Pancreas Flashcards

1
Q

the pancreas is an _____ gland that secretes a variety of digestive hormones

A

exocrine

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2
Q

the _____ function of the pancreas secretes pancreatic islets and hormones to blood

A

endocrine

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3
Q

the four hormones the pancreas secretes to the blood

A

insulin, glucagon, somatostatin, pancreatic polypeptide (PP)

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4
Q

the pancreas is a long and slender organ located _____ to the bottom half of the stomach

A

posterior

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5
Q

the ___ cells (exocrine) of the pancreas secrete digestive enzymes to GI

A

acinar

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6
Q

the ______ (exocrine) of the pancreas secrete hormones to blood

A

pancreatic islets

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7
Q

__ cells produce insulin

A

beta

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8
Q

____ cells produce glucagon

A

alpha

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9
Q

___ cells produce somatostatin

A

delta

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10
Q

___ cells produce PP

A

F

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11
Q

____ and ____ discovered insulin

A

frederick banting and J.J.R. Macleod

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12
Q

insulin is composed of ____

A

two peptide chains (A chain and B chain)

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13
Q

A chain and B chain are linked together by _____

A

two disulfide bonds (and an additional disulfide is formed within the A chain)

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14
Q

insulin is synthesized by ______ and ____ in the beta cells

A

ribosome and endoplasmic reticulum

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15
Q

insulin is packaged into membrane-bound granules by the ____ of beta cells

A

golgi apparatus

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16
Q

insulin is secreted to the neighboring capillary and then the bloodstream by _____

A

exocytosis

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17
Q

preproinsulin consists of _____

A

A+B+C+ signal peptide

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18
Q

proinsulin consists of ______

A

A+B+C peptide

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19
Q

The C peptide is removed from proinsulin producing ____

A

insulin (A+B+peptide)

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20
Q

the half-life of insulin in the circulation in humans is about ____

A

5 min

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21
Q

insulin is destroyed by proteases in the endosomes formed by the ______

A

endocytotic process

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22
Q

4 principle actions of insulin

A

increase usage of nutrition, increase synthesis, increase growth, decrease degradation

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23
Q

for carbohydrate metabolism, insulin stimulates ____, _____, and _____

A

glycolysis, glycogen synthesis, and glucose uptake in muscle and adipose tissue

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24
Q

for fat metabolism, insulin stimulates _____

A

lipogenesis

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25
Q

for protein metabolism, insulin stimulates _____

A

protein synthesis

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26
Q

for carbohydrate metabolism, insulin stops _____ and _____

A

gluconeogenesis, glycogenolysis

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27
Q

for fat metabolism, insulin stops _____ and ____

A

lipolysis, ketogenesis

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28
Q

for protein metabolism, insulin stops ____

A

proteolysis

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29
Q

within seconds, insulin increases transport of ______ into insulin-sensitive cells

A

glucose, amino acids, K+

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30
Q

within minutes, insulin stimulates protein ____

A

synthesis

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31
Q

within minutes, insulin inhibits protein ____

A

degradation

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32
Q

within minutes, insulin activates _______ enzymes and ______

A

glycolytic enzymes and glycogen synthase

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33
Q

within minutes, insulin inhibits _____ and ____ enzymes

A

phosphorylase and gluconeogenic enzymes

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34
Q

insulin receptors have two __ and two __ subunits

A

alpha, beta

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35
Q

the alpha subunits bind insulin and are _____

A

extracellular

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36
Q

the beta subunits span the ___

A

membrane

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37
Q

the intracellular portions of the beta subunits have _____ activity

A

tyrosine kinase

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38
Q

insulin receptors have ___ effects

A

biologic

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39
Q

glucagon is produced by the __ cells of the pancreatic islets and also the ___ cells of the GI tract

A

alpha, L

40
Q

the half-life of glucagon in the circulation is ___

A

5-10 min

41
Q

glucagon is degraded by many tissues but particularly the ___

A

liver

42
Q

glucagon ______the concentration of glucose

A

increases

43
Q

somatostatin is a peptide hormone produced by the __ cells of pancreatic islets and also from _____

A

D cells; also from hypothalamus

44
Q

somatostatin is an ____ hormone

A

inhibitory

45
Q

somatostatin is also known as ______

A

growth hormone-inhibiting hormone (GHIH)

46
Q

somatostatin inhibits the secretion of _____, ____, and ______

A

insulin, glucagon, pancreatic polypeptide

47
Q

somatostatin inhibits the release of ____

A

growth hormone (GH)

48
Q

somatostatin suppresses the release of ______ (endocrine)

A

pancreatic hormones

49
Q

somatostatin suppresses the _____ secretory action of the pancreas

A

exocrine

50
Q

somatostatin inhibits the release of _____

A

thyroid-stimulating hormone (TSH)

51
Q

somatostatin suppresses the release of gastrointestinal hormones such as ___

A

gastrin

52
Q

pancreatic polypeptide (PP) is produced by __ cells in the islets

A

F cells

53
Q

the secretion of PP is decreased by _____

A

somatostatin

54
Q

_____ slows food absorption

A

pancreatic polypeptide (PP)

55
Q

physiological function of PP

A

unknown

56
Q

____ acts on pancreatic beta cells to increase insulin secretion

A

glucose

57
Q

glucose enters beta cells by ____ transporters

A

GLUT2

58
Q

glucose is metabolized to ____ to produce ATP

A

pyruvate

59
Q

ATP inhibits ATP-sensitive __ channels, reducing __ efflux and depolarizing the beta cell

A

K+

60
Q

depolarization of the beta cell increases ___ influx

A

Ca2+

61
Q

the Ca2+ stimulates release of insulin by ____

A

exocytosis

62
Q

glutamine is also formed and primes secretory ____, preparing them for exocytosis

A

granules

63
Q

insulin deficiency is usually caused by an _______ destruction of the beta cells in the pancreatic islets

A

autoimmune

64
Q

destruction of beta cells in the pancreatic islets leads to ______, also known as insulin-dependent diabetes mellitus

A

type 1 diabetes

65
Q

type 1 diabetes usually presents in ___

A

children

66
Q

insulin _____ is dysfunction of insulin receptor and/or its downstream signaling pathways

A

resistance

67
Q

insulin resistance occurs in peripheral tissues such as ___

A

skeletal muscle and liver

68
Q

in type _ diabetes, cells fail to respond normally to insulin

A

2

69
Q

___ diabetes occurs in pregnant women without a previous history of diabetes

A

gestational

70
Q

insulin deficiency causes intracellular deficit of ____

A

glucose

71
Q

insulin deficiency increases the catabolism of ____ and ____

A

protein, fat

72
Q

increased fat catabolism leads to _____

A

ketosis

73
Q

______ is a strong sensation of hunger caused by deficient glucose utilization and deficient hormone sensing in the cells of the hypothalamus

A

hyperphagia

74
Q

thyroid hormones can increase _____ of glucose from the intestine

A

absorption

75
Q

thyroid hormones can accelerate the degradation of ____

A

insulin

76
Q

which intestinal hormones increase insulin secretion

A

glucagon, glucagon derivatives, secretin, cholecystokinin, gastrin, gastric inhibitory peptide (GIP)

77
Q

which protein and fat derivatives increase insulin secretion

A

arginine, leucine, and certain other amino acids, beta-keto acids such as acetoacetate

78
Q

what are the consequences of insulin resistance

A

glucose tolerance, hyperglycemia, intracellular glucose deficiency, protein metabolism, fat metabolism, acidosis, coma

79
Q

three ketone bodies

A

acetone, acetoacetic acid, beta-hydroxybutyric acid

80
Q

what is a long term/chronic complication of diabetes

A

damage to blood vessels

81
Q

symptoms of hypoglycemia

A

headachy, hungry, sweaty, shaky, confused, dizzy, grumpy

82
Q

____ is the only fuel used by the brain

A

glucose

83
Q

how does insulin interact with thyroid hormones

A

thyroid hormones cause hyperglycemic or diabetogenic effects

84
Q

what is the anti-insulin effect of thyroid hormones

A

increase gluconeogenesis and glycogenolysis to generate free glucose

85
Q

three ways thyroid hormones lead to hyperglycemic or diabetogenic effects

A

increase absorption of glucose from the intestine, accelerate the degradation of insulin, cause hepatic glycogen depletion

86
Q

glycogen-depleted liver cells are easily ___

A

damaged. when the liver is damaged, the liver takes up less of the absorbed glucose

87
Q

80% of patients with Cushing’s have ______

A

glucose intolerance (can’t get rid of glucose)

88
Q

in patients with adrenal insufficiency, the plasma glucose lowering effect of insulin is _____

A

enhanced

89
Q

how do adrenal glucocorticoids interact with insulin

A

they have hyperglycemic or diabetogenic effects because they increase protein catabolism, increase gluconeogenesis in liver, and decrease peripheral glucose utilization

90
Q

how does epinephrine interact with insulin

A

epinephrine increases gluconeogenesis and glycogenolysis, increases glycolysis in muscle and decreases glycolysis in liver

91
Q

how does growth hormone interact with insulin

A

it causes hyperglycemic or diabetogenic effects

92
Q

25% of patients with _____ tumors of the pituitary have diabetes

A

growth-hormone secreting tumors

93
Q

_____ treatment increases insulin resistance

A

growth hormone

94
Q

how does growth hormone cause hyperglycemic or diabetogenic effects

A

decreases glucose uptake (anti insulin), increase hepatic glucose output, decrease tissue binding of insulin, mobilize FFA from adipose (favoring ketogenesis)

95
Q

growth hormone does not stimulate insulin secretion directly, but the _____ it produces secondarily stimulates the pancreas and may eventually ______

A

hyperglycemia, exhaust the b cells

96
Q

which hormones interact with insulin and cause hyperglycemia

A

glucagon, thyroid hormones, adrenal glucocorticoids, epinephrine, growth hormone