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Endo Exam 1 > Pancreas > Flashcards

Pancreas Flashcards

1
Q

pancreas secretions

A

insulin
glucagon
somatostatin
pancreatic polypeptide

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2
Q

beta cells

A

insulin

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3
Q

alpha cells

A

glucagon

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4
Q

delta cells

A

somatostatin

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5
Q

remaining cells

A

pancreatic polypeptide

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6
Q

insulin structure

A

peptide hormone

A and B chains linked two disulfide bonds

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7
Q

C peptide

A

secreted with insulin

-good marker of insulin secretion from beta cells

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8
Q

insulin action

A

up-regulates GLUT-4 transporters
-muscle and adipose tissue

promotes formation of glycogen in liver and muscle

inhibits glycogenolysis and gluconeogenesis

decreased FA and ketoacid concentration in blood

stimulates fat deposition and inhibits lipolysis

promotes K uptake into cells

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9
Q

GLUT 2

A

low affinity

  • pancreatic beta cells
  • ilver
  • intestine
  • kidney
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10
Q

GLUT 1 and 3

A

allow glucose to go to brain

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11
Q

GLUT 4

A

skeletal muscle and adipose

insulin-responsive

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12
Q

insulin and potasslum

A

promotes movement of potassium into cells

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13
Q

high insulin:glucagon

A

anabolic state

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14
Q

low insulin:glucagon

A

catabolic state

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15
Q

insulin deficiency

A

leads to ketosis

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16
Q

oral vs. IV glucose

A

oral more powerful

-bc GIP release increases effect of insulin

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17
Q

DM I

A

insulin-dependent - destruction of beta cells
increased blood glucose, FA, ketoacids, AA
increased ketoacids
metabolic acidosis (diabetic ketoacidosis)
polyuria
hyperkalemia

18
Q

DM I and polyuria

A

glucose is an osmotic diuretic

19
Q

DM II

A

insulin-independent - associated with obesity
insulin resistance
normal insulin levels, no response
blood glucose elevated fed and fasting states
Tx: caloric restriction, weight reduction, sulfonylurea drugs and biguanide drugs

20
Q

biguanide drugs

A

upregulate receptors for insulin

Tx for type II DM

21
Q

glucagon secretion

A

stimulated by low blood glucose
inhibited by insulin
stimulated by protein ingestion (Arg, Ala)
stimulated by fasting and exercise
stimulated by alpha-adrenergic stimulation

22
Q

action of somatostatin

A

from delta cells
inhibit secretion of insulin and glucagon

modulate response of insulin and glucagon

23
Q

type I DM

A

immune mediated
beta cell destruction

insulin dependent
ketoacidosis**

24
Q

type II DM

A

insulin resistance

overweight, usually no ketoacidosis

25
Q

gestational DM

A

during pregnancy

26
Q

diabeticogenetic effect

A

acromegaly and hypercortisolism

27
Q

family Hx

A

more with type II DM

28
Q

obesity

A

BMI > 30

kg / m~2

29
Q

pre-diabetic

A

fasting 100-126

2 hour oral glucose tolerance 140-200

30
Q

criteria for diabetes Dx

A

fasting
oral glucose tolerance
random glucose
hemoglobin A1c

31
Q

incretin effect

A

oral glucose - stimulates GLP-1
-potentiates insulin release from beta cells

no GLP-1 with IV

32
Q

glucagon and incretins

A

glucagon, GLP-1, GLP-2 from same gene

33
Q

amylin

A

also from beta cells
suppress appetite
inhibit gastric emptying

34
Q

type 2 diabetics

A

reduced incretin effect

can use GLP-1 agonists

35
Q

fruity odor on breath

A

indicative of ketones

36
Q

type 1 DM

A

cell mediated autoimmune
T cell mediated**

predictable with islet autoantibodies

37
Q

pre-diabetes

A

beta cell mass decreases

after autoantibodies present

38
Q

genes associated with type I DM

A

HLA
also INS, PTPN22

insulin in thymus - protective - recognize as self

39
Q

MHC

A 
class II - DP DQ DR
class I - B C A
40
Q

major islet autoantigens

A

ZnT8
IA-2
GAA
mIAA

41
Q

diabetic ketoacidosis

A

C peptide of zero

42
Q

common to DM I and DM II

A

nonenzymatic glycosylation of proteins

Endo Exam 1 (10 decks)

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