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Endocrine > Pancreas and Diabetes > Flashcards

Pancreas and Diabetes Flashcards

1
Q

Which two hormones does the pancreas secrete ?

A

Insulin and glucagon

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2
Q

Islet of Langerhans has three cell types, what are they?

A
  1. Alpha cells
  2. Beta cells
  3. Delta cells
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3
Q

What do Alpha cells secrete?

A

Glucagon

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4
Q

What do Beta cells secrete?

A

Insulin

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5
Q

What do Delta cells secrete?

A

Somatostatin and pancreatic polypeptide

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6
Q

What 4 things does insulin cause the body to do?

A
  1. Carbs to be stored as glycogen in muscle/liver
  2. Causes fat storage in adipose tissue
  3. Excess carbs that aren’t converted to glyogen are converted to fat and stored
  4. Promotes uptake of amino acids and conversion to protein
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7
Q

Insulin secretion is secreted by what?

A
  1. High blood glucose
  2. Amino acids
  3. Beta-keto acids
  4. Acetylcholine
  5. Glyburide
  6. Obesity
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8
Q

Insulin secretion is inhibited by what?

A
  1. Low blood glucose
  2. Fasting
  3. Catecholamines
  4. Somatostatin
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9
Q

Describe the metabolism of insulin?

A

Plasma half life is 6 mins.

Insulinase degrades unused insulin in live, kidney, and muscles

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10
Q

Which cells in the body handle glucose differently than any other cell group?

A

Neurons in the brain are permeable to glucose

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11
Q

Is insulin an anabolic or catabolic molecule?

A

Anabolic

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12
Q

How do glycogenesis and glyconeogenesis differ?

A

Glycogenesis is storing glucose as glycogen

Glyconeogensis is formation of glycogen from non-carbohydrate sources

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13
Q

What is glucagon?

A

Secreted by alpha cells when blood glucose levels fall. It opposes the effects of insulin.

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14
Q

Insulin or Glucagon: Increases gluconeogenesis?

A

Glucagon

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15
Q

Insulin or Glucagon: Increases glucogenesis?

A

Insulin

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16
Q

Insulin or Glucagon: Inhibits gluconeogenesis and glucogenolysis?

17
Q

Glucagon is stimulated by what?

A
  1. Fasting hypoglycemia
  2. Amino acids
  3. Beta-adrenergic stimulation
  4. Exercise
  5. Cholecystokinin, gastrin, and cortisol
18
Q

What inhibits glucagon secretion?

A
  1. High glucose levels
  2. Somatostatin
  3. Free fatty acids
  4. Ketones
  5. Insulin
19
Q

Anabolic or Catabolic: Associated with the postprandial phase?

20
Q

Describe the anabolic phase?

A
  1. Eat a meal
  2. blood glucose rises above 100
  3. Insulin level increases 10 fold
  4. Level decreases 5-10 later
  5. Shut off 3-5 after glucose level under 80
21
Q

12-24 hours of fasting, what does the body produce energy from?

A

Liver glycogen sufficient for brain

22
Q

After 24 hrs, what does the body produce energy from?

A

Gluconeogenesis uses AAs, glycerol, and lactate

23
Q

What is the most common endocrinopathy?

A

Diabetes Mellitus

24
Q

How do Type 1 and 2 DM differ?

A

Type 1= Causes by lack of insulin secretion

Type 2= Caused by decreased sensitivity of tissues to the metabolic effects of insulin

25
Q

Glucose being reabsorbed by the kidney results in what?

A
  1. Osmotic diuresis, loss of Na, K, and glucosuria

2. Hypovolemic hypotension, dehydration, polyuria, polydipsia, polyphagia

26
Q

What are 5 acute symptoms of DM?

A
  1. Polyuria
  2. Polydipsia
  3. Polyphagia
  4. CNS irritability/confusion
  5. Visual disturbances
27
Q

What are the 3 chronic symptoms of DM?

A
  1. Infection
  2. Macrovascular disease
  3. Microvascular disease
28
Q

What is the leading cause of blindness in the US ages 20-65?

A

Retinopathy related to DM

29
Q

What percentage of pt with DM develop chronic renal failure?

30
Q

DM 1 or DM 2 characterized by destruction of Beta Cells and loss of insulin release?

31
Q

What is normal A1C?

32
Q

Hgb A1C of 7.5 represents what average blood sugar level?

33
Q

Perioperative hyperglycemia causes increased what?

A
  1. CHF
  2. 18x higher mortality
  3. 2 x longer stay
  4. Infection risk
  5. Sepsis
  6. ARF
  7. Neuropathies
  8. CVA
  9. Poor fetal outcomes
34
Q

What is general consensus on ideal blood glucose perioperatively?

A

> 200 should be treated

35
Q

Guidelines for periop management of DM?

A
  1. Plan as 1st surgery
  2. Hold oral hypoglycemics day of
  3. Insulin should be 1/2 dose
  4. Type 1 DM should cont insulin pump
36
Q

What will insulinoma result in?

A

Beta cell adenoma results in insulin shock and coma under 20mg/dl

Treat with glucose, glucagon and epinephrine

Endocrine (6 decks)

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