exam 1 pathophys

Question 1

sources of blood glucose

Answer 1

food (GI tract)
glycogenolysis
gluconeogenesis

Question 2

breaks down
occurs when energy is in excess

Answer 2

anabolic

Question 3

glucose + glucose =

Answer 3

glycogen

Question 4

glycerol + FA =

Answer 4

TG

Question 5

AA + AA =

Answer 5

protein

Question 6

breaking down
occurs when energy is needed

Answer 6

catabolic

Question 7

glycogen =

Answer 7

glucose + glucose + energy

Question 8

TG =

Answer 8

glycerol + FA + energy

Question 9

protein =

Answer 9

AA + AA + energy

Question 10

glucagon is released by

Answer 10

alpha cells

Question 11

insulin is released by

Answer 11

beta cells

Question 12

gluconeogenesis uses

Answer 12

amino acids (alanine and glutamine)
glycerol (lipolysis)
lactate (cori cycle)

Question 13

what facilitates glucose uptake in skeletal muscle and adipose tissue
GLUT4 up regulation

Answer 13

insulin

Question 14

insulin increases surface expression of what

Answer 14

GLUT4 (high affinity transporter)

Question 15

glucose catabolism

Answer 15

glycolysis

Question 16

fatty acid oxidation is what type of reaction

Answer 16

catabolic

Question 17

autoimmune destruction of beta cells
alpha cells stay intact

Answer 17

T1DM

Question 18

insulin receptor desensitization
can lead to beta cell exhaustion

Answer 18

T2DM

Question 19

drug induced DM

Answer 19

glucocorticoids

Question 20

A chain has how many AA

Answer 20

21

Question 21

B chain has how many AA

Answer 21

30

Question 22

what cleaves proinsulin releasing C-peptide

Answer 22

peptidases

Question 23

monomer is what form

Answer 23

active

Question 24

apidra (glulisine) has what change

Answer 24

Lys + Glu on B29 and Asp to Lys on B3
decreases hexamer and dimer formation

Question 25

lispro has what change

Answer 25

B28 and B29 reversed decreases elf aggregation steric hinderance

Question 26

aspart has what change

Answer 26

Pro to Asp sub at B28 decreases self association no alpha helix

Question 27

glargine pH soluble and insoluble levels

Answer 27

insoluble at pH 7 precipitation (hexamers) at injection site causes low release over 24hr

Question 28

16 carbon palmitic acid in what drug

Answer 28

liraglutide

Question 29

carboxylic acid and SU pKa

Answer 29

4-5

Question 30

what drugs increase urinary glucose excretion

Answer 30

SGLT2

Question 31

what increases oxidative stress, platelet aggregation, inflammation

Answer 31

hyperglycemia

Question 32

what pathways lead to ROS production

Answer 32

polyol pathway AGEs PKC hexosamine pathway

Question 33

polyol pathway

Answer 33

affects insulin independent tissues- eyes, kidneys, neurons sorbitol accumulation- aldose reductase converts glucose to sorbitol osmotic stress- intracellular sorbitol accumulation causes cells to swell oxidative stress- decreased production of anti oxidants (NADPH, decreased glutathione)

Question 34

diabetic retinopathy proliferative stage

Answer 34

new abnormal, fragile capillaries

Question 35

Lucentis (ranibizumab) does what

Answer 35

reduces angiogenesis

Question 36

afferent arteriole vaso? efferent vaso?

Answer 36

dilation constriction leads to increased glomerular pressure

Question 37

mesangial cells matrix deposition hypertrophy these cause?

Answer 37

decreased GFR thickened basement membrane