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ENDO > Week 8 > Flashcards

Week 8 Flashcards

1
Q

Define polyuria.

A

Increased urine output

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2
Q

What are the hormones produced by the pancreas?

A
  • Insulin
  • Glucagon
  • Somatostatin
  • Pancreatic polypeptide
  • Amylin
  • Ghrelin
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3
Q

What are the cell types that secrete glucagon?

A

Alpha cells

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4
Q

What type of cell secretes insulin and amylin?

A

Beta cells

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5
Q

What regulates glucagon secretion?

A

Inhibits:

  • Ghrelin
  • Somatostatin
  • Insulin
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6
Q

What regulates insulin secretion?

A

Inhibits:

  • Ghrelin
  • Somatostatin

Stimulate:
-Glucagon

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7
Q

How does insulin circulate in the blood?

A

Unbound

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8
Q

What are the pro hormones of insulin?

A
  • Preproinsulin
  • Proinsulin
  • Insuin & C-peptide
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9
Q

What can measuring the amount of C-peptide tell you?

A

It can give you a measure of the Beta cell function

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10
Q

Describe the mechanism of insulin secretion.

A
  • Glucose is transported into the cell through GLUT 2
  • Increased glucose concentration and metabolism in beta cells
  • Increased ATP:ADP ratio in the cell
  • This causes the ATP-sensitive potassium channels to close
  • There is now no movement of K+ which will cause the membrane to depolarise
  • The depolarisation will cause the Ca++ channel to open
  • This will cause the exocytosis of insulin
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11
Q

What are the factors that will increase insulin secretion?

A
  • increased blood glucose
  • increased blood free fatty acids
  • increased blood amino acids
  • GI hormones (CCK, secretin, gastrin)
  • glucagon
  • beta adrenergic stimulation
  • sulfonylurea drugs
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12
Q

What are the factors that will decrease insulin secretion?

A
  • decreased blood glucose
  • fasting
  • somatostatin
  • alpha adrenergic activity
  • leptin
  • K+ depletion
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13
Q

What receptor does insulin use?

A

-tyrosine kinase

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14
Q

Describe insulins binding to the receptor?

A

-it binds with the alpha subunit on the outside of the cell and auto-phosphorylates portions of the beta subunits within the cell

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15
Q

Which GLUT transporter is insulin dependent?

A

GLUT 4

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16
Q

What are the immediate effects of insulin?

A
  • increased glucose transport, amino acids and K+ into cells
  • stimulates protein synthesis
  • inhibits protein degradation
  • activates glycogen synthase
17
Q

What are the delayed effects of insulin?

A

-Increase mRNA’s

18
Q

What is dominant in a fasting state?

A

-glycogen

19
Q

What hormone work synergistically with insulin?

A

Growth Hormone

20
Q

What second messenger does glucagon use?

A

cAMP

21
Q

What are the actions of glucagon?

A
  • Increase glycogenolysis
  • increase gluconeogenesis
  • increases lipolysis
22
Q

What stimulates glucagon?

A
  • decreased serum glucose
  • exercise
  • fasting
  • some amino acids
23
Q

What inhibits glucagon?

A
  • Fatty acids
  • Somatostatin
  • Insulin
24
Q

What is glucagon’s mechanism of action?

A
  • activates adenylyl cyclase in the liver
  • this forms cAMP
  • activates protein kinase regulator protein
  • converts into phosphorylase A
  • promotes the degradation of glycogen into glucose and release by liver cells
25
Q

What is the action of somatostatin?

A
  • Inhibits insulin, glucagon and pancreatic polypeptide secretion
  • Decreases gastric motility and secretion
26
Q

What are some of the other hyperglycaemic hormones?

A
  • GH
  • Cortisol
  • Thyroid hormones
  • Epinephrine and norepinephrine
27
Q

What is the cause of diabetes mellitus?

A
  • defect in insulin secretion
  • defect in insulin action
  • both of the above
28
Q

What are some of the risk factors for diabetes?

A
  • central obesity
  • hypertension
  • low HDL
  • smoking
  • family history
  • inactive lifestyle
29
Q

What is the difference in type 1 and type 2 diabetes mellitus?

A

Type 1: the beta cell destruction leads to insulin deficiency

Type 2: a progressive insulin secretory defect on the background of insulin resistance

30
Q

What is gestational diabetes?

A

Any degree of glucose intolerance with the onset of first recognition during pregnancy

31
Q

What are some of the symptoms of Type 1 diabetes?

A
  • ketonuria
  • polyuria
  • polydipsia
  • weight loss
  • young age
  • family history of autoimmune disease
  • rapid onset of symptoms
32
Q

Describe what happens to lead to diabetic ketoacidosis?

A
  • increased blood fatty acid and ketoacid concentration from increased lipolysis of fat
  • this increase in ketoacids can lead to diabetic ketoacidosis (DKA)
33
Q

What can cause insulin resistance?

A
  • obesity
  • excess cortisol
  • excess growth hormone
  • pregnancy
  • polycystic ovarian syndrome
34
Q

What are the lab test that will confirm a diagnosis of diabetes?

A
  • fasting plasma glucose
  • oral glucose tolerance test
  • HbA1c

ENDO (10 decks)

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