Endo 5

Question 1

What cells secrete glucagon?

Answer 1

Alpha cells

Question 2

What cells secrete insulin?

Answer 2

Beta cells

Question 3

The pancreas contains ~1-2 million ______

Answer 3

islets of Langerhans

Question 4

α cells and β constitute about ___ of the cells in the islets.

Answer 4

85% of the cells

Question 5

____ secretion is associated with energy abundance. •Composed of two amino acid chains, connected by disulfide linkages.

Answer 5

Insulin

Question 6

___ is a hormone of plenty of nutrients

Answer 6

Insulin

Question 7

T/F: The proinsulin and C peptide have virtually no insulin activity.

Answer 7

True

Question 8

Does insulin circulate bound or unbound?

Answer 8

Unbound

Question 9

Does insulin hang around in circulation long?

Answer 9

No

Question 10

____ is the key regulator of insulin secretion

Answer 10

Glucose

Question 11

_____ are hormones produced by the digestive system that work to stimulate insulin secretion BEFORE plasma glucose is elevated. Includes: Glucagon-like Peptide-1 (GLP-1) and Glucose-dependent Insulinotropic Polypeptide (GIP).

Answer 11

Incretins

Question 12

What brings glucose into the Beta cell from blood?

Answer 12

GLUT-1 and GLUT-2

Question 13

____ secretion rises when blood glucose rises above 100 mg/100ml

Answer 13

Insulin

Question 14

What type of receptor is the insulin receptor?

Answer 14

Tyrosine kinase

Question 15

In the ___ response of target cells to insulin, Increased glucose uptake, especially by muscle cells and adipocytes due to translocation of vesicles containing GLUT-4 to the membrane.

Answer 15

Fast (seconds)

Question 16

T/F: In response to insulin, The membrane also becomes more permeable to many amino acids along with potassium and phosphate ions.

Answer 16

True

Question 17

In the ___ response of target cells to insulin, Change in enzyme activity leading to changes in metabolism.

Answer 17

Slower (10-15 minutes)

Question 18

In the ___ response of target cells to insulin, Changes in gene expression and growth.

Answer 18

Slowest (hours-days)

Question 19

Insulin promotes muscle glucose _____ and glycogen _____

Answer 19

Glucose uptake; glycogen synthesis

Question 20

_____ increases glucose transport –Increases glycogen storage in skeletal muscle–Increases protein synthesis and inhibits protein degradation

Answer 20

Insulin

Question 21

____ promotes Promotes Protein Synthesis and Storage Inhibits Protein Degradation

Answer 21

Insulin

Question 22

Insulin and Growth Hormone Interact _____ to Promote Growth

Answer 22

Synergistically

Question 23

Lack of insulin causes protein _____ and _______ plasma amino acids

Answer 23

protein depletion & increased plasma amino acids.

Question 24

______ promotes the uptake and storage of glucose (as glycogen) by the liver; increases glucose uptake (glucokinase)•Increased glycogen synthase leads to increased glycogen synthesis• decreased breakdown of glycogen by inhibiting liver phosphorylase

Answer 24

Insulin

Question 25

____ promotes conversion of excess glucose into fatty acids; Inhibits gluconeogenesis

Answer 25

Insulin

Question 26

_____ Promotes Fat Synthesis and Storage

Answer 26

Insulin

Question 27

Lack of insulin causes ____ and release of ____ and increases plasma cholesterol and phospholipids conc.

Answer 27

lipolysis; FFA

Question 28

Decreased blood glucose, Fasting, Somatostatin)α-Adrenergic activity, and Leptin ______ insulin secretion

Answer 28

Decrease insulin

Question 29

Increased blood glucose, Increased blood free fatty acids, Increased blood amino acids, Gastrointestinal hormones (gastrin, cholecystokinin, secretin, GIP, Glucagon-like peptide-GLP-1), Glucagon, growth hormone, cortisol, Parasympathetic stimulation; acetylcholine, β-Adrenergic stimulation, Insulin resistance; obesity, Sulfonylurea drugs (glyburide, tolbutamide _____ insulin secretion

Answer 29

Increase insulin

Question 30

29 amino acid peptide, secreted from pancreatic alpha cells •Hormone of “starvation”•Secretion controlled by blood glucose levels (inverse relationship)

Answer 30

Glucagon

Question 31

What is the primary target tissue of glucagon?

Answer 31

Liver

Question 32

Stimulating glycogenolysis & inhibiting glycogen synthesis, 2.Increasing gluconeogenesis, 3.Increases blood fatty acid & ketoacid levels to provide more substrates for gluconeogenesis

Answer 32

Glucagon

Question 33

The ___ functions like a buffer for blood glucose. Individuals with severe disease have difficulty maintaining a narrow plasma glucose range.

Answer 33

liver

Question 34

Metabolic disorder characterized by hyperglycemia due to insufficient insulin or cellular resistance to insulin (or both)

Answer 34

Diabetes mellius

Question 35

T/F: With DM, it takes longer to reduce blood glucose levels and glucose levels don’t reach the control level.

Answer 35

True

Question 36

10% of cases-hypoinsulinemia (DM)

Answer 36

Type 1 Diabetes

Question 37

90% of cases-hyperinsulinemia (DM)

Answer 37

Type 2 Diabetes

Question 38

What are the 3 p's seen in DM?

Answer 38

Polyuria, polydypsia, and polyphagia

Question 39

Urinating often (Polyuria)•Feeling thirsty (Polydypsia)•Feeling hungry (Polyphagia)•Extreme fatigue•Blurry vision•Cuts/bruises that are slow to heal are symptoms of ____

Answer 39

Diabetes mellitus

Question 40

Which type of DM shows Weight loss – even though you are eating more

Answer 40

(type I DM)

Question 41

Which type of DM shows Tingling, pain or numbness in the hands/feet

Answer 41

(type 2 DM)

Question 42

What is the normal fasting plasma glucose level?

Answer 42

100 mg/dL

Question 43

What is the normal 2 hour post prandial glucose?

Answer 43

140 mg/dL

Question 44

What is the normal A1C percentage?

Answer 44

<5.6%

Question 45

Autoimmune destruction of pancreatic beta cells 2.Accounts for 5-10% of diabetes cases3.Formerly called juvenile onset diabetes or insulin dependent diabetes (IDDM)

Answer 45

T1DM

Question 46

Risk Factors of ____ include: 1.Genetic predisposition-increased susceptibility 2.Environmental triggers stimulate autoimmune response a. Viral infections (mumps, rubella)b. Chemical toxins 3.Usually develops < age 40, non-obese younger patients

Answer 46

T1DM

Question 47

Beta cell destruction occurs slowly•Hyperglycemia occurs when 80 – 90% of cells destroyed•Often triggered by stressor (e.g. illness)

Answer 47

T1DM

Question 48

_____ leads to:1.Polyuria (hyperglycemia acts as osmotic diuretic)2.Polydipsia (thirst from dehydration from polyuria)3.Polyphagia (hunger and eats more since cell cannot utilize glucose)4.Glycosuria (renal threshold for glucose exceeded)5.Weight loss (body breaking down fat and protein to restore energy source6.Malaise and fatigue (due to muscle & electrolyte loss) 7.Hyperkalemia-K+ (due to lack of insulin which normally activates the Na+/K+ pump

Answer 48

Hyperglycemia

Question 49

Due to increased lipolysis to fatty acids to produce ketoacids; a response to cellular starvation brought on by relative insulin deficiency and counterregulatory or catabolic hormone excess (glucagon, catecholamines, cortisone and growth hormone); dehydration (hyperglycemia)2.Metabolic acidosis (accumulation of ketones)3.Fluid and electrolyte imbalances (from osmotic diuresis)

Answer 49

Diabetic ketoacidosis (DKA)

Question 50

___ occurs predominantly in patients with type 1 (insulin-dependent) diabetes mellitus, but 10% to 30% of cases occur in newly diagnosed type 2 (non–insulin-dependent) diabetes mellitus, especially in African Americans and Hispanics

Answer 50

DKA

Question 51

Omission or reduced daily insulin injections, dislodgement/occlusion of insulin pump catheter, injection, major surgery, and trauma are all important causes of _____

Answer 51

DKA

Question 52

Fruity breath (due to acetone)–Nausea/ abdominal pain–Dehydration–Tachycardia–Lethargy–Coma–Polydipsia, Polyuria, Polyphagia–Kussmaul respirations (deep, labored breathing) are signs and symptoms of ____

Answer 52

DKA

Question 53

acidosis ______ neuronal function since it blocks inward current of Na+ and Ca2+.

Answer 53

depresses

Question 54

Fasting hyperglycemia despite availability of insulin-Insulin resistance•WAS called non-insulin dependent diabetes or adult onset diabetes. Both misnomers, type II DM may require insulin and occurs in children

Answer 54

T2DM

Question 55

Risk factors of ____ include: History of diabetes in parents or siblings•Obesity (especially of upper body)•Physical inactivity•Race/ethnicity: African American, Hispanic, or American Indian origin•Women: history of gestational diabetes, polycystic ovarian syndrome, delivered baby with birth weight > 9 pounds•Patients with hypertension; HDL cholesterol < 35 mg/dL, and/or triglyceride level > 250 mg/dl.

Answer 55

T2DM

Question 56

The concordance of ______ in identical twins is between 70 and 90%. Individuals with a parent with type 2 DM have an increased risk of diabetes; if both parents have it, the risk approaches 40%

Answer 56

type 2 DM

Question 57

Hyperinsulinemia due to insulin resistance (early)•Beta cell dysfunction with impaired insulin secretion-pancreatic exhaustion? (late); Due to downregulation of insulin receptors in target tissues & insulin resistance

Answer 57

Type 2 DM

Question 58

Insulin resistance is part of a cascade of disorders that are called _____; includes Obesity, especially abdominal deposition 2.Insulin resistance 3.Fasting Hyperglycemia 4.Lipid Abnormalities (High TG and Low HDL) 5.Hypertension

Answer 58

METABOLIC SYNDROME

Question 59

Individuals with ______ have increased risk for cardiovascular disease (CVD), particularly atherosclerosis and insulin resistance is a contributing factor for development of type

Answer 59

metabolic syndrome

Question 60

leading causes of blindness in the United States

Answer 60

Retinopathy:

Question 61

Retinopathy, Nephropathy, Neuropathy, Vascular disease, Myopathies are chronic complications of _____

Answer 61

DM

Question 62

progressive renal dysfunction that can lead to end-stage renal disease.

Answer 62

Nephropathy:

Question 63

peripheral loss of sensation and dysesthesias

Answer 63

Neuropathy:

Question 64

accelerated atherosclerotic cerebrovascular and peripheral vascular diseasesmay occur due to abnormal lipid metabolism

Answer 64

Vascular disease:

Question 65

progressive weakness and diminished exercise tolerance.

Answer 65

Myopathies:

Question 66

The oral manifestations of ____ include: Periodontal Disease•Salivary and taste dysfunction•Oral bacterial and fungal infections (ex. candidiasis)•Oral mucosa lesions (geographic tongue, lichen planus, etc.)•Diminished salivary flow and burning mouth syndrome (with poor glycemic control)•Delayed mucosal wound healing•Xerostomia in patients on oral hypoglycemic

Answer 66

DM

Question 67

_____ disease exacerbates diabetic complications–poor glycemic control–cardiovascular complications (stroke, ischemia, infarction)

Answer 67

Periodontal disease

Question 68

T/F: Control of periodontal infection may improve glycemic control

Answer 68

True