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GERR > Physiology - Carbohydrate metabolism and control of blood glucose > Flashcards

Physiology - Carbohydrate metabolism and control of blood glucose Flashcards

1
Q

what re glucose and amino acids converted to in order to allow them to enter the TCA cycle?

a.acetyl co A
b.acetate
c.pyruvate
d.protein kinase a

A

c.pyruvate

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2
Q

what is formed from oxidative phosphorylation

a.oxygen
b. water and carbon dioxide
c.water and phosphate

A

b. water and carbon dioxide

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3
Q

how is energy generated from fat?

a.b oxidation
b.gluconeogenesis
c.respiration

A

a.b oxidation

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4
Q

how is energy generated from amino acids?

a.b oxidation
b.gluconeogenesis
c.respiration

A

b.gluconeogenesis

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5
Q

hepatocytes contain which enzyme that converts glucose 6 phosphate to glucose for absorption?

a.amyl transferase
b. carbohydrase
c.g6 phosphatase
d.g6 reductase

A

c.g6 phosphatase

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6
Q

where does the process of enzymatic interconversion from glucose 6 phosphate to glucose by g6 phosphatase occur

a.liver
b.kidney
c.stomach
d.intestine

A

a.liver

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7
Q

what are fructose and galactose converted to in the liver?

a.sucrose
b.monosaccharides
d.disaccharides
e.glucose

A

e.glucose

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8
Q

which of these cells contain a large amount of glucose 6 phosphatase ?

a.rbc
b.villi epithelial cells
c.hepatocytes

A

c.hepatocytes

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9
Q

how is glucose transported into the cell

a.active transport
b.facilitated diffusion
c.passive diffusion
d. secondary active transport

A

b.facilitated diffusion

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10
Q

what is normal blood glucose

a.2-4 mM
b.4-6mM
c.6-8mM
d.8-10mM

A

b.4-6mM

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11
Q

which of these glucose transporters is found in most tissues eg brain rbc cornea and has the highest glucose affinity

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4

A

a.GLUT 1

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12
Q

which of these glucose transporters is found in liver, kidney and pancreatic B cells with the lowest glucose affinity and whose function is to remove excess glucose from the blood and regulate insulin release

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4

A

b. GLUT 2

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13
Q

which of these glucose transporters is found in td other the CNS and other tissues with a high glucose affinity and function in basal glucose uptake

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4

A

c. GLUT 3

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14
Q

which of these glucose transporters is found in skeletal muscle and adipose tissue and increases its numbers when insulin is released/ upon excercise
a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4

A

d.GLUT 4

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15
Q

which receptors are involved in sodium glucose transport in the GI tract

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4
e.SGLT

A

e.SGLT

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16
Q

insulin is a polypeptide made up of 2 alpha and 2 beta amino acid chains connected by which type of bond

a.hydrogen
b.covalent
c.ionic
d.disulphide

A

d.disulphide

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17
Q

what cells produce insulin?

a.pancreatic b cells in islets of langerhans
b.hepatocytes
c.pancreatic a cells in islets of langerhans

A

a.pancreatic b cells in islets of langerhans

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18
Q

what enzyme is responsible for degrading glucose

a.g6 phosphatase
b.insulinase
c.insulin oxidase

A

b.insulinase

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19
Q

what is the circulating t1/2 of glucose?

a.6 mins
b.10 mins
c.2 mins
d.1 hr

A

a.6 mins

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20
Q

which receptors for glucose are found on pancreatic b cells?

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4
e.SGLT

A

b. GLUT 2

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21
Q

what process converts glucose to ATP inside B cells?

a.TCA cycle
b.digestion
c.absorption
d.B oxidation

A

a.TCA cycle

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22
Q

what effect does ATP produced from absorbed glucose in B cells have on potassium channels in the cell membrane?

a.opens them
b.closes them
c.increases number of them

A

b.closes them

(causes membrane depolarisation and calcium channel opens)

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23
Q

which ion enters the B cell to initiate the insulin secretion signal?

a.sodium
b.chloride
c.pottassium
d.calcium

A

d.calcium

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24
Q

what is produced in the RER of B cells

a.insulin
b.proinsulin
c.preproinsulin

A

c.preproinsulin

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25
Q

what is produced in the golgi of B cells

a.insulin
b.proinsulin
c.preproinsulin

A

b.proinsulin

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26
Q

which ion causes pro insulin at the golgi to be packaged and undergo excocytosis to be released as insulin into the blood stream?

a.sodium
b.chloride
c.pottassium
d.calcium

A

d.calcium

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27
Q

what enzyme controls the blood glucose?

a.g6 phosphatase
b.insulinase
c.insulin oxidase
d.glucokinase

A

d.glucokinase

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28
Q

which of these drugs increases insulin secretion by acting on the potassium channels of B cells?

a.sulfonylureas
b.glucagon like peptide
c.somatostatin
d.norepinephrine

A

a.sulfonylureas

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29
Q

which of these drugs increases insulin secretion by acting on the calcium intake of B cells?

a.sulfonylureas
b.glucagon like peptide
c.somatostatin
d.norepinephrine

A

b.glucagon like peptide

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30
Q

which of these is NOT a factor regulating insulin secretion

a.GI hormones
b.blood glucose concentration
c.blood amino acid concentration
d. nervous stimulation
e.insulinase levels

A

e.insulinase levels

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31
Q

what effect does increased blood amino acid conc have on insulin secretion?

a.increase
b.decrease

A

a.increase

stimulates tissue protein uptake and insulin secretion

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32
Q

GI hormones such as gastrin, CCK, GIP increase the secretion of which substance from the pancreas?

a.glucagon
b.insulin
c.preproinsulin
d.insulinase

A

b.insulin

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33
Q

which type of stimulation of B cells decreases insulin secretion

a.parasympathetic
b.sympathetic

A

b.sympathetic

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34
Q

which type of stimulation of B cells increases insulin secretion

a.parasympathetic
b.sympathetic

A

a.parasympathetic

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35
Q

which of these is the correct set of effects of insulin in adipose tissue?

a.increase glucose uptake, increased lipogenesis, decreased lipolysis

b.increased glucose uptake , increased glycogen synthesis, increased protein synthesis

c.increased glycogen synthesis, increased lipogenesis and decreased gluconeogenesis

A

a.increase glucose uptake, increased lipogenesis, decreased lipolysis

36
Q

which of these is the correct set of effects of insulin in striated muscle?

a.increase glucose uptake, increased lipogenesis, decreased lipolysis

b.increased glucose uptake , increased glycogen synthesis, increased protein synthesis

c.increased glycogen synthesis, increased lipogenesis and decreased gluconeogenesis

A

b.increased glucose uptake , increased glycogen synthesis, increased protein synthesis

37
Q

which of these is the correct set of effects of insulin in the liver?

a.increase glucose uptake, increased lipogenesis, decreased lipolysis

b.increased glucose uptake , increased glycogen synthesis, increased protein synthesis

c.increased glycogen synthesis, increased lipogenesis and decreased gluconeogenesis

A

c.increased glycogen synthesis, increased lipogenesis and decreased gluconeogenesis

38
Q

which glucose receptor does not take up glucose at low levels?

a.GLUT 1 in brain AND MOST TISSUES
b.GLUT 2 in liver, kidney
c.GLUT 3 in cns
D.GLUT 4 in skeletal muscle and adipose tissue

A

D.GLUT 4 in skeletal muscle and adipose tissue

39
Q

what is energy provided by under fasting conditions?

a.amino acids
b.fatty acids
c.glucose
d.fats

A

b.fatty acids

40
Q

what effect does insulin have on number of GLUT 4 receptors?

a.increase
b.decrease

A

a.increase

41
Q

excercise enhances glucose uptake in muscle in an insulin…………….manner due to muscle contraction a.dependent
b.independent

A

b.independent

42
Q

which enzyme increases in numbers when there is high glucose in the blood in order to increase glucose 6 phosphate and glucose uptake

a.insulinase
b.glucose 6 phosphotase
c.protein kinase a
d.glucokinase

A

d.glucokinase

43
Q

which enzyme causes increased glycogen storage in high insulin states

a.glycogen phosphorylase
b.glucose 6 phosphatase
c.glucokinase
d.glycogen synthetase
e.insulinase

A

d.glycogen synthetase

44
Q

which enzyme causes increased glycogen breakdown in low insulin states

a.glycogen phosphorylase
b.glucose 6 phosphatase
c.glucokinase
d.glycogen synthetase
e.insulinase

A

a.glycogen phosphorylase

45
Q

which enzyme causes decreased glucose 6 phosphate and an increased glucose release in low insulin states

a.glycogen phosphorylase
b.glucose 6 phosphatase
c.glucokinase
d.glycogen synthetase
e.insulinase

A

b.glucose 6 phosphatase

46
Q

insulin does not influence glucose metabolism in which organ?

a.brain
b.liver
c.kidneys
d.heart

A

a.brain

47
Q

which receptors in the brain cells readily take up glucose using it as their primary source of energy

a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4
e.SGLT

A

a.GLUT 1

48
Q

normal blood glucose

A

3.4-6.2 mmol/l

49
Q

which of these substances is secreted by delta cells and decreases glucagon, insulin and GI function
a.insulin
b.glycogen phosphatase
c.glucokinase
d.somatostatin

A

d.somatostatin

50
Q

which of these substances does NOT increase blood glucose?

a.insulin
b.adrenaline
c.noradrenaline
d.cortisol
e.growth hormone

A

a.insulin

51
Q

glucagon is a …

a.small polypeptide
b.laRGE POLYPEPTIDE
c.small protein
d.large protein

A

b.laRGE POLYPEPTIDE

52
Q

what type of receptor is the glucagon receptor?

a.muscarinic
b.nicotinic
c.g coupled

A

c.g coupled

53
Q

correct order of events of activation of a g coupled receptor

A

substrate binds
g protein
adenylyl cyclase
cAMP
protein kinase A
phosphorylase

54
Q

glucgaon secretion is stimulated by decreased blood glucose and which other factor

a.increased circulating amino acids
b. decreased circulating amino acids
c. increased circulating fatty acids
d.decreased circulating fatty acids

A

a.increased circulating amino acids

55
Q

which of these substances has a general suroressive effecr on the action of metabolism therefore extending the amount of time that nutrients can be used

a.insulin
b.adrenaline
c.noradrenaline
d.cortisol
e.somatastain

A

e.somatastain

56
Q

alpha adrenergic activation causes an increase in which process

a.glycogenolysis
b.lipolysis
c.gluconeogenesis
d.respiration

A

a.glycogenolysis

57
Q

beta adrenergic activation causes an increase in which process

a.glycogenolysis
b.lipolysis
c.gluconeogenesis
d.respiration

A

b.lipolysis

58
Q

cortisol and growth hormone stimulate which process?

a.glycogenolysis
b.lipolysis
c.gluconeogenesis and lipolysis
d.respiration

A

c.gluconeogenesis and lipolysis

and decrease tissue glucose uptake
(keep it in blood)
stress hormones protect from hypoglycaemia

59
Q

which of these hormones protect from hypoglycaemia?

a.glucagon and insulin
b.adrenaline cortisol and growth hormone
c.somatastatin and cortisol

A

b.adrenaline cortisol and growth hormone

60
Q

which type of diabetes is least common and due to B cell dysfunction

a.type 1
b. type 2

A

a.type 1

61
Q

which type of diabetes is most common and due to insulin resistance

a.type 1
b. type 2

A

b. type 2

62
Q

which type of diabetes is obesity related with an adult onset typically of >30 yrs

a.type 1
b. type 2

A

b. type 2

63
Q

which type of diabetes is obesity related with an adult onset typically of >30 yrs

a.type 1
b. type 2

A

b. type 2

64
Q

which type of diabetes can be caused by viral infection , autoimmune conditions and is hereditary

a.type 1
b. type 2

A

a.type 1

65
Q

insulin is increased in which type of diabetes

a.type 1
b. type 2

A

b. type 2

continues to rise as receptor still not activated

66
Q

tiredness, frequent urination, sudden weight loss, hunger, blurry vision, numb feet and thirst are characteristic of what

a.diabetes type 1
b.diabetes type 2
c. hyperglycaemia
d.hypoglycaemia

A

c. hyperglycaemia

67
Q

where is all filtered glucose resorbed?

a.liver
b.kidney
c.loop of henle
d.proximal tubule
e.distal tubule

A

d.proximal tubule

68
Q

glycosuria

a.increase in blood glucose
b.decrease in blood glucose
c.increase glucose in urine
d.decrease in glucose in urine

A

c.increase glucose in urine

69
Q

how does glucose enter the cell in the kidney at the brush border membrane to be resorbed

a.SGLT1/2 cotransporter
b.GLUT 1
c.GLUT 2
d. glucose sodium pump

A

a.SGLT1/2 cotransporter

70
Q

what removes sodium from the tubule into the blood

a.SGLT1/2 cotransporter
b.GLUT 1
c.GLUT 2
d. sodium potassium ATPase

A

d. sodium potassium ATPase

71
Q

how does glucose exit the kidney cell at the basolateral membrane to enter the blood

a.SGLT1/2 cotransporter
b.GLUT 1
c.GLUT 2
d. sodium potassium ATPase

A

c.GLUT 2

72
Q

what is the renal threshold for glucose

a.10 mmol/l
b.8 mmol/l
c.3.4-6.2 mmol/l

A

a.10 mmol/l

73
Q

what effect do gliflozins (SGLT2 inhibitor) have on blood glucose levels

a.increase
b.decrease

A

b.decrease
decrease resorbtion at proximal tubule

74
Q

what effect does high blood glucose have on the osmolarity of the ecf?

a.increase
b.decrease

A

a.increase

causes cellular water loss

75
Q

what effect does high blood glucose have on the osmolarity of the renal tubular fluid?

a.increase
b.decrease

A

a.increase

decreases water absorption leads to excessive water loss in urine and polyuria

76
Q

increase of what activates hypothalmic osmoreceptors to secrete anti diuretic hormone

a.blood osmolarity
b.ecf osmolarity
c.blood glucose

A

a.blood osmolarity

77
Q

glycation

A

glucose reacting with and altering proteins
makes advanced glycation end products
makes glycared haemoglobin

78
Q

increase in what leads to
.abberant cell messaging
.chronic inflammation
B cell dysfunction
endothelial dysfunction

a.ADH
b.ECF osmolarity
c.somatastatin
d.reactive oxygen species

A

d.reactive oxygen species

ultimately causes tissue damage

79
Q

increased activity of which enzyme (usually inhibited by insulin) increases lipolysis in the switch to fat metabolism seen in diabetes

a.lipase
b.glucokinase
c.hormone sensitive lipase
d.glycogen phosphorylase

A

c.hormone sensitive lipase

80
Q

the glycerol and fatty acids released from lipolysis during fat metabolism switch in diabetic conditions are taken up by which organ to undergo B oxidastion

a.kidney
b.spleen
c.liver
d.skeletal muscle

A

c.liver

81
Q

FFAs undergo B oxidation to form what substance in the liver

a.acetate
b.keto acids
c.ketones
d.triglycerides

A

c.ketones

82
Q

what effect do ketones produced from FFAs that have undergone beta oxidation in the liver in the diabetic state have on blood pH

a.increase
b.decrease

A

b.decrease

diabetic ketoacidosis

83
Q

increasing circulating H+ in ketoacidosis displaces which ion to cause hyperkalaemia

a.sodium
b.calcium
c.pottassium

A

c.pottassium

84
Q

increased use of protein and fat resulting in depletion of body protein occurs in diabetes as a result of a decrease in which hormone

a.insulin
b.somatostain
c.glycogen
d.glucagon

A

a.insulin

85
Q

rapid weight loss, lack of energy, increased appetite and severe tissue wasting are symptomatic of what condition

a.diabetes
b.untreated diabetes
c.hyperglycaemia
d.hypoglycaemia

A

b.untreated diabetes

86
Q

diagnosis of diabetes (5 tests)

A

.urine glucose (BG > 10 mmol/l)= renal resorbtion exceeded

.Fasting blood glucose (normal 3.4-6.2)

.fasting plasma insulin (NORMAL 10Mu/ml) differentiate between t1 and t2

.glucose tolerance test (delayed decrease BG after oral bolus)

.ketoacidosis (acetone smell on breath)

87
Q

which of these tests for diabetes determines between type 1 and type 2 diabetes

.urinary glucose
b.fasting blood glucose
c.fasting plasma insulin
d.glucose tolerance test
e.ketoacidosis

A

c.fasting plasma insulin

GERR (53 decks)

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