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Physio II > Pancreas > Flashcards

Pancreas Flashcards

1
Q

What is the term for islands of endocrine cells within exocrine tissue?

A

Islets of langerhands

(secrete digestive enzymes)

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2
Q

What do the following cells secrete?

𝛃 cells (60% of endocrine cells)

𝛂 cells (25% of endocrine cells)

𝛅 cells

𝛄 cells

𝝐 cells

A

𝛃 cells = Insulin, Amylin

𝛂 cells = Glucagon

𝛅 cells = Somatostatin

𝛄 cells = Pancreatic polypeptide

𝝐 cells = Ghrelin

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3
Q

What hormones inhibit digestive function/ suppress appetite?

A

Amylin (acts on CNS, suppresses appetite)

Somatostatin (inhibits digestive function)

Pancreatic polypeptide (reduces appetite/ food intake)

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4
Q

What is the role of Ghrelin?

A

Appetite stimulating

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5
Q

Preproinsulin is converted to proinsulin which is cleaved in the granules to what?

A

Insulin + C-peptide (1:1 ratio)

(C-peptide is more reliable measurement for assessing insulin use in DM pts due to longer half life)

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6
Q

Glucose stimulates insulin release via what process in beta cells?

A

Excitation-secretion coupling

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7
Q

What is necessary for the facilitated diffusion of glucose across cell membranes?

A

GLUT2

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8
Q

In the process of insulin release, glucose and PO4 yield glucose-6-phosphate which is then oxidized to form what?

A

ATP

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9
Q

What is the role of ATP in the release of insulin?

A

Closes K+ channels = decreased K+ depolarizes cell membrane

(This leads to voltage- gated Ca channels opening and Ca entering the cell)

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10
Q

In the insulin release process, once Ca enters the beta cells, what does this trigger?

A

Triggers exocytosis of insulin vesicles = insulin secreted into circulation

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11
Q

What are the 3 primary effects of insulin?

A
  1. Affect energy stores
  2. Recruits GLUT-4 to cell surface
  3. Stimulates MAP kinase pathways
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12
Q

Excess insulin can lead to hypoglycemia which can then ultimately lead to what?

A

Depressed brain function/ LOC

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13
Q

How does insulin affect energy storage in carbs, lipids, and proteins?

A

Promotes storage

(decreases blood glucose, fatty acids, and AAs)

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14
Q

In what tissues does the insulin dependent transporter GLUT-4 exist?

A

Adipose and resting muscle cells

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15
Q

Where are GLUT 1, 2, and 3 proteins located?

A

GLUT1 = BBB

GLUT2= kidney/ intestine

GLUT3= neurons

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16
Q

How do you treat an insulin OD?

A

Exogenous sugar

……. or should i say……. a sugary snack

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17
Q

How do you treat reactive hypoglycemia (beta cells release too must insulin in response to glucose)?

A

Control by limit of dietary cards, DO NOT treat with exogenous sugar

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18
Q

What is the most common endocrine disorder?

A

DM = high blood surgar levels over a prolonged period

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19
Q

What is the primary difference between T1 and T2 DM?

A

T1 is autoimmune (T-lymphocytes destroy beta cells = lack of insulin secretion)

T2 is non-insulin dependent (tissue resistant to insulin as a result of life-style choices)

20
Q

What are the acute sxs of DM?

A

High blood glucose

21
Q

What are the chronic sxs of DM? (4)

A

Retinopathy, neuropathy, nephropathy, CV disease

22
Q

A value of what on fasting plasma glucose is concerning for DM?

A

> 126

(N = <110, borderline = 110-125)

23
Q

Ingestion of 75mg of glucose within 5 min and measurement of blood glucose at 60 and 120 min is the protocol for what test?

A

Oral glucose tolerance test (OGTT)

24
Q

What are considered normal values at 1 and 2 hours of the OGTT?

A

1 hour < 180

2 hours < 140

25
Q

What is considered DM on a HbA1c test? (average glucose levels over 3 months)

A

DM > 6.5%

26
Q

What tissues is glucagon expressed in?

A

Liver, intestine, brain, pancreas

27
Q

Glycogen is converted to glucose via what?

(It stimulates gluconeogenesis and glycogenolysis in the liver and lipolysis in adipose tissue)

A

Glucagon

28
Q

↑ glucose, somatostatin, insulin, fatty acids, keto acids leads to what?

A

Inhibition of glucagon

29
Q

↓ glucose, epi (𝛃2), vagal stimulation, CCK, fasting, exercise, protein (in the absence of carbs) leads to what?

A

Stimulation of glucagon

30
Q

Conversion of proglucagon to glucagon also yields what?

A

Incretin (GLP1)

31
Q

When is GLP1 (incretin) released? And what does its release lead to?

A

Increased glucose levels in intestinal lumen

Results in increased insulin release from beta cells

32
Q

Generally speaking, what is the affect of glucagon on energy stores?

A

Favors release

(increased blood glucose, fatty acids/ ketons, and AAs)

33
Q

Glucagon has a minimal effect on what tissue?

A

Proteins

(it does increase blood AAs but has minimal effect and NO effect on skeletal muscle proteins, which is the major protein storage site)

34
Q

What is the primary affect of somatostatin?

A

Inhibits release of insulin and glucagon

(binds to beta and alpha cells via SSTR2 receptor and leads to hyperpolarization of cells)

35
Q

Somatostatin release is stimulated by high fat, carbs, and protein. This ultimately leads to what type of effect in the GI tract?

A

Inhibitory; prolonged duration of intestinal food absorption

36
Q

How does somatostatin affect the release of GH?

A

Inhibits it

37
Q

The CNS plays a role in the control of glucose because it has receptors for nutrient levels and hormones. Where specifically is glucose detected and what hormones does the CNS respond to?

A

Glucose detection in the arcuate nucleus

Hormones = insulin, leptin, GLP1

38
Q

The hypothalamus regulates glucose homeostasis via insulin secretion but is blocked by what?

A

Alpha- adrenergic stimulation of SNS

39
Q

What structure regulates the homeostasis of glucose via insulin secretion, glucose secretion, hepatic glucose output, and glucose uptake by skeletal muscles?

A

Hypothalamus

40
Q

Neural control of glucose involves the control of energy balance via monitoring of what 2 things?

A

Food intake vs energy expenditure

(also control of body weight)

41
Q

What are the orexigenic hormones?

A

Ghrelin

42
Q

What are the anorexigenic hormones?

A

Leptin, insulin

43
Q

What hormone favors release of energy stores during short term stress?

A

Epinephrine

44
Q

What hormone favors release of energy stores during long term stress?

A

Cortisol (decreased glucose uptake in tissues other than the brain)

45
Q

Epinephrine results in decreased insulin secretion via what?

A

Alpha-adrenergic stimulation of beta cells

46
Q

What hormone is released during hypoglycemia, sleep, stress, and exercise, and has a small role in fuel metabolism?

A

Growth hormone

Physio II (14 decks)

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