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Block 2 Pathophysiology > endocrine-pancreas > Flashcards

endocrine-pancreas Flashcards

(51 cards)

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1
Q

Glucose production primarily in the ____ (gluconeogenesis)

A

liver

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2
Q

CNS uses ____ of all blood glucose at rest, 25% of total

A

60%

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3
Q

Skeletal muscle uses glucose for rapid activity, ____ energy from fat at rest

A

85%

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4
Q

RBC require____.

A

glucose

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5
Q

Most tissues can use ____ and___.

A

glucose and fat

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6
Q

β cells secrete___.

A

insulin

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7
Q

α cells secrete ____.

A

glucagon

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8
Q

δ cells secrete _____(inhibits release of gastrin, CCK, secretin)

A

somatostatin

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9
Q

Balance between insulin and glucagon activity normally maintains blood glucose between____, whether in a fasting or postprandial (after eating) state

A

~60 and 140 mg/dL

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10
Q

Insulin is an ______, i.e., it promotes building new tissue and energy storage

A

anabolic hormone

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11
Q

what is insulin secreted by?

A

Secreted by pancreatic β-cells

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12
Q

Insulin release is stimulated by

A 
Glucose (primary stimulus, amino acids to a lesser extent)
Several hormones: 
Gastric inhibitory polypeptide (GIP) 
Glucagon-like peptide-1 (GLP-1) 
Growth hormone (pregnancy, puberty, adolescence)
Estrogens (pregnancy, puberty)
Melatonin
Leptin
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13
Q

Practically speaking, insulin only affects glucose metabolism in what three tissues?

A

Liver
Adipose tissue
Muscle

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14
Q

Insulin Stimulatory Effects in liver

A

Protein, fatty acid and glycogen synthesis

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15
Q

Insulin Stimulatory Effects in adipose tissue

A

Glucose and fatty acid uptake

Triglyceride synthesis and storage

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16
Q

Insulin Stimulatory Effects in muscle

A

Glucose uptake

Protein and glycogen synthesis

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17
Q

Insulin Inhibitory Effects in liver

A

Ketogenesis and gluconeogenesis

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18
Q

Insulin Inhibitory Effects in adipose tissue

A

Lipolysis

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19
Q

Insulin Inhibitory Effects in muscle

A

Proteolysis

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20
Q

______ is a polypeptide secreted by α-cells of the pancreatic islets of Langerhans

A

Glucagon

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21
Q

Glucagon is a _____ hormone which increases blood glucose when glucose is not being absorbed

22
Q

glucagon secretion is Promoted by ______.

Study These Flashcards
A

hypoglycemia and elevated blood amino acids, gastric inhibitory peptide (GIP)

23
Q

glucagon secretion is inhibited by?

Study These Flashcards
A

high blood glucose, free fatty acids and ketones

24
Q

Suppression of glucagon secretion is blunted with prolonged _______ (diabetes)

Study These Flashcards
A

hyperglycemia

25
Glucagon Stimulatory Effects of liver
Gluconeogenesis | Glycogenolysis
26
Glucagon Stimulatory Effects of adipose tissue
Lipolysis, free fatty acid release
27
Glucagon Stimulatory Effects of skeletal muscle
Protein degradation (supply amino acids for gluconeogenesis by liver) Glycogenolysis
28
First-phase insulin release is rapidly triggered in response to __________, lasts ~10 minutes (composed of preformed insulin)
increased blood glucose levels
29
Second-phase insulin release is composed of ______, continues after first-phase and peaks in 1 to 3 hours (depending on glucose load)
newly formed insulin
30
First-phase insulin release inhibits ______ secretion
glucagon
31
what may be the earliest detectable beta cell defect predicting onset of type 2 diabetes?
Reduced first-phase insulin release
32
____ and ____ secretion occur incrementally to maintain blood glucose within narrow limits
Insulin and glucagon
33
what are incretins?
GI hormones that regulate glucose metabolism by effects on insulin and glucagon secretion, tissue insulin sensitivity, and nutrient absorption rate
34
These hormones are released when food enters the GI tract, referred to as the “incretin effect”
incretins
35
Gastric inhibitory polypeptide (GIP) secreted by____ of the proximal duodenum epithelium
K cells
36
Gastric inhibitory polypeptide (GIP) Secretion is stimulated by ?
food entering from stomach
37
what doesGastric inhibitory polypeptide (GIP) stimulate?
Insulin secretion Insulin sensitivity Fatty acid synthesis (liver) and triglyceride synthesis (liver, adipose)
38
what does Gastric inhibitory polypeptide (GIP) inhibit?
gastric acid secretion
39
what in Gastric inhibitory polypeptide (GIP) Degraded by?
dipeptidyl peptidase 4 (DPP-4), a circulating enzyme made by adipose (an “adipokine”)
40
GIP t½ =___ minutes
1-2 minutes
41
what is Released from distal ileum and colon L-cells within minutes of oral food intake?
Glucagon-like peptide-1 (GLP-1)
42
Glucagon-like peptide-1 (GLP-1) is Released from distal ileum and colon L-cells within minutes of oral food intake, followed by a second response when nutrients contact ____.
L-cells
43
Glucagon-like peptide-1 (GLP-1) Secretion stimulated by ____.
oral food intake
44
Glucagon-like peptide-1 (GLP-1) Stimulates | 2 things
Insulin release | Insulin sensitivity
45
Glucagon-like peptide-1 (GLP-1) inhibits (3 things)
Glucagon secretion Hepatic gluconeogenesis Gastric emptying
46
Glucagon-like peptide-1 is degraded by what?
dipeptidyl peptidase 4 (DPP-4)
47
An autoimmune disease characterized by pancreatic β-cell destruction and an absolute deficiency of insulin
Type 1 Diabetes Mellitus
48
Type 1 Diabetes Mellitus Genetic factors
Susceptibility loci: HLA locus contributes up to 50% of risk: 90-95% of Caucasians with type 1 DM have HLA-DR3 or DR4 haplotype (vs 40% without type 1 DM) 40-50% are combined DR3/DR4 heterozygotes (vs 5% without type 1 DM)
49
Type 1 Diabetes Mellitus Environmental factors
Certain viral infections may be involved in triggering islet cell destruction: Mumps, rubella, coxsackie B, or cytomegalovirus, among others
50
Type 1 Diabetes Mellitus Proposed mechanisms for initial immune response
1. "Bystander” damage: Viral infections induce islet injury and inflammation, leading to the release of “sequestered” β-cell antigens and the activation of autoreactive T cells (e.g., post-traumatic uveitis) 2. “Molecular mimicry”: Viruses may produce proteins that mimic β-cell antigens, trigger autoimmune response (e.g., rheumatic fever)
51
autoimmune disease associated with the absolute deficiency of insulin
Type 1 Diabetes Mellitus

Block 2 Pathophysiology (8 decks)

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