Physiology - Carbohydrate metabolism and control of blood glucose Flashcards
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
c.pyruvate
what is formed from oxidative phosphorylation
a.oxygen
b. water and carbon dioxide
c.water and phosphate
b. water and carbon dioxide
how is energy generated from fat?
a.b oxidation
b.gluconeogenesis
c.respiration
a.b oxidation
how is energy generated from amino acids?
a.b oxidation
b.gluconeogenesis
c.respiration
b.gluconeogenesis
hepatocytes contain which enzyme that converts glucose 6 phosphate to glucose for absorption?
a.amyl transferase
b. carbohydrase
c.g6 phosphatase
d.g6 reductase
c.g6 phosphatase
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.liver
what are fructose and galactose converted to in the liver?
a.sucrose
b.monosaccharides
d.disaccharides
e.glucose
e.glucose
which of these cells contain a large amount of glucose 6 phosphatase ?
a.rbc
b.villi epithelial cells
c.hepatocytes
c.hepatocytes
how is glucose transported into the cell
a.active transport
b.facilitated diffusion
c.passive diffusion
d. secondary active transport
b.facilitated diffusion
what is normal blood glucose
a.2-4 mM
b.4-6mM
c.6-8mM
d.8-10mM
b.4-6mM
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.GLUT 1
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
b. GLUT 2
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
c. GLUT 3
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
d.GLUT 4
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
e.SGLT
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
d.disulphide
what cells produce insulin?
a.pancreatic b cells in islets of langerhans
b.hepatocytes
c.pancreatic a cells in islets of langerhans
a.pancreatic b cells in islets of langerhans
what enzyme is responsible for degrading glucose
a.g6 phosphatase
b.insulinase
c.insulin oxidase
b.insulinase
what is the circulating t1/2 of glucose?
a.6 mins
b.10 mins
c.2 mins
d.1 hr
a.6 mins
which receptors for glucose are found on pancreatic b cells?
a.GLUT 1
b. GLUT 2
c. GLUT 3
d.GLUT 4
e.SGLT
b. GLUT 2
what process converts glucose to ATP inside B cells?
a.TCA cycle
b.digestion
c.absorption
d.B oxidation
a.TCA cycle
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
b.closes them
(causes membrane depolarisation and calcium channel opens)
which ion enters the B cell to initiate the insulin secretion signal?
a.sodium
b.chloride
c.pottassium
d.calcium
d.calcium
what is produced in the RER of B cells
a.insulin
b.proinsulin
c.preproinsulin
c.preproinsulin
what is produced in the golgi of B cells
a.insulin
b.proinsulin
c.preproinsulin
b.proinsulin
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
d.calcium
what enzyme controls the blood glucose?
a.g6 phosphatase
b.insulinase
c.insulin oxidase
d.glucokinase
d.glucokinase
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.sulfonylureas
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
b.glucagon like peptide
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
e.insulinase levels
what effect does increased blood amino acid conc have on insulin secretion?
a.increase
b.decrease
a.increase
stimulates tissue protein uptake and insulin secretion
GI hormones such as gastrin, CCK, GIP increase the secretion of which substance from the pancreas?
a.glucagon
b.insulin
c.preproinsulin
d.insulinase
b.insulin
which type of stimulation of B cells decreases insulin secretion
a.parasympathetic
b.sympathetic
b.sympathetic
which type of stimulation of B cells increases insulin secretion
a.parasympathetic
b.sympathetic
a.parasympathetic
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.increase glucose uptake, increased lipogenesis, decreased lipolysis
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
b.increased glucose uptake , increased glycogen synthesis, increased protein synthesis
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
c.increased glycogen synthesis, increased lipogenesis and decreased gluconeogenesis
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
D.GLUT 4 in skeletal muscle and adipose tissue
what is energy provided by under fasting conditions?
a.amino acids
b.fatty acids
c.glucose
d.fats
b.fatty acids
what effect does insulin have on number of GLUT 4 receptors?
a.increase
b.decrease
a.increase
excercise enhances glucose uptake in muscle in an insulin…………….manner due to muscle contraction a.dependent
b.independent
b.independent
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
d.glucokinase
which enzyme causes increased glycogen storage in high insulin states
a.glycogen phosphorylase
b.glucose 6 phosphatase
c.glucokinase
d.glycogen synthetase
e.insulinase
d.glycogen synthetase
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.glycogen phosphorylase
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
b.glucose 6 phosphatase
insulin does not influence glucose metabolism in which organ?
a.brain
b.liver
c.kidneys
d.heart
a.brain
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.GLUT 1
normal blood glucose
3.4-6.2 mmol/l
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
d.somatostatin
which of these substances does NOT increase blood glucose?
a.insulin
b.adrenaline
c.noradrenaline
d.cortisol
e.growth hormone
a.insulin
glucagon is a …
a.small polypeptide
b.laRGE POLYPEPTIDE
c.small protein
d.large protein
b.laRGE POLYPEPTIDE
what type of receptor is the glucagon receptor?
a.muscarinic
b.nicotinic
c.g coupled
c.g coupled
correct order of events of activation of a g coupled receptor
substrate binds
g protein
adenylyl cyclase
cAMP
protein kinase A
phosphorylase
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.increased circulating amino acids
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
e.somatastain
alpha adrenergic activation causes an increase in which process
a.glycogenolysis
b.lipolysis
c.gluconeogenesis
d.respiration
a.glycogenolysis
beta adrenergic activation causes an increase in which process
a.glycogenolysis
b.lipolysis
c.gluconeogenesis
d.respiration
b.lipolysis
cortisol and growth hormone stimulate which process?
a.glycogenolysis
b.lipolysis
c.gluconeogenesis and lipolysis
d.respiration
c.gluconeogenesis and lipolysis
and decrease tissue glucose uptake
(keep it in blood)
stress hormones protect from hypoglycaemia
which of these hormones protect from hypoglycaemia?
a.glucagon and insulin
b.adrenaline cortisol and growth hormone
c.somatastatin and cortisol
b.adrenaline cortisol and growth hormone
which type of diabetes is least common and due to B cell dysfunction
a.type 1
b. type 2
a.type 1
which type of diabetes is most common and due to insulin resistance
a.type 1
b. type 2
b. type 2
which type of diabetes is obesity related with an adult onset typically of >30 yrs
a.type 1
b. type 2
b. type 2
which type of diabetes is obesity related with an adult onset typically of >30 yrs
a.type 1
b. type 2
b. type 2
which type of diabetes can be caused by viral infection , autoimmune conditions and is hereditary
a.type 1
b. type 2
a.type 1
insulin is increased in which type of diabetes
a.type 1
b. type 2
b. type 2
continues to rise as receptor still not activated
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
c. hyperglycaemia
where is all filtered glucose resorbed?
a.liver
b.kidney
c.loop of henle
d.proximal tubule
e.distal tubule
d.proximal tubule
glycosuria
a.increase in blood glucose
b.decrease in blood glucose
c.increase glucose in urine
d.decrease in glucose in urine
c.increase glucose in urine
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.SGLT1/2 cotransporter
what removes sodium from the tubule into the blood
a.SGLT1/2 cotransporter
b.GLUT 1
c.GLUT 2
d. sodium potassium ATPase
d. sodium potassium ATPase
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
c.GLUT 2
what is the renal threshold for glucose
a.10 mmol/l
b.8 mmol/l
c.3.4-6.2 mmol/l
a.10 mmol/l
what effect do gliflozins (SGLT2 inhibitor) have on blood glucose levels
a.increase
b.decrease
b.decrease
decrease resorbtion at proximal tubule
what effect does high blood glucose have on the osmolarity of the ecf?
a.increase
b.decrease
a.increase
causes cellular water loss
what effect does high blood glucose have on the osmolarity of the renal tubular fluid?
a.increase
b.decrease
a.increase
decreases water absorption leads to excessive water loss in urine and polyuria
increase of what activates hypothalmic osmoreceptors to secrete anti diuretic hormone
a.blood osmolarity
b.ecf osmolarity
c.blood glucose
a.blood osmolarity
glycation
glucose reacting with and altering proteins
makes advanced glycation end products
makes glycared haemoglobin
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
d.reactive oxygen species
ultimately causes tissue damage
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
c.hormone sensitive lipase
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
c.liver
FFAs undergo B oxidation to form what substance in the liver
a.acetate
b.keto acids
c.ketones
d.triglycerides
c.ketones
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
b.decrease
diabetic ketoacidosis
increasing circulating H+ in ketoacidosis displaces which ion to cause hyperkalaemia
a.sodium
b.calcium
c.pottassium
c.pottassium
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.insulin
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
b.untreated diabetes
diagnosis of diabetes (5 tests)
.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)
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
c.fasting plasma insulin
