Pancreas Flashcards

1
Q

What is the structure of the pancreas in which active endocrine cells of the pancreas are located?

A

Islet of Langerhans

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2
Q

Which cells of the pancreas release insulin

A

B-cells

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3
Q

which cell of the pancreas release glucagon

A

a-cells

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4
Q

What are the 5 steps of the regulation of insulin release

A
  1. GLUT-2 takes glucose into B-cell
  2. Glucose metabolism generates ATP
  3. ATP inhibits the membrane K+ channel
  4. Depolarization results in Ca influx
  5. Ca influx releases insulin
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5
Q

what cleavage product is left over from endogenous insulin?

A

C-peptide

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6
Q

If a type-1 diabetic comes in and you suspect insulin overdose, what marker can you NOT use

A

C-peptide, differentiate natural and pharmaceutical insulin

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7
Q

what are the effects of insulin on fat tissue

A

Increase glucose uptake and lipogenesis

Decrease lipolysis

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8
Q

What is the effect of insulin on striated muscle

A

Increase glucose uptake, glycogen synthesis, and protein synthesis

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9
Q

What is the effect of insulin on the liver

A

Increase Glycogen synthesis and Lipogenesis

Decrease gluconeogenesis

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10
Q

how does insulin move glucose into cells

A

results in the ascension of GLUT-4 into the cell membrane

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11
Q

What degrades incretins?

A

DPP-4

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12
Q

What would occur if you blocked DPP-4

A

Persistence of active incretins which would increase the action of insulin

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13
Q

What is the leading cause of T1DM

A

Autoimmune antibody generation and lack of self tolerance by T-cells

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14
Q

HLA gene cluster on what chromosome is responsible for 50% of T1DM

A

6p21

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15
Q

Someone has symptomatic T1DM, what percentage of islet cells would you suspect have been damaged

A

At least 90%

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16
Q

What is the cause of T2DM

A

Insulin insensitivity at target organs which leads to B-cell hypertrophy then failure

17
Q

MODY (maturity-onset diabetes of the young) resembles which form of DM and what causes it

A

Resembled type 2 and is caused by mutation in glucokinase

18
Q

What is the classic triad of T1DM

A

Polyphagia
Polydipsia
Polyuria

19
Q

What is the triad of DKA and which form of DM does it predominate

A

predominated T1

Triad: Hyperglycemia, Ketonemia, Metabolic acidosis

20
Q

What type of respiratory issue can arise out of DKA, what is it called

A

Kussmaul respiration

21
Q

Describe Hyperglycemic Hyperosmotic Syndrome

A

acute hyperglycemic crisis in T2DM

NO KETONES

22
Q

Which of the following, DKA or HHS will have a normal bicarb and extremely elevated glucose

A

HHS

Glucose is >600 compared to DKA (>250)

23
Q

What is the target A1C of a diabetic

24
Q

What is the most common cause of death in diabetics

25
What is the screen for Diabetic Nephropathy
Albumin:creatinine ratio
26
What are the three primary pathologic lesions of Diabetic nephropathy
Glomerular sclerosis Renal Vascular Lesions Pyelonephritis
27
What does microalbuminuria mean?
there is 30-300 mg/g of NORMAL albumin in the urine *she made a point to emphasize that micro and macroalbuminuria are about amount, not SIZE
28
What are some ocular problems associated with uncontrolled DM
Hemorrhage Blindness Cataracts Glaucoma
29
What are features of a pancreatic neuroendocrine tumor
solid-tan yellow | well-differentiated
30
What can happen with an insulinoma
transient hypoglycemia elevated C-peptide Amyloid is common
31
What is the gastrinoma triad
Islet cell tumor Gastric Acid Hypersecretion Peptic Ulceration Ulcers are REFRACTORY
32
What are common findings with Somatostatinoma
Diabetes, cholelithiasis, steatorrhea Inhibitory effects - decreased insulin - reduced gallbladder motility - Reduced exocrine pancreas
33
What are the findings of a glucagonoma
Mild diabetes | -Rash: Necrolytic Migratory erythema
34
What are the 4 Ds of glucagonoma
Diabetes Dermatitis Depression DVTs
35
What can occur with a VIPoma
Vasoactive peptide tumor (D1 cells) WDAH syndrome - Watery Diarrhea - Hypokalemia - Achlorhydria