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IPC Endocrine Week 1 > Diabetes Patho > Flashcards

Diabetes Patho Flashcards

(59 cards)

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1
Q

Beta cells produce _______, which ______ (increases or decreases) blood glucose.

A

Beta cells produce INSULIN, which DECREASES blood glucose.

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2
Q

Alpha cells produce _________, which _______ (increases or decreases) blood glucose.

A

Alpha cells produce GLUCAGON, which INCREASES blood glucose.

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3
Q

Which of the following cells produce Somatostatin?
A. beta cells
B. delta cells
C. alpha cells.
D. pancreatic polypeptide cells

A

B. delta cells

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4
Q

What effect does somatostatin have on blood glucose?

A

decreases blood glucose

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5
Q

What is the role of pancreatic polypeptide?

A
  1. stimulated gastic/intestinal enzymes
  2. inhibits intestinal motility
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6
Q

What effect does somatostatin have on insulin and glucagon?

A

inhibits both

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7
Q

What effect does glucagon have on somatostatin and insulin?

A

stimlates both

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8
Q

What effect does insulin have on glucagon and somatostatin?

A

-no effect on somatostatin
-inhibits glucagon

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9
Q

What 5 physiological processes does insulin INHIBIT?

A
  1. gluconeogenesis
  2. glycogenolysis
  3. lipolysis
  4. ketogenesis
  5. proteolysis
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10
Q

What is gluconeogenesis?

A

metabolic process of creating glucose from non-carb sources

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11
Q

What is glycogenolysis?

A

breakdown of glycogen -> glucose

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12
Q

What 5 physiological processes does insulin PROMOTE?

A
  1. glucose uptake in muscle/adipose
  2. glycolysis
  3. glycogen synthesis
  4. protein synthesis
  5. uptake of ions
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13
Q

What is glycolysis?

A

breakdown of glucose

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14
Q

What is glucagon’s effect in the pancreas?

A

-stimulates insulin-> decrease in BG

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15
Q

What is glucagon’s effect in the gut?

A

-decreases GLP-1, which causes decrease in gastric emptying/gut motility

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16
Q

What is glucagon’s effect in adipose tissue?

A

increases lipolysis, decreases TG synthesis

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17
Q

What is glucagon’s effect in the liver?

A

-increases glucose production
-increase ketone synthesis and protein breakdown

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18
Q

Pancreatic polypeptide is released in response to what?

A

-hypoglycemia and food

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19
Q

What is the effect that pancreatic polypeptide has on insulin and glucagon?

A

suppresses both

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20
Q

Name the ominous octet (8 pathophysiological pathways) of type 2 diabetes

A
  1. impaired insulin secretion
  2. decreased incretin effect
  3. increased lipolysis
  4. increased glucose reabsorption
  5. decreased glucose uptake
  6. neurotransmitter dysfunction
  7. increased HGP
  8. increased glucagon secretion
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21
Q

What overall physiological state does the ominous octet cause?

A

hyperglycemia

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22
Q

What is the role of glucagon in the body?

A

maintain normal glucose levels during fasting

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23
Q

Which of the following stimulate glucagon secretion? SATA:
A. glucose
B. amino acids
C. somatostatin
D. catecholamines
E. cortisol and growth Hormones

A

B, C, D (amino acids, catecholamines, cortisol, growth hormones)
-also GIP

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24
Q

Which of the following inhibit glucagon secretion? SATA:
A. fatty acids and ketones
B. glucose
C. insulin
D. cortisol
E. somatostatin

Study These Flashcards
A

-fatty acids and ketones
-glucose
-insulin
-somatostatin
also GLP-1

25
Where are incretins excreted?
large and small intestine (by enteroendocrine cells)
26
What are two incretin hormones?
GLP-1 and GIP
27
What are the two main caues of insulin resistance in muscles?
-weight gain -inactivity
28
What are the three neurotransmitters that regulate appetite?
-serotonin -dopamine -catecholamines
29
What is amylin?
-endocrine hormone co-secreted with insulin -suppresses glucagon secretion after meals
30
What does grehlin do?
-stimulated GH secretion -controls appetite -plays a role in the regulation of insulin sensitivity
31
Describe the insulin resistance cycle?
1. weight gain 2. insulin resistance and beta cell failure 3. decreased GLP-1 and decreased appetite control 4. increased caloric intake -> feeds into weight gain again
32
Describe what happens in the body during normal state when glucose is high and when is it low.
High glucose: -insulin stimulated, glucagon low -glyogen/fat stored -muscle glucose uptake -protein synthesis by muscle Low glucose: -insulin LOW, glucagon secreted -fat mobilized from adipose tissue -muscle protein catabolized
33
During short-term fasting state (8-hours), what does the body do to provide glucose?
-liver produces glucose (glycogenolysis) at same rate that it's being used by resting tissue
34
During long-term fasting (>24-60 hours), what happens in the body?
-glycogen stores are depleted -glucagon increases, insulin decreases -gluconeogenesis is sole source of HGP (making glucose using amino acids)
35
What happens in the body after a carb meal?
-insulin secreted -glucagon suppressed -ketogenesis and HGP suppressed -fat storage
36
What happens in the body after a protein meal?
-insulin AND glucagon stimulated -insulin: amino acid uptake and protein formation -glucagon: HGP (counterbalances any hypoglycemia that insulin might cause)
37
Which neurotransmitter/hormone released during conditions of stress have a longer onset (within hours) of action?
-cortisol -growth hormone
38
Which neurostransmitter/hormone released during conditions of stress have a shorter onset (within mins) of action?
-epinephrine -glucagon
39
Epinephrine _________ (stimulates/inhibits) insulin.
inhibits
40
What is the main pathophysiological characteristic of T1DM?
-ABSOLUTE beta cell destruction
41
What is the main pathophysiological characteristic of T1DM?
-insulin resistance -IMPAIRED insulin secretion
42
What is pre-diabetic A1C range?
5.7-6.4
43
What is the normal A1C range?
<5.7
44
What is normal FPG?
<100
45
What is pre-diabetic FPG?
100-125
46
What is diabetic FBG, A1C, OGTT 2-hr and RBG?
-FBG (FPG): ≥ 126 -A1C ≥6.5 -RBG ≥ 200 -OGTT ≥ 200
47
In patients with which type of diabetes is there typically islet cell antibodies present?
T1DM: it is an autoimmune disease
48
What are the clinical manifestations of T1DM?
-polydipsia -polyuria -polyphagia -weight loss -fatigue
49
What are the key clinical manifestations of T2DM?
-recurrent infections -prolonged wound healing -genital pruritus -visual changes -paresthesias -fatigue
50
Which medications can be considered in pre-diabetes?
-metformin -acarbose
51
What are the 3 types of hyperglycemia?
-hyperglycemia -DKA -HHNKS
52
What BG is hyperglycemia?
250-300
53
What are some clinical manifestations of hypoglycemia?
-sweating -hunger -tremors -anxiety -tachycardia -weakness -night sweats
54
What are the microvascular complications of diabetes?
-retinopathy -neuropathy -nephropathy
55
What are the macrovascular complications of diabetes?
-cerebrovascular disease: stroke -heart disease -peripheral vascular disease
56
True or false: diabetic polyneuropathies are manifested as asymmetric sensory loss in the distal lower extremities.
FALSE: they are manifested as SYMMESTRICAL sensory loss (bilateral)
57
Diabetic autonomic neuropathy affects which systems?
-cardiovascular -genitourinary -gastrointestinal -sudomotor
58
What is the most common cause of ESRD?
diabetes
59
Does hypertension occur before or after nephropathy in T1DM?
-before! -in T2DM, HTN occurs before diagnosis

IPC Endocrine Week 1 (7 decks)

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