Harvluck B8 W4

Question 1

Insulin effect

Answer 1

K+ accumulation and lipolysis which reduces availability of ketones for ketogenesis and ketoacidosis in skeletal muscle

Question 2

Ketoacidosis

Answer 2

High levels of ketone bodies. Causes vasodilation which results in hypotension and hypothermia caused by insulin deficency

Question 3

Incretin which reduces glucagon

Answer 3

Gastric Insulinotropic peptide (GIP) produced by Intestinal K cells. High levels of this in obesity

Question 4

Diabetes insipidus

Answer 4

ADH deficiency due to neurological or nephrogenic dysfunction

Question 5

GLUT2 transporter

Answer 5

Protein on beta cells that causes rise in glucose

Question 6

GLUT4 transporter

Answer 6

Protein on skeletal, adipose or vascular cells that takes up glucose.

Question 7

Insulin receptor substrate 1

Answer 7

Phosphorylation triggers translocation of GLUT-4 to membrane for glucose uptake

Question 8

Action of secretin

Answer 8

Produced by S cells of the duodenum. Secretin acts to cause conversion of ATP -> cAMP. This results in K+ channel and cAMP activated Cl- channel (CFTR) activation. There is great Cl- efflux which is recycled by the CL-/HC03- exchanger to cause bicarbonate secreiton of HCO3-.

Question 9

LADA

Answer 9

Absence of ketoacidosis.

Question 10

Inactive storage form of insulin

Answer 10

Hexameric insulin

Question 11

Difference between insulin intravenous vs orally

Answer 11

Incretin effect is increased insulin production higher in oral than IV.

Question 12

Type 1 diabetes genetic association

Answer 12

Mutation in immunoregulatory genes and MHC

Question 13

Active form of insulin

Answer 13

Monomeric insulin

Question 14

What triggers type 1 diabetes?

Answer 14

Childhood enterovirus that cause bystander activation and molecular mimicry

Question 15

What gives free-flow for bicarbonates?

Answer 15

Water- a lack of this in cystic fibrosis causes autodigestion

Question 16

Effect of GLP-1

Answer 16

Enhances insulin secretion. Increase pancreatic delta cell release of somatostatin, increases Na+ excretion from kidney and reduces inflammation. Cardioprotective due to reduced fatty acid metabolism.

Question 17

Cause of neonatal diabetes

Answer 17

Genetic mutation in insulin production

Question 18

Metformin mechanism of action

Answer 18

cAMP

Question 19

Slow GLP-1 analogue

Answer 19

Liraglutide

Question 20

What causes production of gut hormones?

Answer 20

Food being ingested and moving through GI tract

Question 21

Macrovascular complications of diabetes

Answer 21

Kidney disease, hypertension and atherosclerosis of major arteries of the heart

Question 22

Effect of insulin on receptors

Answer 22

Phosphorylation on G protein coupled receptor

Question 23

Adverse effect of SGTL2 inhibiotr

Answer 23

Increased genitourinary infection

Question 24

Cytokines chronically activated in type 2 diabetes

Answer 24

TNF alpha and IL-6- this is due to ceramide which causes insulin resistance

Question 25

Cells that produce ghrelin

Answer 25

Stomach and pancreatic epsilon cells

Question 26

Golgi body

Answer 26

Organelle where proinsulinn matures into active insulin via action of endopeptidases

Question 27

Formation of glucagon

Answer 27

Action of proprotein convertase cleaving proglucagon in alpha cells

Question 28

Thiazolidinediones

Answer 28

PPAR gamma agonist

Question 29

What causes insulin release exocytosis?

Answer 29

Metabolic and vagal nerve stimualtion

Question 30

Role of bicarbonate

Answer 30

Reduce acidity of chyme in duodenum

Question 31

Long-acting GLP-1 analogue

Answer 31

Exenatide

Question 32

Effect of somatostatin

Answer 32

Neuropeptide and gastirc peptide produced after eating. Inhibits glucagon and insulin release and exocrine pancreatic functions

Question 33

Main killer of beta cells

Answer 33

CD8+

Question 34

Free fatty acids

Answer 34

Cause fat oxidation in mitochondria that produes reactive oxygen species which cause oxidative stress. Produces ceramides for kinase PKB/ Akt which reduces GLUT4 movement to membrane and glycogen synthesis.

Question 35

Condition associated with Type 1 diabetes

Answer 35

Diabetic nephropathy where high glucose causes glomerulus malfunction and leakage of protein that cause scar tissue and cause kidney failure. Occurs in type 2.

Question 36

Glucose entry

Answer 36

Increases intracellular ATP for depolarisation which opens Ca2+ channels and causes insulin exocytosis

Question 37

What is Phase 1?

Answer 37

Beta cells that die by natural causes or infection undergo apoptosis and removed by macorphages. Instead, natural dendritic cells enter and activate to take them up and present to B and T cells.

Question 38

Phase 2

Answer 38

Priming of auto-reactive B and T cells with a balance between regulation and activation. The cells move from pancreatic lymph node into the pancreatic islets.

Question 39

Pancreatic cells secreting somatostatin

Answer 39

Delta cells

Question 40

Effects of severe insulin deficiency

Answer 40

Increased growth hormone levels, cortisol levels and increased glucagon levels

Question 41

Osmotic diuresis

Answer 41

Increased urination which increases loss of sodium