

A

False - in GLUCOSE-INDEPENDENT tissues, glucose transport is regulated by insulin

47
Q

Are glucose transporters always in the membrane w/r/t glucose dependent tissues?

A

Yes

48
Q

True or False: Glucose-independent tissues utilize RTK’s

A

True

49
Q

Skeletal muscle, adipose tissues, and liver are examples of:
A. Glucose independent tissues
B. Glucose dependent tissues

A

A. Glucose independent tissues

50
Q

True or False: Skeletal muscle, adipose tissues, and liver can use glucose or fatty acids to make ATP

A

True

51
Q

What type of glucose transport is used by glucose dependent tissues?
A. Insulin independent glucose transport
B. Insulin dependent glucose transport

A

A. Insulin independent glucose transport

52
Q

What type of tissues have glucose transporters always present in the plasma membrane and require a concentration gradient for glucose entry?
A. Glucose Dependent Tissues
B. Glucose Independent Tissues

A

A. Glucose Dependent Tissues

53
Q

Brain, neurons, RBC’s, renal medulla, and intestinal mucosa are examples of what type of tissues?

A

Glucose-Dependent Tissues

Physiology II (23 decks)

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