Pancreatic Gland Disorders

Question 1

what kind of gland in the pancreas?

Answer 1

endocrine and exocrine

Question 2

alpha cells prodce

Answer 2

glucagon

Question 3

glucagon does what?

Answer 3

increase the blood glucose levels by stimulating the level and other cells to release stored glucose (glycogenolysis)

Question 4

beta cells produce

Answer 4

insulin

Question 5

insulin does what?

Answer 5

lowers blood glucose levels by facilitating the entrance of glucose into the cells for metabolism

Question 6

delta cells produce

Answer 6

somatostatin

Question 7

somatostatin does what?

Answer 7

regulate the release of insulin and glucagon

Question 8

what is diabetes?

Answer 8

defect in the secretion of insulin or action of insulin

Question 9

Chronic hyperglycemia is associated with

Answer 9

long term damage and dysfunction and impairment of tissues organs - eyes kidneys, nerves heart and BVs

Question 10

how do kidneys try to restore glucose blood levels?

Answer 10

excreting excess glucose

Question 11

DM1 pathophysiology

Answer 11

autoantibodies are specific to beta cells

Question 12

what are some characteristics of DM1

Answer 12

decreased utilization of glucose, increased fat mobilization, and impaired protein utilization

Question 13

DM2 pathophysiology

Answer 13

endogenous insulin produce but have difficulty with effective insulin action at the cellular level

Question 14

characteristics of DM2

Answer 14

normal to elevated insulin levels, insulin produced is ineffective because cells are resistance to attachment

Question 15

action of insulin

Answer 15

transports glucose into the cell for use as energy and storage as glycogen – turns food into energy;
glucose levels elevated – beta cells increase secretion of insulin to transport/dispose glucose into peripheral tissue – lowers blood glucose levels and reestablishes homeostasis

Question 16

DM1 also known as

Answer 16

insulin - dependent diabetes

Question 17

DM1 autoimmune -

Answer 17

destroyed beta cells - defects in the production/secretion of insulin

Question 18

DM2 also known as

Answer 18

non-insulin dependent DM

Question 19

onset of DM2

Answer 19

adult - resistance to insulin action an inadequate compensatory insulin secretory response

Question 20

characteristics of DM2

Answer 20

1. no drop in insulin levels at first
2. failure to express enough glucose transporters in skeletal muscles
3. oral durgs help
4. beta cells become exhausted and eventually will require insulin
5. controlled with diet, exercise, and oral hypoglycemic med

Question 21

how does insulin work?

Answer 21

transports glucose to cells; glucose absorbed into blood and is detected by pancreas which then secretes insulin that helps initiate transport to muscles

Question 22

Type 2 - lots of glucose in blood stream becaus:

Answer 22

insulin doesn’t work at the skeletal muscle level …. insulin still binds to insulin receptor but it’s not able to signal GLUT4 protein to go to cellular surface and merge with cell membrane to produce a channel for glucose to allow the glucose to come into the muscle

Question 23

Fasting Plasma Glucose

Answer 23

diabetes: >126
pre-diabetes: >100 and < 126
normal: <100

Question 24

2 hour OGTT

Answer 24

diabetes: > 200

pre-diabetes: >140 and < 140

Question 25

s/s of type 1 diabetes

Answer 25

polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability

Question 26

s/s of type 2

Answer 26

polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability + infections, blurred vision, slow to heal, paresthesis

Question 27

medical management of of diabetes

Answer 27

1. diet modification (2) 2. oral medication (2) 3. IM insulin injection (1 and prolonged 2) 4. Insulin pump (2)

Question 28

complication of diabetes

Answer 28

``` ketoacidosis (500-700 mg/dL) --> fruity breath skin lesions infection neuropathy CAD, stroke, PVD MS problems (CTS, duputytrens, trigger finger, OP) Kidney failure (nephropathy) Vision impairment (retinopathy) ```

Question 29

PT implications of diabetes

Answer 29

monitor glucose levels - exercise can cause hypo

Question 30

Hypoglycemia PT implications

Answer 30

no exercise <70 | s/s: sweating, hunger, trembling, anxiety, blurred vision and confusion

Question 31

Hyperglycemia PT implications

Answer 31

no exercise >300 | s/s: increased thirst, fatigue, blurred vision

Question 32

contraindications to exercise

Answer 32

poor control of glucose levels, poorly controlled retinopathy, HTN, neuropathy, nephropathy, dehydration, extreme environment temperatures

Question 33

Exercise does what to insulin?

Answer 33

increase insulin sensitivity, thus lowering blood glucose levels = allows body to utilize blood glucose

Question 34

exercise does what with metabolism?

Answer 34

increase carb metabolism (lowers glucose levels), increases HDL, decreases triglycerides, BP, stress and Tension

Question 35

s/s of hypoglycemia of <70

Answer 35

nausea, hunger, nervous, cold/clammy, tachycardia, paresthesias, trembling

Question 36

s/s of hypoglycemia of <55

Answer 36

anxiety, confusion, blurred vision/dizziness/HA, weakness, poor coordination, slurred speech

Question 37

s/s of hypoglycemia if <35

Answer 37

seizure, LOC

Question 38

if hypoglycemic, follow what rule:

Answer 38

15:15

Question 39

HbA1c

Answer 39

glucose can attach to hemoglobin and have glycosilated hemoglobin

Question 40

HbA1c is an indication of what?

Answer 40

average amount of BG from previous 3 months

Question 41

Excellent control (HbA1c)

Answer 41

less than or equal to 6; BG < 115

Question 42

good control (HbA1c)

Answer 42

7-8; BG 150-180

Question 43

Action suggested (HbA1c)

Answer 43

level of 0-14; BG 215-380

Question 44

muscle contraction does 2 things:

Answer 44

1. encourage the up-take of glucose | 2. getting GLUT4 to surface w/o help of insulin