Pancreatic Physiology

Question 1

Alpha cells: 
Beta cells: 
Delta cells: 
Epsilon cells: 
F cells:

Answer 1

• Glucagon
• Insulin and amylin
• Somatostatin
• Ghrelin
• Pancreatic polypeptide

Question 2

Effects of insulin:

Answer 2

• Promote glucose (and amino acid) uptake and storage
• Formation of glycogen
• Inhibit gluconeogenesis (phosphoenolpyruvate carboxykinase)
• Lipid synthesis
• K+ uptake

Question 3

The insulin receptor has:

Answer 3

Tyrosine kinase activity

Question 4

How does epinephrine influence insulin?

Answer 4

Inhibits release - binding to alpha adrenergic receptors on beta cells

• It stimulates glucagon release

Question 5

What is the incretin effect?

Answer 5

More insulin is released when introduced via the gut (oral) than via the blood (IV)

Question 6

Glucagon acts via…

Answer 6

• Gs-coupled receptor, increasing cyclic AMP and PKA activity
• Also, IP3 pathway (increase calcium)

Question 7

Stimulatory factors of glucagon:

Answer 7

Fasting, decreased glucose, increased AA concentration, CCK, beta-adrenergic agonists, acetylcholine

• Complimenting the effects of glucagon are: glucocorticoids, catecholamines, GH (increase blood glucose, lipolysis, protein breakdown)

Question 8

What is necrolytic migratory erythema?

Answer 8

Associated with islet cell tumor of pancreas

• plaques on skin, hyperglycemia, diarrhea, weight loss, atrophic glossitis
• remove the tumor

Question 9

What is targeted in Type I diabetes?

Answer 9

Glutamate decarboxylase by T cells in the beta cells

Question 10

Signs/Treatment of diabetic ketoacidosis:

Answer 10

• Hyperglycemia, metabolic acidosis, hyperkalemia, nausea/vomiting, dehydration
• Fluids, insulin, electrolyte replacement

Question 11

Lens cells take up glucose without insulin

Answer 11

Fun fact! Leads to damage

Question 12

What is an insulinoma?

Answer 12

Low sugars, increased c-peptide levels, increased insulin

Question 13

What is gastrinoma?

Answer 13

Treatment-resistant gastric ulcers (gastrin-secreting tumor of islet cells in pancreas)
- Zollinger-Ellison syndrome, can extend into jejunum

Question 14

What is somatostatinoma?

Answer 14

Achlorhydria (inhibition of gastrin)

Inhibition of cholecystokinin causes cholelithiasis and steatorrhea

Question 15

What is VIPoma?

Answer 15

Excessive VIP (vasoactive intestinal peptide from pancreatic tumor) secretion
- Watery diarrhea, hypokalemia, achlorhydria