PART 1 HENRYS Flashcards
- cells in the gastrointestinal tract which are stimulated by nutrients to secrete incretins, peptide hormones that affect pancreatic function, gastric emptying, appetite, and intestinal motility
- _____ pancreas secretes hormones from different cells
- residing in ______ - produced by beta cells
- ____ of islet cells - produced by alpha cells
- ____ of islet cells
- alpha cells can also produce ______ after there has been injury to beta cells - produced by delta cells
- ____ of islet cells - produced by the epsilon cells
- ____ of islet cells - produced by gamma/ f cells
- ____ of islet cells
- ENTEROENDOCRINE
- ENDOCRINE PANCREAS
- islets of Langerhans - INSULIN & AMYLIN
- 55-70% of islet cells - GLUCAGON
- 20% of islet cells
- glucagon-like peptide 1 - SOMATOSTATIN
- 5-10% of islet cells - GHRELIN
- <1-3% of islet cells - PANCREATIC POLYPEPTIDE
- <5% of islet cells
_______: regulates blood sugar level
1. _____ hormone
2. insulin-sensitive tissues (3)
3. _____ + _____
- linked by what bomd
- connected by
4. synthesized initially as a longer single chain peptide precursor hormone
5. immediate precursor of insulin
INSULIN
1. anabolic hormone
2. skeletal muscle, fat, and liver
3. 21 amino acid A chain + 30 amino acid B
- two disulfide bonds
- C-PEPTIDE
4. PREPROINSULIN
5. PROINSULIN
INSULIN cont.
1. half life of pro-insulin is at least ______ as long as that of insulin
2. in vivo studies of proinsulin have shown that it has _____of the biological activity of insulin
3. less common condition associated w/ high proinsulin levels
4. condition caused by mutations in proinsulin gene
5. can be associated w/ _____ or ___
- 3x
- 10-15%
- INSULINOMAS
- FAMILIAL HYPERPROINSULINEMIA
- impaired glucose tolerance or type 2 diabetes
INSULIN cont.
1. _____ & ____ are secreted in equimolar amounts in portal vein
- ratio is about ____ (fasting) to ____
2. _____ in blood is higher than _____ due to hepatic clearance of insulin
3. in _____, HYPERINSULINEMIA is observed as the result of decreased hepatic insulin clearance
4. in healthy individuals, half life of:
- c-peptide and proinsulin =
- insulin
5. unregulated excess of insulin
- seen in _____ (______mg/dL)
6. diagnosed in childhood; causes dysregulation in insulin secretion and hypoglycemia
- C-PEPTIDE & INSULIN
- 5:1 to 15:1 - CPEPTIDE > INSULIN
- CIRRHOSIS
- 30mins
- 4-9mins
- HYPOGLYCEMIA
- INSULINOMAS (<50mg/dL) - CONGENITAL HYPERINSULINISM
INSULIN cont.
1. HIGH INSULIN & HIGH C-PEPTIDE
2. HIGH INSULIN & LOW C-PEPTIDE
3. SERUM INSULIN MEASUREMENTS: may be falsely low in the presence of
4. ____ & _____ are less affected by hemolysis
5. interfere w/ insulin immunoassays = falsely elevated & suppressed levels
- sera from insulinoma patients
- hypoglycemia from injected or exogenous insulin
- HEMOLYSIS
- C-PEPTIDE & PROINSULIN
- INSULIN ANTIBODIES
____: suppresses glucagon release
1. aka
2. _____ amino acid protein
3. associated w/ INCREASE in beta cell apoptosis
4. first synthesized as a larger ______ precursor peptide that is processed within the beta cell
5. may be helpful in diabetes management by limiting postprandial glucose excursions and promoting satiety
6. synthetic analog of AMYLIN; available for use by injection before major meals for patients with insulin-requiring diabetes
AMYLIN
1. ISLET AMYLOID POLYPEPTIDE
2. 37amino acid protein
3. oligomeric forms
4. 89 amino acid precursor peptide
5. AMYLIN ANALOGS
6. PRAMLINTADE ACETATE
______: raises blood sugar level
1. production:
- glucagon in _____
- incretin glucagon-like peptide 1 in ______
2. FASTING PLASMA GLUCAGON CONC
3. RATIO OF INSULIN TO GLUCAGON: important in regulation of ______
4. favored when there’s relative INCREASE in insulin-to-glucagon ratio
5. favored when there’s relative DECREASE in insulin-to-glucagon ratio
6. rare islet cell tumors that produce excessive glucagon
- associated w/ fasting glucagon levels _____
7. glucagon sandwich; more accurate measurements of glycogen
8. autosomal dominant; glucagon levels are HIGH in ASBENCE OF TUMOR
GLUCAGON
1. production:
- pancreatic alpha cells
- L cells
2. 25-50pg/mL
3. carbohydrate metabolism
4. ANABOLISM
5. CATABOLISM
6. GLUCAGONOMAS
- >120pg/mL
7. ENZYME-LINKED IMMUNOSORBENT ASSAY
8. FAMILIAL HYPERGLUCAGONEMIA
______: inhibitor of other hormones
1. discovered as _______
2. found in _____ & ______
3. inhibits PITUITARY hormones (____ & _____)
4. inhibits PANCREATIC hormones (____,____,_____)
5. first isolated somatostatin peptide
6. contains N-terminal extension, was isolated and more potent inhibitor of insulin secretion
7. rare islet cell tumors): secrete HIGH LEVELS of somatostatin causing DM, diarrhea, gallstones
8. used for the diagnosis, localization, and detection of metastatic disease, and for prediction for success of treatment with somatostatin analogs for gastroenteropancreatic neuroendocrine tumors
SOMATOSTATIN
1. hypothalamic hormone
2. GASTROINTESTINAL TRACT & NERVOUS SYSTEM
3. growth hormone & thyrotropin
4. insulin, glucagon, PP
5. SOMATOSTATIN-14
6. SOMATOSTATIN-28
7. SOMATOSTATINOMAS
8. OCTREOTIDE SCINTIGRAPHY
_____: gut hormones, released after eating; oral nutrients stimulate the release of this
1. two most important incretins
2. most active form
- half life
- inactive form represents ____ of circulating GLP-1
3. serine peptidase present on the surface of endothelial cells
4. GLP-1 rapidly STIMULATES ____ & ____
5. GLP-1 rapidly SUPPRESSES _____
6. used for treatment of type 2 diabetes
INCRETINS
1. glucagon-like peptide 1; glucose-dependent insulinotropic peptide
2. glucagon-like peptide 1
- 2-3mins
- 80%
3. DIPEPTIDYL PEPTIDASE-4
4. INSULIN & SOMATOSTATIN
5. GLUCAGON
6. ORAL INHIBITORS OF DPP-4
GLUCOSE MEASUREMENT METHODS
1. devices can measure glucose from _____ FLUID
2. LABORATORY PLASMA GLUCOSE MEASUREMENTS are recommended with:
- analytic imprecise
- bias
- total error
3. these methods provide _____
4. two enzyme have been commonly used
5. enzyme that is rarely employed
- INTERSTITIAL FLUID
- *
- <2.9%
- <2.2%
- <6.9% - SPECIFICITY
- GLUCOSE OXIDASE & HEXOKINASE
- GLUCOSE DEHYDROGENASE
