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ENDO > ENDO Week 8 > Flashcards

ENDO Week 8 Flashcards

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1
Q

what are the two major tissue types of the pancreas

A

acini and islets of langerhans

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2
Q

what is the function of acini

A

exocrine, has a duct, secretes digestive juices in duodenum

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3
Q

what are the islets of langerhans

A

 cell clusters in the pancreas that consist of different types of cells

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4
Q

what is the function of the islets of langerhans

A

endocrine, secretes pancreatic hormones that regulate BG

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5
Q

what are the different cell types in the islets of langerhans and what do they secrete

A

o Alpha (α) cells – glucagon

o Beta (β) cells – insulin and amylin

o Delta (δ) cells – somatostatin

o PP cells (F cells) (trace) – pancreatic polypeptide (PP)

o Epsilon cells – Ghrelin

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6
Q

how do these hormones regulate each others secretion

A

paracrine cell-cell gap junction interaction

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7
Q

which cells secretion regulate one another

A

alpha (glucagon), beta (insulin and amylin) and delta (somatostatin)

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8
Q

which hormone is most important in regulation

A

somatostatin

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9
Q

how does glucagon regulate insulin

A

Glucagon activates insulin and somatostatin secretion

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10
Q

what inhibits insulin

A

somatostatin and ghrelin

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11
Q

what inhibits glucagon

A

insulin and somatostatin

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12
Q

what kind of hormone is insulin

A

peptide hormone
unbound

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13
Q

how is insulin synthesized

A

preproinsulin (cleaved in ER) –>

proinsulin (cleaved in Golgi apparatus) –>

insulin and C peptide

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14
Q

what is C peptide and its action

A

no biological action

1:1 ratio with insulin

marker for insulin secretion, reveals beta cells function

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15
Q

when is insulin secreted

A

increased BG = increased insulin secretion

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16
Q

how does insulin know when BG is present

A

GLUT-2 transports glucose into beta cell

GLUT 2 is independent of insulin *

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17
Q

what is the pathway in which insulin is released

A

glucose enters beta cells via GLUT-2 –>

glucose metabolism –>

increase ATP in cell activates ATP -sensitive K channels to open –>

depolarization –>

voltage gated calcium channel opens –>

insulin is released via exocytosis

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18
Q

what is needed for the exocytosis of insulin

A

calcium needs to be increased/ depolarization

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19
Q

what factors increase insulin

A
  • increased BG
  • increased blood amino acids
  • increased GH
  • increased blood FFA
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20
Q

what decreases insulin secretion

A
  • decreased BG
  • fasting
  • somatostatin
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21
Q

describe insulin receptors

A

glycoprotein, uses tyrosine kinase receptor

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22
Q

what is the tyrosine kinase receptor process by insulin

A

insulin binds to alpha subunit outside cell, beta subunit is activated … intracellular response (insulin action)

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23
Q

what is insulins affect on glucose transport

A

increases glucose transport via GLUT -4 synthesis

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24
Q

what is GLUT-4 function

A

transports glucose from blood to muscle cells, insulin dependent

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25
what is the effect of physical activity on GLUT-4 and BG
increases glut-4, decreases BG
26
what is the effect of insulin on carbohydrate metabolism
- uptake and storage of glucose - decreases BG, hypoglycemia - increases glycogenesis, glycolysis -decreases gluconeogenesis and glycogenolysis
27
what is the effect of insulin on protein metabolism
increases amino acid transport --> protein synthesis (decreased protein breakdown)
28
what is the effect of insulin on fat metabolism
- promotes fat storage, lipogenesis - inhibits lipolysis
29
action of insulin on liver cells
increases: glycogen synthesis, conversion of glucose to fatty acids, protein synthesis inhibits: gluconeogenesis, glycogenolysis
30
insulin action on muscle cells
increases: uptake of glucose from blood to muscle, glycogen synthesis, protein synthesis decrease: protein catabolism
31
insulin action on adipose tissue
stimulates: glucose uptake to glycerol, fat storage and synthesis inhibits: lipolysis
32
what is the relationship between insulin and K+ and GH
* insulin increases K+ intake into the cell** * required for growth with GH
33
what kind of hormone is glucagon
peptide, unbound hyperglycaemic hormone Ketogenic hormone *
34
what is glucagons primary target cell
liver
35
what are the effects of glucagon
antagonistic effect to insulin so... increases, glycogenolysis, gluconeogenesis, lipolysis
36
what factors increase glucagon secretion
- decreased BG - amino acids
37
what are some factors which decrease glucagon secretion
- fatty acids - insulin - somatostatin
38
what is the mechanism of action of glucagon
GPCR --> cAMP --> response (membrane receptor)
39
what are the actions of glucagon
o Breakdown of liver glycogen o Increased: glycogenolysis, gluconeogenesis, lipolysis o Decreased: insulin action, potassium uptake in cells
40
what are 2 features of somatostatin
- inhibits secretion of all other hormones in pancreatic islets - increases gastric emptying time = less hungry
41
what does pancreatic polypeptide inhibit
Inhibits insulin and somatostatin secretion
42
what are some features of amylin
co-secreted with insulin from beta cells decreases glucagon release and decreases gastric emptying time
43
what are incretins
digestive tract hormones that increase insulin secretion
44
what are the 2 main incretins
glucagon like peptide -1 (GLP 1) Glucose dependent insulinotropic polypeptide (GIP)
45
what triggers the release of GLP-1, GIP and insulin
ingestion of food
46
what is the effect of GLP-1 and GIP on insulin
after absorption of food, incretins promote insulin secretion
47
what is the main action of GLP-1
stimulates insulin release**
48
what is the action of GIP
hyperglycaemic state: increases insulin secretion fasted state: increases glucagon
49
are incretins a tropic or trophic hormone
insulinotropic hormones: increase secretion
50
what GIT hormones regulate BG
GLP-1, GIP, amylin, ghrelin
51
what is the importance of maintaining BG in a normal range
hyperglycaemia can cause hyperglycaemic induced organ damage
52
what is insulin and glucagons effect on glucose
insulin converts glucose to glycogen in the liver glucagon converts glycogen to glucose in liver
53
where are GLUT 2 and GLUT 4 found
GLUT 2: hepatic tissue and pancreas GLUT 4: skeletal and adipose tissue
54
what is glucose in urine a sign of
diabetes
55
which hormone dominates in fed and fasted state
fed state: insulin dominates - uptake of glucose (glycogen, fat and protein synthesis) fasting state: glucagon dominates - increases glycogenolysis, gluconeogenesis, ketogenesis
56
what are other hyperglycaemic hormones
* GH * Cortisol * TH * Epinephrine and norepinephrine
57
what is the only hypoglycaemic hormone
insulin
58
when does diabetes occur
if BG is not maintained by normal hormone function
59
what is diabetes insipidus
increase water loss (polyuria) caused by ADH deficiency tasteless urine does not cause polyphagia
60
what is diabetes mellitus
defect in insulin secretion or action or both abnormal carbohydrate fat and protein metabolism sweet urine
61
what are 2 risk factors for diabetes mellitus type 2
obesity, inactive lifestyle
62
what is type 1 DM caused by
Autoimmune against beta cells - beta cell destruction, leads to low or no insulin insulin dependent DM ketosis prone** occurs at any age
63
what are some symptoms of DM type 1
Ketonuria, polyuria, polydipsia, weight loss
64
what are 2 symptoms that pertain to type 1 DM
diabetic ketoacidosis (acid accumulation in blood) kussmaul breathing
65
what is type 2 DM caused by
hyperglycaemia caused by background of insulin resistance insulin is secreted but ineffective non insulin dependent DM adult onset
66
is insulin produced in type 2 DM
BG stimulates beta cells, increased insulin secretion, but insulin resistance does now allow for effect
67
which type of DM leads to increased fat in central region
diabetes mellitus type 2
68
what is gestational diabetes
hyperglycaemia caused by glucose intolerance and insulin resistance during pregnancy
69
what is insulin resistance
* Impaired biological response to insulin * Reduced sensitivity to insulin * Due to GLUT 4 action
70
what are main features of Type 1 and 2 diabetes
Type 1 - spontaneous ketosis - C peptide absent (no insulin secretion) Type 2 - no ketoacidosis (unless chronic) / ketonuria - C peptide detectable
71
what are the major effects of hyperglycaemia
significant effect on all organ systems glycosuria: glucose in urine
72
what are some complications that arise from DM
Nephropathy, neuropathy, retinopathy and vascular diseases
73
what are the 3 symptoms of DM and explain why they occur
* Polyuria: frequent/more urine - Glucose is osmotically active, draws water, so urine output increases * Polydipsia - Because they lose water, they will be dehydrated --> increased thirst * Polyphagia - Insulin is not there, satiety stimulation is not there, will be hungry, eat more
74
what is the effect on diabetes and red blood cells
elevated red blood cell count, increased HbA1c levels
75
what mechanism can cause type 2 diabetes and hypertension
activation of the renin-angiotensin-aldosterone system
76
what is insulinoma
increased insulin secretion
77
does injected insulin increase C peptide
no
78
what can a head injury lead to
decreased ADH/vasopressin --> diabetes insipidus
79
what is the difference between diabetes mellitus and diabetes insipidus
diabetes mellitus is due to insulin deficiency diabetes insipidus is due to decreased ADH ** no polyphagia
80
where is somatostatin secreted from and what pancreatic hormones does it inhibit
secreted from hypothalamus and pancreas inhibits insulin and glucagon

ENDO (8 decks)

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