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Physio > Lab Exam 3 > Flashcards

Lab Exam 3 Flashcards

1
Q

The urinary system is composed of the

A

kidneys, ureters, urinary bladder, and the urethra.

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2
Q

The urinary system is constantly working to maintain the

A

purity and health of the body’s fluids by removing unwanted substances and recycling others.

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3
Q

The kidneys contribute to homeostasis by

A

regulating plasma composition through the elimination of metabolic wastes, toxins, excess ions, and water.

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4
Q

Three main metabolic waste products

A

(nitrogenous compounds), urea, uric acid, creatinine

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5
Q

urea

A

is formed by the breakdown of amino acids

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6
Q

Uric acid

A

is formed by the byproduct of breakdown of nucleic acids

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7
Q

Creatinine

A

is formed from the breakdown of a molecule known as creatine phosphate

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8
Q

Kidney function 1

A

Regulation of the volume, composition, and pH of the body fluids

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9
Q

Kidney function 2

A

Regulation of acid-base homeostasis (via the production of ammonia)

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10
Q

Kidney function 3

A

Regulation of energy metabolism via gluconeogenesis during fasting conditions

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11
Q

Kidney function 4

A

Regulation of plasma osmolarity through the control of aquaporin receptors within the collecting duct

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12
Q

Kidney function 5

A

Detoxification of metabolic wastes through excretory mechanisms

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13
Q

Kidney function 6

A

Conversion of vitamin D3 into its active form

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14
Q

Kidney function 7

A

Synthesis and conversion of important hormones such as erythropoietin and renin.

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15
Q

Kidneys are located in the

A

retroperitoneal space just behind the peritoneum of the abdominal cavity

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16
Q

Right and left kidney will be located on the

A

upper abdominal quadrant of the retroperitoneal space

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17
Q

Right kidney is located

A

a little slightly lower compared to our left kidney

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18
Q

Kidney maintains its shape and structure through its

A

fibrous capsule that’s located along the outside of the organ itself

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19
Q

Renal cortex is below

A

fibrous capsule. Lighter pink outer region and is where urine production can occur.

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20
Q

renal medulla or renal pyramid

A

Small, triangular-shaped, darker pink shapes found inside the kidney

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21
Q

Renal cortex and renal medulla will make up the

A

renal lobe

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22
Q

Renal papillae

A

Apex of the pyramid or point of the pyramid, at the very bottom of the pyramid

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23
Q

Renal columns

A

Between each renal medulla and renal pyramid, lighter pink regions. Maintain the integrity and shape or structure of the kidneys

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24
Q

Minor calyx

A

is where urine formation that found in the medulla will travel down into this minor calyx.

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25
Q

Major calyx

A

where urine travels to after the minor calyx, three major calyxes, will form together to form the regional pelvis

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26
Q

Hilus

A

indentation found on an organ that can contain blood supply and contain neural innervation. Will include the renal pelvis, renal artery, renal vein, and the renal plexus for innervation

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27
Q

Urine will travel through the

A

renal pelvis, down into the ureter, into the urinary bladder and then finally through the urethra

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28
Q

in renal blood flow, the

A

First five arteries will be our last five veins, but they’ll be inverted with each other

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29
Q

Renal blood flow

A

Renal artery -> Segmental artery -> Interlobar artery -> Arcuate artery -> Interlobular artery -> Afferent arteriole -> Glomerulus -> Efferent arteriole -> Peritubular capillaries -> Vasa recta -> Interlobular vein -> Arcuate vein -> Interlobar vein ->Segmental vein -> renal vein

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30
Q

Renal artery

A

branch off of the abdominal aorta and it’s going to be providing deoxygenated blood to the kidneys. Will travel through the hilum

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31
Q

Interlobar arteries travel through the

A

lobes of the medulla

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32
Q

Arcuate artery

A

form arches along the outside of the cortex

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33
Q

Interlobular arteries

A

form these small tree-branch like structures off of the arcuate arteries

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34
Q

Afferent arteriole

A

provides blood supply to the glomerulus

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35
Q

Efferent arteriole

A

exiting the glomerulus

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36
Q

Peritubular capillaries

A

surrounding the tubules, specifically the portions of the proximal convoluted tubule and the distal convoluted tubule

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37
Q

Vasa recta

A

will provide a blood capillary system that surrounds the loop of Henle

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38
Q

Interlobar veins

A

between lobes and medulla

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39
Q

Renal vein

A

enter into the inferior vena cava

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40
Q

The Nephron

A

The main functional unit of the kidney responsible for urine formation, Smallest functioning unit of the kidneys

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41
Q

Cortical nephron

A

found in the cortex, Shorter loops of Henle, About 80-85% of nephrons in humans

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42
Q

Shorter loops of Henle

A

produce more diluted urine

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43
Q

Juxtamedullary nephron

A

located adjacent to the medulla or next to the medulla, Longer loops of Henle that extend down the renal medulla, Only 15-20% of nephrons in humans

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44
Q

Longer loops of Henle that extend down the renal medulla

A

allow for more water reabsorption, will be able to produce much more concentrated urine

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45
Q

The nephron is composed of

A

Renal corpuscle = Bowman’s capsule + glomerulus. Renal tubule

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46
Q

Renal tubule with three distinct parts

A

Proximal Convoluted Tubule, Loop of Henle, Distal Convoluted Tubule

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47
Q

The nephron produces urine through three/four main interaction mechanisms:

A

Filtration, Reabsorption, Secretion, Excretion

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48
Q

Filtration

A

A filtrate of the blood leaves the kidney capillaries and enters the renal tubule. Will only occur at the glomerulus to produce an ultrafiltrate product

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49
Q

Filtration definition

A

the movement of water and plasma solutes through the glomerular capillary walls into the urinary space of the Bowman’s capsule.

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50
Q

Reabsorption

A

Most of the nutrients, water, and essential ions are recovered from the filtrate and returned to the blood. Most reabsorption will occur at the proximal convoluted tubule

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51
Q

Reabsorption definition

A

when a substance is transported from the filtrate, through the tubular cell membrane walls, and eventually into systemic circulation

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52
Q

Secretion

A

Certain substances are secreted from the blood into the filtrate product to be eliminated. Can occur in the proximal convoluted tubule.

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53
Q

Secretion definition

A

a substance is transported from peritubular blood vessels into the filtrate product, which will ultimately form urine

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54
Q

Excretion

A

Process of eliminating or expelling waste matter through the final excretory product, urine

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55
Q

Glomerular filtration is where we see

A

podocytes, forming our internal wall of the glomerulus and this is what helps make it a more structured area to not allow certain products to move out and for only smaller substances to move out the area or out of the bloodstream

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56
Q

When podocytes are formed, there are extensions called

A

pedicles. Pedicles will form filtration slits in the area which will allow filtrate to leave the capillaries and actually enter into Bowman’s capsule

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57
Q

The endothelium of these capillaries are

A

very porous

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58
Q

The endothelium of these capillaries allow

A

fluid, waste products, ions, glucose, and amino acids to pass from the blood into the capsule.

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59
Q

Glomerular Filtration blocks out

A

bigger molecules like blood cells and proteins so they stay in the blood and exit through the vasa recta.

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60
Q

hematuria

A

red blood cells being present in the urine

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61
Q

albuminuria

A

albumin being present in the urine

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62
Q

Glomerular Filtration Rate (GFR)

A

volume of filtrate produced by both kidneys per minute. Physiological indicator of renal function

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63
Q

Glomerular filtration is determined by

A

Starling’s pressures

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64
Q

Proximal Convoluted Tubule (PCT) cell walls are made up of

A

cuboidal epithelial cells containing mitochondria to power pumps that pull sodium ions from the filtrate using active transport

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65
Q

the microvilli in Proximal Convoluted Tubule (PCT)

A

increase surface area to help reabsorb as much of the “good stuff” as possible

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66
Q

The vast majority of renal reabsorption occurs in the

A

proximal convoluted tubule

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67
Q

renal reabsorption is approximately

A

67% of sodium and 67% of water

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68
Q

The coupled sodium and water reabsorption is

A

proportional to each other (isosmotic). This mechanism is essential for the maintenance of the chemical integrity of the extracellular fluid composition and general homeostasis

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69
Q

In a healthy individual there will be

A

~100% reabsorption of glucose

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70
Q

When plasma glucose is below 200 mg/dL

A

most if not all filtered glucose is reabsorbed

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71
Q

Renal threshold for glucose

A

200 mg/dL

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72
Q

In diabetes mellitus, if its left untreated,

A

individuals can present with ketonuria or ketones being present in the urine due to the breakdown of fatty acids for energy

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73
Q

If the blood glucose concentration is higher than 200 mg/dL but lower than 350 mg/dL, what can be said regarding reabsorption and excretion?

A

There is some reabsorption occurring and there’s also some excretion of glucose so they will present with glycosuria

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74
Q

If the blood glucose concentration is higher than 400 mg/dL what can be said regarding reabsorption and excretion?

A

The reabsorption process has reached its maximum rate. That suggests that all glucose transporters are full with glucose. They’re no longer able to reabsorb glucose back into the bloodstream. We should see mainly excretion. No more reabsorption can occur, and excretion will be the predominant source

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75
Q

Loop of Henle

A

Starts in the cortex, dips down in the medulla, comes back into the cortex

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76
Q

Loop of henle contains

A

thin descending, thin ascending, thick ascending

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77
Q

Thin descending

A

is only permeable to water and is through passive transport that water will be reabsorbed back into our blood capillary system. Higher concentration of urine as more water leaves

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78
Q

Thin ascending

A

is impermeable to water and we have active transport of sodium outward so into the interstitial fluid of the medulla and chloride ions will follow passively. This will create a very hypertonic area in that interstitial fluid.

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79
Q

a very hypertonic area in that interstitial fluid will help

A

drive in the descending limb that passive movement of water out of the descending limb of the loop of Henle and into the capillaries

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80
Q

Interstitial fluid is hypertonic to the

A

filtrate

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81
Q

Loop of Henle drives the

A

reabsorb of water by creating a salt concentration gradient in the tissue of the medulla

82
Q

The ascending portion actively

A

pumps out salt and is impermeable to water

83
Q

The high concentration of salt in the interstitial fluid of the medulla causes

A

water to passively flow in the descending portion via osmosis

84
Q

Distal Convoluted Tubule is responsible for

A

the reabsorption of sodium, bicarbonate, and the secretion of ammonium

85
Q

PTH acts on the

A

DCT to stimulate calcium reabsorption

86
Q

Distal Convoluted Tubule is

A

Impermeable to water. In certain cases, when we have aquaporins being inserted through what’s known as our antidiuretic hormone, it can become permeable to water

87
Q

Distal Convoluted Tubule empties into

A

the collecting duct

88
Q

Collecting Duct

A

Contains aquaporins which aid in the reabsorption of water into the blood. Involved in sodium reabsorption and potassium excretion

89
Q

Describe the physiological mechanisms of the renin-angiotensin-aldosterone system (RAAS).

A

Low blood volume activates the juxtaglomerular apparatus in a variety of ways to make it secrete renin.

90
Q

Angiotensin-aldosterone system (RAAS) process

A

Renin > angiotensin I > angiotensin converting enzyme (ACE) > angiotensin II.

91
Q

Angiotensin II has a variety of effects but it also causes

A

the release of aldosterone from the adrenal cortex

92
Q

Aldosterone role in the urinary system

A

Promotes sodium reabsorption in the DCT and collecting duct, Promotes the retention of water and sodium, Stimulates thirst, Increase blood volume and thus increase in blood pressure

93
Q

In the presence of high ADH

A

the renal mechanisms produce hyperosmotic (concentrated) urine.

94
Q

In the absence of ADH

A

the renal excretion mechanisms produce hyposmotic (diluted) urine.

95
Q

ADH increases the

A

permeability of water of the distal convoluted tubule and collecting duct, which are normally impermeable to water. This effect causes increased water reabsorption and retention and decreases the volume of urine produced.

96
Q

Urinary bladder is made of

A

special epithelial cells that will help allow for the stretching of the bladder for increase in volume of urine (transitional epithelial cells)

97
Q

Micturition

A

medical term for urination

98
Q

There are two sphincters, or muscular valves, that

A

separate the bladder from the urethra

99
Q

The sphincters must open before

A

the urine can flow into the urethra

100
Q

External sphincter is a

A

voluntary sphincter and its under voluntary control. Innervated by our somatic pudendal nerve.

101
Q

The internal sphincter is

A

under involuntary control and is regulated by the alpha adrenergic receptors. Can’t be controlled at all

102
Q

Bladder typically “feels full” around

A

150 - 200 mL

103
Q

Perceiving a sense of urgency around

A

300 – 400 mL

104
Q

involuntary urination

A

> 600 mL

105
Q

Urinary Tract Infection

A

Most often occurs in sexually active women. Intercourse drives bacteria from the vagina and the anus through the nearby opening of the short urethra

106
Q

The use of spermicides (found on condoms) magnifies o Urinary Tract Infection because

A

they also kill the natural, “healthy” bacteria and allow pathogenic bacteria to colonize.

107
Q

UTI symptoms

A

burning sensation during micturition, increased urgency and frequency of micturition, fever, and sometimes cloudy or blood-tinged urine.

108
Q

The elderly are also susceptible to UTIs due to

A

weakness of the bladder, incontinence, poor bladder emptying, and retention of urine. Symptoms of a UTI in the elderly include mental changes and confusion.

109
Q

Renal Calculi

A

kidney stones

110
Q

Renal Calculi types

A

4 different types – Calcium oxalate is the most common

111
Q

Renal calculi Risk factors

A

family history, chronic dehydration, obesity, certain diets (such as those with high in protein and/or salt)

112
Q

Stones less than 5mm in diameter

A

will likely pass without intervention

113
Q

Stones >5 mm

A

may become lodged in the ureter blocking the flow of urine and increasing intrarenal pressure

114
Q

Lithotripsy

A

uses shock waves to break up stones

115
Q

Primary endocrine organs

A

produce and secrete hormones as their primary physiological role

116
Q

Secondary endocrine organs and tissues

A

produce and secrete hormones in addition to their main function

117
Q

Hormones

A

chemical messengers secreted by cells into the extracellular fluids. These messengers travel through the blood and regulate the metabolic function of other cells

118
Q

The chemical structure of hormones

A

determines a critical property of a hormone: its solubility in water.

119
Q

Water solubility affects how hormones are

A

transported in the blood, how long it lasts before it is degraded, and what receptors it can act upon

120
Q

Type of hormones

A

amino acid based, steriods

121
Q

Amino acid based

A

Derived from amino acids this includes amines (such as epinephrine and thyroxine) and peptides (such as growth hormone and vasopressin). Usually, water soluble and cannot cross the plasma membrane

122
Q

Steroids

A

Synthesized from cholesterol. Only gonadal and adrenocortical hormones are steroids. Lipid soluble and can cross the plasma membrane

123
Q

Anterior Pituitary Hormones

A

Adrenocorticotropic hormone (ACTH), Thyroid-stimulating hormone (TSH), Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Growth hormone (GH), Prolactin (PRL)

124
Q

Adrenocorticotropic hormone (ACTH) target tissue and effect

A

Target tissue - Adrenal glands, specifically the adrenal cortex
Effect - Secretion of glucocorticoids, mineralocorticoids, and androgens

125
Q

Thyroid-stimulating hormone (TSH) target tissue and effect

A

Target tissue - Thyroid
Effect - Secretion of thyroxine (T4) & triiodothyronine (T3)

126
Q

Luteinizing hormone (LH) target tissue and effect

A

Target tissue - Ovaries and testes
Effect - In females, triggers ovulation. In males, promotes testosterone production

127
Q

Follicle-stimulating hormone (FSH) target tissue and effect

A

Target Tissue - Ovaries and testes
Effect - In females, stimulates ovarian follicle maturation and production of estrogens. In males, stimulates sperm production

128
Q

Growth hormone (GH) target tissue and effect

A

Target tissue - Liver, muscle, bone, cartilage, & other tissues
Effect - Regulates metabolism and body growth

129
Q

Prolactin (PRL) target tissue and effect

A

Target tissue – mammary glands
Effect – Promotes lactation

130
Q

Posterior Pituitary Hormones

A

Anti-diuretic hormone (ADH), Oxytocin

131
Q

Anti-diuretic hormone (ADH) target tissue and effect

A

Target tissue – kidneys
Effect - Stimulate kidney tubule cells to reabsorb water; inhibition of diuresis

132
Q

Oxytocin target tissue and effect

A

Target tissue - Uterine smooth muscle and mammary glands
Effect - Stimulate contractions during labor; initiates labor. Initiates milk ejection while breastfeeding

133
Q

The hypothalamus controls release of

A

hormones from the pituitary gland in two different ways: Anterior pituitary (adenohypophysis) and Posterior pituitary (neurohypophysis)

134
Q

Anterior pituitary (Adenohypophysis)

A

Hypothalamic hormones released into special blood vessels (the hypophyseal portal system) control the production and secretion of anterior pituitary hormones

135
Q

Anterior pituitary (Adenohypophysis) step 1

A

Hypothalamic neurons secrete releasing and inhibiting hormones into capillary plexus.

136
Q

Anterior pituitary (Adenohypophysis) step 2

A

Hypothalamic hormones travel though hypophyseal portal veins to the anterior pituitary; where they stimulate or inhibit release of hormones made in the anterior pituitary.

137
Q

Anterior pituitary (Adenohypophysis) step 3

A

Anterior pituitary hormones are secreted into the secondary capillaries and in turn empties into the general circulation.

138
Q

Posterior pituitary (Neurohypophysis)

A

Action potentials travel down the axons of hypothalamic neurons causing hormones to be released from the axon terminals

139
Q

Posterior pituitary (Neurohypophysis) step 1

A

Hypothalamic neurons synthesize oxytocin and ADH

140
Q

Posterior pituitary (Neurohypophysis) step 2

A

These hormones are then transported down the axons of the hypothalamic-hypophyseal tract to the posterior pituitary where they are stored in axon terminals

141
Q

Posterior pituitary (Neurohypophysis) step 3

A

When associated hypothalamic neurons fire, action potentials arriving at the axon terminals cause the hormones to be released into the blood

142
Q

pineal gland

A

(Epiphysis). Regulates the circadian rhythm through the production and secretion of melatonin

143
Q

Melatonin production and release can be stimulated by

A

darkness or inhibited by light impulses

144
Q

Pineal gland Important precursors:

A

tryptophan and serotonin

145
Q

Adrenal Cortex

A

Release hormones called corticosteroids. Zona glomerulosa, Zona fasciculata, Zona reticularis

146
Q

Zona glomerulosa

A

secretes mineralocorticoids such as aldosterone to regulate sodium and potassium balance

147
Q

Zona fasciculata

A

secretes glucocorticoids such as cortisol which stimulates glucose formation and inhibits utilization of glucose

148
Q

Zona reticularis

A

secrete sex steroids

149
Q

Adrenal medulla

A

Regulated by neural innervation, Secretes epinephrine and norepinephrine, Fight or flight response

150
Q

thyroid hormones

A

(T3 and T4) and calcitonin

151
Q

The thyroid hormones (T3 and T4) affect

A

virtually every cell in the body

152
Q

Thyroid hormones enters

A

the target cell, bind to receptors within the cell’s nucleus, and initiate transcription of mRNA for protein synthesis.

153
Q

Thyroid hormones increase

A

basal metabolic rate and body heat production, and also regulate tissue growth and development.

154
Q

Calcitonin released from

A

parafollicular cells (C-cells) of the thyroid gland in response to a rise in blood calcium levels

155
Q

calcitonin inhibits

A

osteoclast activity, inhibiting bone resorption and the release of calcium from the bony matrix

156
Q

calcitonin counteracts

A

the regulatory effects of the parathyroid glands by promoting osteoblast activity

157
Q

parathyroid gland produce and secrete

A

parathyroid hormone (PTH)

158
Q

parathyroid gland controls

A

calcium concentrations in the blood

159
Q

Low levels of calcium trigger

A

the release of PTH

160
Q

PTH increases calcium levels in the blood by

A

stimulating three target organs: skeleton, kidneys, intestine

161
Q

Skeleton

A

stimulates osteoclasts to digest some of the calcium rich bony matrix and release the calcium and phosphates into the blood

162
Q

kidneys

A

enhances the reabsorption of calcium

163
Q

Intestine

A

promotes activation of vitamin D thereby increasing absorption of calcium by intestinal mucosal cell

164
Q

The pancreas is both an

A

endocrine and an exocrine organ

165
Q

Endocrine cells are located in

A

islets of Langerhans

166
Q

Αlpha cells

A

Secrete glucagon. Hypoglycemia is the main activator of release

167
Q

Beta cells

A

Secrete insulin. Hyperglycemia is the main activator of release

168
Q

Diabetes Mellitus (DM)

A

Characterized by persistent hyperglycemia. Correlated with a variety of negative health implications such as development of Alzheimer’s disease, nerve degeneration, cognitive dysfunction, etc.

169
Q

Type I DM

A

Insulin dependent, “adolescent-onset diabetes”, autoimmune disorder caused by destruction of the beta cells, lack of insulin secretion leads to hyperglycemia and increased lipolysis activity, little correlation with body weight, smaller % of diabetic population

170
Q

Type II DM

A

Non-insulin-dependent, “maturity-onset diabetes”, caused by insulin resistance where the target cells no longer respond normally to insulin, Normal or elevated insulin initially; relative insulin deficiency, strong correlation with body weight; majority of patients are overweight or obese, larger % of diabetic population

171
Q

Receptors for water soluble hormones must be located

A

on the surface of the cell so within the plasma membrane since these hormones cannot enter the cell

172
Q

The receptors for lipid soluble hormones (steroid and thyroid) are going to be located

A

on the inside of the cell because these hormones can enter the cell

173
Q

Pituitary gland is very

A

small

174
Q

Infundibulum is important because

A

it connects the pituitary gland to the hypothalamus

175
Q

Hypothalamus interacts with the anterior pituitary gland primarily through

A

the hypophyseal portal system

176
Q

Hypophyseal portal system is a

A

capillary system so tiny blood vessels that flow between the hypothalamus and the anterior pituitary

177
Q

Hypothalamus will secret hormones into

A

the Hypophyseal portal system and they will signal for the pituitary gland to produce and secrete its own hormones

178
Q

Releasing and inhibiting hormones from the hypothalamus control

A

the production and secretion from the anterior pituitary

179
Q

Hormones of the anterior pituitary are made in the

A

anterior pituitary so the anterior pituitary synthesizes its own hormones

180
Q

The hypothalamus is going to make or synthesize the hormones and just deliver them to

A

posterior pituitary to be stored and released when needed

181
Q

Tryptophan can undergo

A

decarboxylation to form serotonin

182
Q

Within the pineal gland, serotonin is

A

acetylated and then methylated to yield melatonin

183
Q

Blue light blocks

A

melatonin production and secretion

184
Q

Thyroid gland is a

A

butterfly shaped gland located on the anterior aspect of the trachea just inferior to the larynx

185
Q

Thyroid gland is composed of

A

hollow spherical follicles and the walls of each follicle are formed by follicular cells and then the central lumen is filled with a jelly like substance called colloid

186
Q

Thyroid hormone (T3 and T4) is the body’s major

A

metabolic hormone

187
Q

Thyroid hormone is released from the

A

follicular cells

188
Q

Increased thyroid people and decreased thyroid people

A

are warm and thin, decreased thyroid people are cold, tired and put on weight

189
Q

Calcitonin is released from the

A

parafollicular cells

190
Q

Calcitonin’s job is to lower

A

blood calcium levels

191
Q

Calcitonin lowers calcium levels by inhibiting

A

osteoclasts (bonce crushing) and by encouraging osteoblasts (bone building cells)

192
Q

Parathyroid gland are very small glands located on

A

the posterior aspect of the thyroid

193
Q

Adrenal glands are

A

pyramid shaped that sit on top of the kidneys; sometimes referred to as the suprarenal glands

194
Q

All adrenal hormones help us cope with

A

stressful circumstances in some way

195
Q

Adrenal medulla is the

A

innermost region and it functions as part of the sympathetic nervous system

196
Q

Adrenal cortex is the

A

outer portion and have the release of over two dozen steroid hormones collectively called corticosteroids

197
Q

Glucagon (Alpha) is a hypoglycemic hormone works to

A

raise our blood glucose levels it does this mainly by targeting the liver to break down glycogen to glucose and it also tells the liver to synthesize glucose from lactic acid and from other non-carbohydrate molecules

198
Q

Insulin (beta) is a hypoglycemic hormone so its job is to

A

lower the blood glucose. It also promotes the sorts of fat. To lower the blood glucose, insulin will enhance the membrane transport of glucose. So well have the glucose being put into our cells especially our muscle cells and our fat cells so they can use this glucose as energy

199
Q

The energy needs is met first and then if we have extra left over, then we will make

A

glycogen and then if we have even more left over after that, the glucose will be converted to fat

200
Q

Without insulin, your cells cannot

A

accept glucose

201
Q

Type 1 diabetes is treated with

A

injections of insulin, a type of hormone replacement therapy to make up from that lack of production

202
Q

type 2 diabetes treatment

A

Metformin is used as treatment

Physio (7 decks)

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